Stanford University School of Medicine, Stanford, CA 94305, United States.
Stanford University School of Medicine, Stanford, CA 94305, United States.
Curr Opin Immunol. 2019 Dec;61:46-53. doi: 10.1016/j.coi.2019.07.011. Epub 2019 Aug 30.
Trials of antigen-specific tolerance have been undertaken in the clinic for over fifty years and the results of these antigen-specific clinical trials are described in this review. Antigen-specific tolerization of the immune system in protein replacement therapy for hemophilia A is an accepted treatment. Clinical trials are ongoing for autoimmune conditions such as type 1 diabetes, multiple sclerosis, neuromyelitis optica, and rheumatoid arthritis with various antigen-specific strategies. Trials for tolerization in celiac disease aim for antigen specific tolerance to gluten, an environmental trigger, which may then halt the progression to autoimmunity targeting a self-antigen, tissue transglutaminase. Although many promising approaches have been demonstrated in pre-clinical models, this review will focus primarily on clinical trials of antigen-specific tolerance that have been taken to the clinic and with initial results reported in the peer reviewed literature. A separate article on approaches with CAR-T cells appears in this volume.
抗原特异性耐受的临床试验已经在临床上进行了五十多年，本综述描述了这些抗原特异性临床试验的结果。在甲型血友病的蛋白质替代疗法中，免疫系统的抗原特异性耐受已被接受为一种治疗方法。针对 1 型糖尿病、多发性硬化症、视神经脊髓炎和类风湿关节炎等自身免疫性疾病的临床试验正在进行中，采用了各种抗原特异性策略。针对乳糜泻的耐受试验旨在针对麸质（一种环境触发因素）产生抗原特异性耐受，从而阻止针对自身抗原组织转谷氨酰胺酶的自身免疫进展。尽管在临床前模型中已经证明了许多有前途的方法，但本综述将主要关注已进入临床并在同行评议文献中报告了初步结果的抗原特异性耐受临床试验。CAR-T 细胞的方法在本卷中有单独的文章介绍。
