Inverse vaccines An advance against autoimmune disease?

Scientists hope a potential breakthrough treatment, which suppresses a particular part of the immune system rather than amplifying it, could be available within five years

- By David Kohn

Autoimmune diseases affect as many as 800 million people around the world about one in 10 of us. From multiple sclerosis and lupus to type one diabetes and rheumatoid arthritis, these conditions all share a common trait: the body's own immune system turns against itself.

Current treatments aim to suppress that response, but dialing down the entire immune system comes at a steep cost: it leaves patients vulnerable to other illnesses and often requires daily, invasive care.

A revolution is now afoot, as researchers are developing a new approach that targets only the specific part of the immune system that's gone rogue. These treatments are known as "inverse vaccines" because they suppress a particular part of the immune system, rather than amplifying it, as existing vaccines do.

"This is the holy grail," said the Northwestern University immunologist Stephen Miller. "We want to use a scalpel rather than a sledgehammer to treat these diseases." Miller's 2021 paper, published in 2022 in Gastroenterology, was the first to demonstrate that inverse vaccines could be effective in humans.

The study looked at coeliac disease, in which the immune system attacks the intestinal lining when it detects the presence of gluten, a protein found in wheat and other grains.

Over two weeks, 33 coeliac patients who were in remission ingested gluten; about half had received the inverse vaccine beforehand, while the other half got a placebo. After two weeks, researchers examined the subjects' intestinal lining and found that the inverse vaccine group had no damage, while the placebo group showed a noticeable worsening of symptoms.