Vaccine against autoimmune disease: antigen-specific immunotherapy

Abstract

Recent interest in testing whether the success of antigen-specific immunotherapy (ASIT) for autoimmune diseases in mice can be translated to humans has highlighted the need for better tools to study and understand human autoimmunity. Clinical development of ASIT for allergy has been instructive, but limited understanding of CD4 T cell epitope/determinant hierarchies hampers the rational design and monitoring of ASIT. Definitive identification of pathogenic T cell epitopes as is now known in celiac disease and recent initiatives to optimize immune monitoring will facilitate rational design, monitoring and mechanistic understanding of ASIT for human autoimmune diseases.

HLA-DQ Molecules as Affinity Matrix for Identification of Gluten T Cell Epitopes

“…A prerequisite for this therapy is the identification of pathogenic T cell epitopes. The peptide therapy currently under development for CD is based on the immunodominant DQ2.5 epitopes (37). The results presented in the present study suggest that these epitopes will be effective in CD patients who express DQ2.5 but not DQ2.2.…”

“…The method is relevant not only for autoimmune disease but for other systems of MHC class II-restricted epitopes in allergic and infectious diseases as well as for designing effective vaccination, be that against pathogens or against hyper-reactants. Ag-specific immunotherapy is an attractive approach for treatment of autoimmune diseases (37). A prerequisite for this therapy is the identification of pathogenic T cell epitopes.…”

Celiac Disease Treatment: Is It the Chicken or the Egg Yolk?

“…Finally, several immune modulatory strategies have been advanced for CD treatment, from anti-interleukin (IL)-15 antibodies for refractory CD patients to drugs blocking deamidation or presentation of gliadin peptides to T cells. Importantly, efforts have been made to develop a definitive cure for CD by a peptide-based vaccination strategy [7] or suppression of the inflammatory immune response with hookworm infections [8]. The restoration of tolerance toward orally ingested gluten is currently the only approach that might lead to a cure, rather than treatment, of the disease.…”

Diabetes tolerogenic vaccines targeting antigen-specific inflammation

“…39 Besides the mucosal tolerance and SIT, more attractive approaches to achieve tolerogenic responses and induce antigen specific suppression have emerged in recent years 14,27,[40][41][42][43][44] (Fig. 2).…”