title: A pilot study on the immunological effects of oral administration of donor major histocompatibility complex class II peptides in renal transplant recipients.
abstract: Oral tolerance is an important physiological mechanism of immune hyporesponsiveness to dietary antigens and the commensal flora of the gastrointestinal tract. Feeding of alloantigens, therefore, has the potential to suppress undesirable immune responses after transplantation. To date, there are no published reports on the effects of such an approach in human transplant recipients. In the present pilot study, we demonstrate complete suppression of baseline indirect alloreactivity in patients with chronic renal allograft dysfunction following the oral feeding of low (0.5 mg/d) but not higher (1.0 and 5.0 mg/d) doses of donor major histocompatibility complex (MHC) class II peptides. The regimen was well tolerated with no evidence for sensitization to the donor antigen. Our results indicate that oral feeding of low dose donor MHC peptide may represent a safe and effective therapy to suppress indirect alloreactivity in renal transplant recipients with chronic allograft dysfunction and warrants further clinical investigation.
authors.affiliation: Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. kwomer1@jhmi.edu
authors.forename: Karl L
authors.initials: KL
authors.lastname: Womer
authors.forename: Colm C
authors.initials: CC
authors.lastname: Magee
authors.forename: Nader
authors.initials: N
authors.lastname: Najafian
authors.forename: John P
authors.initials: JP
authors.lastname: Vella
authors.forename: Edgar L
authors.initials: EL
authors.lastname: Milford
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Sayegh
authors.forename: Charles B
authors.initials: CB
authors.lastname: Carpenter
mesh_terms: D000284:Administration, Oral; D049109:Cell Proliferation / Q000187:drug effects*; D002908:Chronic Disease; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D015802:HLA-DR2 Antigen / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology; D010446:Peptide Fragments / Q000008:administration & dosage*; D010865:Pilot Projects; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D015802:HLA-DR2 Antigen; D010446:Peptide Fragments