Benjamin R J, Cobbold S P, Clark M R, Waldmann H
J Exp Med. 1986 Jun 1;163(6):1539-52. doi: 10.1084/jem.163.6.1539.
The antiglobulin response is a major complication of mAb therapy. It has been suggested that, in clinical practice, this might be avoided by using human or chimeric mAbs, or by prior induction of tolerance to the therapeutic mAb. In this study, we show that it is possible to induce tolerance in mice to the constant regions of rat IgG2b mAbs by both classical deaggregation methods and by anti-L3T4 mAb therapy. Mice tolerant to IgG2b constant region determinants failed to make an antiglobulin response when immunized with a number of mAbs of the same isotype that had no binding specificity for mouse cells, but produced vigorous antiidiotypic responses to cell-binding mAbs. Binding of antibodies to hemopoietic cells rends their idiotypic determinants major immunogens even in the presence of tolerance to constant region epitopes. These findings suggest that the use of human or chimeric mAbs will not be sufficient to eliminate the antiglobulin response, and that additional methods need to be investigated.
抗球蛋白反应是单克隆抗体治疗的主要并发症。有人提出,在临床实践中,可通过使用人源或嵌合单克隆抗体,或预先诱导对治疗性单克隆抗体的耐受性来避免这种情况。在本研究中,我们表明,通过经典的解聚方法和抗L3T4单克隆抗体治疗,有可能在小鼠中诱导对大鼠IgG2b单克隆抗体恒定区的耐受性。对IgG2b恒定区决定簇耐受的小鼠,在用一些对小鼠细胞无结合特异性的同型单克隆抗体免疫时,未能产生抗球蛋白反应,但对细胞结合性单克隆抗体产生了强烈的抗独特型反应。即使在对恒定区表位存在耐受性的情况下,抗体与造血细胞的结合也会使它们的独特型决定簇成为主要免疫原。这些发现表明,使用人源或嵌合单克隆抗体不足以消除抗球蛋白反应,需要研究其他方法。