Chromogranin A (ChgA) is an autoantigen for CD4 + T cells in the nonobese diabetic (NOD) mouse model of type 1 diabetes (T1D). The natural ChgA-processed peptide, WE14, is a weak agonist for the prototypical T cell, BDC-2.5, and other ChgA-specific T-cell clones. Mimotope peptides with much higher activity share a C-terminal motif, WXRM(D/E), that is predicted to lie in the p5 to p9 position in the mouse MHC class II, IA g7 binding groove. This motif is also present in WE14 (WSRMD), but at its N terminus. Therefore, to place the WE14 motif into the same position as seen in the mimotopes, we added the amino acids RLGL to its N terminus. Like the other mimotopes, RLGL-WE14, is much more potent than WE14 in T-cell stimulation and activates a diverse population of CD4 + T cells, which also respond to WE14 as well as islets from WT, but not ChgA −/− mice. The crystal structure of the IA g7 -RLGL-WE14 complex confirmed the predicted placement of the peptide within the IA g7 groove. Fluorescent IA g7 -RLGL-WE14 tetramers bind to ChgA-specific T-cell clones and easily detect ChgA-specific T cells in the pancreas and pancreatic lymph nodes of NOD mice. The prediction that many different N-terminal amino acid extensions to the WXRM(D/E) motif are sufficient to greatly improve T-cell stimulation leads us to propose that such a posttranslational modification may occur uniquely in the pancreas or pancreatic lymph nodes, perhaps via the mechanism of transpeptidation. This modification could account for the escape of these T cells from thymic negative selection. (T1D) is an autoimmune disease characterized by infiltration of T cells into the pancreatic islets of Langerhans, resulting in destruction of insulin-secreting beta cells (reviewed in ref. 1). Numerous autoantigens, including insulin/ proinsulin itself and chromogranin A (ChgA), have been reported to be T-cell targets in the disease in mice and/or humans (reviewed in refs. 2 and 3). In the nonobese diabetic (NOD) mouse model of T1D, epitopes in the insulin B chain have been shown to be essential for T1D development (4), and CD4 + T-cell clones specific for insulin or ChgA have been shown to be particularly potent in induction of T1D in immune-deficient NOD-scid mice (5). ChgA (gene name CHGA) is a member of the granin family of neuroendocrine secretory proteins. Full-length ChgA is proteolytically processed to yield several functional peptides including a small peptide, WE14 (6). Our group participated in the study that first identified ChgA as the autoantigen and the WE14 peptide as the key epitope for the prototypical BDC-2.5 and other NOD-derived CD4 + T cells (7). WE14 is a weak agonist for these ChgA-specific T cells, but we (7) and others (8, 9) have identified a series of mimotope peptides that are very strong agonists for these T cells. Comparison of the sequence of WE14 with these mimotope peptides reveals the presence of a common amino acid motif, WXRM(D/E), at the C terminus where it is predicted to occupy positions p5 to p9 in the IA g7 binding groove. WE14...