Highlights from

AAN 2019

American Academy of Neurology annual meeting

Philadelphia, USA 4-10 May 2019

Immune tolerance by peptide-loaded tolerogenic dendritic cells

An interesting trial that could help result in a new treatment option for NMOSD (as well as MS), investigated a form of adoptive cell therapy. In a phase 1b study, use of autologous tolerogenic dendritic cells (tolDCs) loaded with myelin and AQP-4 peptides was safe, feasible, and effective in eliciting antigen-specific IL-10 production by regulatory T cells in patients with NMOSD or MS [1].

The first author, Dr Irati Zubizarreta (Institut d’Investigacions Biomediques August Pi Sunyer, Spain), explained that this was an open-label, first-in-human study testing increasing concentrations of autologous tolDCs (50 to 300 x 106 cells divided into 3 doses administered every 2 weeks) loaded with 7 myelin and 1 AQP-4 peptides. Participants were 8 patients with MS and 4 with NMOSD. TolDCs therapy was well-tolerated with 16 adverse events which were mild and reversible; there were no therapy-related reactions. “There were no relapses or increased disease activity”, Dr Zubizarreta added. “There was a significant increase in the production of IL-10 levels in peripheral blood mononuclear cells stimulated with the peptides as well as an increase in the frequency of regulatory T cells by week 12 of follow-up. No significant differences were seen in ex vivo cell proliferation, but there was a trend towards significance in NMOSD patients.” A phase 2 study in NMOSD patients is underway.

  1. Zubizarreta I, et al. AAN 2019, S56.002.

The content and interpretation of these conference highlights are the views and comments of the speakers/authors.