while the invention will now be described in connection with certain preferred embodiments in the following examples so that aspects thereof may be more fully understood and appreciated , it is not intended to limit the invention to these particular embodiments . on the contrary , it is intended to cover all alternatives , modifications and equivalents as may be included within the scope of the invention as defined by the appended claims . thus , the following examples which include preferred embodiments will serve to illustrate the practice of this invention , it being understood that the particulars shown are by way of example and for purposes of illustrative discussion of preferred embodiments of the present invention only and are presented in the cause of providing what is believed to be the most useful and readily understood description of formulation procedures as well as of the principles and conceptual aspects of the invention . twelve weeks old ldl - rd mice ( hybrids of between the c57bl / 6j and 129sv strains ) are created by homologous recombination . the mice are purchased from the jackson laboratory ( bar - harbor me .). the ldl - rd mice are used since they have high cholesterol levels on chow diet ( which are similar to human values ) and develop significant atherosclerosis only when fed a high fat diet . the ldl - rd mice are either fed with a normal chow - diet containing 4 . 5 % fat by weight ( 0 . 02 % cholesterol ) or an atherogenic diet ( harlan , teklad premier laboratory diets , madison , wis .) containing : 1 . 25 % cholesterol , 7 . 5 % casein and 0 . 5 % ( wt /) sodium - cholate . the mice are maintained on 12 hour - dark / 12 hour light cycles and are allowed to access food and water ad libitum . blood for lipoprotein isolation is collected in edta ( 1 mg / ml ) after 12 hours of fasting . ldl ( density = 1 . 019 - 1 . 063 g / l ) is isolated from the plasma after density adjustment with kbr , by preparative ultracentrifugation at 50 , 000 rpm / min for 22 hours , using type 50 rotor . the ldl preparations are washed by ultracentrifugation , dialyzed against a ph 7 . 4 , 0 . 15 mol / l edta , passed through acrodisc filter ( 0 . 22 um pore size ) to remove aggregates , and stored under nitrogen in the dark . ldl oxidation is performed by incubation of pre - dialyzed ldl ( 1 mg of protein / ml in edta - free pbs ) with copper sulfate ( 10 μm ) for 24 h at 37 ° c . lipoprotein oxidation is confirmed by analysis of thiobarbituric acid - reactive substances ( tbars ) which measures malondialdehyde ( mda ) equivalents by the lipid peroxidation test and also by analysis of the conjugated diene content of the lipoprotein . preparation of native and copper - oxidized ldl is preformed . ninety six well polystyrene plates ( nunc maxisorp , denmark ) are coated with either ox ldl , native ldl ( at concentration of 5 ug / ml in pbs ) or pbs overnight at 4 ° c . after washing four times with pbs containing 0 . 05 % tween and 0 . 001 % aprotinin ( sigma , usa ) the plates are blocked with 2 % bovine serum albumin ( bsa ) for 2 hours at room temperature . serum fractions are diluted to 1 : 50 in pbs 0 . 05 % tween 0 . 2 % bsa . after an additional overnight incubation the plates are washed and alkaline phosphatase - conjugated goat anti - mouse igg ( jackson lmmunoresearch laboratory inc ., usa ) are added and diluted to 1 : 10 , 000 in pbs 0 . 05 % tween - 0 . 2 % bsa for 1 hour at room temperature . after extensive washing , 1 mg / ml p - nitrophenyi - phosphate ( sigma ) in 50 mm carbonate buffer containing 1 mm mgcl 2 ph 9 . 8 is added as a substrate . the reaction is stopped after 30 min by adding 1 m of naoh . the color is read at a 405 nm wavelength in a titertek elisa reader ( s . l . t laboratory instruments , vienna , austria ) and results expressed as o . d . at 405 nm . the titer of anti - ox ldl antibodies is calculated by subtracting the value obtained from binding to native ldl from the binding to ox ldl . inhibition assays are performed to confirm the specificity of anti - ox ldl antibodies and to check for a possible cross - reactivity with hsp — an important immunogen in atherosclerosis . the concentration of hsp - 65 - immunized mouse serum giving half of the maximal binding to ox ldl are determined and different inhibitors ( i . e . hsp - 65 , ox ldl , bovine serum albumin ) are applied in increasing concentrations . recombinant hsp - 65 ( 1 μg / ml ) in phosphate buffered saline ( pbs , ph 7 . 2 ) are coated onto flat bottom 96 - well elisa plates ( nunc maxisorp , denmark ) by overnight incubation at 4 ° c . after washings with 0 . 02 % pbs tween and blocking with 1 % bsa in pbs , sera are added in different dilutions ( 1 : 50 , 1 : 100 , 1 : 200 , in pbs ) and incubated for 1 hr at room temperature . peroxidase conjugated rabbit anti - mouse igg ( dako ltd , high wycombe , uk ) are added and incubated for 1 hr at room temperature followed by 4 washings with pbs / tween . finally , 100 μl of citrate phosphate buffer ( 0 . 1 m , ph 4 . 2 ) containing 0 . 53 mg / ml of 2 , 2 - azino - bis 3 - ethylbenzthiazoline - 6 - sulfonic acid ( abts ; sigma ) are added , and absorbance is measured after 30 min at 490 nm in a titertek elisa reader . a modified elisa to determine reactivity of the mouse and human antibodies to pl is perfrormed . microtiter plates ( nunc , maxisorp , denmark ) are coated either with an anionic pl [ cardiolipin ( cl ), phosphatidylserine ( ps ), phosphatidylinositol ( pi )] and phosphatidylcholine ( pc ), all from sigma chemicals co . st . louis , mo ., at a concentration of 50 ug / ml and dissolved in ethanol , except for pc ( choloroform - methanol , 1 : 3 ). plates are dried under vacuum and blocked with tbs containing 0 . 5 % gelatin . the plates are then washed three times with tbs and different concentrations of mouse preparations are added to the wells treated with human β2gpi ( 5 ug / ml for 30 min ) or 0 . 1 % gelatin / tbs alone . the binding of the antibodies is detected with goat anti - mouse alkaline phosphatase conjugate and the addition of substrate ( p - nitro - phenylphosphate ). the results are expressed as absorbance at 405 nm ( od 405 ). one ug / ml β2gpi or a different dm is incubated overnight in 50 mm bicarbonate buffer , ph 9 . 6 at 4 ° c . in 96 - well polystyrene plates ( nunc ). after 3 washings with tbs , blocking is performed with 0 . 5 % gelatin / tbs for 2 hrs ( as for the anti - pl elisa ). the plates are then washed three times and murine sera ( diluted in 1 : 100 in gelatin / tbs ) is added and incubated for 2 hrs at room temperature . after 3 washings , alkaline phosphatase conjugated goat anti - human igg respectively diluted in 0 . 1 % gelatin / tbs ( 1 : 10 , 000 ) is added for 2 hrs . after 3 additional washings , the substrate pnitrophenylphosphate in a sodium carbonate buffer ph 9 . 8 is added and absorbance is read at 405 nm . spleens are removed from mice upon sacrifice , and lymphocytes are isolated . 1 × 10 6 cells per ml are incubated in triplicates for 72 h in 0 . 2 ml of culture medium in microtiter wells in the presence of different concentrations of hsp - 65 , ox ldl , β2gpi or ovalbumin . proliferation is measured by the incorporation of [ 3 h ] thymidine into dna during the final 12 hours of incubation . the results are computed as stimulation index ( s . i . ): the ratio of the mean cpm of the antigen to the mean background cpm obtained in the absence of the antigen . spleen cells are removed following sacrifice and spienocytes are incubated for 3 days with ox ldl , hsp - 65 or ovalbumin following which the supernatant is collected . cytokine profile ( il - 4 , il - 10 , ifn - γ , and tgf - β ) is determined at the cultured supernatant of the splenocytes . the mice used in this experiment are called ldl - receptor deficient ( ldl - rd ) mice . these animals have a genetic mutation which causes a defect in the receptor for ldl in all cells of the body . this receptor is responsible for evacuating and removing from the circulation , the ‘ bad ’ cholesterol ( ldl ), and when it is deficient the mice become hyperlipidemic and develop atherosclerosis when they are fed a high fat diet for 3 - 5 weeks . three groups of mice were used ( 15 ldl - rd mice in each group ). feeding was performed by a special device ( canula ) designed to be introduced to the esophagus and thus assuring the fed substances reaches mostly to the stomach . group 1 : the mice were fed 5 doses of 1 mg of human ox ldl dissolved in pbs , every other day . at the end of the last dose , the mice were put on a high fat diet and sacrificed either after 3 or after 5 weeks of diet . group 2 : the mice were fed 5 does of 1 mg of a control protein ( ovalbumin ) in pbs and then fed with the special diet for 3 or 5 weeks . group 3 : the mice were not fed prior to initiation of the diet . the mice were evaluated , upon sacrifice for the occurrence of atherosclerotic lesions , serum cholesterol values and levels of antibodies to ox ldl . results : all mice were of similar weight prior to , and at the termination of the study . the mice fed ox ldl were found to develop less atherosclerosis ( 30 % less ). in the present studies the beneficial effect of oral tolerance with ox ldl on the induction of atherosclerosis in mice has been shown . there are many studies in which the results point to the effectiveness of oral tolerance in various autoimmune diseases , such as collagen in adjuvant arthritis ( the analogue of rheumatoid arthritis ), in diabetes mellitus , in uveitis , in eae ( analogue to multiple sclerosis ). in the above - mentioned studies human trial was done . recently a remarkable effect was noted when patients with rheumatoid arthritis were given per oral collagen ii ( oral tolerance ). the comparable effect between mice studies and humans in various autoimmune diseases point to the extrapolated success in humans . it should be stressed that this treatment has no side effects . suppression of high fat diet induced atherosclerosis in ldl - receptor deficient mice by feeding with human ox ldl ldl - rd mice ( n = 15 ) are fed 5 doses ( every other day ) of human ox ldl in three different concentrations ( 1 mg / dose , 100 ug / dose and 1 mg / dose ). additional ldl - rd mice ( n = 15 per groups ) are fed a control antigen ( ovalbumin at similar doses ). one day following the last feeding , all mice are challenged with a high fat diet (‘ paigen ’) for 5 weeks . at the end of the experiment , sera from all mice is evaluated for the presence of anti - ox ldl , anti - hsp65 and antiphospholipid antibodies and a lipid profile is carried out ( total cholesterol , ldl , vldl , hdl and triglycerides ). hearts from all mice are removed at the end of the study and frozen in − 70 ° c . until use ( see materials and methods ) immunohistochemical studies on the cryostat sections are performed using monoclonal antibodies to cd3 , cd4 , cd8 , macrophages , smooth muscle cells and lymphocyte activation markers . a similar protocol of feeding is carried out using lpc an active derivative of ox ldl . suppression of mycobaceterium tuberculosis ( mt ) induced atherosclerosis by feeding with hsp - 65 the present inventors have observed that ldl - rd mice immunized once , with mt develop enhanced early atherosclerosis . ldl - rd mice ( n = 15 ) are fed 5 doses ( every other day ) of recombinant hsp65 in three different concentrations ( 100 mg / dose , 10 ug / dose and 1 ug / dose ). additional ldl - rd mice ( n = 15 per groups ) are fed a control antigen ( ovalbumin at similar doses ). one day following the last feeding , all mice are challenged by an immunization with heat killed suspension of mt ( 10 mg / ml ; 100 ug / mouse ) emulsified in incomplete freund &# 39 ; s adjuvant . the mice are sacrificed 12 weeks following the immunization with mt . at the end of the experiment , sera from all mice is evaluated for the presence of anti - hsp65 antibodies , and a lipid profile is carried out ( total cholesterol , ldl , vldl , hdl and triglycerides ). proliferative responses from draining lymph node cells are evaluated to hsp65 from hsp65 tolerized mice and from control fed mice . cytokine levels ( il - 4 , ifn - γ , il - 10 and tgf - β ) are evaluated in the supernatant collected from the medium in which lymphocytes are induced in - vitro with hsp65 . hearts from all mice are removed and frozen in − 70 ° c . to determine the extent of atherosclerosis cryostat sections are performed ( 5 um per section ). the relevant sections ( from the aortic sinus area ) are stained with the oil - red o and the extent of atherosclerosis is determined by counting the area counted by a grid . immunohistochemical studies on the cryostat sections are performed using monoclonal antibodies to cd3 , cd4 , cd8 , macrophages , smooth muscle cells and lymphocyte activation markers . the procedure is similar to the one employed for ox ldl and hsp - 65 and is based on the observation that immunization with β2gpi induces early atherogenesis . quantification of atherosclerotic fatty streak lesions are carried out by calculating the lesion size in the aortic sinus ( with a few modifications ). briefly , the heart and upper section of the aorta are removed from the animals and the peripheral fat cleaned carefully . the upper section is embedded in oct medium and frozen . every other section ( 10 μm thick ) throughout the aortic sinus ( 400 μm ) is taken for analysis . the distal portion of the aortic sinus is recognized by the three valve cusps which are the junctions of the aorta to the heart . sections are evaluated for fatty streak lesions after staining with oil - red o . lesion areas per sections are counted using a grid by an observer unfamiliar with the tested specimen . the extent of atherosclerosis is evaluated at the level of the aortic sinus . processing and staining of the tissue is carried out . lesion area is quantified by the modified method of rubin e m , kraus r m , spangler e a & amp ; al . ( inhibition of early atherogenesis in transegenic mice by human apolipoprotein al . nature 1991 ; 353 : 265 - 267 ). mabs : rat monoclonal antibodies h129 . 19 ( l3t4 )- anti - mouse cd4 + and s3 - 6 . 7 ( ly - 2 )- anti - mouse cd8a are obtained from pharmingen ( san diego , calif ., usa ); mca 497 ( f4 / 80 )- anti - mouse macrophages are obtained from serotec ( oxford , uk ). immunohistochemical staining for cd4 , cd8 and macrophages are carried out on aortic sinus 5 μm thick frozen sections . the sections are fixed for 4 min . in methanol at − 20 ° c . followed by 10 min . incubation with ethanol at − 20 ° c . the sections are then blocked with non - immune goat serum for 15 min . at room temperature followed by incubation with cas blocking reagent for 30 min . at room temperature . subsequently ; the rat - monoclonal anti - mouse cd4 / cd8 is added for 1 hr aroom . after washings , affinity purified biotinylated rabbit anti - rat igg antibodies are added for 30 min at rt . after washings , the slides are incubated with 0 . 3 % h 2 o 2 , followed by additional rinses and incubation with streptavidin - peroxidase conjugate for 30 min at rt . after washings , the slides are developed with 3 amino - 9 - ethylcarbonasole ( aec ) substrate ( dako ) for 15 min . sections are counterstained with hematoxylin . spleen sections are used as a positive control . staining in the absence of 1st or 2nd antibody are used as a negative control . t - cells ( either cd4 or cd8 cells ) will be isolated from the tolerized and non tolerized mice in each of the studies and transferred to ldl - rd littermates which will be challenged with an atherogenic diet for 6 weeks . at the end of the experiments the hearts will be taken for evaluation of atherosclerosis and immunohisotchemistry . it will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative examples and that the present invention may be embodied in other specific forms without departing from the essential attributes thereof , and it is therefore desired that the present embodiments and examples be considered in all respects as illustrative and not restrictive , reference being made to the appended claims , rather than to the foregoing description , and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein .
an immunological oral tolerance - inducing composition for prevention and / or treatment of atherosclerosis , comprising an active component selected from the group consisting of modified low density lipoprotein , oxidized low density lipoprotein , heat shock protein 60 / 65 , beta 2 - glycoprotein - 1 , functional derivatives thereof and mixtures thereof , in combination with a pharmaceutically acceptable carrier for oral administration .