实验性自身免疫性葡萄膜视网膜炎的口服耐受:疾病诱导后喂养的保护作用不如预喂养

John W. Torseth , Dale S. Gregerson
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引用次数: 30

摘要

口服抗原可调节常规皮下注射引起的后续免疫反应。如果给予实验性自身抗原,随后的自身免疫性疾病的诱导可能会受到抑制。然而,在启动或疾病诱导后喂养自身抗原更具有临床意义,但试验不太成功。通过对牛S-Ag肽诱导的LEW大鼠实验性自身免疫性葡萄膜视网膜炎(EAU)的治疗性喂养,我们发现延迟至免疫后喂养只能抑制轻度疾病,并且需要较高的喂养剂量。在更严重的EAU患者中,尽管玻璃体抗原特异性淋巴细胞增殖和血清抗体反应同时下调,但治疗性喂养的临床疗效微乎其微。增加给药剂量对EAU没有进一步的抑制作用。在免疫前饲喂相同的多肽可产生对中度至重度疾病诱导的抵抗力。与预防性喂养方案不同的是,发现在低剂量抗原免疫后喂养导致轻度疾病恶化的情况,需要注意。
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Oral Tolerance in Experimental Autoimmune Uveoretinitis: Feeding after Disease Induction Is Less Protective than Prefeeding

Oral administration of antigen modulates subsequent immune responses raised by conventional subcutaneous priming. If experimental autoantigens are administered, subsequent induction of autoimmune diseases may be inhibited. However, feeding autoantigens after priming or disease induction is more clinically relevant, but the trials have been less successful. Using therapeutic feeding of peptides to inhibit experimental autoimmune uveoretinitis (EAU) induced in LEW rats by bovine S-Ag peptides, we found that only mild disease could be inhibited if feeding was delayed until after immunization, and relatively high feeding doses were required. In recipients with more severe EAU, the clinical efficacy of therapeutic feeding was minimal despite concurrent down-regulation ofin vitroantigen-specific lymphocyte proliferation and serum antibody responses. No further inhibition of EAU was found by increasing the feeding dose. Feeding the same peptides prior to immunization produced resistance to moderate to severe disease induction. Unlike prophylactic feeding protocols, conditions were found such that feeding after immunization with low doses of antigen led to worsening of mild disease, raising a note of caution.

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