Autologous T-cell vaccination for multiple sclerosis: a perspective on progress.
T-cell vaccination (TCV) is a unique approach to induce immune regulation that may have importance in the treatment of autoimmune diseases, including multiple sclerosis (MS). TCV employs a classic vaccine strategy of injecting an attenuated form of the disease-causing agent--in this case, myelin-reactive T cells--that have been selected and expanded from each MS donor and then re-injected after irradiation to induce protective immunity. This anti-T-cell immunity consistently results in selective deletion or regulation of the targeted pathogenic T cells in vivo. Longitudinal studies have established that TCV is safe and often results in a reduced relapse rate and clinical stability or improvement, at least temporarily, in the majority of treated MS patients. These results lend direct support to the involvement of inflammatory myelin-reactive T cells in the MS disease process. However, these hopeful trends reported in a number of pilot trials await validation in larger proof-of-principle trials that are now in progress.
Vandenbark
Arthur A
AA
Neuroimmunology Research, Veterans Affairs Medical Center, Department of Neurology, Oregon Health & Science University, Portland, Oregon 97207, USA. vandenba@ohsu.edu
Abulafia-Lapid
Rivka
R
D006801:Humans; D009103:Multiple Sclerosis / Q000209:etiology / Q000628:therapy*; D009186:Myelin Sheath / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology*; D014611:Vaccination