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Co-stimulatory and co-inhibitory pathways in autoimmunity #MMPMID27192568
Zhang Q; Vignali DA
Immunity 2016[May]; 44 (5): 1034-51 PMID27192568show ga
The immune system is guided by a series of checks and balances, a major component of which is a large array of co-stimulatory and co-inhibitory pathways that modulate the host response. While co-stimulation is essential to boost and shape the initial response following signaling through the antigen receptor, inhibitory pathways are also critical to modulate the immune response. Excessive co-stimulation and/or insufficient co-inhibition can lead to a breakdown of self-tolerance, leading to autoimmunity. In this review, we will focus on the role of co-stimulatory and co-inhibitory pathways in two systemic (Systemic Lupus Erythematosus and Rheumatoid Arthritis) and two organ-specific (Multiple Sclerosis and Type 1 Diabetes) autoimmune diseases that are emblematic. We will also discuss how mechanistic analysis of these pathways has led to the identification of potential therapeutic targets and initiation of clinical trials for autoimmune diseases, as well as outline some of the challenges that lie ahead.