Do Tregitopes have the potential to impact the current treatment landscape of autoimmune diseases?
Abstract
Current treatment of autoimmune disease usually involves the use of cytotoxic drugs or biologic agents that interfere with the activity of B cells, T cells or key cytokines, such as TNF, IL-1 and IL-6. On occasion, polyclonal immunoglobulin G (IgG), intravenous (IVIg) is used. The discovery of IgG- (and hence IVIg-) derived T regulatory (Treg) epitopes that trigger the expansion of Tregs in vitro and in vivo provides a novel explanation for the effect of IVIg. These IgG-derived Treg epitopes (also known as Tregitopes) appear to be effective on their own (in vivo, in autoimmune disease models) and when co-administered with a specific autoimmune disease antigen, contribute to antigen-specific tolerance induction. A description of Tregitopes and a brief discussion of their potential applications in autoimmune disease are provided here. Tregitope-based immunotherapy has the potential to modify the current autoimmune pharmacopeia.