Abstract

The immune system is a complex network of specialized cells and organs that recognises and reacts against foreign pathogens while remaining unresponsive to host tissues. This ability to self-tolerate is known as immunological tolerance. Autoimmune disease occurs when the immune system fails to differentiate between self and non-self antigens and releases autoantibodies to attack our own cells. Anti-idiotypic (anti-ID) antibodies are important in maintaining a balanced idiotypic regulatory network by neutralising and inhibiting the secretion of autoantibodies. Recently, anti-ID antibodies have been advanced as an alternative form of immunotherapy as they can specifically target autoantibodies, cause less toxicity and side effects, and could provide long-lasting immunity. This review article discusses the immunomodulatory potential of anti-ID antibodies for the treatment of autoimmune diseases.

Highlights

  • Epitope AntigenCirculating autoantibodies indicates dysregulation of the humoral immune response. Since anti-ID antibodies can act as the internal image of antigen epitopes, they can competitively bind to the autoantibodies in place of the antigen

  • The capability of anti-ID antibodies in conferring antigen-specific immune tolerance with no compromise in the ability to elicit immune responses to other antigens has paved the way for many therapeutic processes in autoimmune diseases

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Summary

Epitope Antigen

Circulating autoantibodies indicates dysregulation of the humoral immune response. Since anti-ID antibodies can act as the internal image of antigen epitopes, they can competitively bind to the autoantibodies in place of the antigen. A study by Wang et al in 2012 demonstrated that the administration of monoclonal anti-ID specific to GAD65 autoantibody in the non-obese diabetic mouse significantly lowered the severity of insulitis and reduced the incidence rate of diabetes [84] This finding supported the use of anti-ID antibodies as an idiotypic vaccination in performing the protective immune-modulatory role of GAD65Ab-specific anti-ID in the development of T1D. As discussed earlier, SLE patients in a small clinical trial reported positive response upon vaccination with anti-ID antibodies and remained disease-free upon 2 years of follow-up [35]. Despite facing many challenges in the development of anti-ID antibodies as vaccines, research progress and clinical trials continue to produce promising results, suggesting that the scope of anti-ID vaccines could be extended beyond their traditional application in cancer treatment, towards the management of autoimmune diseases

Conclusion
Executive summary

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