Chapter 5 - Peptide-based vaccines and altered peptide ligands: Multiple sclerosis paving the way

Abstract

Multiple sclerosis is a well-characterized autoimmune disease with social consequences as the patient usually remains handicapped and needs help from their family, helpers, nurses, and others. In this chapter, we summarize the advancements in the last 2 decades in the use of altered peptide ligands to treat the disease. Some representative synthetic pathways that involve peptide epitopes from myelin basic protein and their palmitoylated, thiopalmitoylated, and citrullinated analogs are described. Two additional approaches that involve the use of peptide molecules alone or conjugated to carriers, such as mannan, are also described. The synthesis of cyclic peptides is an important step as it offers the advantage of increased stability from proteolytic enzymes. The interaction of altered peptide ligands with human leukocyte antigen-DR2b and the T-cell receptor is important for vaccine design and is presented herein. The discovery of altered peptide ligands represents the importance of rational design and has paved the way for new and more effective nonpeptide mimetic analogs to treat and prevent multiple sclerosis.