Therapeutic vaccines for autoimmune Diseases

Abstract

The immune system has developed several checkpoints to prevent the induction of autoimmune diseases like multiple sclerosis and rheumatoid arthritis. Autoreactive T cells are negatively selected in the thymus but can escape this selection procedure. Peripherally, they are further controlled by homeostatic mechanisms and regulatory T cells (Tregs). Genetic and exogenous factors as well as a disbalanced functioning of Tregs may all influence these checkpoints and contribute to the breakdown of tolerance against ‘self’. Re-establishment of tolerance can be achieved by different vaccination strategies, which are divided into three major groups based on the composition of the vaccine: DNA vaccination, peptide-based-vaccination and T cell vaccination. This review summarizes the mechanisms, clinical trials and pros and cons of these different vaccination strategies.