Despite all these setbacks the immense potential value of the Alzheimer's disease market keeps bringing new players into this arena. For example, Cytos is developing CAD106, Austria-based AFFiRiS has a vaccine called AD02 based on their Affitome technology, which uses a pool of peptides, and researchers from Karolinska Institute in Sweden recently showed their CAD10 amyloid-β vaccine induced antibodies in 74 percent of subjects aged between 50-to-80 years. Hence, despite the setbacks, progress is being made and a vaccine against Alzheimer's may emerge soon.

Parkinson's disease is another incurable disorder that affects the brain and the nervous system, leading to problems with movement and cognition. AFFiRiS has just begun clinical testing of a therapeutic vaccine to treat Parkinson's disease. The vaccine known as PD01A, uses Affiris' Affitome technology, which uses a pool of peptides that mimic the alpha-synuclein and thereby induces antibodies against alpha-synuclein mutant forms that clump together in the brain of patients.

Several vaccines are in development against autoimmune diseases, such as multiple sclerosis (MS) and rheumatoid arthritis. Opexa Therapeutics is developing Tcelna, as a personalized MS therapy. Tcelna is manufactured using ImmPath, Opexa's proprietary method to induce T-cells against selected peptides from myelin basic protein, myelin oligodendrocyte glycoprotein and proteolipid protein. Cytos is developing a vaccine for therapy of rheumatoid arthritis, which induces neutralizing antibodies against the inflammatory mediator, TNF-alpha.

A range of vaccines have been developed for prevention of type 1 diabetes (T1D). Diamyd Medical reported phase II success with their alum-adjuvanted glutamic acid decarboxylase vaccine, Diamyd, but stumbled when a larger Phase III study did not meet the primary efficacy endpoint of preserving beta cell function. A phase II study, DiAPREV-IT, of Diamyd in children at risk of developing T1D is ongoing. A long running study in Melbourne, Australia, of nasal insulin for T1D prevention is struggling with recruitment, showing how tough T1D clinical studies can be. Several immunoregulatory vaccines have also been shown to protect against type 1 diabetes in animal models, including the approved live BCG vaccine (bacillus Calmette-Guerin) or work by our own group showing similar results can be achieved with the approved inactivated Q fever vaccine (Qvax).

Therapeutic vaccines against type 2 diabetes and/or obesity are also in development. Cytos's CYT013-IL1bQb, is designed to induce antibodies against interleukin (IL)-1. Cytos also developed CYT009-GhrQb, an obesity vaccine based on production of neutralizing antibodies to ghrelin, a peptide that enhances appetite and food intake, but failed to show efficacy in clinical studies. Braasch Biotech is attempting to develop an anti-obesity vaccine by immunizing with chimeric somatostatin proteins to induce neutralizing antibodies and thereby enhancing endogenous growth hormone and insulin-like growth factor 1.