The Fleischer Institute for Diabetes and Metabolism, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Thyroid. 2023 Apr;33(4):492-500. doi: 10.1089/thy.2022.0511. Epub 2023 Mar 20.
Autoimmune thyroid diseases (AITD) represent the most common autoimmune diseases. However, current therapies focus on relieving the symptoms instead of curing AITD, and new therapies to reverse the autoimmune attack on the thyroid are needed. HLA-DRβ1-Arg74 is the key HLA class II allele that triggers AITD by presenting pathogenic thyroglobulin (Tg) peptides that activate thyroid self-reactive T cells. We hypothesized that blocking the presentation of Tg peptides to T cells within the HLA-DRβ1-Arg74 peptide binding cleft could reverse the autoimmune response to the thyroid in AITD. The approach we used to block Tg peptide presentation within HLA-DRβ1-Arg74 is to design retro-inverso D-amino acid (RID) peptides that have high affinity to the HLA-DRβ1-Arg74 peptide binding pocket. By using computational approaches and molecular dynamics simulations, we designed two RID peptides, RT-15 and VT-15, that blocked peptide binding to recombinant HLA-DRβ1-Arg74 molecule, as well as T cell activation . Furthermore, RT-15 and VT-15 blocked T cell activation by thyroglobulin in humanized NOD-DR3 mice induced with experimental autoimmune thyroiditis. In summary, we discovered two RID peptides that block thyroglobulin peptide binding to HLA-DRβ1-Arg74 and their presentation to T cells in AITD. These findings set the stage for a personalized medicine therapeutic approach for AITD patients who carry the DRβ1-Arg74 allele. This antigen-specific therapeutic strategy can potentially be extended to other autoimmune diseases.
自身免疫性甲状腺疾病(AITD)是最常见的自身免疫性疾病。然而,目前的治疗方法侧重于缓解症状,而不是治愈 AITD,需要新的治疗方法来逆转针对甲状腺的自身免疫攻击。HLA-DRβ1-Arg74 是触发 AITD 的关键 HLA II 类等位基因,通过呈现激活甲状腺自身反应性 T 细胞的致病性甲状腺球蛋白(Tg)肽来实现。我们假设通过阻断 HLA-DRβ1-Arg74 肽结合槽内 T 细胞中的 Tg 肽呈递,可以逆转 AITD 中针对甲状腺的自身免疫反应。我们用于阻断 HLA-DRβ1-Arg74 内 Tg 肽呈递的方法是设计具有与 HLA-DRβ1-Arg74 肽结合口袋高亲和力的反式-反式二氨基(RID)肽。通过使用计算方法和分子动力学模拟,我们设计了两种 RID 肽,RT-15 和 VT-15,它们阻断了肽与重组 HLA-DRβ1-Arg74 分子的结合以及 T 细胞的激活。此外,RT-15 和 VT-15 阻断了在实验性自身免疫性甲状腺炎诱导的携带 DRβ1-Arg74 等位基因的人源化 NOD-DR3 小鼠中 Tg 诱导的 T 细胞激活。总之,我们发现了两种 RID 肽,它们可以阻断 Tg 肽与 HLA-DRβ1-Arg74 的结合及其在 AITD 中的呈递。这些发现为携带 DRβ1-Arg74 等位基因的 AITD 患者的个性化医学治疗方法奠定了基础。这种抗原特异性治疗策略可能会扩展到其他自身免疫性疾病。
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