Specific antigen vaccination to treat autoimmune disease.
Specific antigen vaccination by administration of the target antigen in aqueous solution has resulted in significant decreases of disease severity in animal models of experimental allergic encephalomyelitis, type I diabetes, and several forms of antigen-induced arthritis, even if administered after the initiation of symptoms. However, in experimental autoimmune encephalomyelitis (EAE) and type I diabetes in nonobese diabetic (NOD) mice, repeated administration of peptide fragments of target antigens in incomplete Freund's adjuvant has resulted in severe anaphylactic reactions. Although these methods of administration are known to potentiate CD4 T helper 2 (Th2) responses, which is the goal of specific antigen vaccination, the risk of anaphylaxis raises a red flag concerning use of this therapy for diseases such as type I diabetes, where the survival time after onset is quite long. It is clear that specific antigen vaccination is effective in preventing several animal models of autoimmune disease, and in treating these diseases once the symptoms are overt. However, the risks of this therapy require serious consideration of alternative methods for down-regulation of the autoimmune process.
Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5204, USA. hughmcd@stanford.edu
Hugh
H
McDevitt
D000818:Animals; D001324:Autoantigens; D001327:Autoimmune Diseases / Q000276:immunology* / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000628:therapy; D004195:Disease Models, Animal; D004681:Encephalomyelitis, Autoimmune, Experimental / Q000276:immunology / Q000628:therapy; D019672:Genes, T-Cell Receptor; D005968:Glutamate Decarboxylase / Q000276:immunology; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods; D007527:Isoenzymes / Q000276:immunology; D051379:Mice; D016688:Mice, Inbred NOD; D008822:Mice, Transgenic; D014612:Vaccines / Q000627:therapeutic use*
D001324:Autoantigens; D007527:Isoenzymes; D014612:Vaccines; D005968:Glutamate Decarboxylase; C401141:glutamate decarboxylase 2