The presentation is focused on the development of a new therapeutic approach that potentially allows achieving long-term remission of an autoimmune disease, with minimal, targeted interference with the immune system and minimal side effects.
The approach is based on an in-depth analysis of individual T-lymphocyte repertoires for a cohort of patients, and the identification, using modem bioinformatics methods, of T-cell receptor variants associated with the development of a specific autoimmune disease, in a specific HLA context.
At present cytotoxic monoclonal antibodies against a certain type of T-cell receptor segments allow targeted elimination of a narrow population of T-lymphocytes, comprising about 1-3% of all T-cells, regardless of their functional type, and including identified variants of T-cell receptors associated with the development of the disease.
This approach has a minimal effect on the immune system, eliminates the entire cause of the disease, and is scaled well - the presence of 30 variants of such monoclonal antibodies potentially allows targeted therapy for a wide variety of autoimmune diseases.
We demonstrate the feasibility of the approach using the example of HLA-B27-associated diseases, such as ankylosing spondylitis and psoriatic arthritis, similarities with the mechanisms of the therapeutic effect in autologous blood cell transplantation are considered, and discuss the perspectives for the development of this approach in real clinical practice are discussed.