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在一项使用细菌酶IdeS的随机剂量递增I期研究中完全清除细胞外IgG抗体——一种新的治疗机会

Complete Removal of Extracellular IgG Antibodies in a Randomized Dose-Escalation Phase I Study with the Bacterial Enzyme IdeS--A Novel Therapeutic Opportunity.

作者信息

Winstedt Lena, Järnum Sofia, Nordahl Emma Andersson, Olsson Andreas, Runström Anna, Bockermann Robert, Karlsson Christofer, Malmström Johan, Palmgren Gabriella Samuelsson, Malmqvist Ulf, Björck Lars, Kjellman Christian

机构信息

Hansa Medical AB, Scheelevägen 22, P.O. Box 785, SE-22007 Lund, Sweden.

Department of Clinical Sciences, Lund, Lund University, SE-221 84 Lund, Sweden.

出版信息

PLoS One. 2015 Jul 15;10(7):e0132011. doi: 10.1371/journal.pone.0132011. eCollection 2015.


DOI:10.1371/journal.pone.0132011
PMID:26177518
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4503742/
Abstract

UNLABELLED: IdeS is a streptococcal protease that cleaves IgG antibodies into F(ab’)2 and Fc fragments with a unique degree of specificity, thereby providing a novel treatment opportunity of IgG-driven autoimmune conditions and antibody mediated transplant rejection. Here we report the results from a first in man, double blinded and randomized study with single ascending doses of IdeS in healthy, male subjects. Twenty healthy subjects were given intravenous single ascending doses of IdeS. With impressive efficacy IdeS cleaved the entire plasma IgG-pool only minutes after dosing. IgG reached nadir 6-24 hours after dosing and then slowly recovered. The half-life of IdeS was 4.9 (±2.8) hours at 0.24 mg/kg with the main fraction eliminated during 24 hours. Already two hours after IdeS-dosing, the phagocytic capacity of IgG/IgG-fragments was reduced to background levels. Importantly, IdeS has the capacity to inactivate Fc-mediated effector function in vivo, was considered safe with no serious adverse events, and without dose limiting toxicity in this study. The complete, rapid, but temporary removal of IgG provides a new potent therapeutic opportunity in IgG-mediated pathogenic conditions. TRIAL REGISTRATION: ClinicalTrials.gov NCT01802697.

摘要

未标注:IdeS是一种链球菌蛋白酶,可将IgG抗体切割成具有独特特异性程度的F(ab’)2和Fc片段,从而为IgG驱动的自身免疫性疾病和抗体介导的移植排斥反应提供了一种新的治疗机会。在此,我们报告了一项在健康男性受试者中进行的首例单剂量递增的人体双盲随机研究结果。20名健康受试者接受了静脉注射单剂量递增的IdeS。给药后仅几分钟,IdeS就以令人印象深刻的效果切割了整个血浆IgG库。给药后6 - 24小时IgG达到最低点,然后缓慢恢复。在0.24mg/kg剂量下,IdeS的半衰期为4.9(±2.8)小时,主要部分在24小时内消除。在IdeS给药两小时后,IgG/IgG片段的吞噬能力就降至背景水平。重要的是,IdeS有能力在体内使Fc介导的效应功能失活,在本研究中被认为是安全的,没有严重不良事件,也没有剂量限制毒性。IgG的完全、快速但暂时的清除为IgG介导的致病状况提供了一种新的有效治疗机会。 试验注册:ClinicalTrials.gov NCT01802697。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/fca690f5c9b2/pone.0132011.g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/245901417781/pone.0132011.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/635415caee2c/pone.0132011.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/d89f4ea394df/pone.0132011.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/d84f6179c6ee/pone.0132011.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/2b1f2d1aefde/pone.0132011.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/3a09a3ba05ed/pone.0132011.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/88622f4a0fb9/pone.0132011.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/747c1b306621/pone.0132011.g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/fca690f5c9b2/pone.0132011.g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/245901417781/pone.0132011.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/635415caee2c/pone.0132011.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/d89f4ea394df/pone.0132011.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/d84f6179c6ee/pone.0132011.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/2b1f2d1aefde/pone.0132011.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/3a09a3ba05ed/pone.0132011.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/88622f4a0fb9/pone.0132011.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/747c1b306621/pone.0132011.g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b6/4503742/fca690f5c9b2/pone.0132011.g009.jpg

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本文引用的文献

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