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APL A12 is an altered peptide ligand (APL) derived from the immunodominant epitope of type II collagen (CII), specifically residues 256-270. It was developed as an immunomodulatory therapy for rheumatoid arthritis (RA). The mechanism involves the induction of peripheral tolerance or bystander suppression by shifting the T-cell response from a pro-inflammatory Th1 phenotype (characterized by interferon-gamma production) to a regulatory or Th2/Th3 phenotype (characterized by IL-4, IL-10, and TGF-beta production). APL A12 is designed to enhance the suppressive function of CD4+ CD25+ regulatory T cells, thereby reducing the autoimmune attack on joint collagen.
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