Blizard Institute, Barts and London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Camstech Limited, Daresbury Laboratory Science and Technology Facilities Council Sci-Tech, Keckwick, Cheshire, UK.
Hum Antibodies. 2021;29(4):255-262. doi: 10.3233/HAB-210453.
Multiple sclerosis is the major demyelinating autoimmune disease of the central nervous system. Relapsing MS can be treated by a number of approved monoclonal antibodies that currently target: CD20, CD25 (withdrawn), CD49d and CD52. These all target potentially pathogenic memory B cell subsets and perhaps functionally inhibit pathogenic T cell function. These consist of chimeric, humanized and fully human antibodies. However, despite humanization it is evident that all of these monoclonal antibodies can induce binding and neutralizing antibodies ranging from < 1% to over 80% within a year of treatment. Importantly, it is evident that monitoring these allow prediction of future treatment-failure in some individuals and treatment cessation and switching therefore potentially limiting disease breakthrough and disability accumulation. In response to the COVID-19 pandemic and the need to avoid hospitals, shortened infusion times and extended dose intervals have been implemented, importantly, subcutaneous delivery of alternative treatments or formulations have been developed to allow for home treatment. Therefore, hospital-based and remote monitoring of ADA could therefore be advantageous to optimize patient responses in the future.
多发性硬化症是中枢神经系统主要的脱髓鞘自身免疫性疾病。许多已批准的单克隆抗体可用于治疗复发型多发性硬化症，这些药物目前的靶点包括：CD20、CD25（已撤回）、CD49d 和 CD52。这些药物都针对潜在致病的记忆 B 细胞亚群，并且可能在功能上抑制致病 T 细胞的功能。这些药物包括嵌合型、人源化和全人源抗体。然而，尽管进行了人源化，但显然所有这些单克隆抗体都可以在治疗后一年内诱导结合和中和抗体，其范围从<1%到超过 80%。重要的是，显然监测这些抗体可以预测某些个体未来的治疗失败，并因此停止治疗和转换治疗，从而潜在地限制疾病突破和残疾积累。为了应对 COVID-19 大流行以及避免前往医院的需要，已经实施了缩短输注时间和延长给药间隔的措施，重要的是，已经开发了替代治疗方法或制剂的皮下给药方式，以允许在家中进行治疗。因此，未来对 ADA 的基于医院和远程监测可能有利于优化患者的反应。
