Multivalent Compounds for Antigen-Specific B Cell Tolerance and Treatment of Autoimmune Diseases

This review covers the design and development of B cell Toleragens, compounds developed for the treatment of antibody-mediated autoimmune diseases by antigen-specific suppression of autoantibodies. Multivalent forms of B cell epitopes consisting of oligonucleotides, peptides, proteins and polysaccharides are under various stages of development for treating systemic lupus nephritis, antiphospholipid syndrome, and organ rejection associated with xenotransplantation. The design and structure of the multivalent ligands are presented along with relevant biological results. Hapten-polymer conjugates that were used to elucidate the principles of B cell suppression are included. Multivalent ligands for T cell receptors and high affinity IgE receptors, which provide insight into immunoglobulin aggregation and signaling, are also briefly discussed.