Autoimmune diseases are driven by immune cells that recognize self-tissues. A major goal for treatment strategies for autoimmune diseases is to turn off or tolerize self-reactive immune cells such as CD4 T cells that coordinate tissue damage in many autoimmune diseases. Autoimmune diseases are often diagnosed many years following their onset. The self-reactive CD4 T cells that must be tolerized, therefore, are previously activated or memory CD4 T cells. Little is known about whether tolerance can be induced in memory CD4 T cells. This paper demonstrates that memory CD4 T cells survive initial exposure to tolerance-inducing signals but that a second activation signal leads to cell death. This study has important implications for immunotherapeutic strategies for autoimmune diseases
