Brod S A, al-Sabbagh A, Sobel R A, Hafler D A, Weiner H L
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.
Ann Neurol. 1991 Jun;29(6):615-22. doi: 10.1002/ana.410290608.
Oral administration of proteins is a long-recognized method of inducing antigen-specific peripheral immune tolerance. We previously showed that oral administration of myelin basic protein suppresses monophasic experimental autoimmune encephalomyelitis in the Lewis rat when it is given in association with immunization and prior to disease onset. As a potential therapy for human autoimmune disease, it is crucial to determine whether oral tolerance can ameliorate an ongoing immune response. We therefore asked whether oral administration of myelin antigens, after sensitization and disease expression has occurred, could affect immunological, clinical, or pathological features of experimental autoimmune encephalomyelitis. Chronic relapsing experimental autoimmune encephalomyelitis was induced in the Lewis rat and strain 13 guinea pig by immunization with whole guinea pig cord homogenate, complete Freund's adjuvant, and Mycobacterium tuberculosis. Following recovery from the first attack, animals were orally given bovine myelin, guinea pig myelin, or guinea pig myelin basic protein three times per week for up to 3 months. Animals receiving myelin products orally had decreased severity and frequency of clinical relapses, decreased delayed-type hypersensitivity responses to myelin antigens, diminished inflammation in the central nervous system (CNS), and decreased areas of CNS demyelination. In the rat, guinea pig myelin basic protein was as effective as guinea pig myelin in ameliorating the disease and also resulted in decreased serum anti-myelin basic protein antibody levels. No exacerbation of disease or worsening of pathological findings occurred in the animals given myelin products. These results demonstrate that oral administration of myelin antigens can suppress chronic relapsing experimental autoimmune encephalomyelitis and have direct relevance to therapy of human demyelinating disorders such as multiple sclerosis.
口服蛋白质是一种长期以来被认可的诱导抗原特异性外周免疫耐受的方法。我们之前表明,在Lewis大鼠中,口服髓鞘碱性蛋白并在免疫的同时且在疾病发作前给药,可抑制单相实验性自身免疫性脑脊髓炎。作为治疗人类自身免疫性疾病的一种潜在疗法,确定口服耐受是否能改善正在进行的免疫反应至关重要。因此,我们研究了在致敏和疾病表现出现后口服髓鞘抗原是否会影响实验性自身免疫性脑脊髓炎的免疫学、临床或病理学特征。通过用全豚鼠脊髓匀浆、完全弗氏佐剂和结核分枝杆菌免疫,在Lewis大鼠和13品系豚鼠中诱导出慢性复发性实验性自身免疫性脑脊髓炎。在首次发作恢复后,动物每周口服三次牛髓鞘、豚鼠髓鞘或豚鼠髓鞘碱性蛋白,持续长达3个月。口服髓鞘产物的动物临床复发的严重程度和频率降低,对髓鞘抗原的迟发型超敏反应降低,中枢神经系统(CNS)炎症减轻,CNS脱髓鞘面积减小。在大鼠中,豚鼠髓鞘碱性蛋白在改善疾病方面与豚鼠髓鞘一样有效,并且还导致血清抗髓鞘碱性蛋白抗体水平降低。给予髓鞘产物的动物未出现疾病加重或病理结果恶化的情况。这些结果表明,口服髓鞘抗原可抑制慢性复发性实验性自身免疫性脑脊髓炎,并且与治疗人类脱髓鞘疾病如多发性硬化症直接相关。