We investigated the therapeutic effect of antilnphocyte serum (ALS) on clinically overt diabetes by using a nonobese diabetic (NOD) Immunotherapy with ALS. ALS was obtained by immunizing rabbits with a pool of lymph node cells prepared from NOD, C3H/He, DBA/2, and (C57BL/6 x A)F1 mice (11). A 0.4-ml injection of ALS was given intraperitoneally to diabetic NOD mice on days 0 (the first day of treatment regardless of the duration of diabetes) and +2. Control mice were given 0.4 ml ofnormal rabbit serum (NRS) on days 0 and +2. Blood glucose levels were monitored every 2-3 days initially and once a week thereafter. Achievement of euglycemia (<11 mM) and independence from exogenous insulin treatment after immunotherapy was defined as clinical remission.Immunotherapy with Monoclonal Antibodis (mAbs). Hybridoma cells producing anti-CD4 (anti-L3T4, clone GK 1.5) mAb were kindly provided by Kevin J. Lafferty (Barbara Davis Center for Juvenile Diabetes, Denver). Hybridomas producing anti-CD8 (anti-Lyt 2.1, clone 116-13.1, and antiLyt 2.2, clone 41-3.48) mAb were obtained from American Type Culture Collection. Ascites fluid that contained mAbs at -5 mg/ml was used. Diabetic NOD mice were treated with anti-CD4 mAb at 0.2 ml on days 0, 7, 14, and 21 and/or 0.1 ml of anti-CD8 (anti-Lyt 2.1) mAb on days 0 and 14. This treatment protocol has been shown (12) to achieve long-term removal of CD4' and/or CD8+ T lymphocytes from peripheral lymphoid organs in other inbred mouse strains. Control diabetic NOD mice were treated with 0.2 ml of anti-Lyt 2.2 mAb on days 0, 7, 14, and 21.Flow Cytometric Analysis. Peripheral lymph node cells were stained with fluorescein isothiocyanate conjugates of mAb 53-6.7 (anti-CD8) and phycoerythrin-conjugates of mAb GK1.5 (anti-CD4), both of which were obtained from Becton Dickinson. Two-color analysis was performed with a singlebeam flow cytometer, FACScan (Becton Dickinson) and the FACSCAN Research Software (Becton Dickinson).Islet Isolation and Transplantation. Because insulitis generally starts at 4 weeks of age (1), NOD islet donors were Abbreviations: NOD, nonobese diabetic; ALS, anti-lymphocyte serum; NRS, normal rabbit serum; mAb, monoclonal antibody.tTo whom reprint requests should be addressed at: CRI, New