Crow Andrew R, Amash Alaa, Lazarus Alan H
Canadian Blood Services Centre for Innovation, Toronto, Ontario, Canada.
Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, Ontario, Canada.
Transfusion. 2015 Jun;55(6 Pt 2):1492-500. doi: 10.1111/trf.12957. Epub 2014 Dec 15.
Several monoclonal antibodies to CD44 can successfully ameliorate murine immune thrombocytopenia (ITP). As these antibodies may be a potential replacement for intravenous immune globulin (IVIG) in the treatment of ITP and other autoimmune diseases, an understanding of their mechanisms of action is important. The role of the inhibitory Fc receptor (FcγRIIb) in the mechanism of action of IVIG and therapeutic CD44 antibodies remains uncertain. To assess if FcγRIIb in splenic macrophages plays a critical role in the action of these two therapeutics, splenectomized mice and mice genetically deficient in FcγRIIb on different backgrounds were evaluated.
Thrombocytopenia was induced in FcγRIIb-deficient mice on B6;129S, C57BL/6, and BALB/C backgrounds, as well as splenectomized mice and control mice by platelet (PLT) antibody. PLT counts were enumerated before and after treatment with anti-CD44, red blood cell antibodies, or IVIG.
Anti-CD44 is ineffective at inhibiting thrombocytopenia in B6;129S FcγRIIb-deficient mice but, like IVIG, is effective in splenectomized mice and FcγRIIb-deficient mice on the BALB/C and C57BL/6 background.
These data suggest that 1) the B6;129S background itself is unlikely to be the sole reason for anti-CD44's inability to function in B6;129S FcγRIIb-deficient mice, 2) the simple loss of macrophage FcγRIIb expression alone is insufficient to explain anti-CD44 ameliorative function, and 3) a combination of mouse background genes in addition to FcγRIIb genetic disruption may affect the ability of anti-CD44 to function therapeutically. Similarities between IVIG and anti-CD44 mechanisms suggest that patients responsive to IVIG may also potentially respond to anti-CD44 treatment.
几种针对CD44的单克隆抗体能够成功改善小鼠免疫性血小板减少症(ITP)。由于这些抗体在治疗ITP和其他自身免疫性疾病方面可能是静脉注射免疫球蛋白(IVIG)的潜在替代品,了解其作用机制很重要。抑制性Fc受体(FcγRIIb)在IVIG和治疗性CD44抗体作用机制中的作用仍不确定。为了评估脾脏巨噬细胞中的FcγRIIb在这两种治疗方法的作用中是否起关键作用,对脾切除小鼠和不同背景下FcγRIIb基因缺陷的小鼠进行了评估。
通过血小板(PLT)抗体在B6;129S、C57BL/6和BALB/C背景的FcγRIIb缺陷小鼠、脾切除小鼠和对照小鼠中诱导血小板减少症。在用抗CD44、红细胞抗体或IVIG治疗前后计数PLT数量。
抗CD44在抑制B6;129S FcγRIIb缺陷小鼠的血小板减少症方面无效,但与IVIG一样,在脾切除小鼠以及BALB/C和C57BL/6背景的FcγRIIb缺陷小鼠中有效。
这些数据表明:1)B6;129S背景本身不太可能是抗CD44在B6;129S FcγRIIb缺陷小鼠中无法发挥作用的唯一原因;2)仅巨噬细胞FcγRIIb表达的简单缺失不足以解释抗CD44的改善功能;3)除了FcγRIIb基因破坏外,小鼠背景基因的组合可能会影响抗CD44的治疗功能。IVIG和抗CD44机制之间的相似性表明,对IVIG有反应的患者可能也对抗CD44治疗有潜在反应。