autoimmunity ͉ regulatory T cell ͉ inflammation ͉ knock-out ͉ multiple sclerosis M ultiple sclerosis (MS) afflicts over 2.5 million people worldwide, with women affected 3 times more frequently than men. Although its precise etiology is unknown, MS has been characterized as a Th1-and/or Th17-mediated autoimmune disease (1). Experimental autoimmune encephalomyelitis (EAE), commonly induced by immunizing with various myelin autoantigens, is an experimental model of MS that allows investigators to study the pathogenesis of this disease and to test new therapeutic strategies (2). Indeed EAE is an acute or chronic-relapsing inflammatory and demyelinating autoimmune disease with resemblance to MS in humans. The major features shared are the autoimmune destruction of the myelin sheaths of the nerve fibers, the presence of multiple CNS lesions with a predominantly perivascular location, and a temporal maturation of lesions from inflammation through demyelination, and finally axonal destruction.Pituitary adenylyl cyclase-activating polypeptide (PACAP) is a 38-amino-acid neuropeptide identified by Arimura and colleagues in 1989 from ovine hypothalamus (3) and belongs to the secretin family. Its closest family member is vasoactive intestinal peptide (VIP), to which it is 68% identical. The actions of PACAP and VIP are mediated by 3 heterotrimeric G protein-coupled receptors, 1 (PAC1), which is highly specific for PACAP except for 1 splice variant (4), and 2 (VPAC1 and VPAC2) which interact with PACAP and VIP with equally high affinity (5). Although PACAP is widely distributed in the CNS and peripheral nervous system and is classically viewed as a neurotransmitter, it is capable of eliciting a broad spectrum of biological actions (5). Numerous results indicate that it exerts growth factor-like activities in the brain during development, regeneration, and tumorigenesis (6-10). Indeed, considerable data indicate that PACAP, mainly via PAC1, regulates neural cell proliferation, survival, axon regeneration and oligodendrocyte progenitor proliferation and maturation (6-9, 11-13).A series of studies beginning in the early 1980s implicated VIP as a regulator of immune function (14). These studies revealed that VIP can modulate both innate and adaptive immunity, showing a predominant anti-inflammatory action on macrophages, promoting a positive Th2/Th1 cytokine balance, and enhancing the production of regulatory T cells (Tregs) (15). Later it was found that PACAP could mimic many of these actions, suggesting the involvement of VPAC receptors. Moreover, it was determined that both VIP and PACAP are expressed in lymphocytes and other immune cell types (16-18), indicating that modulation of inflammation could result from either neurogenic or immunogenic neuropeptide expression. Finally, in the last decade, an increasing body of in vivo data indicates that VPAC receptors may be promising targets for the treatment of inflammatory diseases, and in particular, Th1-associated pathologies such as MS and rheumatoid arthritis. Indeed, adminis...