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1.
Toxins (Basel) ; 9(10)2017 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-28974033

RESUMEN

The goal of the AntiBotABE Program was the development of recombinant antibodies that neutralize botulinum neurotoxins (BoNT) A, B and E. These serotypes are lethal and responsible for most human botulinum cases. To improve therapeutic efficacy, the heavy and light chains (HC and LC) of the three BoNT serotypes were targeted to achieve a synergistic effect (oligoclonal antibodies). For antibody isolation, macaques were immunized with the recombinant and non-toxic BoNT/A, B or E, HC or LC, followed by the generation of immune phage-display libraries. Antibodies were selected from these libraries against the holotoxin and further analyzed in in vitro and ex vivo assays. For each library, the best ex vivo neutralizing antibody fragments were germline-humanized and expressed as immunoglobulin G (IgGs). The IgGs were tested in vivo, in a standardized model of protection, and challenged with toxins obtained from collections of Clostridium strains. Protective antibody combinations against BoNT/A and BoNT/B were evidenced and for BoNT/E, the anti-LC antibody alone was found highly protective. The combination of these five antibodies as an oligoclonal antibody cocktail can be clinically and regulatorily developed while their high "humanness" predicts a high tolerance in humans.


Asunto(s)
Anticuerpos Neutralizantes/inmunología , Toxinas Botulínicas/inmunología , Neurotoxinas/inmunología , Anticuerpos de Cadena Única/inmunología , Animales , Humanos , Inmunización , Proteínas Recombinantes/inmunología
2.
Anal Chim Acta ; 947: 58-65, 2016 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-27846990

RESUMEN

Antithrombin (AT) is a plasma glycoprotein which possesses anticoagulant and anti-inflammatory properties. AT exhibits various forms, among which are native, latent and heterodimeric ones. We studied the potential of capillary electrophoresis-mass spectrometry (CE-MS) using a sheath liquid interface, electrospray ionization (ESI), and a quadrupole-time-of-flight (Q-TOF) mass spectrometer to separate and quantify the different AT forms. For CE separation, a neutral polyvinyl alcohol (PVA) coated capillary was employed. The protein conformation was preserved by using a background electrolyte (BGE) at physiological pH. A sheath liquid of isopropanol-water 50:50 (v/v) with 14 mM ammonium acetate delivered at a flow rate of 120 µL h-1 resulted in optimal signal intensities. Each AT form exhibited a specific mass spectrum, allowing unambiguous distinction. Several co-injection experiments proved that latent AT had a higher electrophoretic mobility (µep) than native AT, and that these conformers could associate to form a heterodimer during the CE analysis. The developed CE-MS method enabled the detection and quantitation of latent and heterodimeric forms in a commercial AT preparation stored at room temperature for three weeks.


Asunto(s)
Proteínas Antitrombina/química , Electroforesis Capilar/métodos , Espectrometría de Masas/métodos , Multimerización de Proteína , Proteínas Antitrombina/aislamiento & purificación , Modelos Moleculares , Estructura Cuaternaria de Proteína , Temperatura
3.
Toxins (Basel) ; 8(9)2016 09 12.
Artículo en Inglés | MEDLINE | ID: mdl-27626446

RESUMEN

Botulinum neurotoxins (BoNTs) cause botulism and are the deadliest naturally-occurring substances known to humans. BoNTs have been classified as one of the category A agents by the Centers for Disease Control and Prevention, indicating their potential use as bioweapons. To counter bio-threat and naturally-occurring botulism cases, well-tolerated antibodies by humans that neutralize BoNTs are relevant. In our previous work, we showed the neutralizing potential of macaque (Macaca fascicularis)-derived scFv-Fc (scFv-Fc ELC18) by in vitro endopeptidase immunoassay and ex vivo mouse phrenic nerve-hemidiaphragm assay by targeting the light chain of the botulinum neurotoxin type E (BoNT/E). In the present study, we germline-humanized scFv-Fc ELC18 into a full IgG hu8ELC18 to increase its immunotolerance by humans. We demonstrated the protection and prophylaxis capacity of hu8ELC18 against BoNT/E in a mouse model. A concentration of 2.5 ng/mouse of hu8ELC18 protected against 5 mouse lethal dose (MLD) in a mouse protection assay and complete neutralization of 1 LD50 of pure BoNT/E toxin was achieved with 8 ng of hu8ELC18 in mouse paralysis assay. Furthermore, hu8ELC18 protected mice from 5 MLD if injected up to 14 days prior to intraperitoneal BoNT/E administration. This newly-developed humanized IgG is expected to have high tolerance in humans.


Asunto(s)
Anticuerpos Monoclonales Humanizados/farmacología , Anticuerpos Neutralizantes/farmacología , Antídotos/farmacología , Antitoxinas/farmacología , Toxinas Botulínicas/antagonistas & inhibidores , Botulismo/prevención & control , Clostridium botulinum/efectos de los fármacos , Anticuerpos de Cadena Única/farmacología , Animales , Toxinas Botulínicas/inmunología , Botulismo/inmunología , Botulismo/microbiología , Clostridium botulinum/inmunología , Clostridium botulinum/metabolismo , Modelos Animales de Enfermedad , Femenino , Ratones
4.
PLoS One ; 11(8): e0161446, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27560688

RESUMEN

Botulinum neurotoxins (BoNTs) are counted among the most toxic substances known and are responsible for human botulism, a life-threatening disease characterized by flaccid muscle paralysis that occurs naturally by food poisoning or colonization of the gastrointestinal tract by BoNT-producing clostridia. To date, 7 serologically distinct serotypes of BoNT (serotype A-G) are known. Due to the high toxicity of BoNTs the Centers for Disease Control and Prevention (CDC) have classified BoNTs as category A agent, including the six biological agents with the highest potential risk of use as bioweapons. Well tolerated antibodies neutralizing BoNTs are required to deal with the potential risk. In a previous work, we described the development of scFv and scFv-Fc (Yumab) from macaque origin (Macaca fascicularis) neutralizing BoNT/A and B by targeting the heavy and light chain of each serotype. In the present study, we humanized the macaque antibodies SEM120-IIIC1 (anti-BoNT/A light chain), A1HC38 (anti-BoNT/A heavy chain), BLC3 (anti-BoNT/B light chain) and B2-7 (anti-BoNT/B heavy chain) by germline-humanization to obtain a better potential immunotolerance in humans. We increased the Germinality Index (GI) of SEM120-IIIC1 to 94.5%, for A1HC38, to 95% for BLC3 and to 94.4% for B2-7. Furthermore, the neutralization efficacies of the germline-humanized antibodies were analyzed in lethal and non-lethal in vivo mouse assays as full IgG. The germline-humanized IgGs hu8SEM120-IIIC1, hu8A1HC38, hu8BLC3 and hu8B2-7 were protective in vivo, when anti-heavy and anti-light chain antibodies were combined. The synergistic effect and high humanness of the selected IgGs makes them promising lead candidates for further clinical development.


Asunto(s)
Anticuerpos Monoclonales Humanizados/inmunología , Toxinas Botulínicas Tipo A/inmunología , Animales , Anticuerpos Neutralizantes/inmunología , Botulismo/inmunología , Clostridium botulinum , Femenino , Humanos , Inmunoglobulina G/inmunología , Macaca fascicularis/inmunología , Ratones , Pruebas de Neutralización , Anticuerpos de Cadena Única/inmunología
5.
Biologicals ; 44(4): 226-233, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27156143

RESUMEN

Albumin displays several important functions for homeostasis amongst which the maintenance of the plasma redox-state. The study aim was to compare the redox state of pharmaceutical human albumin preparations since it reflects the oxidation-reduction status of the surrounding environment. Using an array of analytical methods, four commercially available albumins were compared with respect to their structural characteristics (cobalt ion binding, glycation, spectrophotometric and fluorometric profiles) and their ability to scavenge hydroxyl, peroxyl or free radicals. The different albumins exhibited a similar structural profile as well as hydroxyl and peroxyl scavenging activities. By contrast, the albumin from LFB (Vialebex(®)) possessed a significantly higher capacity to transfer electrons to DPPH, as compared with other albumins that was correlated with the level of free cysteine-34. Commercially available albumins differed for some of their antioxidant properties. The albumin preparation possessing the highest level of free cysteine-34 exhibited the highest antioxidant potential.


Asunto(s)
Antioxidantes/farmacología , Radicales Libres/antagonistas & inhibidores , Radical Hidroxilo/antagonistas & inhibidores , Albúmina Sérica/farmacología , Antioxidantes/química , Antioxidantes/uso terapéutico , Compuestos de Bifenilo/química , Cisteína/química , Depuradores de Radicales Libres/química , Depuradores de Radicales Libres/farmacología , Depuradores de Radicales Libres/uso terapéutico , Radicales Libres/metabolismo , Glicosilación , Humanos , Radical Hidroxilo/metabolismo , Oxidación-Reducción/efectos de los fármacos , Picratos/química , Albúmina Sérica/química , Albúmina Sérica/uso terapéutico , Espectrofotometría
6.
Electrophoresis ; 37(12): 1696-703, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-26989842

RESUMEN

Antithrombin (AT) is a human plasma glycoprotein that possesses anticoagulant and anti-inflammatory properties. However, the native (active) form of AT is unstable and undergoes conformational changes, leading to latent, cleaved, and heterodimeric forms. The presence of these alternative forms mostly inactive can highly impact the quality and therapeutic activity of pharmaceutical AT preparations. We developed a capillary zone electrophoresis method, based on a neutral polyethylene oxide-coated capillary and a buffer close to physiological conditions, enabling the separation of more than eight forms of AT. Several peaks were identified as native, latent, and heterodimeric forms. The CZE method was reproducible with intraday relative standard deviations less than 0.5 and 2% for migration times and peak areas, respectively. The method was applied to the comparison of AT preparations produced by five competitive pharmaceutical companies, and statistical tests were performed. Important differences in the proportion of each form were highlighted. In particular, one AT preparation was shown to contain a high quantity of heterodimer, and two preparations contained high quantities of latent form. In addition, one AT preparation exhibited additional forms, not yet identified.


Asunto(s)
Antitrombina III/aislamiento & purificación , Electroforesis Capilar/métodos , Tampones (Química) , Dimerización , Composición de Medicamentos , Electroforesis Capilar/instrumentación , Polietilenglicoles , Conformación Proteica , Isoformas de Proteínas/aislamiento & purificación
7.
Anal Biochem ; 491: 52-4, 2015 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-26302360

RESUMEN

Rapid and efficient structural analysis is key to the development of new monoclonal antibodies. We have developed a fast and easy process to obtain mass spectrometry profiles of antibodies from culture supernatant. Treatment of the supernatant with IdeS generates three fragments of 25 kDa that can be analyzed by liquid chromatography-mass spectrometry time-of-flight (LC-MS TOF) in one run: LC, Fd, and Fc/2. This process gives rapid access to isoform and glycoform profiles. To specifically measure the fucosylation yield, we included a one-pot treatment with EndoS that removes the distal glycan heterogeneity. Our process was successfully compared with high-performance capillary electrophoresis with laser-induced fluorescence detection (HPCE-LIF), currently considered as the "gold standard" method.


Asunto(s)
Anticuerpos Monoclonales/análisis , Cromatografía Líquida de Alta Presión , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Electroforesis Capilar , Glicosilación , Isoformas de Proteínas/análisis , Espectrometría de Fluorescencia
8.
J Pharm Biomed Anal ; 111: 64-70, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25863018

RESUMEN

With the aim to determine the binding affinity of a new generation of recombinant antithrombin (AT) toward heparin, we developed a dynamic equilibrium-affinity capillary electrophoresis (DE-ACE) method. This method allows the determination of an AT-heparin binding constant (Kd) directly from the cell culture supernatant used to produce the AT variants. Eight measurements per AT variant are sufficient to determine an accurate Kd (uncertainty ≤ 22%, regression coefficient ≥ 0.97), which is not significantly different from the value obtained from a higher number of measurements. Due to the relatively short time required to determine the Kd of one AT variant (2h), this method has the potential for being a low throughput screening method. The method was validated by analyzing five AT variants, whose Kd have been reported in the literature using fluorescence spectroscopy. Finally, the method was applied to estimate the Kd of one new AT variant and one AT conformer, a latent form, that exhibits a significant loss of affinity.


Asunto(s)
Antitrombinas/química , Heparina/química , Técnicas de Cultivo de Célula/métodos , Electroforesis Capilar/métodos , Humanos , Cinética , Espectrometría de Fluorescencia/métodos
9.
Front Immunol ; 6: 39, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25699055

RESUMEN

Despite the reasonably long half-life of immunoglogulin G (IgGs), market pressure for higher patient convenience while conserving efficacy continues to drive IgG half-life improvement. IgG half-life is dependent on the neonatal Fc receptor (FcRn), which among other functions, protects IgG from catabolism. FcRn binds the Fc domain of IgG at an acidic pH ensuring that endocytosed IgG will not be degraded in lysosomal compartments and will then be released into the bloodstream. Consistent with this mechanism of action, several Fc-engineered IgG with increased FcRn affinity and conserved pH dependency were designed and resulted in longer half-life in vivo in human FcRn-transgenic mice (hFcRn), cynomolgus monkeys, and recently in healthy humans. These IgG variants were usually obtained by in silico approaches or directed mutagenesis in the FcRn-binding site. Using random mutagenesis, combined with a pH-dependent phage display selection process, we isolated IgG variants with improved FcRn-binding, which exhibited longer in vivo half-life in hFcRn mice. Interestingly, many mutations enhancing Fc/FcRn interaction were located at a distance from the FcRn-binding site validating our random molecular approach. Directed mutagenesis was then applied to generate new variants to further characterize our IgG variants and the effect of the mutations selected. Since these mutations are distributed over the whole Fc sequence, binding to other Fc effectors, such as complement C1q and FcγRs, was dramatically modified, even by mutations distant from these effectors' binding sites. Hence, we obtained numerous IgG variants with increased FcRn-binding and different binding patterns to other Fc effectors, including variants without any effector function, providing distinct "fit-for-purpose" Fc molecules. We therefore provide evidence that half-life and effector functions should be optimized simultaneously as mutations can have unexpected effects on all Fc receptors that are critical for IgG therapeutic efficacy.

11.
Therapie ; 69(4): 291-302, 2014.
Artículo en Inglés, Francés | MEDLINE | ID: mdl-25099671

RESUMEN

Despite very different aetiologies and clinical expressions, advancing knowledge in the physiopathology and treatment of immune and inflammatory diseases (IID) prompts us to consider them as a whole. These are chronic, often incapacitating and painful illnesses that progress and destroy organs. Management by discipline too often leads to erroneous diagnoses and sometimes inappropriate treatment. More integrated translational research would further understanding of the complex relationships between cytokines and organ damage, which vary with the conditions and patients, making it possible to develop new biomarkers and personalize treatment. The research in France has very many strengths but its organization is fragmented. Better coordinated research into IID, which could be based on creating a strategic valorization field (domaine de valorisation stratégique, DVS) and thematic multi-organization institute (Institut thématique multi-organismes ITMO), would advance patient management.


Asunto(s)
Enfermedades del Sistema Inmune/terapia , Inflamación/terapia , Transferencia de Tecnología , Terapias en Investigación , Investigación Biomédica Traslacional/tendencias , Academias e Institutos , Conducta Cooperativa , Predicción , Francia , Sector de Atención de Salud , Hospitales , Humanos , Enfermedades del Sistema Inmune/clasificación , Enfermedades del Sistema Inmune/fisiopatología , Inflamación/clasificación , Inflamación/fisiopatología , Internacionalidad , Laboratorios
12.
MAbs ; 6(2): 422-36, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24492301

RESUMEN

While glyco-engineered monoclonal antibodies (mAbs) with improved antibody-dependent cell-mediated cytotoxicity (ADCC) are reaching the market, extensive efforts have also been made to improve their pharmacokinetic properties to generate biologically superior molecules. Most therapeutic mAbs are human or humanized IgG molecules whose half-life is dependent on the neonatal Fc receptor FcRn. FcRn reduces IgG catabolism by binding to the Fc domain of endocytosed IgG in acidic lysosomal compartments, allowing them to be recycled into the blood. Fc-engineered mAbs with increased FcRn affinity resulted in longer in vivo half-life in animal models, but also in healthy humans. These Fc-engineered mAbs were obtained by alanine scanning, directed mutagenesis or in silico approach of the FcRn binding site. In our approach, we applied a random mutagenesis technology (MutaGen™) to generate mutations evenly distributed over the whole Fc sequence of human IgG1. IgG variants with improved FcRn-binding were then isolated from these Fc-libraries using a pH-dependent phage display selection process. Two successive rounds of mutagenesis and selection were performed to identify several mutations that dramatically improve FcRn binding. Notably, many of these mutations were unpredictable by rational design as they were located distantly from the FcRn binding site, validating our random molecular approach. When produced on the EMABling(®) platform allowing effector function increase, our IgG variants retained both higher ADCC and higher FcRn binding. Moreover, these IgG variants exhibited longer half-life in human FcRn transgenic mice. These results clearly demonstrate that glyco-engineering to improve cytotoxicity and protein-engineering to increase half-life can be combined to further optimize therapeutic mAbs.


Asunto(s)
Anticuerpos Monoclonales/farmacocinética , Antígenos de Histocompatibilidad Clase I/metabolismo , Inmunoglobulina G/metabolismo , Inmunoterapia/métodos , Ingeniería de Proteínas/métodos , Receptores Fc/metabolismo , Animales , Anticuerpos Monoclonales/genética , Citotoxicidad Celular Dependiente de Anticuerpos/genética , Técnicas de Visualización de Superficie Celular , Citotoxicidad Inmunológica/genética , Glicosilación , Semivida , Antígenos de Histocompatibilidad Clase I/genética , Humanos , Inmunoglobulina G/genética , Inmunoterapia/tendencias , Ratones , Ratones Transgénicos , Mutagénesis Sitio-Dirigida , Mutación/genética , Receptores Fc/genética , Receptores de IgG/antagonistas & inhibidores , Receptores de IgG/inmunología , Receptores de IgG/metabolismo
14.
Anal Chim Acta ; 800: 103-10, 2013 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-24120174

RESUMEN

The present study describes a reproducible and quantitative capillary zone electrophoresis (CZE) method, which leads to the separation of nine forms (native, oxidized and glycated) of human serum albumin (HSA). In an attempt to identify the different species separated by this CZE method, the capillary electrophoresis was coupled to mass spectrometry using a sheath liquid interface, an optimized capillary coating and a suitable CE running buffer. CE-MS analyses confirmed the heterogeneity of albumin preparation and revealed new truncated and modified forms such as Advanced Glycation End products (AGEs). Assignment of the CZE peaks was carried out using specific antibodies, carboxypeptidase A or sample reduction before or during the CE separation. Thus, five HSA forms were unambiguously identified. Using this CZE method several albumin batches produced by slightly different fractionation ways could be discriminated. Furthermore, analyses of HSA preparations marketed by five pharmaceutical industries revealed that two therapeutic albumins, including that marketed by LFB, contained the highest proportion of native form and lower levels of oxidized forms.


Asunto(s)
Electroforesis Capilar , Espectrometría de Masas , Albúmina Sérica/análisis , Carboxipeptidasas A/metabolismo , Productos Finales de Glicación Avanzada/análisis , Humanos , Oxidación-Reducción , Albúmina Sérica/metabolismo
15.
Invest Ophthalmol Vis Sci ; 54(5): 3657-65, 2013 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-23611989

RESUMEN

PURPOSE: Primary cerebral lymphoma (PCL) and primary intraocular lymphoma (PIOL) belong to the systemic diffuse large B-cell lymphoma family and are characterized by the presence of CD20(+) lymphoma B cells in the brain or the eye. These highly aggressive malignancies have a poor prognosis and no specific therapy. The presence of effector immune cells in the damaged brain and vitreous suggests that treatment with anti-human CD20 (hCD20) monoclonal antibodies might be effective. We developed murine models of PCL and PIOL to assess the intracerebral and intraocular antitumor effect of ublituximab, a promising glycoengineered anti-hCD20 mAb with a high affinity for FcγRIIIa (CD16) receptors. METHODS: The murine lymphoma B-cell line A20.IIA-GFP-hCD20 (H-2(d)) was injected into the right cerebral striatum or the vitreous of immunocompetent adult BALB/c mice (H-2(d)). Four to 7 days later, ublituximab was injected intracerebrally or intravitreously into the tumor site. Rituximab was the reference compound. Survival was monitored for injected mice; histopathological and flow cytometric analyses were performed to study tumor growth and T-cell infiltration. RESULTS: Single doses of ublituximab, injected intracerebrally or intravitreously, had a marked antitumor effect, more pronounced than that obtained with the same dose of rituximab in these conditions. The reduction in tumor cells was correlated with an increased proportion of CD8(+) T cells. This efficacy was observed only against lymphoma B cells expressing hCD20. CONCLUSIONS: These in vivo results confirm the potential of the glycoengineered anti-hCD20 mAb ublituximab as an innovative therapeutic approach to treat primary central nervous system lymphoma and other B-cell lymphomas.


Asunto(s)
Anticuerpos Monoclonales/farmacología , Antígenos CD20/inmunología , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Ojo/tratamiento farmacológico , Linfoma de Células B/tratamiento farmacológico , Animales , Anticuerpos Monoclonales de Origen Murino/farmacología , Antineoplásicos/farmacología , Línea Celular Tumoral , Neoplasias del Sistema Nervioso Central/inmunología , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Neoplasias del Ojo/inmunología , Femenino , Humanos , Linfoma de Células B/inmunología , Ratones , Ratones Endogámicos BALB C , Trasplante de Neoplasias , Ingeniería de Proteínas , Rituximab , Ensayos Antitumor por Modelo de Xenoinjerto
16.
Med Sci (Paris) ; 25(12): 1141-4, 2009 Dec.
Artículo en Francés | MEDLINE | ID: mdl-20035694

RESUMEN

The Laboratoire français du fractionnement et des biotechnologies (LFB), the leading manufacturer of plasma-derived medicinal products in France and 6th worldwide, is strongly involved in the development of therapeutic monoclonal antibodies (mAb). For more than 15 years, LFB has been focusing its research effort on the study of structure-function relationship of antibodies. Its studies on the molecular basis of IgG interaction with the receptors for the Fc portion of IgG (FcgRs) has made it possible to develop antibodies with high antibody-dependent cellular cytotoxicity (ADCC) activity and enhanced affinity to FcgRIII (CD16), both correlated to a glycosylation pattern characterized by a low fucose content. Based on these studies, LFB has developed EMABling, a technological platform for the production of antibodies with enhanced cytotoxicity ability. Two EMABling antibodies recently entered clinical development: LFB-R593, a fully human anti-rhesus D (RhD) antibody, for the prevention of feto-maternal allo-immunization in RhD- women, as a substitute for human polyclonal anti-RhD immunoglobulins, and LFB-R603, a monoclonal antibody directed against CD20, for the treatment of B cell malignancies. LFB investment in bioproduction through the recent acquisition of MAbgène company, a fully integrated French contract biopharmaceutical manufacturing company, allows the production of antibodies to a large GMP scale. As a whole, LFB owns a portfolio of several EMABling antibodies with high therapeutic interest, in line with its public health mission.


Asunto(s)
Anticuerpos Monoclonales , Industria Farmacéutica/organización & administración , Animales , Anticuerpos Monoclonales/química , Anticuerpos Monoclonales/inmunología , Anticuerpos Monoclonales/aislamiento & purificación , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados , Citotoxicidad Celular Dependiente de Anticuerpos , Antineoplásicos/inmunología , Antineoplásicos/uso terapéutico , Femenino , Francia , Glicosilación , Humanos , Inmunoglobulina G/inmunología , Recién Nacido , Isoanticuerpos/aislamiento & purificación , Isoanticuerpos/uso terapéutico , Leucemia Linfocítica Crónica de Células B/tratamiento farmacológico , Macaca fascicularis , Embarazo , Procesamiento Proteico-Postraduccional , Receptores de IgG/inmunología , Isoinmunización Rh/prevención & control , Globulina Inmune rho(D) , Tecnología Farmacéutica
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