Re-establishing tolerance to autoantigens is an important aim for the treatment of rheumatoid arthritis (RA). Immunization of HLA-DR4 transgenic mice with citrullinated self-antigens can induce immune tolerance, which suggests that such antigens could have a therapeutic role in anti-citrullinated peptide antibody-positive RA.
References
Scally, S. W. et al. A molecular basis for the association of the HLA-DRB1 locus, citrullination, and rheumatoid arthritis. J. Exp. Med. 210, 2569–2582 (2013).
Ge, C. & Holmdahl, R. The structure, specificity and function of anti-citrullinated protein antibodies. Nat. Rev. Rheumatol. 15, 503–508 (2019).
Kissel, T. et al. Surface Ig variable domain glycosylation affects autoantigen binding and acts as threshold for human autoreactive B cell activation. Sci. Adv. 8, eabm1759 (2022).
McElwee, M. K., Dileepan, T., Mahmud, S. A. & Jenkins, M. K. The CD4 + T cell repertoire specific for citrullinated peptides shows evidence of immune tolerance. J. Exp. Med. 220, e20230209 (2023).
Sakaguchi, N. et al. Altered thymic T-cell selection due to a mutation of the ZAP-70 gene causes autoimmune arthritis in mice. Nature 426, 454–460 (2003).
Ireland, J. M. & Unanue, E. R. Autophagy in antigen-presenting cells results in presentation of citrullinated peptides to CD4 T cells. J. Exp. Med. 208, 2625–2632 (2011).
Carmona-Rivera, C. et al. Synovial fibroblast-neutrophil interactions promote pathogenic adaptive immunity in rheumatoid arthritis. Sci. Immunol. 2, eaag3358 (2017).
Khandpur, R. et al. NETs are a source of citrullinated autoantigens and stimulate inflammatory responses in rheumatoid arthritis. Sci. Transl. Med. 5, 178ra40 (2013).
Brewer, R. C. et al. Oral mucosal breaks trigger anti-citrullinated bacterial and human protein antibody responses in rheumatoid arthritis. Sci. Transl. Med. 15, eabq8476 (2023).
Sonigra, A. et al. Randomized phase-1 trial of antigen-specific tolerizing immunotherapy with peptide/calcitriol liposomes in ACPA + rheumatoid arthritis. JCI Insight 7, e160964 (2022).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
R.T. reports issued patent 9,017,697 B2: 2006 surrounding technology for targeting dendritic cells for antigen-specific tolerance, and funding from CSL to UniQuest to develop antigen-specific immunotherapy in Sjögren syndrome. W.H.R. declares no competing interests.
Rights and permissions
About this article
Cite this article
Thomas, R., Robinson, W.H. Immune tolerance of citrullinated peptides. Nat Rev Rheumatol 20, 141–142 (2024). https://doi.org/10.1038/s41584-024-01081-0
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41584-024-01081-0
- Springer Nature Limited