| [ Summary ] |
Oral tolerance could be a nontoxic immunomodulatory methods for the treatment of human organ-specific autoimmune diseases. After positive results in initial double-blind clinical trials, using oral myelin or type II collagen, in patients with multiple sclerosis(MS)or rheumatoid arthritis(RA), respectively, other clinical trials have been performed with patients having uveitis and type I diabetes.
Although large-scale phase III trials for both MS and RA patients performed in the United States have recently been found to be unsuccessful, they will lead us to seek a better way of selecting patients who may respond well to this treatment. Further experiments using transgenic animal models will be necessary to clearly elucidate precise mechanisms of oral tolerance and immunization, regarding the relationship between MHC antigens and the nature and shape of ingested antigens. This will allow us to confirm the efficacy of oral tolerance therapy in a more specified group of patients, and, moreover, to apply the therapy to modification of transplantation immunity in the near future. |