Monoclonal antibodies in rheumatic disease

M. Scudeletti, F. Puppo, G. Filaci, M. A. Imro, M. Setti, O. Bosco, M. Cutolo, L. Lanza, S. Ferrone, F. Indiveri

Research output: Contribution to journalArticlepeer-review

Abstract

HLA class II-positive activated T lymphocytes play a crucial role in the pathogenesis of autoimmune diseases. Anti-HLA class II monoclonal antibodies (MoAbs), which may inhibit the activity of these molecules, can interfere with important mechanisms leading to autoimmunity. Since the therapeutic use of these MoAbs has been generally complicated by the development of a host immune response to injected alloproteins, antiidiotypic MoAbs have been suggested to be more safe and useful. To this end several murine monoclonal antibodies, which recognize the idiotypic determinants of the combining site of anti-HLA class II MoAbs have been produced and characterized. Among them an antiidiotypic MoAb, directed against an idiotope of the combining site of the anti-DR/DP MoAb CR51-462 has been selected because of its specificity for the combining site of the MoAb. Four patients fulfilling the American College of Rheumatology (ACR) criteria for Rheumatoid Arthritis, 4 affected by systemic lupus erythematosus and 2 with multiple sclerosis, were injected i.m. 3 times with 2 mg of the antiidiotypic MoAb on day 1,21 and 42. All patients studied have been subjected to a series of clinical, laboratory and immunological parameters every week. The clinical and immunological follow- up of patients showed that: a) the treatment with the antiidiotypic MoAb is a safe procedure since neither immune inhibition nor sensibilization to the immunogen were seen; b) 60% of the treated patients produced antibodies inhibiting the immunogen. In conclusion parenteral administration of antiidiotypic MoAb is a safe procedure since neither immune inhibition nor sensibilization to the immunogen were seen. The effect of treatment on the patients clinical course is currently being evaluated.

Original languageEnglish
Pages (from-to)113-117
Number of pages5
JournalEuropean Journal of Internal Medicine, Supplement
Volume3
Issue number1
Publication statusPublished - 1992

ASJC Scopus subject areas

  • Internal Medicine

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