Selective targeting of the immune response in autoimmune demyelination.

Recent developments in molecular and cellular immunology have led to the formulation of refined models that describe how tolerance to self-antigens is broken and autoimmunity develops. This knowledge can now be used to develop alternative approaches to conventional immunosuppression for the treatment of autoimmune demyelinating disorders. The ideal therapy would reverse established disease or prevent further progression by selectively eliminating the aggressive effector molecules or cells while leaving the immune system virtually intact. Indeed, several groups are engaged in preliminary or advanced clinical studies of promising specific immunotherapies for multiple sclerosis and other autoimmune conditions. Current data suggest that the immune response that results in organ-specific autoimmunity is highly complex and redundant in humans. This suggests that antigen-specific approaches may be less successful than broader immunotherapeutic strategies for treating multiple sclerosis and related diseases.