ORAL MUCOSAL IMMUNOTHERAPY Oral Mucosal Delivery of Allergenic Proteins for Inducing Tolerance in Food Allergic Individuals

摘要

Currently, there is a tremendous amount of interest in the delivery of drugs through the oral mucosa for a vast array of medical conditions. The oral mucosa is more permeable than the skin by 1000-fold and lacks the enzymatic activity of the gastrointestinal tract.1 One of the key benefits of this route, however, is the absence of first-pass metabolism. When a drug is delivered directly into the systemic circulation, rather than allowing it to absorb through the stomach and intestinal lining, it bypasses the hepatic venous system and avoids being metabolized by the liver. This can enhance the efficacy of a drug, theoretically lowering the therapeutic dose required. Other routes of drug delivery outside the gastrointestinal tract, such as injection and transdermal application, may be associated with increased discomfort, inconvenience, or undesirable side effects. Oral mucosal delivery is also very useful for children or adults who have difficulty swallowing tablets, or for people with gastrointestinal illnesses that are experiencing nausea, vomiting, or dysphagia.