Restoring tolerance with antigen delivery

Autoimmune disorders encompass a wide range of immunological diseases that affect 4 to 10% of the population worldwide. They occur when immunological tolerance toward self-antigens is broken, resulting in immune responses against cells, tissues, or organs that lead to tissue dysfunction and/or destruction. The goal of autoimmune disease therapy is to restore tolerance to the self-antigen that causes the pathology by targeting autoreactive T cells while preserving immune competence to prevent infections and malignancies. The main challenge of this endeavor resides in choosing the mode by which the disease-driving antigen is delivered so that it can initiate the removal or reprogramming of the autoreactive T cells or the induction and/or expansion of antigen-specific regulatory T (T-reg) cells to suppress autoreactive T cells. Although the potential of antigenbased immunotherapy approaches to restore tolerance have been demonstrated for the treatment of immunoglobulin E (IgE) - mediated peanut allergy (1), antigen therapies for autoimmune disorders are still being developed.