Reinisch and colleagues (Gut 2006;55:1138–44) recently reported that the infusion of fontolizumab, an anti-interferon γ antibody, into patients with Crohn’s disease was generally well tolerated with encouraging clinical responses. Unfortunately, not all first trials with therapeutic antibodies go as well as planned. As we recently witnessed with the intravenous administration of TGN1412, designed to activate regulatory T cells for the treatment of leukaemia and autoimmune diseases such as rheumatoid arthritis, six volunteers were hospitalised, four of whom suffered major organ failure. The patients’ conditions was described as “cytokine release syndrome” which occurs when activated T cells produce a systemic inflammatory response.

Could the violent reaction to the monoclonal antibody be avoided with oral administration? Ochi et al’s recent report may offer an answer. They observed that oral was as effective as intravenous administration of anti-CD3 in reversing established experimental autoimmune encephalomyelitis.¹

While traditionally administered intravenously, when …