Immunotherapies for Multiple Sclerosis

Abstract

Multiple sclerosis (MS), a chronic inflammatory demyelinating disease of the central nervous system (CNS), is currently regarded as an organ-specific, T-cell-mediated autoimmune disease. Although the immunopathogenesis of MS is largely hypothetical and several immune-mediated processes may account for myelin damage, it is widely accepted that the autoimmune process that leads activated, antigen-specific CD4+ T cells to migrate into the brain and initiate inflammation starts in the peripheral immune system. If autoreactive T lymphocytes play a pivotal role in initiating the disease, then selective immunotherapeutic strategies have to be designed to delete these cells by apoptotic mechanism(s) or to block their activation by inducing a state of anergy or suppression. It is a common feeling that the rapid progress in biotechnology and immunology will make available, within a few years, many potential treatments for MS. This article is a concise overview of only some of the immunotherapies, mainly based on the antigen-specific modulation of the immune response, elaborated in recent years. Most of the immune-selective therapies here described have been designed for and successfully applied to prevent, suppress and/or treat the animal model of inflammatory autoimmune demyelinating disease, the experimental allergic encephalomyelitis (EAE). Some of these therapies have been also applied to human pathology, and will be herewith described with more details.