Amelioration of autoimmune encephalomyelitis by myelin basic protein synthetic peptide-induced anergy

Selective immunosuppression

Experimental models of autoimmune diseases have demonstrated that such disease can be prevented or treated by selectively interfering with activation of any of these cell types: antigen-presenting cells, autoreactive T cells and regulatory T cells. Luciano Adorini and colleagues discuss these approaches to selective immunosuppression and examine how similar strategies may become applicable to the treatment of human autoimmune diseases.

Hormones in self tolerance and autoimmunity: a role in the pathogenesis of rheumatoid arthritis?

Recent studies indicate that pituitary hormones play an important role in immunoregulation. The evidence that endocrine abnormalities are associated with, and may contribute to the development of autoimmune disease is reviewed and discussed. Patients suffering from rheumatoid arthritis show a number of endocrine abnormalities that indicate altered pituitary function. The decreased bioactivity of prolactin and possible inadequate glucocorticoid response to inflammation found in patients may have an etiological role in rheumatoid arthritis. The further clarification of the possible role of endocrine factors in the etiology of autoimmune disease is needed urgently.

Factors governing the binding and recognition of foreign and self-peptides by MHC class II

Considerable progress has been made in understanding the basis of T cell recognition and T cell activation. This knowledge has recently been used to modulate T cell activation in animal models of experimental autoimmune disease by two means--selective MHC blockade and peptide-induced tolerance. The use of peptides to interfere with the binding of autoantigenic peptides to MHC requires knowledge of both the class II allele which presents the immunodominant peptide to autoimmune T cells and the identification of peptide analogs that bind with high affinity to that allele. The alternative strategy of peptide-induced tolerance will require identification of the autoantigen and its immunodominant peptides. While the latter approach holds great promise for immunointervention, its wide application will require full knowledge of the mechanisms by which tolerance to self is maintained and how it can be broken.