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靶向 α-突触核蛋白的主动免疫疗法 PD03A 治疗早期帕金森病患者的安全性和耐受性:一项随机、安慰剂对照、I 期研究。

Safety and Tolerability of Active Immunotherapy Targeting α-Synuclein with PD03A in Patients with Early Parkinson's Disease: A Randomized, Placebo-Controlled, Phase 1 Study.

机构信息

Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.

PROSENEX Study Center at Privatklinik Confraternitaet, Vienna, Austria.

出版信息

J Parkinsons Dis. 2021;11(3):1079-1089. doi: 10.3233/JPD-212594.

Abstract

BACKGROUND

Immunotherapies targeting α-synuclein aim to limit its extracellular spread in the brain and prevent progression of pathology in Parkinson's disease (PD). PD03A is a specific active immunotherapy (SAIT) involving immunization with a short peptide formulation.

OBJECTIVE

This phase 1 study characterized the safety and tolerability of PD03A in patients with early PD. A key secondary objective was to evaluate immunological activity following immunization.

METHODS

This was a phase 1 study of two different doses of PD03A versus placebo in PD patients. Patients were randomized (1:1:1) to receive four priming plus one booster vaccination of PD03A 15μg, PD03A 75μg or placebo and were followed for 52 weeks.

RESULTS

Overall, 36 patients were randomized, of which 35 received five immunizations and completed the study. All patients experienced at least one adverse event. Transient local injection site reactions affected all but two patients; otherwise most AEs were considered unrelated to study treatment. A substantial IgG antibody response against PD03 was observed with a maximum titer achieved at Week-12. Differences in titers between both active groups versus placebo were statistically significant from the second immunization at Week-8 until Week-52.

CONCLUSION

The safety profile and positive antibody response of PD03A supports the further development of active immunotherapeutic approaches for the treatment of PD.

摘要

背景

针对α-突触核蛋白的免疫疗法旨在限制其在大脑中的细胞外扩散,并防止帕金森病(PD)的病理进展。PD03A 是一种涉及用短肽制剂免疫的特异性主动免疫疗法(SAIT)。

目的

本研究旨在评估 PD03A 在早期 PD 患者中的安全性和耐受性。次要关键目标是评估免疫接种后的免疫活性。

方法

这是一项在 PD 患者中进行的两种不同剂量的 PD03A 与安慰剂的 1 期研究。患者按 1:1:1 的比例随机分为 PD03A 15μg、PD03A 75μg 或安慰剂四剂初免加一剂加强免疫组,并随访 52 周。

结果

共有 36 例患者随机分组,其中 35 例接受了五次免疫接种并完成了研究。所有患者均至少发生了一次不良事件。除两名患者外,所有患者均出现短暂的局部注射部位反应;否则,大多数不良事件被认为与研究治疗无关。观察到针对 PD03 的大量 IgG 抗体反应,最大滴度在第 12 周达到。从第 8 周的第二次免疫到第 52 周,两个活性组与安慰剂相比,滴度差异均具有统计学意义。

结论

PD03A 的安全性和阳性抗体反应支持进一步开发用于治疗 PD 的主动免疫治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0690/8461711/97c4033c4a8f/jpd-11-jpd212594-g001.jpg

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