Figure 1.

Heat‐shock protein (HSP) loaded tolerogenic dendritic cell (tolDC) vaccination in rheumatoid arthritis (RA). This figure depicts the potential process that takes place in the patient's joint after injection with HSP loaded tolDCs. TolDCs produce anti‐inflammatory cytokines [e.g. interleukin‐10 (IL‐10)] and present epitopes of HSP to naive CD4⁺ T cells. These CD4⁺ T cells differentiate into HSP‐specific regulatory T (Treg) cells and suppress stressed (HSP expressing) cells via immunomodulatory cytokines like IL‐10 and transforming growth factor‐β (TGF‐β). Furthermore, bystander suppression could lead to suppression of pathogenic effector T (Teff) cells recognizing the unknown autoantigen, thereby inhibiting inflammatory symptoms. The presence of self HSP in the synovial fluid of RA patients might favour the selection of the generation of Treg cells and their function.