Research ArticleMultiple Sclerosis

Antigen-Specific Tolerance by Autologous Myelin Peptide–Coupled Cells: A Phase 1 Trial in Multiple Sclerosis

Science Translational Medicine  05 Jun 2013:
Vol. 5, Issue 188, pp. 188ra75
DOI: 10.1126/scitranslmed.3006168

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Multiple Sclerosis Therapy Attached at the Hip

In multiple sclerosis (MS), a patient’s own immune cells are thought to attack antigens in the brain and spinal cord. One approach to prevent this attack is through tolerization: harnessing one way the body itself attempts to prevent autoimmunity. Ideally, this would happen in an antigen-specific way so that autoimmunity is blocked, while the protective functions of the immune system remain intact. There has been considerable success inducing antigen-specific tolerance in mouse models of MS by chemically coupling the antigen of choice to carrier cells. Now, Lutterotti et al. take this approach into human patients.

The authors coupled peripheral blood mononuclear cells from MS patients with seven different myelin peptides thought to be potentially antigenic in MS. Patients who had T cell responses restricted to at least one of the peptides tested were selected. Indeed, patients who received the highest doses of antigen-coupled cells demonstrated decreases in antigen-specific T cell responses after therapy. Although the patient numbers are small in this first-in-human study, the safety, feasibility, and early results suggest that this approach may provide a promising avenue for future trials.