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Immune Diseases Could Be Thwarted

By Wilson J. Liao

A revolutionary medical technique that had its beginnings in ancient China may be effective in treating autoimmune diseases such as diabetes, rheumatoid arthritis, and multiple sclerosis, Harvard researchers announced this week.

The new technique, called oral tolerization, strengthens a person's immune defense system by gradually exposing the person to substances which it otherwise would reject. The procedure's name comes from the fact that the person ingests the substances orally.

The group of scientists, headed Kroc Associate Professor of Neurology Dr. Howard L. Weiner, said the technique may also one day facilitate organ transplants by greatly reducing the likelihood of rejection.

The researchers said their finding coincides with an ancient Chinese medical principle discovered 4000 years ago: that a patient suffering from liver problems could sometimes be cured by feeding the patient animal liver.

Likewise, American Indians are reported to have eaten poison Ivy leaves to guard against the skin's reaction to the plant.

Modern researchers are now beginning to understand why this technique seems to work and have transformed age-old myth into an cutting-edge technology.

"This technique could mean a major revolution in modern medicine," said Weiner, co-director of the Center for Neurologic Diseases at the Brigham and Women's Hospital in Boston.

Weiner, a pioneer in the development of the technique, hypothesized that a treatment for autoimmune diseases--in which the body's immune system attacks its own cells rather than foreign ones--might be found by using the well known fact that the body rarely rejects substances which are ingested orally.

"The gut has an immune response which almost never rejects proteins," said Weiner. "From that fact, we postulated that if a person was fed the protein which his immune system was attacking, the body would acquire a tolerance to the protein and thereby lessen the attack."

Results from similar studies currently being carried out around the country are extremely favorable.

Weiner and one of his colleagues, Dr. David A. Hafler, found in one study that giving the protein myelin to multiple sclerosis patients decreased the chance of a relapse by 50 percent.

In a study of rheumatoid arthritis given at the Beth Israel Hospital in Boston, Dr. David E. Trentham found that patients given chicken collagen in their orange juice each morning experienced less joint pain and swelling. Four of the patients in the study even went into complete remission.

Weiner said that oral tolerization could become standard medical practice in about three years. One of the main advantages of the method, he said, is the case with which it can administered.

"It is a form of vaccination via the gut," he said.

Another significant advantage of the technique is that in contrast to immunosuppressant drugs which display serious side effects, oral tolerization produces almost no side effects whatsoever."

"It's very safe, because it is really just a protein meal," said Professor of Medicine Dr. Charles B. Carpenter, an immunogeneticist at Harvard Medical School.

Carpenter is studying how oral tolerization can be used to decrease the chance of organ rejection in an organ transplant. In studies using rats and mice, he learned that hearts and kidneys from normally incompatible donors could successfully be transplanted by feeding the subjects specific peptides from the donors.

Carpenter says he plans to start a pilot study involving humans within the next few months. If the study proves successful, it will mean that patients in need of a new organ will not have to wait for the "perfect match." Instead, they can be pre-treated so that they can accept a larger degree of incompatibility.

According to the American Autoimmune Related Diseases Association, Inc., about 50 million Americans, most them women, suffer from the more than 80 known autoimmune diseases

Results from similar studies currently being carried out around the country are extremely favorable.

Weiner and one of his colleagues, Dr. David A. Hafler, found in one study that giving the protein myelin to multiple sclerosis patients decreased the chance of a relapse by 50 percent.

In a study of rheumatoid arthritis given at the Beth Israel Hospital in Boston, Dr. David E. Trentham found that patients given chicken collagen in their orange juice each morning experienced less joint pain and swelling. Four of the patients in the study even went into complete remission.

Weiner said that oral tolerization could become standard medical practice in about three years. One of the main advantages of the method, he said, is the case with which it can administered.

"It is a form of vaccination via the gut," he said.

Another significant advantage of the technique is that in contrast to immunosuppressant drugs which display serious side effects, oral tolerization produces almost no side effects whatsoever."

"It's very safe, because it is really just a protein meal," said Professor of Medicine Dr. Charles B. Carpenter, an immunogeneticist at Harvard Medical School.

Carpenter is studying how oral tolerization can be used to decrease the chance of organ rejection in an organ transplant. In studies using rats and mice, he learned that hearts and kidneys from normally incompatible donors could successfully be transplanted by feeding the subjects specific peptides from the donors.

Carpenter says he plans to start a pilot study involving humans within the next few months. If the study proves successful, it will mean that patients in need of a new organ will not have to wait for the "perfect match." Instead, they can be pre-treated so that they can accept a larger degree of incompatibility.

According to the American Autoimmune Related Diseases Association, Inc., about 50 million Americans, most them women, suffer from the more than 80 known autoimmune diseases

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