On the day of the appointment we were told that my wife was still producing mrtc's and they would make an appointment for the blood procurement, but the next day she got a call that Opexa hadn't been able to isolate mrtc's (I got the info second hand, so take it with a grain of salt) and that my wife had the option of any other treatment option of her choice OR being checked periodically to see if mrtc's can be detected at some point in the future.
The option of any other treatment would mean dropping out of the extension study. Anyone at any time has the option to drop out of the study and use another treatment. I think having Opexa check your wife’s blood for MRTCs every 3 months is the best thing to do and is consistent with how the results of Tovaxin may evolve for those lucky enough to only need to be monitored.
Despite my realizing that an absence of myelin reactive t cells might be considered a good thing, being told that they can't make the vaccine for her was kind of a scary and uncertain situation.......uncertain whether or not "no" mrtc's really meant NO mrtc's were circulating in her system or if it really only meant that mrtc's were there but weren't detectible due to masking.
If your wife has not changed what she is taking, and she is avoiding the list of drugs that Lars posted http://www.thisisms.com/ftopic-3826-0.html
(It is about midway down the first page), then any masking she was experiencing would be the same now as when she started the study. It seems that you would need to be taking a significant amount of something on the list before you would down regulate the immune system enough to not be producing a detectable amount.
When I first started looking into masking MRTCs, I thought masking was a means that prevented the MRTCs from being detected. That is partially true. I think masking/suppressing might be better terminology. The drugs in the list above suppress the immune system. If they are able to suppress the production of a particular MRTC below the point at which it can be detected, it has essentially masked that particular MRTC.
Since Tovaxin causes the body to produce memory WBCs that produce T-cells that destroy the MRTCs as they are produced, your wife may not be producing any MRTCs or her immune system has a sufficient number of memory T-Cells to adequately remove the MRTCs as they are produced. I assume there may be a point at which the balance between the production of MRTCs and the amount of memory T-Cells producing T-Cells that remove the MRTCs cancels each other out. This is something that Opexa is trying to determine and it sounds like a few people in the study have achieve that balance.
Everyone is going to build protection against MRTCs differently. Everyone is going to have a different rate at which they produce MRTCs. By monitoring a patient's blood, the amount of Tovaxin needed to keep the MRTCs at or near zero can be determined and the appropriate dose and cycle of vaccine can be determined.
For the current study, I have heard that 25% of the people who were on Tovaxin are no longer producing MRTCs. That is a good thing. Two people who were in Dr. Zhang's T-cell vaccine study at Baylor in the late 1990s no longer produce MRTCs. They will still need to be monitored, but at this point I would say they are in remission.
Tovaxin will evolve. It is patient specific, and as such, each patient will need a certain number of treatments per year to keep the memory T-cells at a sufficient level to control whatever amount of MRTCs are produced.
He said that they figure only a tiny few of them are actually doing the bad stuff, and if they can nuke those, then it's pretty much gone.
Your doctor seems to be well informed. The following is from a previous post.
The Tovaxin protocol uses 163 different peptide fragments over 3 of the major myelin proteins to identify an individual’s MRTC set. 109 of these peptides have been found to identify MRTCs. When I started the study, they were using only 6 peptides from one of the proteins for screening.
The initial screening determines if an individual has circulating MRTCs that react with these myelin peptide fragments (called epitopes). A negative result means that MRTCs could not be detected by the assay. The inability of the test to detect MRTCs means that at that time an individual for some reason does not have adequate levels of MRTCs to be detected.
Both people with MS and healthy subjects make MRTCs. In people without MS, the immune system realizes that those cells are "self reactive" and they are not allowed to expand. In people with MS, at certain times and for as yet unknown reasons, these MRTCs are allowed to expand. The body does not seem to have any defense against autoimmune diseases. With self-reactive cells, the body produces them and is not able to realize that they are destructive.
The body produces more than one billion lymphocytes and other immune system cells daily. Since there are approximately only 10 or 20 MRTCs per 1 million WBCs, eliminating them appears to not compromise the immune system, but it does eliminate the pathogenic T-cells that destroy myelin. A flare is when the body produces too many of these bad T-cell