More MS news articles for May 2000

T-cell immunization

There are several centers in the US and Europe that are engaged in research which attempts to create a "vaccine" for MS. Realize that what is meant by a vaccine in these cases is not a way to ever prevent the disease from happening by immunizing lots of normal people. It is a way of shutting down the pathologic immune response in diagnosed MS patients, in a very targeted way that only affects the misbehaving cells and leaves the rest of the immune system unaffected.

You have to decide what to use to make the vaccine. The principle is that the immune cells and the molecules on their surfaces, and which they can set free outside of themselves to do the immune system's work, can be sorted by different techniques into groups that may attack and cause the MS lesion, and others that don't.

The ones that are potentially dangerous are the ones that in turn we would like to target for an immune attack, so that we can neutralize their ability to do their dirty work. We don't know exactly which parts of the immune cells are really different in MS from other diseases, or normal states, so it has been hard to make vaccines that work. We don't know which targets in the MS nervous system are common to many patients, either everyone seems to have a different group of identifiable targets for the bad immune attack, both between people, and even in the same person over time.

Here is the announcement about the vaccine that we at USC are presently trying:

The USC T-Cell Vaccine - A Clinical Trial for Patients with Secondary Progressive MS  [Enrollment open]

The MS community has awaited the development of the USC T Cell Vaccine with great anticipation. We are very excited about this project, the product of many years of work by the USC MS Research Group under the direction of Dr. Leslie Weiner.

It is the first MS vaccine program to ever be given Investigational New Drug (IND) status by the FDA.

The etiology of multiple sclerosis is uncertain, but at some point in the pathogenesis of myelin destruction an autoimmune process becomes central to disease progression. The genetics, clinical course and brain pathology suggest a multifactorial process with variation from patient to patient.

It is our contention that as MS progresses, associated with increasing tissue destruction, there is epitope spreading and further breakdown of the host's ability to regulate pathogenic T cells. The immune attack is complex and idiosyncratic to the particular patient.

Thus, these secondary progressive MS (SP-MS) patients are difficult to treat and need aggressive cytotoxic drugs that often have undesirable side effects. Our hypothesis suggests that such a variable disease requires manipulation of the immunopathologic process on a patient-by-patient basis. We propose that the best way to treat a patient with SP-MS is to suppress or remove myelin specific T cells that react with the greatest number of myelin antigens unique to a given patient.

Eighty SP-MS patients are being selected for this phase II, double-blinded, placebo-controlled single-center trial. We will determine if a T cell vaccine stimulated and expanded by the broadest myelin antigenic exposure in the form of bovine myelin proteins will halt or improve patients with secondary progressive MS when inoculated over 24 months.

Norm Kachuck, MD