T-cell vaccination in multiple sclerosis: Immunoregulatory mechanism and prospects for therapy

Vaccination with inactivated autoreactive T cells (T-cell vaccination) was originally developed to study immune regulation in experimental autoimmune conditions. During the last two decades, research in this area has led to the new understanding of cellular and molecular mechanisms whereby autoreactive T cells are regulated in vivo and the development of new therapeutic strategies using synthetic peptides and plasmid or viral DNA vectors. Recently T-cell vaccination has been advanced to human trials in patients with multiple sclerosis. These early clinical studies were designed to test the potential treatment efficacy of T-cell vaccination and have shown some promising results. In this article, new insights in the understanding of the regulatory mechanism induced by T-cell vaccination and the results of the clinical trials are reviewed. In particular, issues related to the improvement of the current T-cell vaccination protocol are discussed in relationship to the concept of immune regulation and clinical considerations.