title: Modulation of T cell function by combination of epitope specific and low dose anticytokine therapy controls autoimmune arthritis.
abstract: Innate and adaptive immunity contribute to the pathogenesis of autoimmune arthritis by generating and maintaining inflammation, which leads to tissue damage. Current biological therapies target innate immunity, eminently by interfering with single pro-inflammatory cytokine pathways. This approach has shown excellent efficacy in a good proportion of patients with Rheumatoid Arthritis (RA), but is limited by cost and side effects. Adaptive immunity, particularly T cells with a regulatory function, plays a fundamental role in controlling inflammation in physiologic conditions. A growing body of evidence suggests that modulation of T cell function is impaired in autoimmunity. Restoration of such function could be of significant therapeutic value. We have recently demonstrated that epitope-specific therapy can restore modulation of T cell function in RA patients. Here, we tested the hypothesis that a combination of anti-cytokine and epitope-specific immunotherapy may facilitate the control of autoimmune inflammation by generating active T cell regulation. This novel combination of mucosal tolerization to a pathogenic T cell epitope and single low dose anti-TNFalpha was as therapeutically effective as full dose anti-TNFalpha treatment. Analysis of the underlying immunological mechanisms showed induction of T cell immune deviation.
authors.affiliation: Department of Medicine, University of California San Diego, La Jolla, California, United States of America.
authors.forename: Sarah T A
authors.initials: ST
authors.lastname: Roord
authors.forename: Evelien
authors.initials: E
authors.lastname: Zonneveld-Huijssoon
authors.forename: Tho
authors.initials: T
authors.lastname: Le
authors.forename: Gisella Puga
authors.initials: GP
authors.lastname: Yung
authors.forename: Eva
authors.initials: E
authors.lastname: Koffeman
authors.forename: Arash
authors.initials: A
authors.lastname: Ronaghy
authors.forename: Negar
authors.initials: N
authors.lastname: Ghahramani
authors.forename: Paola
authors.initials: P
authors.lastname: Lanza
authors.forename: Rosario
authors.initials: R
authors.lastname: Billetta
authors.forename: Berent J
authors.initials: BJ
authors.lastname: Prakken
authors.forename: Salvatore
authors.initials: S
authors.lastname: Albani
mesh_terms: D000595:Amino Acid Sequence; D000818:Animals; D000942:Antigens, Bacterial / Q000235:genetics / Q000276:immunology; D001169:Arthritis, Experimental / Q000276:immunology* / Q000473:pathology / Q000628:therapy*; D015551:Autoimmunity; D001483:Base Sequence; D018834:Chaperonin 60 / Q000235:genetics / Q000276:immunology; D016207:Cytokines / Q000037:antagonists & inhibitors* / Q000235:genetics / Q000378:metabolism; D017931:DNA Primers / Q000235:genetics; D018984:Epitopes, T-Lymphocyte / Q000235:genetics / Q000276:immunology*; D000068800:Etanercept; D006614:Hindlimb / Q000473:pathology; D006801:Humans; D018928:Immunity, Mucosal; D007074:Immunoglobulin G / Q000008:administration & dosage; D007167:Immunotherapy / Q000379:methods*; D016219:Immunotherapy, Adoptive; D008297:Male; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000276:immunology; D051381:Rats; D011917:Rats, Inbred Lew; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage; D013601:T-Lymphocytes / Q000276:immunology*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000942:Antigens, Bacterial; D018834:Chaperonin 60; D016207:Cytokines; D017931:DNA Primers; D018984:Epitopes, T-Lymphocyte; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept