Therapeutic tolerance in autoimmune disease.

Area of Science:

• Immunology
• Transplantation Medicine
• Autoimmunity

Background:

• Experimental immune tolerance induction demonstrated in the 1950s.
• Therapeutic tolerance induction for transplant rejection and autoimmunity emerged in the 1980s.
• Clinical translation of immune tolerance strategies has been slow but is accelerating.

Purpose of the Study:

• To review the current landscape and future directions of immune tolerance induction.
• To highlight advancements in clinical strategies and monitoring for tolerance induction.
• To discuss the potential for treating preclinical and prodromal autoimmune diseases.

Main Methods:

• Review of experimental and clinical strategies for immune tolerance induction.
• Discussion of emerging technologies for monitoring immune responses.
• Analysis of the progression of autoimmunity and potential intervention points.

Main Results:

• Numerous immune tolerance strategies are under clinical investigation, including antibody, peptide, and cellular therapies.
• Advanced monitoring of serological and cellular autoreactivity can serve as biomarkers.
• Recognition of preclinical autoimmunity phases prompts consideration for early intervention.

Conclusions:

• The convergence of advanced strategies, monitoring capabilities, and understanding of preclinical disease suggests an acceleration in clinical trials.
• Future trials are anticipated for tolerogenic strategies in preclinical disease stages.
• Intensive immune monitoring will be crucial for guiding therapeutic interventions in tolerance induction and autoimmunity.