Interferon-beta therapy for multiple sclerosis--is the injection site the relevant action site?
Multiple sclerosis (MS) has been characterized as a T cell-mediated autoimmune disease. Recent research on the immunopathology of MS has implicated dendritic cells, professional antigen-presenting cells essential for T cell differentiation and proliferation of self-reactive T cells. Interferon-beta therapy effectively reduces relapse rates in MS and can slow the progression of disability in patients with relapsing-remitting MS. The principal mechanism by which interferon-beta drugs exert their effect is unclear; however, it is possible that an interaction with dendritic cells local to the site of injection may be critical. Most subcutaneously administered interferon-beta never leaves the injection site. This article reviews current concepts on the immunopathogenesis of MS and presents the hypothesis that the main effect of interferon-beta in MS is mediated by local effects on dendritic cells at the injection site.
Smith
Derek
D
Thames Neurologic Institute, Norwich, CT 06360, USA. drsmith@neurologyassociates.org
D000818:Animals; D003713:Dendritic Cells / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007273:Injections, Intramuscular; D016899:Interferon-beta / Q000008:administration & dosage*; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology; D012867:Skin / Q000276:immunology* / Q000378:metabolism*
D016899:Interferon-beta