超越“魔弹”:多发性硬化症治疗性疫苗的最新进展。

Beyond the Magic Bullet: Current Progress of Therapeutic Vaccination in Multiple Sclerosis.

机构信息

Department of Neurology, Antwerp University Hospital, 2650, Edegem, Belgium.

Laboratory of Experimental Hematology, Vaccine and Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Wilrijk, Belgium.

出版信息

CNS Drugs. 2018 May;32(5):401-410. doi: 10.1007/s40263-018-0518-4.

Abstract

Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system (CNS) characterized by neuroinflammation, neurodegeneration and impaired repair mechanisms that lead to neurological disability. The crux of MS is the patient's own immune cells attacking self-antigens in the CNS, namely the myelin sheath that protects nerve cells of the brain and spinal cord. Restoring antigen-specific tolerance via therapeutic vaccination is an innovative and exciting approach in MS therapy. Indeed, leveraging the body's attempt to prevent autoimmunity, i.e., tolerization, focuses on the underlying cause of the disease and could be the key to solving neuroinflammation. In this perspective, antigen-specific vaccination targets only the detrimental and aberrant immune response against the specific disease-associated antigen(s) involved while retaining the capacity of the immune system to respond to unrelated antigens. We review the experimental approaches of tolerance-inducing vaccination in relapsing and progressive forms of MS that have reached the clinical development phase, including vaccination with autologous T cells, autologous tolerogenic dendritic cells, T cell receptor peptide vaccination, altered peptide ligand, ATX-MS-1467, cluster of differentiation (CD)-206-targeted liposomal myelin basic protein peptides and DNA vaccination. Failures, successes and future directions are discussed.

摘要

多发性硬化症 (MS) 是一种慢性免疫介导的中枢神经系统 (CNS) 疾病,其特征为神经炎症、神经退行性变和受损的修复机制,导致神经功能障碍。MS 的关键是患者自身的免疫细胞攻击中枢神经系统中的自身抗原,即保护大脑和脊髓神经细胞的髓鞘。通过治疗性疫苗接种恢复抗原特异性耐受是 MS 治疗中的一种创新和令人兴奋的方法。事实上,利用身体预防自身免疫的尝试,即耐受化,专注于疾病的根本原因,可能是解决神经炎症的关键。从这个角度来看,抗原特异性疫苗接种仅针对涉及的特定疾病相关抗原的有害和异常免疫反应,同时保留免疫系统对无关抗原的反应能力。我们回顾了在复发型和进展型 MS 中已进入临床开发阶段的诱导耐受的疫苗接种实验方法,包括自体 T 细胞疫苗接种、自体耐受树突状细胞疫苗接种、T 细胞受体肽疫苗接种、改变肽配体、ATX-MS-1467、CD206 靶向脂质体髓鞘碱性蛋白肽和 DNA 疫苗接种。讨论了失败、成功和未来的方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1b6/5976685/c611fdbe9d6e/40263_2018_518_Fig1_HTML.jpg

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