**6. Conclusion**

The prospects for progress in developing novel approaches for the diagnosis and treatment of MS have been greatly encouraged by several observations. These include:


Achievements in medical abzymology could be a promising basis to design new medicines. The most dynamic trend is related to the synthesis of catalytic Abs that are able to destroy circulating drugs before initiating toxic effects on nervous system and other tissues. Catalytic Abs directly affecting the physiologic reconstruction of tissues and organ systems with complex architectonics including neuroglia are of special value. Neurology is estimated as an interesting area for abzyme application since Abs can be used for the induction of remyelination and the restoration of previously lost glia functions in MS.

List of abbreviations:

486 Autoimmune Disorders – Current Concepts and Advances from Bedside to Mechanistic Insights

will have considerable practical potential in many different medical applications, i.e., would

Medical abzymology as a novel trend in medical immunology and enzymology, and a new avenue in the clinical practice appears to demonstrate a revolutionary growth today. The antibody catalysis as itself and regardless to a defined field of medical application appears to stress a new area of medical research and a novel field of medical application that provoke considerable interest for medical investigators and clinical practitioners. (Suchkov

Autoimmune diseases actually represent a challenging frontier in contemporary medical research and clinical practice, and, thus, in areas overlapped with medical abzymology. The proper relation of clinical autoimmunity to the generation of natural catalytic antibody response is absolutely evident, and, in general terms, the phenomenon of autoantibody catalysis can potentially be applied to isolate efficient catalytic domains directed against autoimmune epitopes pathogenically and clinically relevant. This can be done by exposing the autoimmune repertoire to identify autoantigens or their mimicking counterparts capable

The prospects for progress in developing novel approaches for the diagnosis and treatment

2. the demonstration that both B and T cell responses to MBP are focused on this region,

3. clinical studies suggesting that patients treated with MBP peptide 82–98 can be made tolerant to the protein in association with delayed disease progression or reduced disease activity over time. Autoantibody mediated tissue destruction is among the main features of organ-specific autoimmunity. Since the original discovery of catalytic antibodies, ample data established their contribution to pathological effects in disease as well as their possible biomedical applications. The practical relevance of abzymes is due to the unique characteristic distinguishing them from other biocatalysts: abzymes could be produced for the catalysis of almost all reactions occurring in living systems and catalyzed by appropriate enzymes. Abzymes may also be designed for the development of fundamentally new catalysts without natural analogues. The proved possibility to set a cell on secretion of engineering biocatalysts is intensively discussed. Serum level of proteolytic Abs may provide a clinically important predictive biomarker for demyelination in MS patients and formulating prognosis of the disease. The serum levels of the Ab-mediated catalytic activity as prognostic criteria could also differentiate MS patients with probably favorable or severe disease course or outcome, and outcome criteria are now being designed to assess the overall impact of MS as dependent variables for clinical studies. Ultimately, analysis of autoAb-mediated MBP degradation may provide a supplementary clinical and laboratory tool for assessing the disease progression and disability of MS patients. The possibility of forced stimulation of B-cells to produce proteolytic Abs with a given design is also intensively discussed. Such technology could

be widely applied to treat and prevent socially relevant autoimmune disorders. Achievements in medical abzymology could be a promising basis to design new medicines. The most dynamic trend is related to the synthesis of catalytic Abs that are able to destroy

of MS have been greatly encouraged by several observations. These include: 1. the identification of a major immunogenic region in MBP, peptide 82–98;

form the frame of medical abzymology.

of recruiting the germ line genes encoding the catalytic site.

particular for patients who express HLA-DR2;

et al., 2006; Suchkov et al., 2001)

**6. Conclusion** 

MS - Multiple sclerosis CNS - central nervous system autoAbs – Autoantibodies catAbs *-* catalytic antibodies Igs – immunoglobulins TS - transition states MBP - myelin basic protein EAE - experimental autoimmune encephalomyelitis MOG - myelin oligodendrocyte glycoprotein HSP – heat shock protein MAC - membrane attack complex PLP - Proteolipid protein SLE - system lupus erythematosis CIS - clinically isolated syndrome CDMS - clinically definite multiple sclerosis EDSS - Expanded disability status scale MRI – magnetic resonance imaging
