Autologous T-Cell Vaccination for Multiple Sclerosis
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.
KeywordsMultiple Sclerosis Experimental Autoimmune Encephalomyelitis Multiple Sclerosis Patient Myelin Basic Protein Expand Disability Status Scale
The authors wish to thank Ms Eva Niehaus for assistance in preparing the manuscript and acknowledge the support of the Yeshya Horowitz Association (New York, NY, USA), the National Institutes of Health (grant no. NS23221), the Nancy Davis MS Center Without Walls, and the Biomedical Laboratory R&D Service, Department of Veterans Affairs.
Dr Vandenbark has a significant financial interest in Orchestra Therapeutics (formerly the Immune Response Corporation), a company that has a commercial interest in this research and technology. This potential conflict of interest has been reviewed and managed by Oregon Health and Science University and the Veterans Affairs Medical Center (Portland, OR, USA). Dr Abulafia-Lapid has no conflicts of interest that are directly relevant to the content of this review.
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