Epitope-based precision immunotherapy of Type 1 diabetes

Hum Vaccin Immunother. 2023 Dec 31;19(1):2154098. doi: 10.1080/21645515.2022.2154098. Epub 2023 Jan 19.

Abstract

Antigen-specific immunotherapies (ASITs) address important clinical needs in treating autoimmune diseases. However, Type 1 diabetes is a heterogeneous disease wherein patient characteristics influence responsiveness to ASITs. Targeting not only disease-relevant T cell populations, but also specific groups of patients using precision medicine is a new goal toward achieving effective treatment. HLA-restricted peptides provide advantages over protein as antigens, however, methods for profiling antigen-specific T cells need to improve in sensitivity, depth, and throughput to facilitate epitope selection. Delivery approaches are highly diverse, illustrating the many ways relevant antigen-presenting cell populations and anatomical locations can be targeted for tolerance induction. The role of persistence of antigen presentation in promoting durable antigen-specific tolerance requires further investigation. Based on the outcome of ASIT trials, the field is moving toward using patient-specific variations to improve efficacy, but challenges still lie on the path to delivering more effective and safer treatment to the T1D patient population.

Keywords: Type 1 diabetes; antigen-specific therapy; antigen-specific tolerance; endotype; epitope; precision medicine.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens
  • Autoimmune Diseases*
  • Diabetes Mellitus, Type 1* / therapy
  • Epitopes
  • Humans
  • Immunotherapy / methods

Substances

  • Epitopes
  • Antigens