A Vaccine for Multiple Sclerosis: Is it a Feasible Option?

Multiple sclerosis is an immune-mediated disease of the CNS, and T cells appear to play a central role in its pathogenesis. In an animal model, T cells specific for myelin basic protein (MBP) induce a syndrome (experimental autoimmune encephalomyelitis) with symptoms similar to multiple sclerosis. This suggests that T cells specific for this protein may be pathogenic in multiple sclerosis. Anti-T cell vaccines that induce regulation of autoreactive T cells are effective treatments for experimental autoimmune encephalomyelitis. These anti-T cell vaccines include whole T cell vaccination, T cell receptor peptide immunisation, oral administration of myelin antigens and major histocompatibility complex (MHC) class II peptide immunisation. Preliminary experience in patients who have multiple sclerosis with the first 3 approaches suggests that anti-T cell vaccines represent feasible treatments for this disorder.