Supplementary Table 1. Antibodies and dilutions used in the immunohistochemical study Antigen Species Clone Source Dilution Insulin Guinea pig - Dako, Carpinteria, 1:200 Glucagon Rabbit - Dako, Carpinteria, 1:100 Glucagon Mouse K79bB10 Abcam, Cambridge, UK 1:2000 Enterovirus VP-1 peptide Mouse 5-D8/1 Novocastra, Newcastle Upon Tyne, UK 1:200 Interferon-alpha Mouse MMHA-3 PBL Biomedical Laboratories, 1:50 Piscataway, NJ Interferon-beta1 Rabbit - LifeSpan BioSciences, Seattle, WA 1:100 Interferon-gamma Rabbit - Santa Cruz Biotechnology, Santa Cruz, 1:50 CXCL10 Goat - R&D Systems, Minneapolis, MN 1:80 CXCR3/CD183 Mouse 1C6 BD Bioscience, San Jose, 1:50 MHC class I Mouse EMR8-5 HOKUDO Co., LTD., Sapporo, Japan 1:50 MHC class II Mouse TAL.1B5 Dako, Carpinteria, 1:30 TLR3 Rabbit - ABGENT, San Diego, 1:25 TLR4 Mouse 76B357.1 IMGENEX, SanDiego, 1:100 RIG-I/DDX58 Rabbit - Abcam, Cambridge, UK 1:200 MDA5 Goat - Abcam, Cambridge, UK 1:50 CD1a Mouse 010 Dako, Carpinteria, 1:50 CD4 Mouse IF6 Novocastra, Newcastle Upon Tyne, UK 1:50 CD8 Mouse C8/144B Dako, Carpinteria, 1:50 CD11c Rabbit EP1347Y Abcam, Cambridge, UK 1:100 CD56 Mouse 123C3 Dako, Carpinteria, 1:50 CD57 Mouse B321(NK-1) Abcam, Cambridge, UK 1:20 CD68 Mouse PG-M1 Dako, Carpinteria, 1:50 Foxp3 Rat PCH101 ebioscience, San Diego, 1:20 IL-18 Mouse 25-2G MBL, Nagoya, Japan 1:20 IL-18 Rabbit - MBL, Nagoya, Japan 1:200 IL-12 Mouse JJ07 Santa Cruz Biotechnology, Santa Cruz, 1:50 IL-12 Mouse 24910 R&D Systems, Minneapolis, MN 1:25 Fas Rabbit - Santa Cruz Biotechnology, Santa Cruz, 1:25 FasL Rabbit - Santa Cruz Biotechnology, Santa Cruz, 1:50 Cleaved caspase 3 Rabbit - Cell Signaling Technology, Danvers, 1:400 MA Cleaved caspase 8 Rabbit 18C8 Cell Signaling Technology, Danvers, 1:50 MA Cleaved caspase 9 Rabbit - Novus Biologicals, Littleton, CO 1:1000 RARRES3 Rabbit - Sigma, St. Louis, MO 1:250 IRF-7 Rabbit - Novus Biologicals, Littleton, CO 1:200
Supplementary Figure 1. Immunohistochemical staining in pancreas from non-diabetic controls (A-H) and patients with type 1 diabetes (I-L). A-D: Immunohistochemical staining of MDA5 (A), glucagons (B), insulin (C) and merged image of (D) of (A) (B) and (C) in pancreases of non-diabetic controls. The merged image (D) shows weak expression of MDA5 in a few alpha cells (arrowheads). E-H. Immunostaining for RIG-I (E), glucagons (F), insulin (G), merged image (H) of (E) (F) and (G) in nondiabetic controls. Hyper-expression of RIG-I is hardly observed. (I)-(J): Immunohistochemical staining of MDA5 (I) and merged image (J) of insulin (red) and MDA5 (green, arrowheads) in type 1 diabetic control pancreas. Similar to non-diabetic controls, weak expression of MDA5 in non-beta cells (green, arrowheads) was observed in type 1 diabetic control pancreas. (K), (L): Immunohistochemical staing of RIG-I (K) and CD 68 (L) in type 1 diabetic control pancreas showed no RIG-I expression in the CD68+mononuclear cell infiltrated islet.
Supplementary Figure 2. Immunohistochemical staining of the pancreas obtained from fulminant type 1 diabetes for enterovirus capsid protein (VP1)(A) and insulin (B). The merged image (C) shows positive staining for VP1 in beta cell and non-beta cells (x200, case 2). Non-diabetic control pancreas showed no staining for VP1 (D). Color balance of (C) is adjusted.
Supplementary Figure 3. Fas and Fas-ligand (FasL) expression in the pancreas of non-diabetic controls and type 1 diabetic controls. Fas was not stained in both non-diabetic controls and type 1 diabetic controls (A), (E). FasL-positive mononuclear cells (G) are infiltrated to the islet of type 1 diabetic controls, while FasL was not stained for the islet of non-diabetic controls (C). (B), (D), (F), (H): Immuno-histochemical staining for insulin.
Supplementary Figure 4. Immunohistochemical demonstration of RARRES3, activated caspase 8, caspase 9 and caspase 3 in the affected islets by fulminant type 1 diabetes. (A), (B), (C): Double-immunofluorescent staining for insulin (A) and RARRES3 (B)(x400, case2). A merged image (C) shows specific expression of RARRES3 in beta cells (arrowheads). Double-immunofluorescent staining for insulin (D) and activated caspase 8 (E) (x400, case1). The merged image (F) demonstrates that activated caspase 8 is expressed specifically in beta cells (arrowheads). Double-immunofluorescent staining for insulin (G) and activated caspase 9 (H) (x400, case1). The merged image (I) demonstrates that activated caspase 9 is expressed specifically in beta cells (arrowheads) (x400, case1). Double-immunofluorescent staining for insulin (J) and activated caspase 3 (K) (x400, case 1). The merged image (L) demonstrates that activated caspase 3 is expressed specifically in beta cells (arrowheads).
Supplementary Figure S5. Immunohistochemical staining of activated caspase 8, caspase 9 and caspase 3 in type 1 diabetic controls and autopsied non-diabetic controls. (A), (B), (C): Double-immunostaining for caspase 8 (A) and insulin (B) in type1 diabetic controls (x200). A merged image (C) shows weak staining in some islet beta cells. (D), (E), (F): Double-immunostaining for caspase 8 (D) and insulin (E) and merged image (F) in autopsied nondiabetic controls. Activated caspase 8 was not shown. (G), (H), (I): Double-immunostaining for caspase 9 (G) and insulin (H) in type1 diabetic controls (x200). A merged image (I) shows weak staining in some islet beta cells. (J), (K), (L): Double-immunostaining for caspase 9 (J) and insulin (K) and merged image (L) in autopsied nondiabetic controls. Activated caspase 9 was not shown. (M), (N), (O): Double-immunostaining for caspase 3 (M) and insulin (N) in type1 diabetic controls (x200). A merged image (O) shows weak staining in some islet beta cells. (P), (Q), (R): Double-immunostaining for caspase 3 (P), insulin (Q) and merged image (R) in autopsied nondiabetic controls. Activated caspase 3 was not shown.