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
Summary
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
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