T-CELL VACCINATION - CLINICAL-APPLICATION IN AUTOIMMUNE-DISEASES

T cell responses to myelin basic protein (MBP) are implicated to play an important role in the pathogenesis of multiple sclerosis (MS). Thes e MBP autoreactive T cells are found to undergo in vivo activation and clonal expansion in patients with MS. They accumulate in the brain co mpartment and map reside in the brain lesions of patients with MS, As MBP-reactive T cells potentially hold a central position in initiation and perpetuation of the brain inflammation, specific immune therapies designed to deplete them may improve the clinical course of the disea se. We review here the recent application of T cell vaccination in pat ients with MS to deplete circulating MBP-reactive T cells. The results of our phase I clinical trial indicate that T cell vaccination with i nactivated MBP autoreactive T cells induces specific regulatory T cell network of the host immune system to deplete circulating MBP-reactive T cells in a clonotype-specific fashion. The immunity induced by T ce ll vaccination is clonotype specific and longlasting. Our longitudinal clinical evaluation further suggests a moderately lower rate of clini cal exacerbation, disability score, and brain lesions (measured by mag netic resonance imaging) in vaccinated patients than in matched contro ls. Our study should encourage further investigation on the treatment efficacy of T cell vaccination and further improvement for its clinica l administration in other human autoimmune diseases. This review discu sses the immune regulation and therapeutic administration of T cell va ccination in human autoimmune diseases, exemplified by our recent T ce ll vaccination trial in MS.