Research ArticleRheumatoid Arthritis

Citrullinated peptide dendritic cell immunotherapy in HLA risk genotype–positive rheumatoid arthritis patients

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Science Translational Medicine  03 Jun 2015:
Vol. 7, Issue 290, pp. 290ra87
DOI: 10.1126/scitranslmed.aaa9301

Immunotherapy out of joint

Autoantibodies to anti–citrullinated peptides (ACPA) are found in most patients with rheumatoid arthritis (RA), especially those with HLA-DRB1 risk alleles. Benham et al. report a first-in-human phase 1 trial of a single injection of autologous dendritic cells modified with an NF-κB inhibitor that have been exposed to four citrullinated peptide antigens. They find that HLA risk genotype–positive RA patients had reduced numbers of effector T cells and decreased production of proinflammatory cytokines compared with untreated RA patient controls. The therapy was safe and did not induce disease flares. These data support larger studies of antigen-specific immunotherapy for RA.

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