T-cell vaccination and antigen-driven immunotherapy for multiple sclerosis
The development of advanced and specific immunotherapies for the treatment of immune-mediated neurological diseases such as multiple sclerosis (MS) is based on the recent understanding of the aberrant immune activation and the interactions of the autoimmune T cells, the autoantigen(s) and the antigen-presenting cells (APCs) in this disease. Thus, the trimolecular complex, comprising the T-cell antigen receptor (TCR), the self-antigenic epitopes and the MHC class-II molecule expressed on the surface of the APCs, represents distinct molecular targets for specific therapeutic strategies aimed at suppression and prevention of disease activity in MS. Accordingly, disease-specific therapies for MS include T-cell or TCR peptide vaccination for the induction of immunoregulatory networks of anti-autoimmune T cells, or glatiramer acetate (copolymer-1; Cop-1), oral tolerance or altered peptide ligands (APL) as antigen-based immunotherapies (Fig. 24.1).