Modification of the Fc region of a primatized IgG antibody to human CD4 retains its ability to modulate CD4 receptors but does not deplete CD4(+) T cells in chimpanzees.

Keliximab, a Primatized IgG1 CD4 mAb, was reconfigured to an IgG4 antibody. The gamma4 constant region was further modified by substituting glutamic acid for serine at position 235 in the CH2 domain (IgG4-E), to remove residual binding to Fcgamma receptors, and substitution of serine with proline at position 228 in the hinge region (IgG4-PE) for greater stability. Pharmacokinetic analysis in rats gave a t(1/2) of approximately 4 days for IgG4-E and 9 days for IgG4-PE, consistent with a greater stability of the IgG4-PE molecule. The effects on T cell subsets were assessed in chimpanzees given escalating doses of IgG4-PE: 0.05 mg/kg on Day 16, 1.5 mg/kg dose on Day 43, and 15 mg/kg on Day 85. Receptor modulation was observed at the two highest doses, but no depletion of T cells at any dose. The in vitro and in vivo results demonstrate the potential of this IgG4-PE mAb for use in human trials.

[1]  F. Emmrich,et al.  Treatment of rheumatoid arthritis with an anti-CD4 monoclonal antibody. , 1991, Arthritis and rheumatism.

[2]  H. Waldmann,et al.  The use of monoclonal antibodies to achieve immunological tolerance. , 1993, Trends in pharmacological sciences.

[3]  P. Morel,et al.  Anti-CD4 monoclonal antibody administration in renal transplanted patients. , 1990, Clinical immunology and immunopathology.

[4]  W. Seaman,et al.  Induction of immune tolerance during administration of monoclonal antibody to L3T4 does not depend on depletion of L3T4+ cells. , 1988, Journal of immunology.

[5]  J. Ridgway,et al.  Intra-articular primatised anti-CD4: efficacy in resistant rheumatoid knees. A study of combined arthroscopy, magnetic resonance imaging, and histology , 1999, Annals of the rheumatic diseases.

[6]  D. Burton,et al.  Human antibody effector function. , 1992, Advances in immunology.

[7]  H. Weiner,et al.  Anti-CD4 and anti-CD2 monoclonal antibody infusions in subjects with multiple sclerosis. Immunosuppressive effects and human anti-mouse responses. , 1988, Journal of immunology.

[8]  J. Bill,et al.  Selective accumulation of related CD4+ T cell clones in the synovial fluid of patients with rheumatoid arthritis. , 1998, Journal of immunology.

[9]  J. Leonard,et al.  A primatized MAb to human CD4 causes receptor modulation, without marked reduction in CD4+ T cells in chimpanzees: in vitro and in vivo characterization of a MAb (IDEC-CE9.1) to human CD4. , 1997, Clinical immunology and immunopathology.

[10]  Dallas E. Johnson,et al.  Analysis of messy data , 1992 .

[11]  W. Jochum,et al.  T cells involved in psoriasis vulgaris belong to the Th1 subset. , 1994, The Journal of investigative dermatology.

[12]  B. Hazleman,et al.  A therapeutic human IgG4 monoclonal antibody that depletes target cells in humans , 1996, Clinical and experimental immunology.

[13]  D. Wofsy,et al.  Treatment of murine lupus with F(ab')2 fragments of monoclonal antibody to L3T4. Suppression of autoimmunity does not depend on T helper cell depletion. , 1989, Journal of immunology.

[14]  U. Wagner,et al.  Functional subsets of CD4 T cells in rheumatoid synovitis. , 1998, Arthritis and rheumatism.

[15]  D. Burton,et al.  Localization of the binding site for the human high-affinity Fc receptor on IgG , 1988, Nature.

[16]  D. Mould,et al.  A population pharmacokinetic‐pharmacodynamic analysis of single doses of clenoliximab in patients with rheumatoid arthritis , 1999, Clinical pharmacology and therapeutics.

[17]  M. Doyle,et al.  Elimination of Fc Receptor-Dependent Effector Functions of a Modified IgG4 Monoclonal Antibody to Human CD4 , 2000, The Journal of Immunology.

[18]  S. Paget,et al.  Predominantly T-cell infiltrate in rheumatoid synovial membranes. , 1975, The New England journal of medicine.

[19]  N. Hanna,et al.  “Primatization” of Recombinant Antibodies for Immunotherapy of Human Diseases: A Macaque/Human Chimeric Antibody Against Human CD4 , 1992, Bio/Technology.

[20]  F. Emmrich,et al.  Treatment of refractory juvenile chronic arthritis by monoclonal CD4 antibodies: a pilot study in two children. , 1995, Annals of the rheumatic diseases.

[21]  Rupert G. Miller Simultaneous Statistical Inference , 1966 .

[22]  A. Lawson,et al.  A single amino acid substitution abolishes the heterogeneity of chimeric mouse/human (IgG4) antibody. , 1993, Molecular immunology.

[23]  R. Winchester,et al.  Ia+ T cells in synovial fluid and tissues of patients with rheumatoid arthritis. , 1981, Arthritis and rheumatism.

[24]  B. Nickoloff,et al.  Injection of pre-psoriatic skin with CD4+ T cells induces psoriasis. , 1999, The American journal of pathology.

[25]  H. Waldmann,et al.  Induction of tolerance in peripheral T cells with monoclonal antibodies , 1990, European journal of immunology.

[26]  N. Brousse,et al.  Treatment of recalcitrant plaque psoriasis with a humanized non-depleting antibody to CD4. , 1998, Journal of autoimmunity.

[27]  D. Enzmann,et al.  Phase 1 clinical trial of chimeric monoclonal anti‐CD4 antibody in multiple sclerosis , 1994, Neurology.

[28]  D. Kioussis,et al.  "Infectious" transplantation tolerance , 1993, Science.

[29]  Henry Y. Wang,et al.  Antibody Expression and Engineering , 1995 .

[30]  H. Stockinger,et al.  Anti-CD4 antibody treatment of patients with rheumatoid arthritis: I. Effect on clinical course and circulating T cells. , 1989, Journal of autoimmunity.

[31]  F. Bemelman,et al.  Tolerance induction with CD4 monoclonal antibodies. , 1998, Novartis Foundation symposium.

[32]  J. Isaacs,et al.  Therapy with monoclonal antibodies. An in vivo model for the assessment of therapeutic potential. , 1992, Journal of immunology.

[33]  I. Brooks,et al.  Determination of rate and equilibrium binding constants for macromolecular interactions using surface plasmon resonance: use of nonlinear least squares analysis methods. , 1993, Analytical biochemistry.

[34]  G. Hale,et al.  Monoclonal-antibody therapy in systemic vasculitis. , 1990, The New England journal of medicine.