Moreover, other bigger molecules than PEG (whose molecular mass is around 40–50kDa) have been recently proposed to potentially cross the capillary wall, like ipilimumab, a recombinant monoclonal antibody of 148kDa directed against cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), which can trigger an hypophysitis state in humans by binding the CTLA-4 when expressed on the pituitary cells (Iwama et al. 2014). The gene discussed is CTLA4; the disease is hypophysitis.