August 1, 2023—A groundbreaking study at the Hebrew University of Jerusalem (HU), has uncovered exciting possibilities for treating inflammatory disorders and preventing cytokine storms, which can damage the body and even be lethal.

The inflammatory response is indispensable for protective immunity, yet microbial pathogens often trigger an excessive response, known as a ‘cytokine storm,’ which is harmful to the host. Despite recent advances in our understanding of inflammatory signaling, how to prevent a cytokine storm remains a challenge. HU scientists have discovered that particular domains within key mediators of our immune response, called B7 and CD28 receptors, have a crucial role in enabling the inflammatory response and can be targeted with man-made molecules to manage immune responses and inflammation, saving lives. These findings bring us one step closer to developing effective treatments for inflammatory diseases.

A team of researchers at the HU Faculty of Medicine conducted this study with the aim of understanding how our immune system works and why it sometimes goes into overdrive during severe infections and autoimmune diseases. They created small copies of specific domains within the B7 and CD28 receptors, called mimetic peptides to investigate how these affect the production of inflammatory molecules. The study’s results showed that these mimetic peptides successfully reduced the interaction between B7 and CD28 receptor proteins and thereby lowered the production of inflammatory molecules in human immune cells. This suggests that they could be used to develop treatments for inflammatory disorders caused by bacterial infections, severe sepsis, and viral infections involving lung injury such as influenza and corona.

Excitingly, when tested on biological models, these mimetic peptides provided significant protection against lethal toxic shock caused by a harmful bacterial toxin that kills by eliciting an inflammatory cytokine storm. Even at exceedingly low doses, the specific B7-1 and CD28 mimetic peptides showed remarkable effectiveness in preventing the harmful effects of the toxin and protecting from death. “Our findings demonstrate for the first time the critical role played by these B7 and CD28 receptor domains in controlling immune responses and inflammation,” said Prof. Raymond Kaempfer, of the HU Faculty of Medicine. “By selectively reducing inflammation yet without completely stopping it, we may be able to protect against cytokine storms associated with severe infections and autoimmune diseases.”

This research opens new possibilities for developing targeted therapies that can balance immune activation needed to protect patients from pathogens yet prevent excessive inflammation. By regulating the interaction between B7 and CD28 receptors, we may be able to fine-tune the immune response and prevent harmful inflammatory reactions.

Funding: This work was supported by the US National Institute of Allergy and Infectious Diseases (NIAID) grants UC1AI067231 and 2U54AI057168, grant DM170164 from US Department of Defense Congressionally Directed Medical Research Programs (CDMRP), and the Milgrom Family Foundation to R. Kaempfer.