Erythrocyte-Specific Antibodies As a Potential New Therapeutic Modality in Autoimmune and Inflammatory Disorders Beyond Immune Thrombocytopenia (ITP)
Notice bibliographique
Résumé
Abstract ITP is an autoimmune bleeding disorder characterized by platelet destruction and suppression of platelet production. In the majority of patients, platelet destruction due to IgG antibodies reactive with platelet GPIIbIIIa results in platelet phagocytosis by phagocytic cells in the mononuclear phagocytic system. Anti-D is an effective first-line therapy for patients with ITP and was originally brought into practice based on the ability of anti-D to competitively inhibit opsonized-platelet clearance by phagocytic cells. Similar to anti-D, an RBC-specific monoclonal antibody (TER-119) is also able to inhibit platelet clearance in a murine model of passive ITP, also ostensibly due to RBC clearance and competitive inhibition of phagocytic cells. Here, we show that TER-119 only caused measurable anemia after 3 hours post-injection while its ability to ameliorate thrombocytopenia in the passive-murine ITP model was clearly evident by 30 minutes post-injection. Further, TER-119 mediated maximal anemia 4 days after its injection, yet displayed no measurable ameliorative effects in passive-ITP at this time point. Based on these observations, we hypothesized that anti-inflammatory activity, rather than simple competitive inhibition of opsonized-platelet clearance, might be involved in this mechanism. To test this hypothesis, the ability of TER-119 to successfully treat inflammatory diseases not involving antibody-mediated splenic cellular sequestration were examined. In the K/BxN serum-transfer model of arthritis, recipient C57BL/6 mice are injected with K/BxN serum and a rapidly progressing arthritis occurs due to antibodies specific to the self-protein glucose-6-phosphate isomerase. Using this model, the same dose of TER-119 (50 μg/mouse) which was effective in murine ITP could significantly prevent the induction of inflammatory arthritis. In separate experiments, mice were allowed to develop significant arthritis for 5 days and then injected with TER-119. These arthritic mice underwent a reversal in disease severity with significant and substantial decreases in joint swelling and clinical score evident 24 hours after injection of TER-119. In fact three days after injection with TER-119, clinical scores and ankle width measurements returned to baseline. The function of the Fc region was important in the anti-inflammatory activity of TER-119 as deglycosylation of the Fc region of the antibody (known to inhibit IgG Fc region effector functions) dramatically reduced anti-inflammatory function in the arthritis model. To determine if TER-119 could also ameliorate disease activity in an unrelated (non-autoimmune) inflammatory disease model, TER-119 was also examined in a murine model of transfusion-related acute lung injury (TRALI). TRALI is a syndrome of respiratory distress primarily triggered by leukocyte-reactive antibodies from blood product transfusions and is the leading cause of transfusion-related mortality. TRALI was induced by injecting mice with the anti-MHC class I antibody (34-1-2s) which induced a rapid decrease in body temperature and induced significant lung damage, assessed by the presence of pulmonary edema. Mice pretreated with TER-119 (50 μg) underwent a rescue from hypothermia and exhibited an almost complete inhibition of lung edema. We conclude that TER-119 has significant anti-inflammatory activity and suggest that RBC specific antibodies such as anti-D may have significant therapeutic potential in inflammatory disorders beyond just ITP. Disclosures Semple: Novartis: Consultancy; Rigel: Consultancy; Amgen: Consultancy; UCB: Consultancy. Lazarus: CSL pharmaceuticals: Research Funding; Momenta pharmaceuticals: Honoraria; Rigel pharmaceuticals: Research Funding; St.Michael's Hosp/The Canadian Blood Services: Other: Patents on monoclonal antibodies as IVIg and anti-D replacements.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».