Antigen-specific immunotherapies in rheumatic diseases

Judit Pozsgay, Z. Szekanecz, G. Sármay

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

The main goal of antigen-specific immunotherapy (ASI) in autoimmune and rheumatic diseases is to reprogramme or remove autoreactive cells and/or induce immune tolerance to self-antigens. Current therapies in these diseases either treat symptoms or slow down disease progression but are not yet curative or preventative-disease-specific treatments are urgently needed. In contrast to the nonspecific treatments in current use that induce generalized immune suppression, which is associated with several adverse effects including increased risk of infections, ASIs target a restricted subset of B cells or T cells, and thus do not compromise systemic immunity and host defence. This Review provides a summary of novel approaches for identifying autoepitopes and detecting and targeting autoreactive cells that might help in the development of ASIs. Promising approaches include the use of tolerizing peptides coupled to MHC constructs and/or nanocompounds, tolerizing dendritic cells and antigen-specific vaccines. Following studies in animal models of rheumatoid arthritis and systemic lupus erythematosus, several of these strategies have now entered clinical trials. However, to use these approaches in humans, several important limitations must first be addressed, such as; selecting the proper immunodominant autoantigen; identifying the optimal timing, dosing and route of administration; finding biomarkers for monitoring the therapy; and optimizing methodology.

Original languageEnglish
Pages (from-to)525-537
Number of pages13
JournalNature Reviews Rheumatology
Volume13
Issue number9
DOIs
Publication statusPublished - Sep 1 2017

Fingerprint

Rheumatic Diseases
Immunotherapy
Antigens
Autoantigens
B-Lymphocyte Subsets
Immune Tolerance
Therapeutics
Systemic Lupus Erythematosus
Dendritic Cells
Autoimmune Diseases
Disease Progression
Immunity
Rheumatoid Arthritis
Vaccines
Animal Models
Biomarkers
Clinical Trials
T-Lymphocytes
Peptides
Infection

ASJC Scopus subject areas

  • Rheumatology

Cite this

Antigen-specific immunotherapies in rheumatic diseases. / Pozsgay, Judit; Szekanecz, Z.; Sármay, G.

In: Nature Reviews Rheumatology, Vol. 13, No. 9, 01.09.2017, p. 525-537.

Research output: Contribution to journalReview article

@article{6f565faa158a4a21a7b9fe045e72d915,
title = "Antigen-specific immunotherapies in rheumatic diseases",
abstract = "The main goal of antigen-specific immunotherapy (ASI) in autoimmune and rheumatic diseases is to reprogramme or remove autoreactive cells and/or induce immune tolerance to self-antigens. Current therapies in these diseases either treat symptoms or slow down disease progression but are not yet curative or preventative-disease-specific treatments are urgently needed. In contrast to the nonspecific treatments in current use that induce generalized immune suppression, which is associated with several adverse effects including increased risk of infections, ASIs target a restricted subset of B cells or T cells, and thus do not compromise systemic immunity and host defence. This Review provides a summary of novel approaches for identifying autoepitopes and detecting and targeting autoreactive cells that might help in the development of ASIs. Promising approaches include the use of tolerizing peptides coupled to MHC constructs and/or nanocompounds, tolerizing dendritic cells and antigen-specific vaccines. Following studies in animal models of rheumatoid arthritis and systemic lupus erythematosus, several of these strategies have now entered clinical trials. However, to use these approaches in humans, several important limitations must first be addressed, such as; selecting the proper immunodominant autoantigen; identifying the optimal timing, dosing and route of administration; finding biomarkers for monitoring the therapy; and optimizing methodology.",
author = "Judit Pozsgay and Z. Szekanecz and G. S{\'a}rmay",
year = "2017",
month = "9",
day = "1",
doi = "10.1038/nrrheum.2017.107",
language = "English",
volume = "13",
pages = "525--537",
journal = "Nature reviews. Rheumatology",
issn = "1759-4790",
publisher = "Nature Publishing Group",
number = "9",

}

TY - JOUR

T1 - Antigen-specific immunotherapies in rheumatic diseases

AU - Pozsgay, Judit

AU - Szekanecz, Z.

AU - Sármay, G.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - The main goal of antigen-specific immunotherapy (ASI) in autoimmune and rheumatic diseases is to reprogramme or remove autoreactive cells and/or induce immune tolerance to self-antigens. Current therapies in these diseases either treat symptoms or slow down disease progression but are not yet curative or preventative-disease-specific treatments are urgently needed. In contrast to the nonspecific treatments in current use that induce generalized immune suppression, which is associated with several adverse effects including increased risk of infections, ASIs target a restricted subset of B cells or T cells, and thus do not compromise systemic immunity and host defence. This Review provides a summary of novel approaches for identifying autoepitopes and detecting and targeting autoreactive cells that might help in the development of ASIs. Promising approaches include the use of tolerizing peptides coupled to MHC constructs and/or nanocompounds, tolerizing dendritic cells and antigen-specific vaccines. Following studies in animal models of rheumatoid arthritis and systemic lupus erythematosus, several of these strategies have now entered clinical trials. However, to use these approaches in humans, several important limitations must first be addressed, such as; selecting the proper immunodominant autoantigen; identifying the optimal timing, dosing and route of administration; finding biomarkers for monitoring the therapy; and optimizing methodology.

AB - The main goal of antigen-specific immunotherapy (ASI) in autoimmune and rheumatic diseases is to reprogramme or remove autoreactive cells and/or induce immune tolerance to self-antigens. Current therapies in these diseases either treat symptoms or slow down disease progression but are not yet curative or preventative-disease-specific treatments are urgently needed. In contrast to the nonspecific treatments in current use that induce generalized immune suppression, which is associated with several adverse effects including increased risk of infections, ASIs target a restricted subset of B cells or T cells, and thus do not compromise systemic immunity and host defence. This Review provides a summary of novel approaches for identifying autoepitopes and detecting and targeting autoreactive cells that might help in the development of ASIs. Promising approaches include the use of tolerizing peptides coupled to MHC constructs and/or nanocompounds, tolerizing dendritic cells and antigen-specific vaccines. Following studies in animal models of rheumatoid arthritis and systemic lupus erythematosus, several of these strategies have now entered clinical trials. However, to use these approaches in humans, several important limitations must first be addressed, such as; selecting the proper immunodominant autoantigen; identifying the optimal timing, dosing and route of administration; finding biomarkers for monitoring the therapy; and optimizing methodology.

UR - http://www.scopus.com/inward/record.url?scp=85028012871&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028012871&partnerID=8YFLogxK

U2 - 10.1038/nrrheum.2017.107

DO - 10.1038/nrrheum.2017.107

M3 - Review article

VL - 13

SP - 525

EP - 537

JO - Nature reviews. Rheumatology

JF - Nature reviews. Rheumatology

SN - 1759-4790

IS - 9

ER -