Citrullinated peptide-specific T cell (None)

Citrullinated peptide-specific T cells are a specialized subset of CD4+ T lymphocytes that play a central role in the pathogenesis of Rheumatoid Arthritis (RA). These cells recognize self-proteins that have undergone citrullination—a post-translational modification where arginine is converted to citrulline by peptidylarginine deiminase (PAD) enzymes—presented by specific HLA-DRB1 shared epitope alleles (Thomas, R., 2017, Nature Reviews Rheumatology). In RA patients, the breakdown of peripheral tolerance allows these T cells to activate, providing essential help to B cells for the production of anti-citrullinated protein antibodies (ACPAs) and driving chronic synovial inflammation through the secretion of pro-inflammatory cytokines like IL-17 and IFN-gamma (Law, S. C., et al., 2020, JCI Insight). Because these T cells are highly specific to the autoimmune process in RA, they are considered an ideal target for antigen-specific immunotherapy (ASIT). Experimental treatments like DEN-181 utilize liposomes containing citrullinated peptides to induce immune tolerance, aiming to reprogram the immune system to ignore these self-antigens without compromising general immunity (Janssen Biotech; University of Queensland). This approach represents a shift from broad immunosuppression toward precision medicine in rheumatology.

Other names

Citrulline-specific T cellsACPA-associated T cellsCitrullinated antigen-reactive T cellsCCP-reactive CD4+ T cells

Induction of antigen-specific peripheral tolerance through the expansion of regulatory T cells (Tregs) and the induction of anergy or deletion of autoreactive CD4+ T cells.