Autoreactive CD4- CD8- alpha beta T cells to vaccinate adjuvant arthritis

Tovaxin for multiple sclerosis

INTRODUCTION

A potential therapeutic possibility for multiple sclerosis (MS) is provided by Tovaxin, a personalized autologous T-cell immunotherapy utilizing myelin-reactive lymphocytes from peripheral blood.

AREAS COVERED

This review covers the production of the vaccine, which follows a series of steps after the acquisition of T-cells. This includes identification of the subsets that are myelin reactive, expansion ex vivo and, also extrinsically, inactivation of their replication capacity by cellular irradiation. Once attenuated, the modified cells are reintroduced into the donor. This process appears to induce a vigorous immune response towards specific populations of autoreactive T-cells determined to attack the myelin and its derivatives by trafficking from the vascular space into the CNS in MS. Historical aspects of the T-cell vaccination with Tovaxin, the process to obtain reactive T-cells and their attenuation techniques ex vivo are described. The clinical results obtained from clinical trials are also discussed.

EXPERT OPINION

The process of T-cell vaccination is complicated and presents some limitations. Further studies are required to provide scientific support and clinical evidence of the efficacy of Tovaxin in MS.

Human CD4- 8- T cells are a distinctive immunoregulatory subset

Human CD4(-)8(-) T cells are a minor subset quantitatively but potentially important in immunity because they are predominantly distributed at body surfaces, and their number and activities increase in autoimmune diseases and decrease with aging. Distinguishing characteristics of CD4(-)8(-) T cells are found to include a unique profile of cytokines, including Serpin E1, which is not generated by other T cells, MIF, and TGF-beta. At 2-5% of the total in mixtures with CD4 + CD8 T cells, CD4(-)8(-) T cells enhance the generation of IFN-gamma and IL-17 by up to 12- and 5-fold, respectively, without contributing either cytokine or affecting cytokine production by NK/NKT cells. CD4(-)8(-) T cell-derived MIF is their major enhancer and TGFbeta their principal inhibitor of CD4 and CD8 T cell cytokine production. Decreases in CD4(-)8(-) T cell effects may diminish protective immunity in aging, whereas increases may augment the severity of autoimmune diseases.

Characterization of CD4- CD8- CD3+ T-cell receptor-alphabeta+ T cells in murine cytomegalovirus infection

In this study, we have investigated that after the intraperitoneal infection with murine cytomegalovirus (MCMV), the CD3+ CD4- CD8-(double negative; DN) T-cell receptor (TCR)alphabeta+ T cells increased in peritoneal cavity, liver and spleen in both resistant C57BL/6 and susceptible BALB/c mice. The total cellular population of these cells showed peak levels around day 5 after infection in all the three investigated organs and the following phenotypical and functional characteristics emerged. The peritoneal DN TCRalphabeta+ T cells expressed highly skewed TCRVbeta8 on day 5 after infection compared with the uninfected mice, but those in spleen and liver showed moderate and low skewed TCRVbeta8, respectively. The percentages of NK1.1+ DN TCRalphabeta+ T cells gradually decreased as did modulation of some of their activation markers consistent with an activated cell phenotype. The peritoneal DN TCRalphabeta+ T cells on day 5 after infection expressed the genes of interferon-gamma (IFN-gamma), tumour necrosis factor-alpha, Eta-1 (early T-cell activation-1) and MCP-1 (monocyte chemoattractant protein 1) but lacked expression of interleukin-4 (IL-4). After in vitro stimulation with phorbol 12-myristate 13-acetate and calcium ionophore in the presence of Brefeldin A, higher frequencies of intracellular IFN-gamma+ DN TCRalphabeta+ T cells were detected in all three investigated organs of infected mice compared with those of uninfected mice. Stimulation of peritoneal DN TCRalphabeta+ T cells with plate-bound anti-TCRbeta monoclonal antibodies showed proliferation and also produced IFN-gamma but not IL-4. These results suggest that DN TCRalphabeta+ T cells were activated and may have an antiviral effect through producing IFN-gamma and some macrophage-activating factors during an early phase of MCMV infection.