Preliminary results of a small group of patients, researchers presented at the 26th Congress of the European Committee for Treatment and Research of Multiple Sclerosis (ECTRIMS), which will be held October 13-16 in Gothenburg, Sweden. They indicate that the new method inhibits the lesions in the brain, reduces the number of relapses (the waves), SM, and leads to improved health status of patients. The annual study, the researchers did not observe any adverse effects of therapy.
"It's very encouraging results, but to ascertain the effectiveness of our method, we conduct research for at least another year" - reserved in an interview with Professor PAP. Chris Selmaj, Head of Department of Neurology, Medical University of Lodz, president of the Polish Neurological Society.
Multiple sclerosis (MS) is a chronic disease of the central nervous system (brain and spinal cord). Reasons for its development are not exactly known. According to the best-proven theory, it causes autoimmunity immune cells that mistakenly learned to recognize the protein on its own nerve tissue as foreign. More precisely, it is a myelin protein, namely the structure of the nerve fibers forming a kind of rehabilitation of the insulator conduction stimuli.
Poorly trained immune cells from a group called. T cells penetrate the brain where the myelin recognize as the enemy, then attack and destroy it. This causes disturbances in nerve conduction so strong that the patient see a different neurological symptoms - vision problems, vertigo, numbness and muscle rigidity, difficulty walking, fatigue. Disease accompanied by inflammation of nerve tissue, and neuronal death.
MS suffers 2.5 million people in the world and in Poland from 1950 to 1960 thousand. The disease gradually leads to disability and disability.
Although the event is not possible to cure the disease, has recently appeared in a number of drugs that can greatly enhance the effects of therapy. "The problem is that these new drugs are not very precise, therefore, have side effects such as lowered immunity - explained Prof. PAP. Selma.
Researchers aim to develop a therapy that works exclusively on the immunological mechanisms responsible for the development of MS. We mean such drugs which only impede the aggressive response of lymphocytes against myelin proteins - said neurologist.
So far, attempts to obtain a variety of methods, such as giving specific proteins (called antigens), oral or subcutaneous injection. Polish scientists decided to apply them to the skin of patients with MS.
The study included 30 patients, 20 of them glued to the skin slice with the three myelin proteins, and the other slice with placebo. Initially, slices exchanged once a week, then once a month.
It appeared that myelin antigens stimulate the formation of regulatory T cells, skin resistance (so-called dendritic cells). These, in turn, move to the lymph nodes, where they learn self-injurious re-lymphocytes recognizing myelin proteins as "their". "You could say that dendritic cells teach the correct behavior, which reduces self-injurious responses in patients with MS," - explained the professor. Selma. With the biopsy, the researchers confirmed the presence of lymph node cells of immune tolerance to myelin proteins.
Studies using magnetic resonance imaging (MRI) showed that in the brains of patients who were glued to the protein mielinowymi slices occurred after a year to reduce the number of pathological changes. Decreased the incidence of MS exacerbations and improved the clinical status of patients. Have not yet seen any side effects of this therapy.
In a study funded by a grant from the Ministry of Science and Higher Education also took part, scientists from the Jagiellonian University in Krakow.
From Gothenburg Joanna Morga (PAP)
Date of publication: 15/10/2010
Epicutaneous immunisation with myelin peptides induces a unique population of tolerogenic dendritic cells in lymph nodes of multiple sclerosis patients
M. Jurynczyk, A. Walczak, A. Jurewicz, D. Jesionek-Kupnicka, M. Szczepanik, K. Selmaj (Lodz, Cracow, PL)
Antigen-specific therapy in multiple sclerosis is aimed at selective inhibition of autoimmune myelin-reactive responses. Key autoantigens in MS include myelin basic protein (MBP), proteolipid protein (PLP) and myelin oligodendrocyte glycoprotein (MOG). Epicutaneous application of myelin peptides has proven to be effective in induction of antigen-specific immune tolerance in experimental models of MS.
We have conducted a one-year placebo-controlled clinical study of myelin peptides (MBP85-99, PLP139-151 and MOG35-55) applied in a mixture to the skin of patients with relapsing-remitting MS patients. In subjects participating in the study (n = 30) we examined immune responses in the skin, lymph nodes and peripheral blood immune cells.
In the skin at the site of immunization in patients treated epicutaneously with myelin peptides we found dendritic Langerhans cells showing an activated phenotype with enlarged cell bodies and extensive CD1a staining. In local lymph nodes of myelin-peptide-treated patients we detected a unique population of large, highly granular cells that was absent in the placebo group. All of these cells were found to be CD11c+ dendritic cells. A subset of these cells also expressed HLA-DR, -DP, -DQ suggesting a capacity for antigen presentation. Induction of this population was accompanied in the peripheral blood by the generation of type 1, IL-10 producing regulatory T cells, suppression of specific autoreactive proliferative responses and suppression of IFN-gamma and TGF-beta production.
We demonstrated that epicutaneous immunization with myelin peptides generates a unique population of tolerogenic dendritic cells in local lymph nodes and attenuates autoimmunity in MS patients.
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