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多发性硬化症患者中干扰素β制剂的不同免疫原性潜力。

Differing immunogenic potentials of interferon beta preparations in multiple sclerosis patients.

作者信息

Gneiss C, Tripp P, Reichartseder F, Egg R, Ehling R, Lutterotti A, Khalil M, Kuenz B, Mayringer I, Reindl M, Berger T, Deisenhammer F

机构信息

Clinical Department of Neurology, Innsbruck Medical University, 6020 Innsbruck, Austria.

出版信息

Mult Scler. 2006 Dec;12(6):731-7. doi: 10.1177/1352458506070941.

Abstract

Interferon beta (IFNbeta) is a first-line therapy for multiple sclerosis (MS). However, some patients experience a decline in efficacy with continued therapy due to the development of anti-IFNbeta neutralizing antibodies (NAb). We investigated the frequency of NAb cross-sectionally in 846 MS patients who were receiving IFNbeta-1b, IFNbeta-1a im, or IFNbeta-1a sc. The frequency of NAb in patients receiving IFNbeta-1a im was lower (5%) than in patients treated with any other form of IFNbeta (22-35%) (P < 0.0001). Binding antibodies (BAb) were measured in 808 patients. The frequency differed significantly between treatment groups, ranging from 45% (IFNbeta-1a im) to 88% (IFNbeta-1b). The proportion of NAb-positive patients within the BAb-positive group differed significantly among treatment groups, ranging between 12% (IFNbeta-1a im) and 51% (IFNbeta-1a sc). The median NAb titer from all IFNbeta-1a-treated patients was higher than from IFNbeta-1b-treated patients (446 versus 171 NU/ mL, P = 0.04). Among NAb-positive patients, the frequency of NAb titers > 100 NU/mL was 71% for IFNbeta-1a compared with 58% for IFNbeta-1b (P = 0.04). Except for conflicting data regarding IFNbeta-1a sc, the results are generally consistent with the literature and together with the differing proportion of NAb-positive patients within the BAb-positive group, provide further insight into the immunogenicity of the IFNbeta preparations.

摘要

干扰素β(IFNβ)是治疗多发性硬化症(MS)的一线药物。然而,由于抗IFNβ中和抗体(NAb)的产生,一些患者在持续治疗过程中疗效会下降。我们对846例接受IFNβ-1b、肌肉注射IFNβ-1a或皮下注射IFNβ-1a治疗的MS患者进行了NAb的横断面频率调查。接受肌肉注射IFNβ-1a的患者中NAb的频率(5%)低于接受任何其他形式IFNβ治疗的患者(22%-35%)(P<0.0001)。在808例患者中检测了结合抗体(BAb)。各治疗组之间的频率差异显著,范围从45%(肌肉注射IFNβ-1a)到88%(IFNβ-1b)。BAb阳性组中NAb阳性患者的比例在各治疗组之间差异显著,范围在12%(肌肉注射IFNβ-1a)至51%(皮下注射IFNβ-1a)之间。所有接受IFNβ-1a治疗患者的NAb中位滴度高于接受IFNβ-1b治疗的患者(446对171 NU/mL,P=0.04)。在NAb阳性患者中,IFNβ-1a的NAb滴度>100 NU/mL的频率为71%,而IFNβ-1b为58%(P=0.04)。除了关于皮下注射IFNβ-1a的数据存在矛盾外,这些结果总体上与文献一致,并且结合BAb阳性组中NAb阳性患者的不同比例,进一步深入了解了IFNβ制剂的免疫原性。

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