Autoreactive T cells in pemphigus: perpetrator and target

Area of Science:

• Immunology
• Dermatology
• Autoimmunity

Background:

• Pemphigus vulgaris (PV) is an autoimmune blistering disease caused by autoantibodies against desmogleins (Dsgs).
• Autoreactive CD4+ T cells are crucial for PV pathogenesis, interacting with B cells to produce autoantibodies.
• Genetic factors, including human leucocyte antigen (HLA) alleles, are strongly associated with PV.

Purpose of the Study:

• To review the current understanding of autoreactive T cell development, characteristics, and function in pemphigus.
• To present emerging T cell-targeted therapeutic strategies for PV.

Main Methods:

• Literature review of studies on T cells in pemphigus vulgaris.
• Analysis of genetic associations and epitope spreading in PV pathogenesis.
• Discussion of regulatory T cells and other CD4+ T cell subsets (Tfh, Th17) in PV.

Main Results:

• Autoreactive CD4+ T cells are essential for PV induction and perpetuation.
• Epitope spreading contributes to disease progression by broadening the autoimmune response.
• Alterations in regulatory T cells and involvement of T follicular helper and Th17 cells are implicated in PV.

Conclusions:

• Understanding autoreactive T cells is key to pemphigus pathogenesis.
• New T cell-targeted therapies show promise for treating PV.