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BHT-3009,一种用于治疗多发性硬化症的髓鞘碱性蛋白编码质粒。

BHT-3009, a myelin basic protein-encoding plasmid for the treatment of multiple sclerosis.

作者信息

Correale Jorge, Fiol Marcela

机构信息

Raúl Carrea Institute for Neurological Research (FLENI), Department of Neurology, Buenos Aires, Argentina.

出版信息

Curr Opin Mol Ther. 2009 Aug;11(4):463-70.

Abstract

Even though the etiology of multiple sclerosis (MS) remains largely unknown, research data support the hypothesis that autoimmunity plays a major role in disease development. Several disease-modifying agents have been approved for the treatment of MS; however, there is still a need for antigen-specific treatments that combine efficacy and safety. DNA vaccination represents a new therapeutic alternative in this respect. Preclinical studies in different models of autoimmunity have demonstrated that injection of plasmid DNA encoding a self-antigen in mice restores self-tolerance, leaving immunity against infectious and tumor antigens intact. Based on this evidence, the first DNA vaccine for MS has been created. Bayhill Therapeutic Inc's BHT-3009 encodes full-length, human myelin basic protein (MBP), and has recently been evaluated in a phase I/II and a phase II clinical trial. BHT-3009 was safe and well tolerated in both trials, inducing immune tolerance that extended beyond MBP to other myelin antigens. In addition, a reduction in the number of active lesions was observed, which was accompanied by a decrease in clinical relapse rates, particularly in patients with high immunological activity at baseline. BHT-3009 appears to be a promising new approach for the treatment of MS, although further clinical trials are warranted to confirm the early findings.

摘要

尽管多发性硬化症(MS)的病因在很大程度上仍不明确,但研究数据支持自身免疫在疾病发展中起主要作用这一假说。几种疾病修正药物已被批准用于治疗MS;然而,仍需要兼具疗效和安全性的抗原特异性治疗方法。在这方面,DNA疫苗代表了一种新的治疗选择。在不同的自身免疫模型中进行的临床前研究表明,向小鼠注射编码自身抗原的质粒DNA可恢复自身耐受性,同时保持对感染性抗原和肿瘤抗原的免疫力。基于这一证据,首个用于MS的DNA疫苗已研制成功。贝希尔治疗公司的BHT-3009编码全长人髓鞘碱性蛋白(MBP),最近已在一项I/II期和一项II期临床试验中进行了评估。在两项试验中,BHT-3009均安全且耐受性良好,诱导的免疫耐受不仅针对MBP,还扩展到了其他髓鞘抗原。此外,观察到活动性病灶数量减少,同时临床复发率降低,尤其是基线免疫活性较高的患者。BHT-3009似乎是一种有前景的MS治疗新方法,不过仍需进一步的临床试验来证实早期研究结果。

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