Kivisäkk P, Alm G V, Fredrikson S, Link H
Division of Neurology, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.
Eur J Neurol. 2000 Jan;7(1):27-34. doi: 10.1046/j.1468-1331.2000.00002.x.
Interferon-beta (IFN-beta) is currently the most commonly used treatment of relapsing-remitting multiple sclerosis (MS). At the time of this study, two preparations of IFN-beta were available, IFN-beta-1a (Avonextrade mark) and IFN-beta-1b (Betaferon(R)), which both can elicit an immune response with the development of anti-IFN-beta antibodies. Direct comparisons between these two preparations regarding antibody frequencies have, however, been difficult to perform, because two different analysis methods measuring partly different biological effects of IFN-beta have been employed. In the present study, binding and neutralizing anti-IFN-beta-1a and -1b antibodies were detected in parallel by an independent, well-acknowledged, interferon research laboratory using an immunoassay and a cytopathic virus inhibition assay. Five per cent of patients treated with IFN-beta-1a intramuscularly (n = 20) had neutralizing antibodies (NABs) compared with 44% of patients treated with IFN-beta-1b subcutaneously (n = 48). A high degree of cross-reactivity between neutralizing anti-IFN-beta-1a and -1b antibodies was observed. No effect of NABs on clinical outcome could be detected in this limited material. Binding anti-IFN-beta antibodies were observed in 20% of IFN-beta-1a treated patients compared with 81% of patients treated with IFN-beta-1b. Only one of 17 patients examined (6%) had detectable titres of binding anti-IFN-beta-1b antibodies in the cerebrospinal fluid (CSF). These data are the first using identical methodology to show that IFN-beta-1a gives rise to fewer NABs than IFN-beta-1b at recommended treatment schedules.
β-干扰素(IFN-β)是目前复发缓解型多发性硬化症(MS)最常用的治疗药物。在本研究开展时,有两种β-干扰素制剂可供使用,即IFN-β-1a(商品名Avonex)和IFN-β-1b(商品名Betaferon),这两种制剂均可引发免疫反应并产生抗IFN-β抗体。然而,由于采用了两种部分测量IFN-β不同生物学效应的不同分析方法,很难对这两种制剂的抗体频率进行直接比较。在本研究中,一个独立的、公认的干扰素研究实验室使用免疫测定法和细胞病变病毒抑制测定法同时检测了结合性和中和性抗IFN-β-1a及抗IFN-β-1b抗体。肌肉注射IFN-β-1a治疗的患者中有5%(n = 20)产生了中和抗体(NABs),而皮下注射IFN-β-1b治疗的患者中有44%(n = 48)产生了中和抗体。观察到中和性抗IFN-β-1a和抗IFN-β-1b抗体之间存在高度交叉反应性。在这一有限样本中未检测到NABs对临床结局的影响。接受IFN-β-1a治疗的患者中有20%出现了结合性抗IFN-β抗体,而接受IFN-β-1b治疗的患者中有81%出现了结合性抗IFN-β抗体。在接受检查的17例患者中,只有1例(6%)脑脊液(CSF)中可检测到结合性抗IFN-β-1b抗体的滴度。这些数据首次使用相同方法表明,在推荐治疗方案下,IFN-β-1a产生的NABs比IFN-β-1b少。