Role of T Cells in Immune Disease Treatment

Dear Colleagues, 

The prevalence of autoimmune diseases is increasing worldwide, necessitating a clearer understanding of their pathogenesis and, as a result, delineation of novel approaches to treat and perhaps cure the many patients afflicted by these often devastating chronic conditions. CD4⁺ T cell receptor (TCR) αβ T cells play a central role in autoimmune diseases through TCR-mediated recognition of autoantigens presented by major histocompatibility complex (MHC) class II molecules on dendritic cells. These T cells then provide signals driving the proliferation and maturation of auto-reactive B cells to plasma cells producing deleterious autoantibodies. Subsets of CD4⁺ T cells involved in harmful autoimmunity include T helper (Th) type 2 cells, follicular helper CD4⁺ T cells, and Th1 and Th17 cells. In addition, autoreactive TCR αβ CD8⁺ T cells directly mediate tissue damage by cell-mediated cytotoxicity. On the other hand, regulatory FOXP3⁺CD4⁺ T cells may serve to dampen autoimmunity. In addition, “nonclassical” T cells, including TCR γδ T cells, MAIT (mucosal-associated invariant T) cells, and natural killer T (NKT) cells bearing unique TCRs, also participate in autoimmunity. The central role of these T cells marks them and the molecular pathways mediating their effects as critically relevant targets for therapeutic intervention. Classically, cyclosporine, which inhibits T cell activation, has been in clinical use for decades. During recent years, molecules involved in T cell activation pathways, e.g., those mediated by CD28 or CD40L, have been targeted by monoclonal antibodies (mAb) and are in clinical trials and in widespread clinical use in a variety of autoimmune diseases. Most recently, cell-mediated therapy, e.g., infusions of Treg and T cells bearing chimeric antigen receptors (CARs) directed against autoreactive B cells, has been used in limited clinical trials with marked success in previously nonresponsive diseases such as scleroderma and severe lupus nephritis.

In this series of papers, we present noteworthy research relating to a deeper understanding of the varied roles and uses of T cells and the molecular pathways involved in autoimmune conditions. Collectively, this unique collection of papers will further our understanding of the mechanisms underlying T cell involvement in autoimmunity and novel therapeutic developments in the field.

Dr. Ilan Bank
Guest Editor

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• autoimmunity
• autoimmune diseases
• immunotherapy
• immune diseases
• T cells
• B cells
• natural killer T cells