Department of Anesthesiology, University of California, San Diego School of Medicine, La Jolla, CA 92093, USA Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA Division of Immunology, Cleveland Clinic, Cleveland, Ohio 44195, USA Provenance Biopharmaceuticals Corp. Waltham, MA 01821, USA Department of Hematology/Oncology, Children's University Hospital, Tuebingen 72076, Germany Division of Pediatric Hematology and Oncology, Duke University, Durham, NC 27708, USA Department of Oncology, University of California San Diego, La Jolla, CA 92093, USA Genomics Research Center, Academia Sinica, Taipei, Taiwan.
Pain. 2010 Apr;149(1):135-142. doi: 10.1016/j.pain.2010.01.024. Epub 2010 Feb 19.
Monoclonal antibodies against GD(2) ganglioside, such as ch14.18, the human-mouse chimeric antibody, have been shown to be effective for the treatment of neuroblastoma. However, treatment is associated with generalized, relatively opiate-resistant pain. We investigated if a point mutation in ch14.18 antibody (hu14.18K332A) to limit complement-dependent cytotoxicity (CDC) would ameliorate the pain behavior, while preserving antibody-dependent cellular cytotoxicity (ADCC). In vitro, CDC and ADCC were measured using europium-TDA assay. In vivo, allodynia was evaluated by measuring thresholds to von Frey filaments applied to the hindpaws after injection of either ch14.18 or hu14.18K332 into wild type rats or rats with deficient complement factor 6. Other rats were pretreated with complement factor C5a receptor antagonist and tested following ch14.18 injection. The mutation reduces the antibody's ability to activate complement, while maintaining its ADCC capabilities. Injection of hu14.18K322 (1 or 3mg/kg) produced faster resolving allodynia than that engendered by ch14.18 (1mg/kg). Injection of ch14.18 (1mg/kg) into rats with C6 complement deficiency further reduced antibody-induced allodynia, while pre-treatment with complement factor C5a receptor antagonist completely abolished ch14.18-induced allodynia. These findings showed that mutant hu14.18 K322 elicited less allodynia than ch14.18 and that ch14.18-elicited allodynia is due to activation of the complement cascade: in part, to formation of membrane attack complex, but more importantly to release of complement factor C5a. Development of immunotherapeutic agents with decreased complement-dependent lysis while maintaining cellular cytotoxicity may offer treatment options with reduced adverse side effects, thereby allowing dose escalation of therapeutic antibodies.
针对 GD(2)神经节苷脂的单克隆抗体,如嵌合人鼠抗体 ch14.18,已被证明对神经母细胞瘤的治疗有效。然而,这种治疗与全身性、相对阿片类药物抗性疼痛有关。我们研究了 ch14.18 抗体(hu14.18K332A)中的一个点突变是否会减轻疼痛行为,同时保留抗体依赖性细胞毒性(ADCC)。在体外,通过使用铕-TDA 测定法测量补体依赖性细胞毒性(CDC)和抗体依赖性细胞毒性(ADCC)。在体内,通过测量向野生型大鼠或补体因子 6 缺乏大鼠的后爪注射 ch14.18 或 hu14.18K332 后,von Frey 纤维施加的阈值来评估痛觉过敏。其他大鼠用补体因子 C5a 受体拮抗剂预处理,然后在 ch14.18 注射后进行测试。该突变降低了抗体激活补体的能力,同时保持了其 ADCC 能力。注射 hu14.18K322(1 或 3mg/kg)比注射 ch14.18(1mg/kg)产生更快缓解的痛觉过敏。向 C6 补体缺乏的大鼠注射 ch14.18(1mg/kg)进一步降低了抗体引起的痛觉过敏,而用补体因子 C5a 受体拮抗剂预处理则完全消除了 ch14.18 引起的痛觉过敏。这些发现表明,突变体 hu14.18 K322 引起的痛觉过敏比 ch14.18 少,而 ch14.18 引起的痛觉过敏是由于补体级联的激活:部分原因是膜攻击复合物的形成,但更重要的是补体因子 C5a 的释放。开发具有降低补体依赖性裂解而同时保持细胞毒性的免疫治疗剂可能会提供减少不良反应的治疗选择,从而允许治疗性抗体的剂量增加。
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