Insights into immune tolerance from AIRE deficiency. (December 2017)

• Record Type: Journal Article
• Authors: Proekt, Irina; Miller, Corey N; Lionakis, Michail S; Anderson, Mark S
• Is Part Of: Current opinion in immunology. Volume 49(2017)
• Page Start: 71
• Page End: 78
• Publication Date: 2017-12
• Subjects: Immunology -- Periodicals; Allergy -- Periodicals; Immunology -- Abstracts -- Periodicals; Allergy -- Abstracts -- Periodicals; 616.079
• DOI: 10.1016/j.coi.2017.10.003
• Languages: English
• ISSNs: 0952-7915

Abstract

Highlights: APS-1/APECED patients exhibit marked phenotypic variability despite genotypic similarities. Defects in AIRE synergize with defects in peripheral tolerance to promote autoimmunity. Manipulation of AIRE-dependent thymic tolerance is an emerging therapeutic target. Abstract : AIRE is a well-established master regulator of central tolerance. It plays an essential role in driving expression of tissue-specific antigens in the thymus and shaping the development of positively selected T-cells. Humans and mice with compromised or absent AIRE function have markedly variable phenotypes that include a range of autoimmune manifestations. Recent evidence suggests that this variability stems from cooperation of autoimmune susceptibilities involving both central and peripheral tolerance checkpoints. Here we discuss the broadening understanding of the factors that influence Aire expression, modify AIRE function, and the impact and intersection of AIRE with peripheral immunity. This rapidly expanding body of knowledge will force a reexamination of the definition and clinical management of APS-1 patients as well as provide a foundation for the development of immunomodulatory strategies targeting central tolerance.