Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 May 22;1(1):ltab009.
doi: 10.1093/immadv/ltab009. eCollection 2021 Jan.

Advancement of antigen-specific immunotherapy: knowledge transfer between allergy and autoimmunity

Naomi Richardson  1 , David Cameron Wraith  1
Affiliations
Review

Advancement of antigen-specific immunotherapy: knowledge transfer between allergy and autoimmunity

Naomi Richardson et al. Immunother Adv. .

Erratum in

Abstract

Targeted restoration of immunological tolerance to self-antigens or innocuous environmental allergens represents the ultimate aim of treatment options in autoimmune and allergic disease. Antigen-specific immunotherapy (ASI) is the only intervention that has proven disease-modifying efficacy as evidenced by induction of long-term remission in a number of allergic conditions. Mounting evidence is now indicating that specific targeting of pathogenic T cells in autoinflammatory and autoimmune settings enables effective restoration of immune homeostasis between effector and regulatory cells and alters the immunological course of disease. Here, we discuss the key lessons learned during the development of antigen-specific immunotherapies and how these can be applied to inform future interventions. Armed with this knowledge and current high-throughput technology to track immune cell phenotype and function, it may no longer be a matter of 'if' but 'when' this ultimate aim of targeted tolerance restoration is realised.

Keywords: allergy; autoimmunity; immune tolerance; immunoregulation; immunotherapy.

PubMed Disclaimer

Conflict of interest statement

D.C.W. is Professor of Immunology at the University of Birmingham and CSO and Founder of Apitope International NV. N.R. declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Proposed mechanism of action of bystander suppression. Antigen-specific immunotherapies prevent the generation and activation of CD4+ Teff and instead divert Tconv CD4+ cells towards anergy and also promote the expansion of antigen-specific Tr1-like cells and/or Treg. Both tolerised Tr1-like and Treg can exert cell-contact mediated and cytokine mediated suppression (dashed lines) on APC and non-antigen-specific T cells to ultimately prevent T cell activation in a non-antigen-specific manner.
Figure 2
Figure 2
Summarised mechanisms of action of ASI/AIT and associated risks. Antigen-specific immunotherapies have varying mechanisms of action and potential risks depending on whether they utilise (A) intact allergen, (B) intact autoantigen, or (C) peptides representing T cell epitopes of either allergen or autoantigen. Promotion of activity denoted by black arrows, inhibition of activity denoted by black dashed lines and mitigation of risks denoted by red crosses.
See this image and copyright information in PMC

References

    1. Pawankar R. Allergic diseases and asthma: a global public health concern and a call to action. World Allergy Organ J 2014;7:12. 10.1186/1939-4551-7-12 - DOI - PMC - PubMed
    1. Levy ML, Price D, Zheng X et al. Inadequacies in UK primary care allergy services: national survey of current provisions and perceptions of need. Clin Exp Allergy 2004;34:518–9. 10.1111/j.1365-2222.2004.1945.x - DOI - PubMed
    1. Lerner A, Jeremias P, Matthias T. The world incidence and prevalence of autoimmune diseases is increasing. Int J Celiac Dis 2015;3:151–5. 10.12691/IJCD-3-4-8 - DOI
    1. Medawar R. Nobel lecture. NobelPrize.org. Nobel Media AB 2021. Available at: https://www.nobelprize.org/prizes/medicine/1960/medawar/lecture/
    1. Dakin R. Remarks on a cutaneous affection, produced by certain poisonous vegetables. Am J Med Sci 1829;4:98–100.

LinkOut - more resources