Developing non-immunosuppressive immune-based therapeutics for targeted treatment of autoimmune diseases

项目摘要 寻常天疱疮是一种破坏性的B细胞介导的自身免疫性疾病。B细胞产生的自身抗体 靶向桥粒芯糖蛋白-3（Dsg 3），一种桥粒蛋白，对细胞间粘附至关重要，负责细胞间粘附， 粘膜优势型的疾病，并导致疼痛的粘膜深层糜烂。抗Dsg 3 自身抗体导致角质形成细胞连接的破坏，从而导致 水泡和糜烂抗Dsg 3自身抗体在PV中的直接致病作用已经确立。 已经证明单价抗体足以导致水疱的形成。标准 治疗包括全面抑制免疫系统的免疫抑制药物。这个目标 该项目旨在开发新的，有针对性的，免疫治疗方法，以特异性和精确地靶向， 耗尽识别Dsg 3的自身反应性B细胞。建立的Dsg 3特异性自身反应性B细胞用于 优化这些方法。我们将使用外周血来确定该方法的有效性和特异性 从疾病不同阶段（包括治疗）的PV患者中获得的单核细胞（PBMC）- 幼稚和复发，以及该疾病的体内小鼠模型。成功完成这项研究将有助于 将这些方法转化为临床前，并最终转化为临床环境。易于生产，成本低， 与基于细胞的靶向方法相比， PV的治疗使所提出的治疗学突破性治疗选择成为可能。而且 这里开发的技术可以直接应用于所有自身抗体驱动的疾病， 靶向自身反应性细胞而不引起整体免疫抑制。

Project Summary Pemphigus vulgaris is a devastating B-cell mediated autoimmune disease. Autoantibodies produced by B cells targeting desmoglein-3 (Dsg3), a desmosomal protein, critical for intercellular adhesion, is responsible for the mucosal-dominant type of the disease and cause painful deep erosions in the mucosa. Anti-Dsg3 autoantibodies result in the disruption of the keratinocytes' connections, and, thereby, cause the formation of blisters and erosions. The direct pathogenic role of anti-Dsg3 autoantibodies in PV has been established. Monovalent antibodies have been shown to be sufficient to result in the formation of blisters. Standard treatments include immunosuppressive drugs that globally suppress the immune system. The goal of this project is to develop novel, targeted, immuno-therapeutic approaches to specifically and precisely target and deplete autoreactive B cells recognizing Dsg3. Established Dsg3 specific autoreactive B cells are used to optimize these methods. We will determine the efficacy and specificity of the approach using peripheral blood mononuclear cells (PBMCs) obtained from PV patients in different phases of the disease, including treatment- naive and relapse, and in vivo mouse models of the disease. Successful completion of this study will help translate the methods into a preclinical and, eventually, a clinical setting. The ease of production, low cost, compared to cell-based targeted approaches, and the lack of off-target side-effects compared to the existing treatments for PV make the proposed therapeutics breakthrough treatment options. Furthermore, the technology developed here can have wider applications to all autoantibody-driven diseases by directly targeting autoreactive cells without causing global immunosuppression.