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CD6 is a glycoprotein expressed on CD4 and CD8 T cells involved in immunoregulation. CD318 has been identified as a CD6 ligand. The role of CD318 in T cell immunity is restricted as it has only been investigated in a few mice autoimmune models but not in human diseases. CD318 expression was thought to be limited to mesenchymal-epithelial cells and, therefore, contribute to CD6-mediated T cell activation in the CD318-expressing tissue rather than through interaction with antigen-presenting cells. Here, we report CD318 expression in a subpopulation of CD318+ myeloid dendritic (mDC), whereas the other peripheral blood populations were CD318 negative. However, CD318 can be induced by activation: a subset of monocytes treated with LPS and IFNγ and in vitro monocyte derived DCs were CD318+. We also showed that recombinant CD318 inhibited T cell function. Strikingly, CD318+ DCs suppressed the proliferation of autoreactive T cells specific for GAD65, a well-known targeted self-antigen in Type 1 Diabetes (T1D). Our study provides new insight into the role of the CD318/CD6 axis in the immunopathogenesis of inflammation, suggesting a novel immunoregulatory role of CD318 in T cell-mediated autoimmune diseases and identifying a potential novel immune checkpoint inhibitor as a target for intervention in T1D which is an unmet therapeutic need.
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Antígenos CD , Autoantígenos , Moléculas de Adesão Celular , Células Dendríticas , Diabetes Mellitus Tipo 1 , Ilhotas Pancreáticas , Ativação Linfocitária , Humanos , Antígenos CD/metabolismo , Antígenos CD/imunologia , Antígenos de Diferenciação de Linfócitos T/metabolismo , Antígenos de Diferenciação de Linfócitos T/imunologia , Autoantígenos/imunologia , Células Cultivadas , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Diabetes Mellitus Tipo 1/imunologia , Diabetes Mellitus Tipo 1/metabolismo , Glutamato Descarboxilase , Ilhotas Pancreáticas/imunologia , Ilhotas Pancreáticas/metabolismo , Ativação Linfocitária/imunologia , Linfócitos T/imunologia , Linfócitos T/metabolismo , Moléculas de Adesão Celular/imunologia , Moléculas de Adesão Celular/metabolismo , Antígenos de Neoplasias/imunologia , Antígenos de Neoplasias/metabolismoRESUMO
Ductal progenitor-like cells are a sub-population of ductal cells in the adult human pancreas that have the potential to contribute to regenerative medicine. However, the microenvironmental cues that regulate their activation are poorly understood. Here, we establish a 3-dimensional suspension culture system containing six defined soluble factors in which primary human ductal progenitor-like and ductal non-progenitor cells survive but do not proliferate. Expansion and polarization occur when suspension cells are provided with a low concentration (5% v/v) of Matrigel, a sarcoma cell product enriched in many extracellular matrix (ECM) proteins. Screening of ECM proteins identified that collagen IV can partially recapitulate the effects of Matrigel. Inhibition of integrin α1ß1, a major collagen IV receptor, negates collagen IV- and Matrigel-stimulated effects. These results demonstrate that collagen IV is a key ECM protein that stimulates the expansion and polarization of human ductal progenitor-like and ductal non-progenitor cells via integrin α1ß1 receptor signaling.
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Cluster of differentiation 47 (CD47) occupies the outer membrane of human cells, where it binds to soluble and cell surface receptors on the same and other cells, sculpting their topography and resulting in a pleiotropic receptor-multiligand interaction network. It is a focus of drug development to temper and accentuate CD47-driven immune cell liaisons, although consideration of on-target CD47 effects remain neglected. And yet, a late clinical trial of a CD47-blocking antibody was discontinued, existent trials were restrained, and development of CD47-targeting agents halted by some pharmaceutical companies. At this point, if CD47 can be exploited for clinical advantage remains to be determined. Herein an airing is made of the seemingly conflicting actions of CD47 that reflect its position as a junction connecting receptors and signalling pathways that impact numerous human cell types. Prospects of CD47 boosting and blocking are considered along with potential therapeutic implications for autoimmune diseases and cancer.
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Antineoplásicos , Neoplasias , Humanos , Fagocitose , Antígeno CD47/metabolismo , Imunoterapia/métodos , Neoplasias/metabolismo , Antineoplásicos/uso terapêuticoRESUMO
Cheese whey (CW) is a nutrient deficient dairy effluent, which requires external nutrient supplementation for aerobic treatment. CW, supplemented with ammonia, can be treated using aerobic granular sludge (AGS) in a sequencing batch reactor (SBR). AGS are aggregates of microbial origin that do not coagulate under reduced hydrodynamic shear and settle significantly faster than activated sludge flocs. However, granular instability, slow granulation start-up, high energy consumption and CO2 emission have been reported as the main limitations in bacterial AGS-SBR. Algal-bacterial granular systems have shown be an innovative alternative to improve these limitations. Unfortunately, algal-bacterial granular systems for the treatment of wastewaters with higher organic loads such as CW have been poorly studied. In this study, an algal-bacterial granular system implemented in a SBR (SBRAB) for the aerobic treatment of ammonia-supplemented CW wastewaters was investigated and compared with a bacterial granular reactor (SBRB). Mass balances were used to estimate carbon and nitrogen (N) assimilation, nitrification and denitrification in both set-ups. SBRB exhibited COD and ammonia removal of 100% and 94% respectively, high nitrification (89%) and simultaneous nitrification-denitrification (SND) of 23% leading to an inorganic N removal of 30%. The efficient algal-bacterial symbiosis in granular systems completely removed COD and ammonia (100%) present in the dairy wastewater. SBRAB microalgae growth could reduce about 20% of the CO2 emissions produced by bacterial oxidation of organic compounds according to estimates based on synthesis reactions of bacterial and algal biomass, in which the amount of assimilated N determined by mass balance was taken into account. A lower nitrification (75%) and minor loss of N by denitrifying activity (<5% Ng, SND 2%) was also encountered in SBRAB as a result of its higher biomass production, which could be used for the generation of value-added products such as biofertilizers and biostimulants.
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Microalgas , Águas Residuárias , Esgotos/microbiologia , Nitrogênio/análise , Carbono , Simbiose , Amônia , Dióxido de Carbono , Reatores Biológicos , Nitrificação , Bactérias , Desnitrificação , Eliminação de Resíduos LíquidosRESUMO
The use of treatments, such as programmed death protein 1 (PD1) or cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) antibodies, that loosen the natural checks upon immune cell activity to enhance cancer killing have shifted clinical practice and outcomes for the better. Accordingly, the number of antibodies and engineered proteins that interact with the ligand-receptor components of immune checkpoints continue to increase along with their use. It is tempting to view these molecular pathways simply from an immune inhibitory perspective. But this should be resisted. Checkpoint molecules can have other cardinal functions relevant to the development and use of blocking moieties. Cell receptor CD47 is an example of this. CD47 is found on the surface of all human cells. Within the checkpoint paradigm, non-immune cell CD47 signals through immune cell surface signal regulatory protein alpha (SIRPα) to limit the activity of the latter, the so-called trans signal. Even so, CD47 interacts with other cell surface and soluble molecules to regulate biogas and redox signaling, mitochondria and metabolism, self-renewal factors and multipotency, and blood flow. Further, the pedigree of checkpoint CD47 is more intricate than supposed. High-affinity interaction with soluble thrombospondin-1 (TSP1) and low-affinity interaction with same-cell SIRPα, the so-called cis signal, and non-SIRPα ectodomains on the cell membrane suggests that multiple immune checkpoints converge at and through CD47. Appreciation of this may provide latitude for pathway-specific targeting and intelligent therapeutic effect.
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Antígeno CD47 , Neoplasias , Humanos , Antígenos de Diferenciação/farmacologia , Receptores Imunológicos/metabolismo , Neoplasias/terapia , Anticorpos/farmacologia , Proteínas de Transporte , FagocitoseRESUMO
Sporadic colorectal cancer (sCRC) initially presents as metastatic tumors in 25-30% of patients. The 5-year overall survival (OS) in patients with metastatic sCRC is 50%, falling to 10% in patients presenting with synchronous metastatic disease (stage IV). In this study, we systematically analyzed the mutations of RAS, PIK3CA and BRAF genes in circulating tumor DNA (ctDNA) and tumoral tissue DNA (ttDNA) from 51 synchronous metastatic colorectal carcinoma (SMCC) patients by real-time PCR, and their relationship with the clinical, biological and histological features of disease at diagnosis. The highest frequency of mutations detected was in the KRAS gene, in tumor biopsies and plasma samples, followed by mutations of the PIK3CA, NRAS and BRAF genes. Overall, plasma systematically contained those genetic abnormalities observed in the tumor biopsy sample from the same subject, the largest discrepancies detected between the tumor biopsy and plasma from the same patient being for mutations in the KRAS and PIK3CA genes, with concordances of genotyping results between ttDNA and ctDNA at diagnosis of 75% and 84%, respectively. Of the 51 SMCC patients in the study, 25 (49%) showed mutations in at least 1 of the 4 genes analyzed in patient plasma. From the prognostic point of view, the presence and number of the most common mutations in the RAS, PIK3CA and BRAF genes in plasma from SMCC patients are independent prognostic factors for OS. Determination of the mutational status of ctDNA in SMCC could be a key tool for the clinical management of patients.
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DNA Tumoral Circulante , Neoplasias do Colo , Neoplasias Colorretais , Neoplasias Retais , Humanos , DNA Tumoral Circulante/genética , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/genética , Mutação , Classe I de Fosfatidilinositol 3-Quinases/genética , Biomarcadores Tumorais/genética , Análise Mutacional de DNARESUMO
Systematic seafloor surveys are a highly desirable method of marine litter monitoring, but the high costs involved in seafloor sampling are not a trivial handicap. In the present work, we explore the opportunity provided by the artisanal trawling fisheries to obtain systematic data on marine litter in the Gulf of Cadiz between 2019 and 2021. We find that plastic was the most frequent material, with a prevalence of single-use and fishing-related items. Litter densities decreased with increasing distance to shore with a seasonal migration of the main litter hotspots. During pre-lockdown and post-lockdown stages derived from COVID-19, marine litter density decreased by 65 %, likely related to the decline in tourism and outdoor recreational activities. A continuous collaboration of 33 % of the local fleet would imply a removal of hundreds of thousands of items each year. The artisanal trawl fishing sector can play a unique role of monitoring marine litter on the seabed.
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COVID-19 , Pesqueiros , Humanos , Monitoramento Ambiental , Controle de Doenças Transmissíveis , Poluição Ambiental , Plásticos , Resíduos/análiseRESUMO
Thrombospondin-1 (TSP1) is a secreted protein minimally expressed in health but increased in disease and age. TSP1 binds to the cell membrane receptor CD47, which itself engages signal regulatory protein α (SIRPα), and the latter creates a checkpoint for immune activation. Individuals with cancer administered checkpoint-blocking molecules developed insulin-dependent diabetes. Relevant to this, CD47 blocking antibodies and SIRPα fusion proteins are in clinical trials. We characterized the molecular signature of TSP1, CD47, and SIRPα in human islets and pancreata. Fresh islets and pancreatic tissue from nondiabetic individuals were obtained. The expression of THBS1, CD47, and SIRPA was determined using single-cell mRNA sequencing, immunofluorescence microscopy, Western blot, and flow cytometry. Islets were exposed to diabetes-affiliated inflammatory cytokines and changes in protein expression were determined. CD47 mRNA was expressed in all islet cell types. THBS1 mRNA was restricted primarily to endothelial and mesenchymal cells, whereas SIRPA mRNA was found mostly in macrophages. Immunofluorescence staining showed CD47 protein expressed by ß cells and present in the exocrine pancreas. TSP1 and SIRPα proteins were not seen in islets or the exocrine pancreas. Western blot and flow cytometry confirmed immunofluorescent expression patterns. Importantly, human islets produced substantial quantities of secreted TSP1. Human pancreatic exocrine and endocrine tissue expressed CD47, whereas fresh islets displayed cell surface CD47 and secreted TSP1 at baseline and in inflammation. These findings suggest unexpected effects on islets from agents that intersect TSP1-CD47-SIRPα.NEW & NOTEWORTHY CD47 is a cell surface receptor with two primary ligands, soluble thrombospondin-1 (TSP1) and cell surface signal regulatory protein alpha (SIRPα). Both interactions provide checkpoints for immune cell activity. We determined that fresh human islets display CD47 and secrete TSP1. However, human islet endocrine cells lack SIRPα. These gene signatures are likely important given the increasing use of CD47 and SIRPα blocking molecules in individuals with cancer.
Assuntos
Antígeno CD47 , Neoplasias , Humanos , Antígeno CD47/genética , Antígeno CD47/metabolismo , Macrófagos/metabolismo , Neoplasias/metabolismo , Receptores de Superfície Celular/metabolismo , Trombospondinas/metabolismo , Trombospondinas/uso terapêutico , Trombospondina 1/genética , Trombospondina 1/metabolismoRESUMO
PURPOSE: The F3II cell line is a highly invasive variant of mammary carcinoma. Although it is frequently used as a model to evaluate the efficacy of immunotherapy, its impact on the immune system remains poorly understood. The main objectives of this study were to evaluate the effects of F3II tumors on the development of chronic inflammation and to characterize tumor-associated immunosuppression. METHODS: Following the experimental implantation of F3II tumors in BALB/c mice, alterations in the liver and spleen anatomy and the numbers of circulating leukocytes, myeloid-derived suppressor cells (MDSCs), and regulatory T cells were measured using hematological techniques, histopathological analysis, and flow cytometry. The capacity of the F3II tumor-bearing mice to reject MB16F10 allogeneic tumor transplantation was also evaluated. In addition, the restoration of immune parameters in tumor-bearing mice was evaluated after standard breast cancer chemotherapy and surgical tumor excision. RESULTS: F3II tumor implantation increased the levels of chronic inflammatory markers, such as the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, and caused myeloid alterations, including extramedullary granulopoiesis and megakaryopoiesis, along with the recruitment of MDSCs to the spleen. Chemotherapy or surgical F3II tumor removal completely rescued the tumor-associated extramedullary granulopoiesis and megakaryopoiesis. Notably, the presence of F3II tumors reduced the capacity of BALB/c mice to reject MB16F10 allogeneic tumor transplantation. CONCLUSION: These results support the occurrence of F3II tumor-mediated immune cell dysfunction, which mimics the immune alterations characterized by chronic systemic inflammation and immunosuppression observed in breast cancer in clinical settings. Thus, the F3II tumor model is relevant for evaluating novel breast cancer immunotherapies and combinations in preclinical studies. This model could also be useful for identifying appropriate therapeutic targets and developing proof-of-concept experiments in the future.
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PURPOSE OF REVIEW: Type 1 diabetes (T1D) results from the loss of immune tolerance to pancreatic beta-cells leading to their destruction. Immune intervention therapies tested in T1D so far delayed progression but failed to restore tolerance, which partly explains their lack of durable clinical efficacy. RECENT FINDINGS: The role of beta-cells and islets themselves in dialogue with their micro- and macro-environment including the immune system and the intestinal microbiome is increasingly evident. Indeed, islets can both maintain and break immune tolerance. Some recent immune therapies in cancer that block immune regulation also break tolerance. Induction of immune tolerance requires activating immune activation too, whereas immune suppression precludes this process. Immunotherapy alone my not suffice without engaging islets to restore tolerance and preserve beta-cell function. SUMMARY: New insight into the role of islet tissue and its interaction with its environment in preserving or breaking tolerance has contributed to understand the development of islet autoimmunity and T1D. Knowing which factors in islets and the immune system contribute to maintaining, breaking, and restoring the balance in the immune system is critical to prevent initiation and reverse disease progression, and guides the design of novel tolerogenic strategies for durable therapeutic intervention and remission that target both the immune system and distressed islets.
Assuntos
Diabetes Mellitus Tipo 1 , Tolerância Imunológica , Células Secretoras de Insulina , Autoimunidade/efeitos dos fármacos , Autoimunidade/imunologia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/imunologia , Microbioma Gastrointestinal/imunologia , Humanos , Tolerância Imunológica/efeitos dos fármacos , Tolerância Imunológica/imunologia , Imunoterapia/métodos , Células Secretoras de Insulina/efeitos dos fármacos , Células Secretoras de Insulina/imunologia , Ilhotas Pancreáticas/efeitos dos fármacos , Ilhotas Pancreáticas/imunologiaRESUMO
Background: Salivary alpha-amylase (sAA) initiates the digestion process in the mouth and its levels might influence feelings of hunger and the propensity toward obesity. This study aims to evaluate basal differences in sAA between adolescents with excess weight (EW) and normal weight (NW), and the associations between sAA levels and feelings of hunger after viewing food images. Methods: Adolescents (13-18 years old) classified as EW (n = 30) or NW (n = 30) participated in the study. Saliva samples were collected before the administration of a food-choice task. Hunger was evaluated before and after the food-choice task. Results: EW adolescents showed lower basal sAA levels than NW adolescents and a greater increase in hunger levels after viewing food images. In addition, sAA levels had a significant inverse relationship with the increase in hunger in EW adolescents, but not in NW adolescents. Finally, significant inverse associations between sAA, BMI, and body fat percentage were found. Conclusions: Levels of hunger and changes therein, after viewing food are dependent on sAA levels in EW adolescents. This finding indicates that sAA levels may be a mediator of feelings of hunger in individuals with overweight in the context of viewing food cues, suggesting the utility of the sAA enzyme as a marker of hunger and propensity toward obesity.
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Fome/fisiologia , Obesidade Infantil/fisiopatologia , Estimulação Luminosa , alfa-Amilases Salivares/metabolismo , Adolescente , Feminino , Alimentos , Humanos , Fome/classificação , MasculinoRESUMO
Annually, sand and gravel processing generates approximately 20 million tonnes of non-commercial by-product as fine silt particles (<63⯵m) which constitutes approximately 20% of quarry production in the UK. This study is significant as it investigated the use of quarry silt as a sub-soil medium to partially substitute soil-forming materials whilst facilitating successful post-restoration crop establishment. In a glasshouse pot experiment, top-soil and sub-soil layering was simulated, generating an artificial sub-soil medium by mixing two quarry non-commercial by-products, i.e. silt and overburden. These were blended in three ratios (100:0, 70:30, 50:50). Pots were packed to two bulk densities (1.3 and 1.5â¯g cm-3) and sown with three cover crops used in the early restoration process namely winter rye (Secale cereale), white mustard (Sinapis alba) and a grassland seed mixture (Lolium perenne, Phleum pratense, Poa pratensis, Festuca rubra). Three weeks into growth, the first signs of nitrogen (N) deficiency were observed in mustard plants, with phosphorus (P) and potassium (K) deficiencies observed at 35 days. Rye exhibited minor N deficiency symptoms four weeks into growth, whilst the grassland mixture showed no deficiency symptoms. The 70:30 silt:overburden sub-soil blend resulted in significantly higher Root Mass Densities of grassland seed mixture and rye in the sub-soil layer as compared with the other blends. The innovation in this work is the detailed physical, chemical and biological characterisation of silt:overburden blends and effects on root development of plants commonly used in early restoration to bio-engineer soil structural improvements.
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Recuperação e Remediação Ambiental/métodos , Dióxido de Silício/farmacologia , Solo/química , Produtos Agrícolas/metabolismo , Nitrogênio/deficiência , Fósforo/deficiência , Raízes de Plantas/crescimento & desenvolvimento , Poaceae/metabolismo , Deficiência de Potássio , Reino UnidoRESUMO
[This corrects the article DOI: 10.1371/journal.pone.0180088.].
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CD6 is associated with T-cell modulation and is implicated in several autoimmune diseases. We previously demonstrated that Itolizumab, a CD6 domain 1 (CD6D1) specific humanized monoclonal antibody, inhibited the proliferation and cytokine production by T lymphocytes stimulated with anti-CD3 antibody or when co-stimulated with ALCAM. Aberrant IL-17 producing CD4+ helper T-cells (Th17) have been identified as pivotal for the pathogenesis of certain inflammatory autoimmune disorders, including psoriasis. Itolizumab has demonstrated efficacy in human diseases known to have an IL-17 driven pathogenesis. Here, in in vitro experiments we show that by day 3 of human PBMC activation using anti-CD3 and anti-CD28 co-stimulation in a Th17 polarizing milieu, 15-35% of CD4+ T-cells overexpress CD6 and there is an establishment of differentiated Th17 cells. Addition of Itolizumab reduces the activation and differentiation of T cells to Th17 cells and decreases production of IL-17. These effects are associated with the reduction of key transcription factors pSTAT3 and RORγT. Further, transcription analysis studies in these conditions indicate that Itolizumab suppressed T cell activation by primarily reducing cell cycle, DNA transcription and translation associated genes. To understand the mechanism of this inhibition, we evaluated the effect of this anti-human CD6D1 mAb on ALCAM-CD6 as well as TCR-mediated T cell activation. We show that Itolizumab but not its F(ab')2 fragment directly inhibits CD6 receptor hyper-phosphorylation and leads to subsequent decrease in associated ZAP70 kinase and docking protein SLP76. Since Itolizumab binds to CD6 expressed only on human and chimpanzee, we developed an antibody binding specifically to mouse CD6D1. This antibody successfully ameliorated the incidence of experimental autoimmune encephalitis in the mice model. These results position CD6 as a key molecule in sustaining the activation and differentiation of T cells and an important target for modulating autoimmune diseases.
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Anticorpos Monoclonais Humanizados/farmacologia , Diferenciação Celular/efeitos dos fármacos , Ativação Linfocitária/efeitos dos fármacos , Linfócitos T/imunologia , Animais , Anticorpos Monoclonais/farmacologia , Células Cultivadas , Citometria de Fluxo , Humanos , CamundongosRESUMO
Ataxia-telangiectasia is a multisystemic disease with severe neurological affectation, immunodeficiency and telangiectasia. The disorder is caused by alterations in the ATM gene, whose size and complexity make molecular diagnosis difficult. We designed a target-enrichment next-generation sequencing strategy to characterize 28 patients from several regions of Spain. This approach allowed us to identify gene variants affecting function in 54 out of the 56 alleles analyzed, although the two unresolved alleles belong to brothers. We found 28 ATM gene mutations, of which 10 have not been reported. A total of 171 gene variants not affecting function were also found, of which 22 are reported to predispose to disease. Interestingly, all Roma (Spanish Gypsies) patients are homozygous for the same mutation and share the H3 ATM haplotype, which is strong evidence of a founder effect in this population. In addition, we generated a panel of 27 primary T cell lines from A-T patients, which revealed significant expression of ATM in two patients and traces of the protein in nine more. None of them retained residual ATM activity, and almost all T cell lines show increased or intermediate radiosensitivity.
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Proteínas Mutadas de Ataxia Telangiectasia/genética , Ataxia Telangiectasia/genética , Ataxia Telangiectasia/etnologia , Proteínas Mutadas de Ataxia Telangiectasia/metabolismo , Sequência de Bases , Linhagem Celular , Códon sem Sentido , Ensaio de Unidades Formadoras de Colônias , Análise Mutacional de DNA , Efeito Fundador , Mutação da Fase de Leitura , Haplótipos/genética , Humanos , Fosforilação , Polimorfismo de Nucleotídeo Único , Processamento de Proteína Pós-Traducional , Roma (Grupo Étnico)/genética , Alinhamento de Sequência , Análise de Sequência de DNA/métodos , Deleção de Sequência , Espanha/epidemiologia , Linfócitos T/metabolismo , Linfócitos T/patologiaRESUMO
The objective of this study was to assess the safety and efficacy of itolizumab with methotrexate in active rheumatoid arthritis (RA) patients who had inadequate response to methotrexate. In this open-label, phase 2 study, 70 patients fulfilling American College of Rheumatology (ACR) criteria and negative for latent tuberculosis were randomized to four arms: 0.2, 0.4, or 0.8 mg/kg itolizumab weekly combined with oral methotrexate, and methotrexate alone (2:2:2:1). Patients were treated for 12 weeks, followed by 12 weeks of methotrexate alone during follow-up. Twelve weeks of itolizumab therapy was well tolerated. Forty-four patients reported adverse events (AEs); except for six severe AEs, all others were mild or moderate. Infusion-related reactions mainly occurred after the first infusion, and none were reported after the 11th infusion. No serum anti-itolizumab antibodies were detected. In the full analysis set, all itolizumab doses showed evidence of efficacy. At 12 weeks, 50 % of the patients achieved ACR20, and 58.3 % moderate or good 28-joint count Disease Activity Score (DAS-28) response; at week 24, these responses were seen in 22 and 31 patients. Significant improvements were seen in Short Form-36 Health Survey and Health Assessment Questionnaire Disability Index scores. Overall, itolizumab in combination with methotrexate was well tolerated and efficacious in RA for 12 weeks, with efficacy persisting for the entire 24-week evaluation period. (Clinical Trial Registry of India, http://ctri.nic.in/Clinicaltrials/login.php , CTRI/2008/091/000295).
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Anticorpos Monoclonais Humanizados/administração & dosagem , Antirreumáticos/administração & dosagem , Artrite Reumatoide/tratamento farmacológico , Metotrexato/administração & dosagem , Administração Oral , Adulto , Relação Dose-Resposta a Droga , Quimioterapia Combinada/métodos , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Reprodutibilidade dos Testes , Reumatologia/métodos , Inquéritos e Questionários , Resultado do TratamentoAssuntos
Anticorpos Monoclonais Humanizados/administração & dosagem , Psoríase/diagnóstico , Psoríase/tratamento farmacológico , Qualidade de Vida , Adulto , Anticorpos Monoclonais Humanizados/efeitos adversos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Esquema de Medicação , Feminino , Seguimentos , Humanos , Infusões Intravenosas , Masculino , Dose Máxima Tolerável , Pessoa de Meia-Idade , Medição de Risco , Índice de Gravidade de Doença , Tempo , Resultado do Tratamento , Suspensão de TratamentoRESUMO
BACKGROUND: Itolizumab, a humanized monoclonal antibody to CD6, is a novel therapeutic agent evaluated in chronic plaque psoriasis. OBJECTIVE: We sought to assess the safety and efficacy of itolizumab in moderate to severe chronic plaque psoriasis. METHODS: A total of 225 patients were randomized (2:2:1) to 2 different itolizumab arms (A or B; A = 4-week loading dose of 0.4 mg/kg/wk followed by 1.6 mg/kg every 2 weeks; B = 1.6/mg every 2 weeks) or placebo. At week 12, the placebo arm was switched to 1.6 mg/kg itolizumab every 2 weeks. The primary end point was the proportion of patients with at least 75% improvement in Psoriasis Area and Severity Index score at week 12. RESULTS: At week 12, 27.0% in arm A (P = .0172 vs placebo), 36.4% in B (P = .0043 vs placebo), and 2.3% in the placebo arm had at least 75% improvement in Psoriasis Area and Severity Index score. At week 28, the proportion with at least 75% improvement in Psoriasis Area and Severity Index score was comparable: 46.1%, 45.5%, and 41.9% for A, B, and placebo, respectively. In weeks 1 to 12, the incidence of all adverse events was comparable across arms (A, 43%; B, 38%; placebo, 47%) and the incidence of infections was not greater than placebo (11.1%, 8.9%, and 18.6% for A, B, and placebo). LIMITATIONS: No active comparator is a limitation. CONCLUSIONS: Itolizumab is an effective and well-tolerated novel biological therapy in moderate to severe psoriasis.