Checkpoint Molecules in Rheumatology-or the Benefits of Being Exhausted

Curr Rheumatol Rep. 2021 Mar 2;23(4):22. doi: 10.1007/s11926-021-00991-2.

Abstract

Purpose of review: This review will focus on the most common co-inhibitory molecules, emphasizing the importance of these in relation to rheumatic disease.

Recent findings: Checkpoint molecules are pivotal in determining the outcome of antigen activation. Checkpoint molecules consist of co-stimulatory and co-inhibitory molecules, where the first activates and the latter inhibits the antigen presentation process. Studies show that increased activity of co-inhibitory molecules is associated with a good prognosis in rheumatic diseases. Opposite, when cancer patients are treated with antibodies blocking the inhibitory pathways, autoimmune diseases, including arthritis, develop as immune-related adverse events (IrAE). This emphasizes the importance of these pathways in autoimmune disease. Co-inhibitory molecules are becoming increasingly interesting as future treatment targets in rheumatic conditions. Treatments with antibodies blocking these pathways result in IrAE, often manifesting as autoimmune rheumatic diseases. Therefore, a need to get acquainted with these molecules is growing so we can cope with future challenges in rheumatic diseases.

Keywords: Autoimmunity; Co-inhibitory molecules; Exhausted T cells; Rheumatic diseases.

Publication types

  • Review

MeSH terms

  • Arthritis
  • Autoimmune Diseases*
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use*
  • Immune Checkpoint Proteins / immunology*
  • Neoplasms
  • Rheumatic Diseases* / drug therapy
  • Rheumatology

Substances

  • Immune Checkpoint Inhibitors
  • Immune Checkpoint Proteins