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*
Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104;
Immune Cell Biology Program, Naval Medical Research Institute, Bethesda, MD 20889; and
Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
Previous studies have shown complex roles for the B7 receptors in
providing both positive and negative regulation of experimental
autoimmune encephalomyelitis (EAE). B7 blockade can ameliorate clinical
EAE by indirectly interfering with CD28 signaling. However, B7 blockade
can also result in disease exacerbation, presumably by interfering with
regulatory B7:CTLA-4 interactions. Therefore, we have directly targeted
T cell CD28 with specific mAbs both during initial Ag priming and after
the onset of clinical signs of EAE. We found that CD28 blockade
ameliorated EAE during the efferent and afferent limbs of the immune
response. Disease amelioration at disease onset was associated with
suppression of TNF-
production. Finally, Ab blockade of T cell CD28
during the first disease episode resulted in significant attenuation of
the subsequent disease course, with no significant relapses. In
contrast to previous studies targeting APC B7 with CTLA4-Ig, reagents
targeting CD28 can block ongoing disease. Therefore, the present
results suggest a clinically relevant therapeutic scenario for human
diseases, such as multiple sclerosis.
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