Clinical Research of Calorad®
& Collagen
Oral desensitization in the treatment of human immune
diseases.
Vischer TL.
Division of Rheumatology, Hospital Cantonal Universitaire,
Geneve, Switzerland.
Oral desensitization or oral tolerance is induced by
giving antigenic peptides by the mucosal route. In man,
only the oral route has been used up to now. Experiments
in animal models of human autoimmune diseases, have shown
that it is not necessary to use the primary antigen responsible
for disease induction.
Antigens implicated in secondary immune phenomenon can
act similarly by means of the so-called "bystander
suppression." Thus, for diseases such as multiple
sclerosis (MS) and rheumatoid arthritis (RA), candidate
antigens for desensitization are available. Many patients
with MS have immunity to myelin basic protein (MBP). A
recent controlled trial giving MBP to patients with MS
is discussed (Weiner et al., Science 259, p. 1321, 1993).
No clear-cut effect was obtained. Collagen II is used
to induce experimental arthritis in rats; signs of immunity
against it can be found in patients with RA.
Collagen-induced arthritis has been successfully modified
in animals by feeding of collagen II. In man, one open,
uncontrolled trial and one other placebo controlled blind
trial have been reported, and these are discussed (Trentham
et al., Science 261, 1727, 1993). These trials suggest
that oral desensitization might be useful and devoid of
side effects. Subreum is a peptic E. coli extract containing
heat shock protein 60. Its efficacy as a disease-controlling
agent in RA has been documented (Clin. Exp. Rheum. 11,
p. 121, 1993). It is given orally. Data suggesting that
Subreum acts by oral desensitization are discussed.
Considering the low incidence of side effects observed
with oral desensitization, this therapeutic approach should
also be tested in other forms of arthritis and other inflammatory
diseases.
Publication Types:
Review
Review, Tutorial
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