Immune tolerance therapies for autoimmune diseases: Shifting the goalpost to cure

Autoimmune rheumatic diseases are characterised by an autoimmune inflammatory response to antigens of synovial tissue, muscles, and other organs. While the prognosis of these disorders has improved remarkably over recent years with the advent of biological therapeutics, prolonged drug-free remission is still rare. Advances in the understanding of the immunopathogenesis and response to immunotherapy of seropositive autoimmune rheumatic diseases, such as rheumatoid arthritis systemic lupus erythematosus, type 1 diabetes and the autoimmune-like celiac disease have revealed novel therapeutic opportunities. An improved understanding of preclinical disease states and how disease risk can be mitigated underpins further development of therapeutics to restore tolerance for disease prevention or early disease interception.