Epstein-Barr virus-specific adoptive immunotherapy for progressive multiple sclerosis.
Bottom Line: We have treated a patient with secondary progressive MS with in vitro-expanded autologous EBV-specific CD8(+) T cells directed against viral latent proteins.This adoptive immunotherapy had no adverse effects and the patient showed clinical improvement with reduced disease activity on magnetic resonance imaging and decreased intrathecal immunoglobulin production.This is the first report of the use of EBV-specific adoptive immunotherapy to treat MS or any other autoimmune disease.
Affiliation: The University of Queensland, School of Medicine, Brisbane, Queensland, Australia QIMR Centre for Immunotherapy and Vaccine Development and Department of Immunology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia email@example.com.Show MeSH
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Mentions: The treatment was successfully completed without significant adverse effects. In particular there were no fevers, flu-like symptoms or malaise. Two to three days after the second and third infusions the patient had tingling and numbness of the lips and tongue for 3–6 h, but in the previous year there had been two attacks of these symptoms, each lasting a week. Following the treatment he experienced a reduction in fatigue and painful lower limb spasms, an improvement in cognition and hand function, and increased productivity at work. These improvements were sustained up to the time of the latest review, 21 weeks after the final T-cell infusion, when neurological examination demonstrated increased voluntary movement of his lower limbs, particularly of the right knee flexors and left knee flexors and extensors to a Medical Research Council grade of 3/5, compared with 1/5 prior to the T-cell therapy. Following treatment the frequency of circulating EBV-specific CD8+ T cells increased (Figure 1(a) and (b)), and there were decreases in the number and size of gadolinium-enhancing MRI brain lesions and in intrathecal IgG production (Figure 1(c–f)). The CSF IgG index decreased from 0.79 (normal <0.70) before treatment to 0.74, 6 weeks after completion of treatment, and then decreased further to 0.63, 21 weeks after completion.
Affiliation: The University of Queensland, School of Medicine, Brisbane, Queensland, Australia QIMR Centre for Immunotherapy and Vaccine Development and Department of Immunology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia firstname.lastname@example.org.