摘要：

This chapter discusses the mechanisms and therapeutic applications of oral tolerance. The most striking characteristic of the gut mucosa is the abundance of the lymphoid tissue associated with it. There are 10 12 lymphoid cells per meter of human small intestine. Cell surface molecules and cytokines associated with inductive events in the gut that generate and modulate oral tolerance are not completely understood. Three major immunological consequences of oral antigen administration are described in the chapter—namely, (1) a local (noninflammatory) immune response resulting in the production of secretory immunoglobulin A (IgA), (2) a systemic inflammatory response with the generation of serum-specific antibodies, and (3) a systemic state of hyporesponsiveness to the antigen, termed "oral tolerance." The first two outcomes are often referred to as "oral immunization," although represent distinct phenomena. It appears that the clinical applications of oral antigen for the treatment of human conditions depend on the specific disease and the nature and dosages of proteins administered and might be benefitted from the use of synergists or mucosal adjuvants to enhance biologic effects.

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