Antigen-specific therapies for the treatment of multiple sclerosis: a clinical trial update

Antigen-specific therapy of rheumatoid arthritis

BACKGROUND

Immunotherapy offers the promise of antigen-specific suppression of pathological immune responses in conditions such as autoimmunity and organ transplantation. Substantial advances have been made in recent years in terms of understanding basic immunological mechanisms of autoreactivity, as well as clinically implementing immune-based therapies that are antigen nonspecific.

OBJECTIVE

To provide an integrated overview of the current state of the art in terms of antigen-specific tolerance induction, as well as to predict future directions for the field.

METHODS

Examples of successes and failures of antigen-specific immunotherapy were sought. Particular attention was paid to the well-established collagen II-induced model of arthritis.

RESULTS/CONCLUSIONS

Previous failures of antigen-specific immunotherapy were associated with lack of identification of clinically relevant antigens, as well as inappropriate tolerogenic methodologies. The advances in proteomics combined with novel gene-specific immune modulatory techniques place today's translational researchers in a unique position to tackle the problem of antigen-specific immunotherapeutic protocols.

The origin and application of experimental autoimmune encephalomyelitis

Experimental autoimmune encephalomyelitis (EAE) is a model of the neuroimmune system responding to priming with central nervous system (CNS)-restricted antigens. It is an excellent model of post-vaccinal encephalitis and a useful model of many aspects of multiple sclerosis. EAE has been established in numerous species and is induced by priming with a large number of CNS-derived antigens. As a consequence, the pathogenesis, pathology and clinical signs vary significantly between experimental protocols. As I describe in this Timeline article, the reductionist approach taken in some lines of investigation of EAE resulted in a reliance on results obtained under a narrow range of conditions. Although such studies made important contributions to our molecular understanding of inflammation, T-cell activation, and MHC restriction, they did not advance as effectively our knowledge of the polyantigenic responses that usually occur in CNS immunopathology and autoimmunity.

Nano neurology and the four P's of central nervous system regeneration: preserve, permit, promote, plasticity

True nanomaterials are delivered as a specific structure, or combination of structures, designed to deliver the therapeutic intact, directly to the site, requiring a much lower dose. These materials use very specific and deliberate molecular structures that can interact with neurons or protein structures inside the cells. Until recently, functional recovery of the central nervous system (CNS) was an unattainable goal and nanotechnology was an invisible science. A well-planned treatment spaced over time will produce functional return in the CNS. The four P's of CNS regeneration is a new framework for approaching CNS injury and evidence shows that nanotechnology is currently being used for stroke rehabilitation and, in several clinical trials, the treatment of scar formation blockade in the spinal cord. The four components are preserve, permit, promote, and plasticity.