Gut response. Therapy with ingested immunomodulatory proteins

The recent negative results of the 2-year phase III trial of enteral myelin (Myloral), a preparation of bovine myelin given orally in multiple sclerosis (MS), warn that the efficacy of oral tolerization (ie, inducing hyporesponsiveness to a specific autoantigen) and the attractiveness of oral desensitization in animal models of MS may not translate into clinical practice. However, such failure should not deter further examination of the mouth, an immunologically interesting and patient-friendly route for immunomodulatory proteins.