Naomi Benne, Daniel Sáenz Fernández, Deja Porenta, Laura Bolkaerts, Arie Jan Stoppelenburg, Antoinette van den Dikkenberg, Kankipati Teja Shyam, Enrico Mastrobattista, Jerome J A Hendriks, Femke Broere
Chronic autoinflammatory diseases such as rheumatoid arthritis and multiple sclerosis lack curative therapies, and current immunosuppressive treatments often cause systemic off-target effects. To address this unmet need, we previously developed an "inverse vaccine" based on anionic phosphatidylglycerol liposomes carrying a disease-specific peptide antigen conjugated to dexamethasone. Here, we assess the therapeutic efficacy and immunomodulatory mechanisms of this platform in two murine models of autoimmunity. In the proteoglycan-induced arthritis model, a single administration of liposomal dexamethasone-human proteoglycan peptide (Dex-K4-hPG) markedly slowed arthritis progression compared to an equivalent dose of free Dex-K4-hPG. Long-term follow-up showed that two injections provided superior protection over a single dose, whereas a third injection yielded no additional benefit. Flow cytometry of paw draining lymph nodes revealed reduced RORγt+CD4+ T cells in mice receiving multiple doses indicating a shift toward less pro-inflammatory T-cell responses. Histological staining of the knees of mice also revealed less damage to the joints of mice receiving 2 or 3 injections of liposomes. To evaluate the versatility of this platform, we generated a novel Dex-peptide conjugate by replacing hPG for myelin oligodendrocyte glycoprotein (MOG). The resulting Dex-K4-MOG conjugate was encapsulated in the liposomes at high encapsulation efficiency (~60%), demonstrating platform modularity. In an experimental autoimmune encephalomyelitis mouse model, two injections of Dex-K4-MOG liposomes (one before disease induction and one after) strongly suppressed disease development compared with controls. Together, these findings demonstrate that antigen-specific inverse vaccination using anionic liposomes offers a modular and broadly applicable strategy for inducing long-term protection in multiple autoimmune disease models. The platform elicits regulatory immune signatures and suppresses pathogenic Th17 responses, supporting its potential as a tolerogenic therapeutic approach.