Finck B K, Chan B, Wofsy D
Arthritis/Immunology Section, Veterans Administration Medical Center, San Francisco, California 94121.
J Clin Invest. 1994 Aug;94(2):585-91. doi: 10.1172/JCI117373.
To investigate the role of IL-6 in systemic lupus erythematosus (SLE), we selectively inhibited IL-6 in lupus-prone NZB/NZW F1(B/W) mice by chronic administration of a rat mAb to mouse IL-6. Anti-IL-6 alone elicited an anti-rat response that blocked its biologic effects. To circumvent this problem, we rendered B/W mice tolerant to the rat mAb by administration of anti-CD4 concurrent with the first dose of anti-IL-6. Thereafter, the mice received weekly injections of anti-IL-6 alone. There were two control groups: one group received the tolerizing regimen of anti-CD4 along with a control rat IgG1 mAb (GL113) instead of anti-IL-6; the other control group received PBS. Mice that received anti-CD4 were tolerant to the rat mAb for 6 mo. Throughout this period, treatment with anti-IL-6 prevented production of anti-dsDNA, significantly reduced proteinuria, and prolonged life. Mice that received anti-IL-6 without anti-CD4 developed an immune response to the rat mAb and then developed anti-dsDNA antibodies, proteinuria, and mortality comparable with control mice. These findings establish that IL-6 promotes autoimmunity in B/W mice. They further indicate that, although mAb to IL-6 can suppress murine lupus, the development of host immunity to the mAb abrogates its beneficial effects. Finally, this is the first study to demonstrate that a brief course of anti-CD4 can induce tolerance to another therapeutic mAb, in this case an anti-cytokine mAb.
为了研究白细胞介素-6(IL-6)在系统性红斑狼疮(SLE)中的作用,我们通过长期给易患狼疮的NZB/NZW F1(B/W)小鼠注射抗小鼠IL-6的大鼠单克隆抗体,选择性抑制IL-6。单独使用抗IL-6会引发抗大鼠反应,从而阻断其生物学效应。为了解决这个问题,我们在首次注射抗IL-6的同时给予抗CD4,使B/W小鼠对大鼠单克隆抗体产生耐受性。此后,小鼠每周仅注射抗IL-6。有两个对照组:一组接受抗CD4的耐受方案,同时注射对照大鼠IgG1单克隆抗体(GL113)而非抗IL-6;另一对照组接受磷酸盐缓冲盐水(PBS)。接受抗CD4的小鼠对大鼠单克隆抗体的耐受性持续6个月。在此期间,抗IL-6治疗可防止抗双链DNA(dsDNA)的产生,显著降低蛋白尿,并延长生存期。未接受抗CD4而仅接受抗IL-6的小鼠对大鼠单克隆抗体产生免疫反应,随后出现抗dsDNA抗体、蛋白尿,死亡率与对照小鼠相当。这些发现证实IL-6在B/W小鼠中促进自身免疫。它们还进一步表明,尽管抗IL-6单克隆抗体可抑制小鼠狼疮,但宿主对该单克隆抗体产生的免疫反应会消除其有益作用。最后,这是第一项证明短期抗CD4疗程可诱导对另一种治疗性单克隆抗体(在本研究中为抗细胞因子单克隆抗体)产生耐受性的研究。