Table 3 Comparative overview of antigen-specific immunotherapies in multiple sclerosis
From: Multiple sclerosis: molecular pathogenesis and therapeutic intervention
Antigen-specific immunotherapies | Advantages | Disadvantages |
|---|---|---|
Peptide and protein-based approaches | High specificity and selectivity in targeting autoreactive immune cells Low toxicity and minimal systemic immunosuppression Versatile mechanisms, including oral tolerance and high-zone tolerance induction | Limited clinical success due to variability in patient response Poor stability and short half-life of peptides High production costs and challenges in delivery |
DNA vaccination approach | Induces long-lasting antigen-specific immune tolerance Safe and well-tolerated in early trials Broad tolerance induction, extending to multiple myelin antigens Flexible delivery methods (intramuscular, intradermal, gene gun) | Variable efficacy in clinical trials; inconsistent results Potential risk of unintended immune responses Low transfection efficiency compared to viral-based gene delivery Regulatory and standardization challenges |
Peptide-loaded into a carrier approaches | Enhanced antigen delivery and immune modulation Availability of large-scale manufacturing, low production costs and easy manufacturing processes. Small, soluble and bioavailable carrier platforms Targeted biodistribution | Potential risk of immune activation instead of tolerance Limited large-scale clinical evidence Regulatory challenges due to the novelty of nanotechnology in medicine |
Cellular immunotherapy approaches | Minimal risk of immune rejection or pro-inflammatory immune response Reduced need for targeted delivery Demonstrated feasibility and safety in preclinical trials | High cost and complex manufacturing of personalized cell therapies Variability in patient response and durability of effects. Limited large-scale clinical validation Ethical and regulatory challenges, particularly with genetically modified cells |
