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Immunotherapeutics of multiple sclerosis
1Istituto di Clinica delle Malattie del Sistema Nervoso Università di Torino, Italy.
Immunosuppressive therapy may act specifically by inhibiting a certain stage of the immune response, or, by contrast, by inducing an overall inhibition of the immune system. Low dosage, a specific immunosuppressive therapeutic protocols with corticosteroids or azathioprine are used routinely, although there is no evidence of their effects. There are, however, unquestionable data on the numerous (and serious) side effects. High dosage, a specific immunosuppression appears to be better tolerated (probably due to the brevity of the treatment) and to have certain immunodepressant effects within the CNS. ACTH and methylprednisolone are recommended for short-term relapse therapy. Specific immunosuppressive treatment will no doubt be part of future autoimmune disease therapy, but for the time being is no more than theoretically stimulating experimentation (anti-idiotypic monoclonal antibodies, specific T cell suppressor factor, T cell "vaccination"). Important multicentric studies on cyclosporin-A and copolymer 1 are almost complete on the numerous side effects as regard to cyclosporin-A. Clinical trials with alpha or beta-interferons are still in progress and, so far at least, these drugs appear to be characterized by the absence of important side effects.
Immunosuppressive therapy may act specifically by inhibiting a certain stage of the immune response, or, by contrast, by inducing an overall inhibition of the immune system. Low dosage, a specific immunosuppressive therapeutic protocols with corticosteroids or azathioprine are used routinely, although there is no evidence of their effects. There are, however, unquestionable data on the numerous (and serious) side effects. High dosage, a specific immunosuppression appears to be better tolerated (probably due to the brevity of the treatment) and to have certain immunodepressant effects within the CNS. ACTH and methylprednisolone are recommended for short-term relapse therapy. Specific immunosuppressive treatment will no doubt be part of future autoimmune disease therapy, but for the time being is no more than theoretically stimulating experimentation (anti-idiotypic monoclonal antibodies, specific T cell suppressor factor, T cell "vaccination"). Important multicentric studies on cyclosporin-A and copolymer 1 are almost complete on the numerous side effects as regard to cyclosporin-A. Clinical trials with alpha or beta-interferons are still in progress and, so far at least, these drugs appear to be characterized by the absence of important side effects.