What is oral tolerance and how is it used in the treatment of human leukocyte antigen (HLA) B27–associated acute anterior uveitis (AAU)?

Updated: Oct 30, 2018
  • Author: Anna Luisa Di Lorenzo, MBBCh; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Answer

Oral tolerance involves administering an antigen orally to induce a specific peripheral immune tolerance. The mechanisms of oral tolerance are unclear, but it is believed that it involves a specific antigen and the generation of active suppression or clonal anergy dependent on the antigen dose. Oral tolerance has been shown to be successful in experimental models dealing with multiple sclerosis, arthritis, diabetes, myasthenia gravis, and uveitis. Based on this, clinical studies have been initiated using such antigens as myelin in multiple sclerosis, collagen in rheumatoid arthritis, and uveitogenic peptides in intermediate and posterior uveitis, again with success and few adverse effects from the treatment. An HLA-B27-derived peptide (B27PD) mimicking retinal autoantigen has been found to be effective in both animal models and patients with uveitis.


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