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一种新型的、具有阻断作用的、Fc沉默的抗CD40单克隆抗体在不进行B细胞清除的情况下可延长非人灵长类动物肾移植的存活时间。

A novel, blocking, Fc-silent anti-CD40 monoclonal antibody prolongs nonhuman primate renal allograft survival in the absence of B cell depletion.

作者信息

Cordoba F, Wieczorek G, Audet M, Roth L, Schneider M A, Kunkler A, Stuber N, Erard M, Ceci M, Baumgartner R, Apolloni R, Cattini A, Robert G, Ristig D, Munz J, Haeberli L, Grau R, Sickert D, Heusser C, Espie P, Bruns C, Patel D, Rush J S

机构信息

Department of Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, Basel, Switzerland.

Hôpital de Hautepierre, Strasbourg, France.

出版信息

Am J Transplant. 2015 Nov;15(11):2825-36. doi: 10.1111/ajt.13377. Epub 2015 Jul 2.

Abstract

CD40-CD154 pathway blockade prolongs renal allograft survival in nonhuman primates (NHPs). However, antibodies targeting CD154 were associated with an increased incidence of thromboembolic complications. Antibodies targeting CD40 prolong renal allograft survival in NHPs without thromboembolic events but with accompanying B cell depletion, raising the question of the relative contribution of B cell depletion to the efficacy of anti-CD40 blockade. Here, we investigated whether fully silencing Fc effector functions of an anti-CD40 antibody can still promote graft survival. The parent anti-CD40 monoclonal antibody HCD122 prolonged allograft survival in MHC-mismatched cynomolgus monkey renal allograft transplantation (52, 22, and 24 days) with accompanying B cell depletion. Fc-silencing yielded CFZ533, an antibody incapable of B cell depletion but still able to potently inhibit CD40 pathway activation. CFZ533 prolonged allograft survival and function up to a defined protocol endpoint of 98-100 days (100, 100, 100, 98, and 76 days) in the absence of B cell depletion and preservation of good histological graft morphology. CFZ533 was well-tolerated, with no evidence of thromboembolic events or CD40 pathway activation and suppressed a gene signature associated with acute rejection. Thus, use of the Fc-silent anti-CD40 antibody CFZ533 appears to be an attractive approach for preventing solid organ transplant rejection.

摘要

CD40-CD154通路阻断可延长非人灵长类动物(NHP)肾移植的存活时间。然而,靶向CD154的抗体与血栓栓塞并发症发生率增加相关。靶向CD40的抗体可延长NHP肾移植的存活时间,且无血栓栓塞事件,但伴有B细胞耗竭,这就引发了B细胞耗竭对抗CD40阻断疗效的相对贡献问题。在此,我们研究了完全沉默抗CD40抗体的Fc效应功能是否仍能促进移植物存活。亲本抗CD40单克隆抗体HCD122在MHC不匹配的食蟹猴肾移植中延长了移植物存活时间(52、22和24天),同时伴有B细胞耗竭。Fc沉默产生了CFZ533,这是一种不能导致B细胞耗竭但仍能有效抑制CD40通路激活的抗体。在没有B细胞耗竭且移植物组织形态良好的情况下,CFZ533将移植物存活时间和功能延长至98-100天的既定方案终点(100、100、100、98和76天)。CFZ533耐受性良好,没有血栓栓塞事件或CD40通路激活的证据,并抑制了与急性排斥相关的基因特征。因此,使用Fc沉默的抗CD40抗体CFZ533似乎是预防实体器官移植排斥的一种有吸引力的方法。

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