Objective. Autoreactive CD41 T cells are involved in the pathogenesis of Sj€ ogren's syndrome (SS). The aim of the present study was to clarify the dominant T cell epitopes of M3 muscarinic acetylcholine receptor (M3R) and to establish a new antigen-specific therapy for SS using an experimental mouse model.Methods. Production of cytokines from M3R-reactive CD41 T cells, after culture with various M3R peptides, was analyzed by enzyme-linked immunosorbent assay. Adoptive cell transfer was performed using splenocytes from M3R 2/2 mice that were immunized with M3R peptides or phosphate buffered saline plus H37Ra as a control. Rag1 2/2 mice were inoculated with the splenocytes and examined for the development of sialadenitis. Altered peptide ligands (APLs) of the T cell epitopes, with substitutions in amino acid residues at T cell receptor contact sites, were synthesized, and the ability of the APLs to suppress sialadenitis was evaluated. The mechanisms underlying such effects were assessed.Results. CD41 M3R-reactive T cells produced interleukin-17 (IL-17) and interferon-g (IFNg) in response to the N-terminal 1 (N1) and 1st extracellular loop peptides of M3R, and Rag1 2/2 mice that received N1-and/or 1st peptide-immunized splenocytes developed sialadenitis. Among the designed APLs, N1-APL7 (NfiS at amino acid 15) significantly suppressed IFNg production in vitro, and also suppressed sialadenitis in vivo. Levels of early growth response 2 in CD41 T cells from the cervical lymph nodes of N1-APL7-treated mice were significantly higher than those of control mice, and cell proliferation was reversed by administration of exogenous IL-2. Levels of the anergy-related molecules itchy homolog E3 ubiquitin-protein ligase, Casitas B-lineage lymphoma b, gene related to anergy in lymphocytes, and Deltex-1 were significantly higher in CD41 T cells cultured with N1-APL7. Conclusion. The major T cell epitopes were from the N1 and 1st peptide regions. Moreover, N1-APL7, selected as the antagonistic APL in vitro, also suppressed sialadenitis through the induction of anergy. This is a potentially useful strategy for regulating pathogenic T cell infiltration in SS. Sj€ ogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the lacrimal and salivary glands, leading to dry eyes and dry mouth. Immunohistochemical studies have shown that most infiltrating lymphocytes around the labial salivary glands, lachrymal glands, and kidneys are CD41 a/b T cells (1). Moreover, the restricted usage of T cell receptor (TCR) a/b has been reported, suggesting that the antigen-specific immune response is the main pathologic mechanism of SS, and that non-antigen-specific immune responses are secondary mechanisms (2). Autoantigens, dumped from the damaged salivary glands, are presented by antigen-presenting cells (APCs), and autoantigen-specific T cells are activated to induce the proliferation of polyclonal T cells.