IMMUNOTOLERANCE AND PREVENTION OF OCULAR AUTOIMMUNE-DISEASE

Immunotherapeutic approaches to autoimmune disease have a common goal of inducing antigen-specific, long-lasting tolerance to autoantigens, without otherwise compromising the immune response. Here we review som e of the most interesting experimental advances in this area. We discu ss the use of T cell targeting drugs that have been reported to induce long lasting tolerance to ocular antigens. Strategies involving the t argeting of idiotypic and clonotypic determinants associated with ocul ar autoimmunity, such as idiotypic network manipulation and T cell vac cination, are reviewed. The use of cytokines to promote perturbation o f the Th1/Th2 balance with its possible implications for treatment of uveitis, is analysed. Finally, we review tolerogenic strategies based on acquisition of tolerance following presentation of antigen through alternative routes, such as injection of antigen into the anterior cha mber, intravenous infusion of antigen, and oral administration of reti nal antigens. Special emphasis is placed on the last strategy, since t here are ongoing clinical trials using oral tolerance as an immunother apeutic approach to treat autoimmune diseases, among them uveitis.