Therapeutic Advances in Demyelinating Disease Research Autoreactive T Cell Vaccine for Multiple Sclerosis Recently, Israeli scientists published a paper on the use of an autoreactive T cell vaccine for the treatment of multiple sclerosis. In a double-blind comparative approach, T cells with antimyelinating properties collected from patients with secondary progressive multiple sclerosis were first grown and expanded in vitro, and their activity was reduced by radiation (similar to polio and hepatitis B attenuated vaccines) to prepare a vaccine, which was finally injected back into the patients subcutaneously in several doses. ” (control group) treatment, the 16 patients who received the T-cell vaccine treatment had lower extended disability scale scores, shorter time required to walk 10 meters, and a significantly lower relapse rate compared to the 7 patients treated with the “sham-received vaccine” (control group). This indicates that this auto-reactive T-cell vaccine has a therapeutic effect on multiple sclerosis. The authors concluded that the T-cell vaccine is feasible and safe, however, more patient participation is needed to validate it. Note: This research work has been initiated abroad in the 1990s. The theoretical mechanism of the cure: Self-myelin-specific T cells (cells that destroy myelin) are attenuated and denatured, and then inoculated into the body. The body’s immune system is then induced to mount cellular and humoral immune responses against these “denatured” cells, which in turn prevents the growth, expansion, resurgence, and even elimination of all similar autoimmune T cells in the body, in order to cure or control multiple sclerosis. Other areas of research, including tumor vaccines, are to be expected and tried. Mesenchymal stem cell transplantation for multiple sclerosis At the beginning of the new year, in the first issue of the Journal of Neuroscience, doctors from the Cleveland Clinic reviewed and analyzed information about research on mesenchymal stem cell transplantation for multiple sclerosis. MSCs are pluripotent stem cells derived from bone marrow (some believe that bone marrow is also part of the hematopoietic lineage) and other tissues, but not of blood origin, which are purified through in vitro culture and expansion to induce differentiation to resemble primitive pluripotent stem cells: with multiple phenotypes and functions. Many aspects, such as immunomodulatory effects, tissue protective effects and recovery promoting effects, have been confirmed by in vivo and ex vivo studies in animals. They are of great interest to scientists because of their potential therapeutic effects on a variety of diseases, including multiple sclerosis. Other advantages of MSCs include their immunological properties (allowing for allogeneic transplantation) and migration to a variety of tissues after intravascular injection. There is little existing experience with the use of MSCs in the treatment of multiple sclerosis, but a few case reports have shown promising results. From the experience of several research groups, including the authors, the therapeutic procedure with autologous bone marrow MSCs has been accepted, and issues regarding safety and effectiveness require further technical evaluation. Note: Bone marrow MSC transplantation for the treatment of diseases is not a new topic, such as leukemia, which has been performed for more than half a century both at home and abroad, and the treatment of autoimmune diseases, including multiple sclerosis, has been carried out for decades. However, because of its high cost and variable duration of effect, not much progress has been made. Theoretically, I think: transplantation of allogeneic homozygous homozygous (monozygotic) or similar genetic (relatives, others) stem cells should be better than transplantation of bone marrow hematopoietic stem cells from the patient itself, after all, the patient’s internal environment has been changed. Mesenchymal stem cells such as umbilical cord and amniotic membrane have advantages in treating diseases (low immunogenicity, easy source, lower cost, etc.), which have been clinically proven (including by us). Because of imperfections, they cannot be performed now due to government policy restrictions. Topiramate for multiple sclerosis pain 1 case report In multiple sclerosis, patients often have severe painful discomfort. Amitriptyline, duloxetine and the antiepileptic drugs carbamazepine, gabapentin and pregabalin are currently the first-line drugs for the treatment of neuropathic pain. Italian physicians report a case of pain treated with topiramate, another antiepileptic drug. The patient, a 42-year-old woman with an 8-year history of multiple sclerosis, took topiramate for 8 months, and her pain disappeared with no adverse effects. Note: Case report, individual variation, need to draw on with caution.