Antigen-based immunotherapy for autoimmune disease: current status

Figures & data

Table 1 Representative autoantigens involved in autoimmune disease

Disease	Autoantigen
Type I diabetes	Carboxypeptidase H
	Chromogranin A
	Glutamate decarboxylase
	Imogen-38
	Insulin
	Insulinoma antigen-2 and 2β
	Islet-specific glucose-6-phosphatase catalytic subunit related protein (IGRP)
	Proinsulin^Citation9
Multiple sclerosis	α-enolase
	Aquaporin-4
	β-arrestin
	Myelin basic protein
	Myelin oligodendrocytic glycoprotein
	Proteolipid protein
	S100-β^Citation10
Rheumatoid arthritis	Citrullinated protein
	Collagen II
	Heat shock proteins
	Human cartilage glycoprotein 39^Citation12
Systemic lupus erythematosus	Double-stranded DNA
	La antigen
	Nucleosomal histones and ribonucleoproteins (snRNP)
	Phospholipid-β-2 glycoprotein I complex
	Poly(ADP-ribose) polymerase
	Sm antigens of U-1 small ribonucleoprotein complex^Citation11

Abbreviation: snRNP, small nuclear ribonucleoprotein.

Table 2 Antigen-specific immunotherapy using insulin as the target antigen

Treatment	Year	Patient characteristics	Outcome	Reference
Oral insulin (2.5 mg or 7.5 mg daily)	2000	131 patients with positive autoantibodies within 2 weeks of diagnosis of T1D	No difference between treatment groups and placebo	Chaillous et al^Citation26
Oral insulin (5 mg daily)	2000	80 patients with T1D	No difference between treatment and placebo groups	Pozzilli et al^Citation27
Intranasal insulin (1.6 mg)	2004	38 patients with autoantibodies	Intranasal insulin was safe and induced immune changes consistent with mucosal tolerance to insulin	Harrison et al^Citation28
Intranasal insulin (1 unit/kg daily)	2008	224 infants and 40 siblings with autoantibodies	No difference between treatment and placebo groups	Näntö-Salonen et al^Citation29

Abbreviation: TID, Type 1 diabetes.

Table 3 Diabetes Prevention Trial-Type 1

Treatment	Patients	Outcome
Low-dose systemic insulin administered twice daily for total dose of 0.25 U/kg/day	372 relatives of T1D with islet cell antibodies and 26%–50% 5-year risk of developing T1D	No effect on diabetes incidence
Oral insulin (7.5 mg daily)	372 relatives of T1D with islet cell antibodies and 26%–50% 5-year risk of developing T1D	No effect in major outcomes, but a subgroup analysis suggested a possible benefit in subjects with insulin autoantibody levels >80 nU/mL

Abbreviation: TID, Type 1 diabetes.

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