Oral Tolerance

Oral tolerance is the immunologic mechanism by which the mucosal immune system maintains unresponsiveness to the myriad of antigens in the mucosal environment which might otherwise induce untoward immune responses. Recent studies have shown that it is mediated by several distinct, yet interacting mechanisms including the generation of suppressive T cells producing antigen nonspecific cytokines and the induction of clonal deletion and/or anergy. In this review of oral tolerance, we discuss these mechanisms in detail and show how oral tolerance or lack therof may explain the occurrence of mucosal inflammation. In addition, we discuss how induction of oral tolerance can be used to treat autoimmune states.     

Tolerance in Drosophila

The set of genes that underlie ethanol tolerance (inducible resistance) are likely to overlap with the set of genes responsible for ethanol addiction. Whereas addiction is difficult to recognize in simple model systems, behavioral tolerance is readily identifiable and can be induced in large populations of animals. Thus, tolerance lends itself to analysis in model systems with powerful genetics. Drosophila melanogaster has been used by a variety of laboratories for the identification of genes that interfere with the acquisition of ethanol tolerance. Here, I discuss the genes identified as being important for the production of ethanol tolerance in Drosophila. Some of these genes have also been shown to be important for the production of tolerance in mammals, demonstrating that gene discovery in Drosophila has predictive value for understanding the molecular pathways that generate tolerance in mammals.     

Tolerance and immune regulation

Understanding of both the phenomenon of immunological tolerance and the mechanisms by which it is achieved is rapidly advancing, as was evident from a recent meeting. This report summarizes key developments in both T- and B-cell biology.     

Tolerance can be infectious

Studies focused on the goal of eliciting transplant tolerance led Herman Waldmann to rejuvenate discarded ideas of 'suppressor T cells'. Such cells are now known to exist.     

Mechanisms of Oral Tolerance

Oral tolerance is a state of systemic unresponsiveness that is the default response to food antigens in the gastrointestinal tract, although immune tolerance can also be induced by other routes, such as the skin or inhalation. Antigen can be acquired directly by intestinal phagocytes, or pass through enterocytes or goblet cell-associated passages prior to capture by dendritic cells (DCs) in the lamina propria. Mucin from goblet cells acts on DCs to render them more tolerogenic. A subset of regulatory DCs expressing CD103 is responsible for delivery of antigen to the draining lymph node and induction of Tregs. These DCs also imprint gastrointestinal homing capacity, allowing the recently primed Tregs to home back to the lamina propria where they interact with macrophages that produce IL-10 and expand. Tregs induced by dietary antigen include Foxp3⁺ Tregs and Foxp3^? Tregs. In addition to Tregs, T cell anergy can also contribute to oral tolerance. The microbiota plays a key role in the development of oral tolerance, through regulation of macrophages and innate lymphoid cells that contribute to the regulatory phenotype of gastrointestinal dendritic cells. Absence of microbiota is associated with a susceptibility to food allergy, while presence of Clostridia strains can suppress development of food allergy through enhancement of Tregs and intestinal barrier function. It is not clear if feeding of antigens can also induce true immune tolerance after a memory immune response has been generated, but mechanistic studies of oral immunotherapy trials demonstrate shared pathways in oral tolerance and oral immunotherapy, with a role for Tregs and anergy. An important role for IgA and IgG antibodies in development of immune tolerance is also supported by studies of oral tolerance in humans. The elucidation of key pathways in oral tolerance could identify new strategies to increase efficacy of immunotherapy treatments for food allergy.     

Experimentally Induced Transplantation Tolerance

Neonatal tolerance was induced in CBA mice to alloantigens expressed by lymphoid cells of the A/Sn strain. 50% of the grafted animals maintained viable skin grafts for greater than 120 days and thus were considered operationally tolerant. However, splenic lymphocytes from these animals were capable of in vitro activation of DNA synthesis in response to the tolerizing alloantigens. Likewise, the spleen contained precursors of cytotoxic effector cells capable, upon activation, of similarly recognizing the major histocompatibility complex alloantigens used for tolerance induction. In contrast, in vivo graft-versus-host (GVH) effector function was absent, suggesting a possible dissociation of cells involved in the in vitro cell-mediated lympholysis and the in vivo GVH. Determination of potential serum-blocking factors as a possible mechanism of graft survival in these tolerant animals proved negative.     

Central Tolerance of T Cells

The immune system is constructed to tolerate self antigens but give vigorous responses to foreign antigens. How this state of self/nonself discrimination is maintained is controversial. In the case of T cells, many self antigens are transported to the thymus via the bloodstream and induce tolerance (clonal deletion) of self-reactive thymocytes in situ. Although such central tolerance in the thymus is well documented, it is often argued that full induction of tolerance requires peripheral mechanisms such as suppression or induction of anergy. This article proposes that steady-state tolerance of T cells to self components is due solely to central tolerance to circulating self antigens combined with sequestration of tissue-specific antigens. Backup mechanisms for tolerance do exist but such immunoregulation only operates when self tolerance breaks. This scheme allows the immune system to give unrestricted primary responses to foreign antigens.