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Amid A, Perkins H, Gauthier J, Bonnefoy A, Carcao M, Rivard GÉ, Klaassen RJ. Immune tolerance induction using Fc-fusion-protein recombinant factor IX in severe haemophilia B. Haemophilia 2021; 27:e776-e779. [PMID: 34599780 DOI: 10.1111/hae.14424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 09/08/2021] [Accepted: 09/19/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Ali Amid
- Division of Hematology/Oncology, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada.,Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Heather Perkins
- Division of Hematology/Oncology, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada
| | - Julie Gauthier
- Molecular Diagnostic Laboratory, CHU Sainte-Justine, Montreal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Montreal, Québec, Canada
| | - Arnaud Bonnefoy
- Department of Pediatrics, Université de Montréal, Montreal, Québec, Canada.,Division of Hematology/Oncology, Montreal, Québec, Canada
| | - Manuel Carcao
- Division of Haematology/Oncology, Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto, Ontario, Canada
| | - Georges-Étienne Rivard
- Department of Pediatrics, Université de Montréal, Montreal, Québec, Canada.,Division of Hematology/Oncology, Montreal, Québec, Canada
| | - Robert J Klaassen
- Division of Hematology/Oncology, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada.,Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
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2
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Roberts JC, Jesudas R, Tarantino MD. Development of an inhibitor in a child with severe hemophilia B. Blood Coagul Fibrinolysis 2019; 30:291-294. [DOI: 10.1097/mbc.0000000000000829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3
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Malec L, Abshire T, Jobe S, White G. rFIXFc for Immune Tolerance Induction in a Severe Hemophilia B Patient with an Inhibitor and Prior History of ITI Related Nephrotic Syndrome. Haemophilia 2018; 24:e294-e296. [PMID: 30024646 DOI: 10.1111/hae.13583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Lynn Malec
- Blood Research Institute, BloodCenter of Wisconsin, part of Versiti, Milwaukee, Wisconsin.,Medical College of Wisconsin, Milwaukee, WI
| | - Thomas Abshire
- Blood Research Institute, BloodCenter of Wisconsin, part of Versiti, Milwaukee, Wisconsin.,Medical College of Wisconsin, Milwaukee, WI
| | - Shawn Jobe
- Blood Research Institute, BloodCenter of Wisconsin, part of Versiti, Milwaukee, Wisconsin.,Medical College of Wisconsin, Milwaukee, WI
| | - Gilbert White
- Blood Research Institute, BloodCenter of Wisconsin, part of Versiti, Milwaukee, Wisconsin.,Medical College of Wisconsin, Milwaukee, WI
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4
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Tolerogenic properties of the Fc portion of IgG and its relevance to the treatment and management of hemophilia. Blood 2018; 131:2205-2214. [PMID: 29588277 DOI: 10.1182/blood-2017-12-822908] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/15/2018] [Indexed: 12/14/2022] Open
Abstract
Hemophilia, or inherited genetic deficiencies in coagulation factors, results in uncontrolled bleeding requiring replacement therapy with recombinant proteins given preventively or on demand. However, a major problem with these approaches is the potential for development of immune responses to the administered proteins due to the underlying genetic deficiency of the factor(s) throughout life. As such, there is great interest in developing strategies that avoid immunogenicity and induce immune tolerance. Recently, recombinant factor VIII (rFVIII) and rFIX fused to the crystallizable fragment (Fc) domain of immunoglobulin G (IgG) have been developed as therapeutic agents for hemophilia A and B, respectively. Although it is well known that the possession of an Fc domain confers IgG's longer-lasting circulating half-life, it is not generally appreciated that the Fc domain also confers immunoregulatory properties that are associated with the induction of tolerance. Here, we review some of the latest advances in our understanding of the tolerogenic abilities of IgG Fc and the impact of Fc-fusion proteins of rFVIII on the treatment of hemophilia.
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