Journal of Clinical and Cellular Immunology
Open Access

Abstract

Immunotherapy in Rheumatoid Arthritis: Prospects for the Restoration of Tolerance

Jenny L McGovern and Clare A Notley

Rheumatoid arthritis (RA) is an autoimmune disease that can have significant effects on the health and wellbeing of patients and generates a heavy burden for healthcare providers. Severe disability associated with RA has been reduced by the development and use of biological therapies including anti-TNF-α and anti-IL-6R. Here we will review how immune modulating agents currently available for the treatment of RA can effect regulation of inflammation. Furthermore, we discuss how inflammation is regulated by specialized regulatory T cell subsets (Treg) and how defects in regulation have led to the concept that boosting Treg numbers or function in RA may lead to long lasting disease remission. We proceed to describe how immunotherapy may contribute to the modulation of Treg and how cellular therapies such as antigen-specific Treg and tolerogenic dendritic cells may provide a mechanism to reestablish antigen-specific suppression of inflammation in RA.