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T-cells play a central role in the pathogenesis of multiple sclerosis (MS). Altered peptide ligands (APLs) have most commonly been used as T-cell receptor (TCR) ligands, to alter T-cell responses to presumed immunogenic or target antigens. The treatment therapies targeting T-cells non-specifically are: lymphocytapheresis, total lymphoid irradiation, anti-CD4 antibody, anti-CD3 antibody, anti-CD154 antibody, CTLA4Ig, interleukin-12, tumor necrosis factor alpha, interferon gamma and transforming growth factor beta. Although the T-cell is not the primary target of several drugs that are currently approved or are under investigation for the treatment of MS, many of these therapies have secondary effects on T-cell measures. The T-cell is an important target in MS therapeutics. The success of several drugs that specifically target the T-cell and T-cell responses reinforces this point. Further success of T-cell directed therapies depends on the appropriate targeting of phases of T-cell activation and function and the accurate identification of antigens.
Multiple sclerosis (MS) individuals who use complementary and alternative medicine (CAM) generally do so because they experience improvement in their quality of life, and in various MS symptoms such as fatigue, spasticity, or pain. The different CAM therapies used commonly by individuals with MS are: mind-body therapies, dietary changes and supplement use that include low fat diet, essential fatty acids and anti-oxidants, ginseng, acupuncture, low-dose naltrexone and cannabis. Despite the widespread use of CAM therapies among MS patients, most of these therapies have not been evaluated in well-designed, randomized, controlled clinical trials, the lack of which is the main reason why most neurologists do not incorporate CAM therapies into their management of MS patients. Clearly there are certain therapies, such as anti-oxidants and essential fatty acids, which have a scientific rationale for use in MS and are also supported by preclinical or pilot clinical data.
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