RESUMO
We wanted to examine tolerability and efficacy of NSI-189, a benzylpiperizine-aminiopyridine neurogenic compound for treating major depressive disorder (MDD). This was a Phase 1B, double blind, randomized, placebo controlled, multiple-dose study with three cohorts. The first cohort received 40 mg q.d. (n=6) or placebo (n=2), the second cohort 40 mg b.i.d. (n=6) or placebo (n=2), and the third cohort 40 mg t.i.d. (n=6) or placebo (n=2). Twenty-four patients with MDD were recruited, with the diagnosis and severity confirmed through remote interviews. Eligible patients received NSI-189 or placebo for 28 days in an inpatient setting with assessments for safety, pharmacokinetics (PK) and efficacy. Outpatient follow-up visits were conducted until day 84 (±3). NSI-189 was relatively well tolerated at all doses, with no serious adverse effects. NSI-189 area under the curve increased in a dose-related and nearly proportional manner across the three cohorts, with a half-life of 17.4-20.5 h. The exploratory efficacy measurements, including Symptoms Of Depression Questionnaire (SDQ), Montgomery-Asberg Depression Scale (MADRS), Clinical Global Impressions-Improvement (CGI-I), and The Massachusetts General Hospital (MGH) Cognitive and Physical Functioning Questionnaire (CPFQ) showed a promising reduction in depressive and cognitive symptoms across all measures for NSI-189, with significant improvement in the SDQ and CPFQ, and a medium to large effect size for all measures. These improvements persisted during the follow-up phase. In summary, NSI-189 shows potential as a treatment for MDD in an early phase study. The main limitation of this preliminary study was the small sample size of each cohort.
Assuntos
Aminopiridinas/administração & dosagem , Transtorno Depressivo Maior/tratamento farmacológico , Piperazinas/administração & dosagem , Adulto , Aminopiridinas/farmacocinética , Biomarcadores Farmacológicos/sangue , Depressão/sangue , Depressão/tratamento farmacológico , Depressão/metabolismo , Transtorno Depressivo Maior/sangue , Transtorno Depressivo Maior/metabolismo , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Piperazinas/farmacocinética , Escalas de Graduação Psiquiátrica , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Inibidores Seletivos de Recaptação de Serotonina/farmacocinética , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Resultado do TratamentoRESUMO
The ability of interferon-alpha (IFN-alpha) to augment the cytotoxicity of human natural killer (NK) cells was used to probe the neutralization capacity of human antibodies to IFN-alpha. Sera from patients treated with IFN-alpha were tested for antibodies that could bind to IFN-alpha, neutralize IFN-alpha antiviral activity, or neutralize IFN-alpha-mediated augmentation of NK cytolytic activity. The NK-augmenting activity of IFN-alpha was measured in a chromium-release cytotoxicity assay using K562 targets and human peripheral blood mononuclear cells in the presence of a constant amount of antibody from patients treated with IFN-alpha. Neutralization of IFN-alpha-mediated antiviral activity did not correlate with neutralization of NK augmentation. However, all sera that neutralized a biologic activity of IFN-alpha also bound IFN-alpha. Conversely, sera that did not bind to IFN-alpha also did not neutralize either biologic activity. The data suggest that some immunogenic epitopes of IFN-alpha reside in distinct domains that mediate different biologic activities of IFN-alpha. The identification of neutralizing antibodies for the NK immunomodulating function of IFN-alpha but not antiviral function suggests that assessment of antiviral neutralization alone may be an incomplete evaluation of the potential significance of binding antibodies that occur subsequent to the administration of therapeutic IFNs.
Assuntos
Reações Antígeno-Anticorpo , Antivirais/farmacologia , Interferon-alfa/farmacologia , Células Matadoras Naturais/imunologia , Bioensaio , HumanosRESUMO
The metabolism of the polycyclic aromatic hydrocarbon (PAH) 7,12-dimethylbenz[a]anthracene (DMBA) was studied in murine lymphocytes. This carcinogen has previously been shown to be immunosuppressive to lymphocytes regardless of their ability to be induced via the Ah locus and receptor. Experiments were designed to quantify the generation of metabolites of DMBA by lymphocytes incubated with [14C]DMBA and to ascertain whether radioactivity was covalently bound to cellular macromolecules in DMBA-exposed lymphocytes. No significant metabolism of DMBA was detected in culture supernatants, except when cultures were incubated in the presence of Arochlor-induced rat liver 9000 x g supernatants (S9). Covalent binding of 14C to cellular macromolecules was enhanced approximately eightfold in the presence of S9. Inhibition of monooxygenase activity by alpha-naphthoflavone did not modulate the immunosuppressive character of DMBA. Furthermore, addition of S9 did not amplify or ablate DMBA-mediated suppression of lymphocyte proliferation to the mitogen concanavalin A (Con A). Selected metabolites of DMBA were evaluated for immunosuppressive effects in cultures stimulated with mitogens and cellular alloantigens. 7-Hydroxymethyl-12-methylbenz[a]anthracene (OHMe) and 5,6-dihydro-5,6-dihydroxybenz[a]anthracene (Diol) were found to cause only slightly greater suppression of lymphocyte responses than DMBA. Thus, it appears that metabolites of DMBA were not responsible for the immunosuppression observed in lymphocyte cultures and that lymphocytes were not equipped to metabolize any significant amount of DMBA. These data lend support to the hypothesis that parent compound alone is responsible for the immunosuppressive effects observed in murine lymphocyte culture.
Assuntos
9,10-Dimetil-1,2-benzantraceno/metabolismo , Linfócitos/metabolismo , 9,10-Dimetil-1,2-benzantraceno/farmacologia , Animais , Benzoflavonas/farmacologia , Células Cultivadas , Cromatografia Líquida de Alta Pressão , Concanavalina A/farmacologia , Inibidores das Enzimas do Citocromo P-450 , Feminino , Terapia de Imunossupressão , Ativação Linfocitária/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C3H , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos DBA , Microssomos/enzimologia , Oxigenases de Função Mista/antagonistas & inibidores , Baço/citologiaRESUMO
A kinetic enzyme immunoassay was developed and validated to quantitate human antibodies to the humanized monoclonal antibody CAMPATH1-1H (C1H) in human serum. The assay was configured using C1H-coated 96-well plates which were blocked with bovine serum albumin, and incubated with dilutions of human serum containing anti-C1H antibody. Antibody was detected using biotinylated C1H followed by streptavidin-conjugated alkaline phosphatase and p-nitrophenyl phosphate. Absorbance data were collected for 10 min, and mOD min-1 data were exported to MultiCalc data analysis software. A 4-parameter logistic-log algorithm was shown to model the data through the range of the standard curve within 15% of nominal values. The overall assay performance coefficient of variation by ANOVA was 9.2%. The lower limit of detection was defined at 160 Units ml-1. The anti-idiotype antibody standard stock solution is stable at 4 degrees C and at -80 degrees C for at least 11 months in buffer. The anti-idiotype antibody controls are stable for at least seven freeze-thaw cycles and at least 6 months in human serum stored at -20 degrees C. A strategy was devised by which to establish the specific antibody potency for any given batch of anti-C1H antibody standard relative to the Reference Standard. This EIA has been used to quantify and characterize anti-C1H antibody in human serum in support of clinical safety and efficacy studies.
Assuntos
Anticorpos Anti-Idiotípicos/sangue , Anticorpos Monoclonais/imunologia , Anticorpos Antineoplásicos/imunologia , Técnicas Imunoenzimáticas/métodos , Alemtuzumab , Algoritmos , Análise de Variância , Animais , Anticorpos Monoclonais Humanizados , Estudos de Avaliação como Assunto , Humanos , Cinética , Camundongos , Ratos , Padrões de ReferênciaRESUMO
It is now known that chemicals and drugs may induce selective toxicity which may alter the interactions between immunocompetent cells, especially if the toxicity occurs during proliferation and differentiation. Hence, a flexible panel of sensitive in vivo and in vitro assays has been developed and validated to assess the immunotoxicity or immunopharmacology of suspect agents in rodents. The combined use of such sequential analysis methods with host resistance assays can effectively define immunomodulation following exposure to xenobiotics. Methods development, refinement and validation will be an ongoing requirement because of our rapidly expanding knowledge of the cell biology of the immune system. Classic studies of the comparative preclinical toxicology of several immunosuppressive drugs have substantiated species similarities and have contributed significantly to the development of predictive rodent models for extrapolation to humans. Studies of immunopharmacology and immunotoxicity of cyclosporin A, for example, produced both the desired pharmacology and the undesired toxicity at similar doses in both rodents and humans. When species differences are observed during toxicology studies they are most probably due to differences in absorption, disposition, metabolism, excretion, or delivered dose at the target tissue, rather than major species differences in cellular targets or cell physiology. This assumption is the basis for using rodent species to predict the toxicity of chemicals and drugs under development.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Sistema Imunitário/efeitos dos fármacos , Toxicologia , Animais , Humanos , Dose Letal Mediana , Concentração Máxima Permitida , Camundongos , RatosRESUMO
Antibodies produced in recurrent respiratory papillomatosis (RRP) patients treated with lymphoblastoid interferon (lyIFN) may neutralize antiviral activity or may only bind to lyIFN. These antibodies were characterized for immunoglobulin class, IgG subclass, and light chain type by an indirect immunoassay. Serum dilutions were incubated on lyIFN-coated plates and the presence of antibody detected using peroxidase-conjugated goat antibodies to each human immunoglobulin class and light chain isotype, or using MoAbs to each human IgG subclass. Neutralizing activity was measured as the inhibition of lyIFN antiviral activity for Vervet monkey cells challenged with Semliki Forest Virus. Among antibody-positive patients, 12% produced IgM coincident with IgG, and 25% produced IgA coincident with IgG. Thus, antibody responses in patients treated with lyIFN are not exclusively of IgG class. The predominant lyIFN-specific subclasses were IgG1 and IgG3, which occurred in 70% and 83% of patients, respectively. An IgG4 response was detected in two patients who also had antibody of other isotypes; no IgG2 antibody was detected in any patient. Antibodies were not IgG subclass-restricted, a trend which was more pronounced in patients having neutralizing antibody than non-neutralizing antibody. Light chain molecules of lyIFN-specific antibody were of both kappa and lambda isotypes, with kappa chains occurring most frequently. Among patients having non-neutralizing antibodies, monotypic light chains occurred in 65% of the patients, whereas no patient with neutralizing antibody had monotypic light chain antibody. Sera from 599 normal human volunteers were assayed for antibody, and seven were found to be immunoreactive to lyIFN. Only one serum of the seven was positive for neutralizing activity.
Assuntos
Imunoglobulina G/análise , Interferon-alfa/imunologia , Ensaio de Imunoadsorção Enzimática , Humanos , Isotipos de Imunoglobulinas , Cadeias Leves de Imunoglobulina/análise , Interferon-alfa/uso terapêutico , Neoplasias Pulmonares/imunologia , Papiloma/imunologiaRESUMO
Chemotactic activity for human polymorphonuclear neutrophils (PMNs) was detectable in culture filtrates (CFs) of Blastomyces dermatitidis and may have influenced the pathogenesis of blastomycosis. Production of this chemotaxin depended upon culture age and medium; peak levels were achieved after incubation for 17 days or more in minimal essential medium. This factor was also chemotactic for human monocytes. CF was temperature stable even after treatment at 100 degrees C for 60 min. The activity was stable under alkaline conditions but was destroyed below pH 7. Dialyzed, chemotactically active CF contained approximately 60 micrograms of carbohydrate per ml; total protein was estimated to be less than 0.8 micrograms/ml. Preincubation of PMNs with CF or N-formyl-L-methionyl-L-leucyl-L-phenylalanine deactivated their chemotactic response to each agent, whereas the chemotactic response to zymosan-activated serum was not affected. In addition, deactivation with N-formyl-L-methionyl-L-leucyl-L-phenylalanine reduced the response to CF. Pretreatment of CF with PMNs decreased chemotactic activity, which may reflect binding of the chemotaxin molecules to PMN receptors. A modified chemotaxis assay was developed in which commercial, disposable multiwell plates are used. This method was rapid, efficient, and inexpensive and permitted the assay of larger numbers of samples than was previously feasible with conventional chemotaxis methods.
Assuntos
Blastomyces/imunologia , Fatores Quimiotáticos/imunologia , Quimiotaxia de Leucócito , Proteínas de Bactérias/análise , Carboidratos/análise , Humanos , Concentração de Íons de Hidrogênio , Monócitos/imunologia , Neutrófilos/imunologia , TemperaturaRESUMO
A predominantly agricultural community in California was surveyed for prevalent fungal spores during a 12-month period. Alternaria, Macrosporium and Stemphylium were recovered during asparagus and strawberry harvesting times year-round. Fusarium and Botrytis were less frequently associated with the strawberry harvest and were recovered only during the first quarter of the year. Epicoccum was recovered in the north end of the Salinas valley in low numbers throughout the year and was strongly associated with the strawberry and artichoke harvest. Aureobasidium (Pullularia) recovery occurred in different locations according to season, correlating somewhat with the cabbage harvest as well as with the harvest of strawberries. Recovery of the pigmented yeats showed strong correlation with the local growing season for lettuce. Cladosporium was prevalent year-round but did not appear to be signficantly affected by changing argicultural conditions. These data have permitted the predictability of mold aeroallergens with medical applications.
Assuntos
Doenças dos Trabalhadores Agrícolas/imunologia , Hipersensibilidade/imunologia , Esporos Fúngicos/imunologia , Alternaria/imunologia , Fusarium/imunologia , Fungos Mitospóricos/imunologia , Chuva , Saúde da População Rural , Estações do AnoRESUMO
The effects of the immunosuppressive polycyclic aromatic hydrocarbon (PAH) 7,12-dimethylbenz[a]anthracene (DMBA) were studied directly by in vitro exposure of splenic lymphocytes. On the basis of evidence from prior studies that DMBA immunotoxicity in vivo may not be dependent upon induction of the Ah locus in mice, splenocytes from Ah-responsive B6C3F1, Ah-nonresponsive DBA/2N, and in C57BL/6J Ah-congenic mice (responsive B6-Ah(b)Ah(d) and nonresponsive B6-Ah(d)Ah(d) were exposed to xenobiotic in culture. For some experiments, B6C3F1 mice were pretreated with 200 nmol 2,3,7,8-tetrachlorodibenzop-dioxin (TCDD) to induce Ah-associated enzymatic activity prior to in vitro splenocyte exposure to DMBA. Humoral immunity assessed as splenic antibody plaque-forming cells measured after a 5-day in vitro immunization to sheep erythrocytes (SRBC) was suppressed up to 99% by continuous exposure to 20 microM DMBA, and was comparable between control mice having basal levels of hepatic monooxygenase activity and Ah-induced mice (TCDD-treated) having elevated enzyme activity. Similarly, cytotoxic T-lymphocyte generation against P815 target cells was suppressed up to 88 and 86% in 40 microM DMBA-exposed splenocytes from Ah-induced and noninduced mice, respectively. The mixed lymphocyte responsiveness (MLR) of B6C3F1, DBA/2N, B6-Ah(b)Ah(d), and B6-Ah(d)Ah(d) splenocytes exposed in vitro to 40 microM DMBA was suppressed 54, 72, 51, and 29%, respectively. However, the degree of suppression was not significantly different between the strains. The secretion of interleukin 2 (IL2) was also suppressed in splenocytes from both strains exposed to 40 microM DMBA in vitro. Studies which included benzo[a]pyrene (BaP) as a control xenobiotic known to demonstrate Ah dependence showed that the MLR of splenic lymphocytes from Ah-congenic mice was comparably suppressed following 40 microM DMBA exposure, whereas exposure to 40 microM BaP resulted in suppression of the MLR only in B6-Ah(b)Ah(d) splenocytes. In addition, mitogen-stimulated proliferation was inhibited in both B6C3F1 and DBA/2N splenocytes exposed to 40 microM DMBA, whereas 40 microM BaP inhibited only B6C3F1 splenocyte proliferation to LPS. These data suggest that DMBA may act on immunocytes by mechanisms largely independent of the Ah locus and associated metabolic processes.
Assuntos
9,10-Dimetil-1,2-benzantraceno/toxicidade , Linfócitos/efeitos dos fármacos , Baço/efeitos dos fármacos , 9,10-Dimetil-1,2-benzantraceno/metabolismo , Animais , Formação de Anticorpos/efeitos dos fármacos , Feminino , Imunidade Celular/efeitos dos fármacos , Técnicas In Vitro , Ativação Linfocitária/efeitos dos fármacos , Linfócitos/imunologia , Camundongos , Camundongos Endogâmicos , Dibenzodioxinas Policloradas/toxicidade , Receptores de Hidrocarboneto Arílico , Receptores de Droga/metabolismo , Baço/imunologiaRESUMO
Recent reports suggest that the immunotoxicity of certain polycyclic aromatic hydrocarbons is associated with the Ah locus in mice. To test whether immunosuppression mediated by 7,12-dimethylbenz[a]anthracene (DMBA) is regulated by the Ah locus, several endpoints of immune function were measured in Ah-responsive B6C3F1 and Ah-nonresponsive DBA/2N and in Ah-congenic C57BL/6J (responsive B6-AhbAhd and nonresponsive B6-AhdAhd) mice dosed sc with up to 100 micrograms/g DMBA in corn oil. Some groups of B6C3F1 and DBA/2N mice were exposed to 100 micrograms/g benzo[a]pyrene (B(a)P) or 1 nmol 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) for determination of hepatic microsomal monooxygenase activity. The body weights of all mice were unaffected by DMBA exposure, but thymus weights and spleen cellularity were decreased. Antibody plaque-forming cells (PFC) measured 4 days after iv sheep erythrocyte (SRBC) immunization were suppressed 99% in B6C3F1 and 96% in DBA/2 mice. Antibody PFC after in vitro immunization to SRBC were similarly suppressed 98% in both B6-AhbAhd and B6-AhdAhd Ah-congenic mice exposed to 100 micrograms/g DMBA. Responses to the T-cell mitogens concanavalin A and phytohemagglutinin were significantly suppressed in both B6C3F1 and DBA/2N strains, as was mitogenesis to bacterial lipopolysaccharide. The unidirectional mixed lymphocyte responses of the congenic strains were suppressed 76% in B6-AhbAhd and 85% in B6-AhdAhd, cytotoxic lymphocyte generation was suppressed 68% in B6-AhbAhd and 78% in B6-AhdAhd. The overall differences between immunosuppressive responses in splenocytes from B6-AhbAhd and B6-AhdAhd congenics were not significant. Induction of cytochrome P1-450, a marker of Ah responsiveness, was determined by 7-ethoxycoumarin O-deethylase monooxygenase activity in hepatic microsomes or splenocytes. This monooxygenase activity was not significantly increased in either B6C3F1 or DBA/2 mice exposed to DMBA, whereas B(a)P and TCDD exposure significantly induced enzyme activity in B6C3F1 hepatocytes. These data suggest that DMBA has an immunosuppressive action on murine splenocytes which is independent of the Ah locus and associated induction of cytochrome P1-450 xenobiotic-metabolizing enzymes.
Assuntos
9,10-Dimetil-1,2-benzantraceno/toxicidade , Terapia de Imunossupressão , Receptores de Droga/genética , 9,10-Dimetil-1,2-benzantraceno/metabolismo , Animais , Formação de Anticorpos/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Citotoxicidade Imunológica/efeitos dos fármacos , Feminino , Imunidade Celular/efeitos dos fármacos , Ativação Linfocitária/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos DBA , Microssomos Hepáticos/enzimologia , Tamanho do Órgão/efeitos dos fármacos , Fenótipo , Receptores de Droga/efeitos dos fármacosRESUMO
Previous reports have shown that exposure of murine splenic lymphocytes to the substituted anthraquinone 1,4-bis[(2-aminoethyl)amino]-5,8-dihydroxy-9,10-anthracenedione dihydrochloride (AEAD) results in a persistent, strong immunosuppression which is limited to induction of cytotoxic T-lymphocytes (CTL). In the present study the cellular mechanism of this specificity was examined in detail. Proliferation of T-lymphocytes is inhibited by in vitro exposure to AEAD, with suggestive evidence that this inhibition may be selective for the CTL precursor cells. Activation and differentiation of CTL precursors into functional CTL, as well as the function of T-helper lymphocytes, was unaffected by AEAD exposure. Rather, the committed CTL precursor cells are prevented from clonal proliferation, resulting in a much smaller population of antigen-induced CTL effectors. Finally, it was shown that AEAD is unable to prevent the anamnestic response of CTL memory cells to eliciting antigen. Taken together these data provide strong evidence that AEAD-induced CTL suppression results from its antiproliferative effect, directed primarily toward the CTL precursor subpopulation. This effect is manifested as decreased CTL function due to lower absolute number of specific CTL, since AEAD has no significant direct effect on expression of either specific or polyclonal cytolysis by T-lymphocytes.
Assuntos
Mitoxantrona/análogos & derivados , Linfócitos T Citotóxicos/imunologia , Animais , Células Cultivadas , Relação Dose-Resposta Imunológica , Feminino , Interleucina-5 , Interleucinas/metabolismo , Cinética , Ativação Linfocitária , Camundongos , Mitoxantrona/imunologia , Mitoxantrona/farmacologia , RNA/biossíntese , RNA/imunologia , Baço/citologia , Baço/efeitos dos fármacos , Baço/imunologia , Linfócitos T Citotóxicos/efeitos dos fármacosRESUMO
The immune response of murine splenic lymphocytes was characterized following both in vivo and in vitro exposure to the novel and highly-substituted anthraquinone AEAD. Gross indicators of toxicity such as changes in body weight, lymphoid organ weights or lymphoid organ cellularity were unaffected. Similarly, the antibody plaque-forming cell response and natural killer cell function were unaltered. The most consistent effect noted was the selective suppression of the cytotoxic T-lymphocyte (CTL) response, which persisted for an extended period of time following in vivo exposure at concentrations of 0.75-3.0 micrograms/g. In contrast to the CTL suppression induced by the polycyclic aromatic hydrocarbon 7,12-dimethylbenz[a]-anthracene, AEAD-induced CTL suppression could not be restored by addition of exogenous interleukin-2. Studies are currently underway to further characterize AEAD-induced immunosuppression at the cellular and molecular levels.
Assuntos
Mitoxantrona/análogos & derivados , Linfócitos T Citotóxicos/efeitos dos fármacos , Animais , Formação de Anticorpos/efeitos dos fármacos , Feminino , Terapia de Imunossupressão , Técnicas In Vitro , Injeções Intraperitoneais , Células Matadoras Naturais/efeitos dos fármacos , Camundongos , Mitoxantrona/farmacologia , Tamanho do Órgão , Linfócitos T Citotóxicos/imunologia , Fatores de Tempo , Ensaio de Placa ViralRESUMO
Serum specimens from 53 evaluable patients enrolled in a clinical trial of lymphoblastoid interferon in recurrent respiratory papillomatosis were screened for the presence of interferon-binding antibodies by an indirect enzyme immunoassay and evaluated for neutralizing antibody measured as the inhibition of antiviral activity. Immunoglobulin G antibodies that specifically bound lymphoblastoid interferon were detected in 66% (35 of 53) of patients; neutralizing antibody was detected in 11 of the 35 patients having binding antibody (and in none of the patients who were negative for binding antibody). The incidence of detectable neutralizing antibody in this study population was 20.8% (11 of 53), which is markedly higher than in previous reports of lymphoblastoid interferon in patients with other diseases (i.e., less than 1% incidence). The cumulative dose received at the time of detection of neutralizing antibody ranged from 163 to 385 MU per square meter of body surface. Neutralizing antibody was detectable at a median time of 120 days after initiation of interferon therapy, and binding antibody appeared earlier in those patients (median 59 days) than in patients in whom only binding antibody was produced (median 116 days). Despite the tendency of binding antibody to appear either in patients in whom neutralizing antibody was eventually formed, the detection of binding antibody was not necessarily predictive of the subsequent development of neutralizing antibodies. Binding antibody persisted after neutralizing antibodies had become undetectable.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Anticorpos/análise , Interferon-alfa/uso terapêutico , Papiloma/terapia , Neoplasias do Sistema Respiratório/terapia , Anticorpos/imunologia , Formação de Anticorpos , Seguimentos , Humanos , Interferon-alfa/imunologia , Recidiva Local de Neoplasia/imunologia , Testes de Neutralização , Papiloma/imunologia , Papiloma/patologia , Probabilidade , Neoplasias do Sistema Respiratório/imunologia , Neoplasias do Sistema Respiratório/patologia , Fatores de TempoRESUMO
OBJECTIVE: Therapeutic trials in rheumatoid arthritis with the monoclonal antibody Campath-1H have demonstrated recurrent clinical synovitis in some patients, despite profound depletion of circulating lymphocytes. This study was undertaken to examine the cellular infiltrates in synovial tissue at a time of persistent peripheral lymphopenia. METHODS: Immunohistochemical staining of synovial tissue and peripheral blood lymphocyte phenotyping. RESULTS: Synovial tissues from 2 patients with recurrent synovitis after Campath-1H therapy contained significant T lymphocytic infiltrates at a time when circulating T lymphocytes were markedly depleted. CONCLUSION: These results demonstrate that peripheral blood analysis may not accurately reflect the synovial tissue response to monoclonal antibody therapy.
Assuntos
Antígenos CD/uso terapêutico , Antígenos de Neoplasias , Glicoproteínas , Membrana Sinovial/imunologia , Antígenos CD/efeitos adversos , Antígenos CD/análise , Antígenos CD19 , Antígenos CD20 , Antígenos de Diferenciação de Linfócitos B/análise , Artrite Reumatoide/terapia , Subpopulações de Linfócitos B/citologia , Subpopulações de Linfócitos B/imunologia , Complexo CD3/análise , Linfócitos T CD4-Positivos/citologia , Antígeno CD52 , Humanos , Imuno-Histoquímica , Prótese do Joelho , Linfopenia/etiologia , Inclusão em Parafina , Membrana Sinovial/patologiaRESUMO
Radiolabeled antibodies have shown promise for the treatment of lymphoma and for solid tumor targeting. Campath-1H is a humanized monoclonal antibody that reacts with the CD52 antigen present on human lymphoid and myeloid cells. Campath-1H is a gamma1 (G1) isotype that induces lymphopenia via an Fc-mediated mechanism(s). Isotype switches were engineered, and the resulting antibodies were expressed in NS0 mouse myeloma cells and biosynthetically radiolabeled with [35S]methionine. The forms included G1, G4, and a G4 variant that contained alanine substitutions at (EU numbering) Leu-235, Gly-237, and Glu-318. All isotypes bound antigen equivalently as assessed by target cell binding in vitro. The G4 variant had a greatly reduced capacity to interact with Fc receptor by virtue of reduced binding to THP-1 human myeloid cells and by a 1000-fold increase in EC50 to intermediate antibody-dependent cellular cytotoxicity. The pharmacokinetics of the isotypes were compared in CD-1 (nu/nu) mice bearing an experimental antigen-expressing tumor. The plasma half-life and tumor uptake were increased for the G4 variant. The G4 variant showed significantly less spleen, liver, and bone uptake but similar uptake in the lung, kidney, and stomach and lower tissue-to-blood ratios. Immunogenicity was assessed after repeated monthly administrations of unlabeled antibody in BALB/c mice. A 50% reduction in the incidence of anti-globulin response was observed for the G4 variant. These properties suggest that antibodies with reduced Fc receptor interaction merit additional study as potential targeting vehicles relative to other isotypes for radioimmunotherapy or situations where diminished normal tissue binding contributes to efficacy.
Assuntos
Anticorpos Monoclonais/farmacocinética , Citotoxicidade Celular Dependente de Anticorpos , Neoplasias Experimentais/imunologia , Alemtuzumab , Animais , Anticorpos Monoclonais/biossíntese , Anticorpos Monoclonais Humanizados , Anticorpos Antineoplásicos/biossíntese , Células CHO , Linhagem Celular , Cricetinae , Feminino , Variação Genética , Meia-Vida , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Mutagênese Sítio-Dirigida , Neoplasias Experimentais/metabolismo , Mutação Puntual , Prolina , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/farmacocinética , Serina , Relação Estrutura-Atividade , Distribuição Tecidual , Transplante Heterólogo , Células Tumorais CultivadasRESUMO
beta-HCH, an isomeric contaminant formed during the manufacture of the insecticide lindane, is a persistent environmental and food chain pollutant which has been reported to exhibit estrogenic activity in rodents and in fish. To investigate potential toxic effects on the reproductive and immune systems, beta-HCH was fed to female B6C3F1 mice for 30 days. Mice exposed to 0, 100, or 300 mg of beta-HCH/kg of diet were evaluated for changes in ovarian and uterine histology, body weight, lymphoid organ weight and histology, splenic cellularity, antigen-specific IgM and IgG plaque-forming cells (PFC), proliferative responses to mitogens, natural killer (NK) cell activity, and induction of cytolytic T lymphocytes. The ovaries and endometrial epithelium exhibited normal architecture. No alterations were observed in body weight, lymphoid organ weight and histology, or splenic cellularity whereas significant changes were found in several immune functions at the 300 mg/kg dose. Proliferation of splenocytes to the mitogens LPS, PHA, and Con A was decreased by 39, 43, and 57%, respectively. T-lymphocyte-mediated cytolysis of tumor targets was decreased by 25% with a concurrent reduction of 45% in NK activity. There was no significant reduction in the number of IgM or IgG PFC in exposed animals. These data indicate that beta-HCH causes nonestrogenic immune function changes in the adult mouse without gross changes in lymphoid organ weight, histology, or cellularity.
Assuntos
Hexaclorocicloexano/toxicidade , Imunidade/efeitos dos fármacos , Animais , Divisão Celular/efeitos dos fármacos , Dieta , Feminino , Técnica de Placa Hemolítica , Sistema Linfático/citologia , Sistema Linfático/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos DBA , Camundongos Endogâmicos , Tamanho do Órgão/efeitos dos fármacos , Baço/citologia , Baço/efeitos dos fármacosRESUMO
Interest in 1,3-butadiene (BD) as a potential immunomodulator was prompted by reports of an increased incidence of neoplasia in humans exposed to BD during the manufacture of styrene-butadiene synthetic rubber, and by a recent study which demonstrated a high incidence of thymic lymphomas in B6C3F1 mice. B6C3F1 mice were exposed to 1250 ppm BD by inhalation 6 hr per day, 5 days per week, for 6 or 12 weeks. Immune function assays were selected to evaluate specific humoral and cell-mediated immunity and spontaneous cytotoxicity; lymphoid organ histopathology was also evaluated. A slight decrease in antibody plaque-forming cells (PFC) per spleen was observed in exposed mice, although PFC per 10(6) splenic lymphocytes was normal. Significant extramedullary hematopoiesis and erythroid hyperplasia was observed in spleens from exposed mice, and correlated with a twofold increase in thymidine incorporation in spontaneously proliferating splenocytes. No differences in proliferation to alloantigens were demonstrable between control and BD-exposed splenocytes. Mitogenesis by phytohemagglutinin, Concanavalin A, and lipo polysaccharide was suppressed in splenocytes from exposed mice, but may have been due to the cellular dilution effect of hematopoietic activity. Cytotoxic T-lymphocyte generation was suppressed after a 6-week exposure to BD, but was comparable to controls after 12 weeks of exposure. No differences in spontaneous cytotoxicity were observed between control and exposed mice. Overall, no persistent immunological defects were detectable after inhalation exposure to this tumorigenic agent.
Assuntos
Formação de Anticorpos/efeitos dos fármacos , Butadienos/toxicidade , Imunidade Celular/efeitos dos fármacos , Administração por Inalação , Animais , Antígenos de Superfície/análise , Peso Corporal/efeitos dos fármacos , Citotoxicidade Imunológica/efeitos dos fármacos , Ativação Linfocitária/efeitos dos fármacos , Masculino , Camundongos , Tamanho do Órgão/efeitos dos fármacos , Baço/efeitos dos fármacos , Timo/efeitos dos fármacos , Fatores de TempoRESUMO
One hundred thirty-eight patients with hairy cell leukemia were randomized to receive either a dose of 2.0 megaunits (MU)/m2 or a 10-fold lower dose of 0.2 MU/m2 of a highly purified natural alpha-interferon, administered daily for 28 days followed by a three times a week schedule. Ninety-seven of these patients had previously undergone splenectomy, but otherwise none of the patients had received prior therapy for their leukemia. The two doses were comparable in their effect on improving the neutrophil and platelet count, whereas the higher dose had a greater beneficial effect on the hemoglobin level and a greater antileukemic effect on the marrow. Acute toxicity in the form of a flu-like syndrome, neurologic side effects, neutropenia, and the need for platelet transfusions was observed less frequently in the low-dose group, as was the chronic fatigue syndrome. No neutralizing antibody activity was seen in the sera from 61 patients examined. Because of its beneficial effect on the neutrophil and platelet count and a lower degree of toxicity (ie, a superior therapeutic/toxicity ratio), the low dose is recommended as initial therapy in patients with hairy cell leukemia. This therapy may be followed by dose escalation once clinical improvement is observed.
Assuntos
Interferon-alfa/administração & dosagem , Leucemia de Células Pilosas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos/sangue , Medula Óssea/patologia , Relação Dose-Resposta a Droga , Feminino , Hemoglobinas/metabolismo , Humanos , Interferon-alfa/efeitos adversos , Interferon-alfa/uso terapêutico , Leucemia de Células Pilosas/sangue , Leucemia de Células Pilosas/patologia , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos/patologia , Contagem de Plaquetas , EsplenectomiaRESUMO
OBJECTIVE: A 24 week study of subcutaneous (sq) dosing with titration of CAMPATH-1H (C1H) dose against the circulating CD4+ T cell count in patients with rheumatoid arthritis (RA) was undertaken to examine the safety, biologic activity, and clinical efficacy of this approach. METHODS: All patients met American Rheumatism Association (ARA) criteria for active RA. Patients received either 0.5 or 1.0 mg of C1H subcutaneously twice per week; dosing could be doubled after the first 8 weeks of treatment and subsequently following 4 week dose intervals for lack of clinical efficacy, but was discontinued any time the CD4+ T cell count fell below 400/mm3. Patients were evaluated weekly for 2 weeks and then biweekly for clinical and laboratory variables of safety, biological activity, and disease activity. RESULTS: Ten patients were treated, 6 in the 0.5 mg cohort and 4 in the 1.0 mg cohort. Four of ten patients had a 20% modified Paulus response (2 in each cohort) while taking drug; there were minimal side effects, primarily limited to local reaction at the injection site. All patients had a > 50% drop in circulating CD4+ T cells within the first 2 weeks of therapy, with no further significant reduction; only 1/6 patients in the 0.5 mg cohort had dose limiting CD4+ T cell depression vs 2/4 in the 1.0 mg cohort. All patients developed antibodies to C1H. Appearance of anti-C1H was temporarily associated with a halt in further reduction of CD4+ T cell count despite continued C1H administration. CONCLUSION: Subcutaneous administration of C1H in low doses (0.5 mg biweekly) was well tolerated and did not result in dose limiting CD4+ T cell depletion in 5 of 6 patients. Clinical efficacy was observed in some patients but could not be maintained, possibly due to the production of anti-C1H antibodies.