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NIAID Plan for Research on Immune Tolerance
PART 1: Overview
As the leading NIH Institute for research in immunology, the NIAID is in
a unique position to capitalize on advances in basic, pre-clinical and clinical
research focused on achieving immune tolerance for immune-mediated diseases,
including autoimmune and allergic diseases as well as transplant rejection.
This research plan provides a broad-based set of strategies and initiatives
to further our understanding of immune tolerance and to accelerate the clinical
evaluation of tolerogenic approaches to treat and prevent immune system
diseases.
Overall Conceptual Framework
The plan provides an effective model for translational research and for
ensuring that key studies are performed in a coordinated and efficient
manner. The plan is designed around a mechanism-based (as opposed to a
disease-oriented) approach, focusing on immune tolerance as the overall
scientific framework and clinical objective. The goal is to begin a more
collaborative and coordinated research effort-one involving basic immunologists,
relevant clinical specialties, other NIH Institutes and the pharmaceutical
and biotechnology industry. Major features of the plan are outlined below.
- Establish new, and use existing, clinical research infrastructures
to accelerate multi-center studies, including cooperative clinical trial
groups in kidney transplantation, islet transplantation, autoimmune
and allergic diseases.
- Incorporate studies of underlying mechanisms in non-human primate
and clinical research.
- Incorporate developmental work to identify and validate surrogate
markers of immune tolerance as well as disease stage, activity and therapeutic
response.
- Engage the participation of the pharmaceutical and biotechnology industry
by creating an infrastructure that will accelerate quality pre-clinical
and clinical research.
- Support basic research to expand knowledge of the molecular basis
for tolerance induction and maintenance and innovative research to expand
the universe of tolerogenic approaches.
- Ensure the availability of critical research resources, including
research training programs for physicians and Ph.D.s.
- Co-stimulatory blockade (e.g., anti-CD40 ligand, anti-B7, CTLA4-Ig)
- Cytokine modulation (e.g., IL-4, IL-12, TNF, TGFß
- Deletion of responding lymphocytes (e.g., Fas-ligand)
- Other approaches, such as leukocyte migration blockade, peptide-based
therapies targeted at specific antigens, and the use of molecularly
engineered cells and tissues for deletion or inactivation of pathogenic
lymphocytes.
Key Components of the Research Plan
A. Transplantation
- Kidney transplantation
- Islet transplantation
B. Autoimmune Diseases
- Type 1 Diabetes Mellitus
- Multiple Sclerosis
- Rheumatoid Arthritis
- Systemic Lupus Erythematosus
C. Asthma and Allergic Diseases
D. Cross-Cutting Research
- Human Immunology Cooperative Study Groups
- Research Resources
- Exploratory/Developmental Research
- Basic Studies for Future Discovery
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