1 Department of Surgery, Research Center, CHUM, Notre-Dame Hospital, University of Montreal, Montreal, Quebec, Canada. 2 Laboratory Animals Center, the Academy of Military Medical Sciences, Beijing, China. 3 Translational and Development Pharmacology-US, Drug Discovery Research, Astellas Research Institute of America LLC, Northbrook, IL. 4 Astellas Research Technology Inc., Osaka, Japan. 5 Drug Metabolism Research Labs. Astellas Pharma Inc., Osaka, Japan. 6 Pharmacological Research Labs., Kyowa Hakko Kirin Co., Ltd., Shizuoka, Japan. 7 Address correspondence to: Huifang Chen, M.D., Ph.D., Laboratory of Experimental Surgery, Research Center, CHUM, Notre-Dame Hospital, University of Montréal, 2099 Alexandre de Sève, Montréal, Room Y1611, Québec, Canada H2L 2W5.
Transplantation. 2014 Aug 15;98(3):267-76. doi: 10.1097/TP.0000000000000236.
Blocking the CD40-CD154 signal pathway has previously shown promise as a strategy to prevent allograft rejection. In this study, the efficacy of a novel fully human anti-CD40 monoclonal antibody-ASKP1240, administered as a monotherapy or combination therapy (subtherapeutic dose of tacrolimus or mycophenolate mofetil), on the prevention of renal allograft rejection was evaluated in Cynomolgus monkeys.
Heterotopic kidney transplants were performed in ABO-compatible, stimulation index 2.5 or higher in the two-way mixed lymphocyte reaction monkey pairs. Animals were divided into 12 groups and observed for a maximum of 180 days. Histopathologic, hematology, and biochemistry analyses were conducted in all groups. Cytokine release (interleukin [IL]-2, IL-4, IL-5, IL-6, tumor necrosis factor, and interferon-γ) was investigated in several groups.
ASKP1240 prolonged renal allograft survival in a dose-dependent manner in monotherapy. Low-dose (2 mg/kg) or high-dose (5 mg/kg) ASKP1240, in combination with mycophenolate mofetil (15 mg/kg) or tacrolimus (1 mg/kg), showed a significantly longer allograft survival time compared with monotherapy groups. No obvious side effects including drug-related thromboembolic complications were found. Cytokine release was not induced by ASKP1240 administration.
The present study indicates that ASKP1240, alone or in combination with other immunosuppressive drugs, could be a promising antirejection agent in organ transplantation.
阻断 CD40-CD154 信号通路已被证明是预防同种异体移植物排斥反应的一种有前途的策略。在这项研究中,评估了一种新型全人抗 CD40 单克隆抗体-ASKP1240 作为单药或联合治疗(他克莫司或霉酚酸酯的亚治疗剂量)在预防猕猴肾移植排斥反应中的疗效。
在 ABO 相容、双向混合淋巴细胞反应刺激指数为 2.5 或更高的猕猴对中进行异位肾移植。动物分为 12 组,观察时间最长为 180 天。所有组均进行组织病理学、血液学和生物化学分析。在几个组中研究了细胞因子释放(白细胞介素[IL]-2、IL-4、IL-5、IL-6、肿瘤坏死因子和干扰素-γ)。
ASKP1240 在单药治疗中以剂量依赖性方式延长了肾移植的存活时间。低剂量(2mg/kg)或高剂量(5mg/kg)ASKP1240 与霉酚酸酯(15mg/kg)或他克莫司(1mg/kg)联合使用,与单药治疗组相比,移植肾存活时间显著延长。未发现明显的副作用,包括与药物相关的血栓栓塞并发症。ASKP1240 给药未诱导细胞因子释放。
本研究表明,ASKP1240 单独或与其他免疫抑制剂联合使用,可能成为器官移植中一种有前途的抗排斥药物。