VIB-UGent Center for Medical Biotechnology, Ghent University, Ghent, Belgium.
Orionis Biosciences, Ghent, Belgium.
Front Immunol. 2020 May 14;11:674. doi: 10.3389/fimmu.2020.00674. eCollection 2020.
Autoimmune diseases such as multiple sclerosis (MS), type I diabetes (T1D), inflammatory bowel diseases (IBD), and rheumatoid arthritis (RA) are chronic, incurable, incapacitating and at times even lethal conditions. Worldwide, millions of people are affected, predominantly women, and their number is steadily increasing. Currently, autoimmune patients require lifelong immunosuppressive therapy, often accompanied by severe adverse side effects and risks. Targeting the fundamental cause of autoimmunity, which is the loss of tolerance to self- or innocuous antigens, may be achieved via various mechanisms. Recently, tolerance-inducing cellular therapies, such as tolerogenic dendritic cells (tolDCs) and regulatory T cells (Tregs), have gained considerable interest. Their safety has already been evaluated in patients with MS, arthritis, T1D, and Crohn's disease, and clinical trials are underway to confirm their safety and therapeutic potential. Cell-based therapies are inevitably expensive and time-consuming, requiring laborious manufacturing. Therefore, direct targeting of tolerogenic cell types offers an attractive alternative, and several strategies are being explored. Type I IFN was the first disease-modifying therapy approved for MS patients, and approaches to endogenously induce IFN in autoimmune diseases are being pursued vigorously. We here review and discuss tolerogenic cellular therapies and targeted tolerance approaches and propose a novel strategy for cell-specific delivery of type I IFN signaling to a cell type of choice.
自身免疫性疾病,如多发性硬化症 (MS)、1 型糖尿病 (T1D)、炎症性肠病 (IBD) 和类风湿关节炎 (RA),是慢性、无法治愈、使人丧失能力且有时甚至致命的疾病。在全球范围内,数以百万计的人受到影响,主要是女性,而且这个数字还在稳步增加。目前,自身免疫性疾病患者需要终身接受免疫抑制治疗,通常伴随着严重的不良反应和风险。通过各种机制,可以针对自身免疫的根本原因,即对自身或无害抗原的耐受性丧失,进行靶向治疗。最近,诱导耐受的细胞疗法,如耐受原性树突状细胞 (tolDCs) 和调节性 T 细胞 (Tregs),引起了相当大的兴趣。它们在多发性硬化症、关节炎、1 型糖尿病和克罗恩病患者中的安全性已经得到了评估,并且正在进行临床试验以确认它们的安全性和治疗潜力。基于细胞的疗法不可避免地昂贵且耗时,需要费力的制造。因此,直接针对耐受原性细胞类型提供了一种有吸引力的替代方案,并且正在探索几种策略。I 型干扰素是第一种被批准用于多发性硬化症患者的疾病修正治疗方法,并且正在积极寻求内源性诱导自身免疫疾病中 IFN 的方法。我们在这里回顾和讨论了诱导耐受的细胞疗法和靶向耐受的方法,并提出了一种将 I 型 IFN 信号递送到所选细胞类型的新型细胞特异性传递策略。