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Wang Q, Shangguan J, Zhang Y, Pan Y, Yuan Y, Que W. The prevalence of thyroid autoantibodies in autoimmune connective tissue diseases: a systematic review and meta-analysis. Expert Rev Clin Immunol 2020; 16:923-930. [PMID: 32811198 DOI: 10.1080/1744666x.2020.1811089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AIM Patients with autoimmune connective tissue disease (ACTD) may have anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb). This study aimed to compare the prevalence of thyroid autoantibodies in ACTD patients and controls. METHODS All case-control studies published between 1980 and 2019 in English were searched from Medline, Embase, Web of Science, PubMed databases for meta-analysis and subgroup analyses. RESULTS Total 10,321 ACTD cases and 12,949 healthy controls were included, and the prevalence of thyroid autoantibody positivity was higher in ACTD patients than in controls. Subgroup analysis revealed positive association between TgAb and ACTD in populations from all continents including European, Asian, African, and American. In addition, we found positive association between TgAb positivity and most ACTD cases including RA, SLE, pSS, and UCTD, positive association between TPOAb positivity and all ACTD cases including RA, SLE, pSS, SSc, and UCTD, and positive association between TPOAb positivity and ACTD in European, Asian, and African but not in American populations. CONCLUSION Thyroid autoantibodies are more prevalent in ACTD patients than in healthy controls. It is important to screen patients with ACTD for the presence of thyroid autoimmunity, and perform thyroid function tests in clinical evaluation of ACTD patients.
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Affiliation(s)
- Qinqin Wang
- Department of Rheumatology, The Affiliated Nanping First Hospital of Fujian Medical University , Nanping, Fujian Province, China
| | - Jie Shangguan
- Department of Anesthesiology, The Affiliated Nanping First Hospital of Fujian Medical University , Nanping, Fujian Province, China
| | - Yanping Zhang
- Department of Scientific Research, the Affiliated Nanping First Hospital of Fujian Medical University , Nanping, Fujian Province, China
| | - YiDan Pan
- Department of Internal Medicine, Puyang County People's Hospital , Puyang, Henan Province, China
| | - Yue Yuan
- Department of Medical Imaging, The 989 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army , Pingdingshan, Henan Province, China
| | - Wenzhong Que
- Department of Rheumatology, The Affiliated Nanping First Hospital of Fujian Medical University , Nanping, Fujian Province, China
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2
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Ferreira HB, Pereira AM, Melo T, Paiva A, Domingues MR. Lipidomics in autoimmune diseases with main focus on systemic lupus erythematosus. J Pharm Biomed Anal 2019; 174:386-395. [DOI: 10.1016/j.jpba.2019.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/31/2019] [Accepted: 06/04/2019] [Indexed: 01/03/2023]
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3
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OSU-T315 as an Interesting Lead Molecule for Novel B Cell-Specific Therapeutics. J Immunol Res 2018; 2018:2505818. [PMID: 30276218 PMCID: PMC6157143 DOI: 10.1155/2018/2505818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/09/2018] [Indexed: 11/17/2022] Open
Abstract
B cells are pathogenic in various disease processes and therefore represent an interesting target for the development of novel immunosuppressants. In the search for new therapeutic molecules, we utilized an in vitro B cell activation assay with ODN2006-stimulated Namalwa cells to screen a chemical library of small molecules for B cell modulating effects. OSU-T315, described as an inhibitor of integrin-linked kinase (ILK), was hereby identified as a hit. On human and murine primary B cells, OSU-T315 potently suppressed the proliferation and the production of antibodies and cytokines upon stimulation, suggesting that ILK could be a promising target in the modulation of B cell activity. Mice with B cell-specific knockout of ILK were generated. Surprisingly, knockout of ILK in murine B cells did not affect B cell function as assessed by several in vivo and ex vivo B cell assays and did not alter the B cell immunosuppressive activity of OSU-T315. In conclusion, OSU-T315 displays potency as B cell modulator, probably through a mechanism of action independent of ILK, and might serve as lead drug molecule for the development of novel B cell-selective drugs.
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4
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"To be or not to be" for PET in rheumatology. A marriage of love or of convenience? Reumatologia 2017; 55:1-3. [PMID: 28386135 PMCID: PMC5380765 DOI: 10.5114/reum.2017.66679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 02/27/2017] [Indexed: 11/17/2022] Open
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5
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Bolge SC, Eldridge HM, Lofland JH, Ravin C, Hart PJ, Ingham MP. Patient experience with intravenous biologic therapies for ankylosing spondylitis, Crohn's disease, psoriatic arthritis, psoriasis, rheumatoid arthritis, and ulcerative colitis. Patient Prefer Adherence 2017; 11:661-669. [PMID: 28405158 PMCID: PMC5378465 DOI: 10.2147/ppa.s121032] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE The objective of this study was to describe patient experience with intravenous (IV) biologics for ankylosing spondylitis, Crohn's disease, psoriatic arthritis, psoriasis, rheumatoid arthritis, or ulcerative colitis. METHODS Semi-structured telephone interviews were conducted in 405 patients with these autoimmune diseases who were receiving an IV biologic to treat their disease. RESULTS On a 7-point scale (1= not at all satisfied; 7= very satisfied), mean satisfaction with IV medication was rated 6.1; 77% of patients rated satisfaction as 6 or 7. The most frequently perceived benefits of IV therapy were related to supervision provided by health care professionals. Most patients (82%, n=332) preferred their IV medication to subcutaneous injection. The three most common reasons for preferring IV were not wanting to self-inject (43%), less frequent dosing (34%), and preference for administration by a health care professional (24%). African-American/black patients had a stronger preference for IV administration than Caucasian/white patients (97% vs 80%, P<0.05) and a greater dislike of needles/self-injection (71% vs 40%, P<0.05). Hospital outpatient departments were not rated as well as physician in-office infusion. Only half (49%) of the patients reported that both they and their physician equally influenced the choice to switch from subcutaneous to IV therapy, and only 30% were given a choice of infusion center. CONCLUSION Users of IV biologics are highly satisfied with their medications and perceive the opportunity for health care provider interaction at their infusion facilities as an advantage of their regimen. These findings support continued need for IV therapeutic options and shared decision-making between patients and physicians while selecting biologic treatments.
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Affiliation(s)
- Susan C Bolge
- Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Raritan
- Correspondence: Susan C Bolge, Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, 1000 Route 202 – Room 3348, Raritan, NJ 08869, USA, Tel +1 908 927 7426, Fax +1 908 927 3166, Email
| | - Helen M Eldridge
- Payer Provider Insights & Analytics, Janssen Services, LLC, Titusville, NJ
| | - Jennifer H Lofland
- Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Horsham, PA
| | - Caitlin Ravin
- Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Horsham, PA
| | - Philip J Hart
- Value Communications, Medaxial Group, New York, NY, USA
| | - Michael P Ingham
- Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Raritan
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6
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Comparative In Vitro Immune Stimulation Analysis of Primary Human B Cells and B Cell Lines. J Immunol Res 2016; 2016:5281823. [PMID: 28116319 PMCID: PMC5220478 DOI: 10.1155/2016/5281823] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/10/2016] [Accepted: 11/22/2016] [Indexed: 11/17/2022] Open
Abstract
B cell specific immunomodulatory drugs still remain an unmet medical need. Utilisation of validated simplified in vitro models would allow readily obtaining new insights in the complexity of B cell regulation. For this purpose we investigated which human B lymphocyte stimulation assays may be ideally suited to investigate new B lymphocyte immunosuppressants. Primary polyclonal human B cells underwent in vitro stimulation and their proliferation, production of immunoglobulins (Igs) and of cytokines, and expression of cell surface molecules were analysed using various stimuli. ODN2006, a toll-like receptor 9 (TLR9) agonist, was the most potent general B cell stimulus. Subsequently, we investigated on which human B cell lines ODN2006 evoked the broadest immunostimulatory effects. The Namalwa cell line proved to be the most responsive upon TLR9 stimulation and hence may serve as a relevant, homogeneous, and stable B cell model in an in vitro phenotypic assay for the discovery of new targets and inhibitors of the B cell activation processes. As for the read-out for such screening assay, it is proposed that the expression of activation and costimulatory surface markers reliably reflects B lymphocyte activation.
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7
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Aira LE, Hernández P, Prada D, Chico A, Gómez JA, González Z, Fuentes K, Viada C, Mazorra Z. Immunological evaluation of rheumatoid arthritis patients treated with itolizumab. MAbs 2015; 8:187-95. [PMID: 26466969 DOI: 10.1080/19420862.2015.1105416] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rheumatoid arthritis is an autoimmune disease characterized by joint inflammation that affects approximately 1% of the general population. Itolizumab, a monoclonal antibody specific for the human CD6 molecule mainly expressed on T lymphocytes, has been shown to inhibit proliferation of T cells and proinflammatory cytokine production in psoriasis patients. We have now assessed the immunological effect of itolizumab in combination with methotrexate in rheumatoid arthritis by analyzing clinical samples taken from 30 patients enrolled in a clinical trial. T and B cell subpopulations were measured at different time points of the study. Plasma cytokine levels and anti-idiotypic antibody response to itolizumab were also evaluated. The combined treatment of itolizumab and methotrexate led to a reduction in the frequency of T cell subpopulations, and plasma levels of proinflammatory cytokines showed a significant decrease up to at least 12 weeks after treatment ended. No anti-idiotypic antibody response was detected. These results support the relevance of the CD6 molecule as a therapeutic target for the treatment of this disease.
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Affiliation(s)
| | | | | | | | | | | | | | - Carmen Viada
- a Center of Molecular Immunology ; Havana , Cuba
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8
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Chopra A, Chandrashekara S, Iyer R, Rajasekhar L, Shetty N, Veeravalli SM, Ghosh A, Merchant M, Oak J, Londhey V, Barve A, Ramakrishnan MS, Montero E. Itolizumab in combination with methotrexate modulates active rheumatoid arthritis: safety and efficacy from a phase 2, randomized, open-label, parallel-group, dose-ranging study. Clin Rheumatol 2015; 35:1059-64. [PMID: 26050104 DOI: 10.1007/s10067-015-2988-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 05/14/2015] [Accepted: 05/30/2015] [Indexed: 11/28/2022]
Abstract
The objective of this study was to assess the safety and efficacy of itolizumab with methotrexate in active rheumatoid arthritis (RA) patients who had inadequate response to methotrexate. In this open-label, phase 2 study, 70 patients fulfilling American College of Rheumatology (ACR) criteria and negative for latent tuberculosis were randomized to four arms: 0.2, 0.4, or 0.8 mg/kg itolizumab weekly combined with oral methotrexate, and methotrexate alone (2:2:2:1). Patients were treated for 12 weeks, followed by 12 weeks of methotrexate alone during follow-up. Twelve weeks of itolizumab therapy was well tolerated. Forty-four patients reported adverse events (AEs); except for six severe AEs, all others were mild or moderate. Infusion-related reactions mainly occurred after the first infusion, and none were reported after the 11th infusion. No serum anti-itolizumab antibodies were detected. In the full analysis set, all itolizumab doses showed evidence of efficacy. At 12 weeks, 50 % of the patients achieved ACR20, and 58.3 % moderate or good 28-joint count Disease Activity Score (DAS-28) response; at week 24, these responses were seen in 22 and 31 patients. Significant improvements were seen in Short Form-36 Health Survey and Health Assessment Questionnaire Disability Index scores. Overall, itolizumab in combination with methotrexate was well tolerated and efficacious in RA for 12 weeks, with efficacy persisting for the entire 24-week evaluation period. (Clinical Trial Registry of India, http://ctri.nic.in/Clinicaltrials/login.php , CTRI/2008/091/000295).
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Affiliation(s)
- Arvind Chopra
- Department of Rheumatology, Center for Rheumatic Disease, Pune, India
| | - S Chandrashekara
- ChanRe Rheumatology and Immunology Centre and Research, Bangalore, India
| | - Rajgopalan Iyer
- Department of Orthopedics, St. John's Medical College Hospital, Bangalore, India
| | - Liza Rajasekhar
- Department of Rheumatology, Nizams institute of Medical sciences, Hyderabad, India
| | - Naresh Shetty
- Department of Orthopedics, M.S. Ramaiah Memorial Hospital, Bangalore, India
| | | | - Alakendu Ghosh
- Department of Rheumatology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Mrugank Merchant
- Department of Orthopedics, Shubhechha Multispecialty Hospital, Vadodara, India
| | - Jyotsna Oak
- Department of Rheumatology, LTM Medical College & LTMG Hospital, Mumbai, India
| | - Vikram Londhey
- Medicine Department and Rheumatology Clinic, TNMC & BYL Nair Charitable Hospital, Mumbai, India
| | - Abhijit Barve
- Research & Development, Biocon Research Limited, Bommasandra Industrial Estate - phase IV, Bangalore, 560099, India.
| | - M S Ramakrishnan
- Research & Development, Biocon Research Limited, Bommasandra Industrial Estate - phase IV, Bangalore, 560099, India
| | - Enrique Montero
- Research & Development, Biocon Research Limited, Bommasandra Industrial Estate - phase IV, Bangalore, 560099, India.,Center of Molecular Immunology, Havana, Cuba
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9
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Discovery and hit-to-lead optimization of 2,6-diaminopyrimidine inhibitors of interleukin-1 receptor-associated kinase 4. Bioorg Med Chem Lett 2015; 25:1836-41. [PMID: 25870132 DOI: 10.1016/j.bmcl.2015.03.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 03/16/2015] [Accepted: 03/18/2015] [Indexed: 01/16/2023]
Abstract
Interleukin receptor-associated kinase 4 (IRAK4) is a critical element of the Toll-like/interleukin-1 receptor inflammation signaling pathway. A screening campaign identified a novel diaminopyrimidine hit that exhibits weak IRAK4 inhibitory activity and a ligand efficiency of 0.25. Hit-to-lead activities were conducted through independent SAR studies of each of the four pyrimidine substituents. Optimal activity was observed upon removal of the pyrimidine C-4 chloro substituent. The intact C-6 carboribose is required for IRAK4 inhibition. Numerous heteroaryls were tolerated at the C-5 position, with azabenzothiazoles conferring the best activities. Aminoheteroaryls were preferred at the C-2 position. These studies led to the discovery of inhibitors 35, 36, and 38 that exhibit nanomolar inhibition of IRAK4, improved ligand efficiencies, and modest kinase selectivities.
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10
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Robert S, Steidler L. Recombinant Lactococcus lactis can make the difference in antigen-specific immune tolerance induction, the Type 1 Diabetes case. Microb Cell Fact 2014; 13 Suppl 1:S11. [PMID: 25185797 PMCID: PMC4155828 DOI: 10.1186/1475-2859-13-s1-s11] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Especially in western civilizations, immune diseases that are driven by innocuous (auto- or allo-) antigens are gradually evolving to become pandemic threats. A particularly poignant example is type 1 diabetes, where young children are confronted with the perspective and consequences of total pancreatic β-cell destruction. Along these disquieting observations we find ourselves equipped with impressively accumulating molecular immunological knowledge on the ins and outs of these pathologies. Often, however, it is difficult to translate this wealth into efficacious medicines. The molecular understanding, the concept of oral tolerance induction, the benefit of using recombinant Lactococcus lactis therein and recent openings towards their clinical use may well enable turning all colors to their appropriate fields on this Rubik's cube.
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Affiliation(s)
- Sofie Robert
- Clinical and Experimental Endocrinology (CEE), KU Leuven, 3000, Leuven, Belgium
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11
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Aira LE, López-Requena A, Fuentes D, Sánchez L, Pérez T, Urquiza A, Bautista H, Falcón L, Hernández P, Mazorra Z. Immunological and histological evaluation of clinical samples from psoriasis patients treated with anti-CD6 itolizumab. MAbs 2014; 6:783-93. [PMID: 24594862 PMCID: PMC4011922 DOI: 10.4161/mabs.28376] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 02/26/2014] [Accepted: 02/27/2014] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic inflammatory disease with a prevalence of approximately 2-3% in the general population. The majority of diagnosed patients have plaque psoriasis, and about 20% have moderate-to-severe disease. Itolizumab, a new monoclonal antibody specific for the CD6 molecule mainly expressed on T lymphocytes, has demonstrated to inhibit in vitro ligand-induced proliferation and pro-inflammatory cytokine production. We assessed the immunological and histopathological effect of the antibody using clinical samples taken from 26 patients with moderate-to-severe psoriasis included in a clinical trial. The precursor frequency of lymphocytes activated with anti-CD2/CD3/CD28 beads, as well as the number of interferon (IFN)-γ-secreting T cells after stimulation, were measured at different time points of the study. Serum cytokine levels and anti-idiotypic antibody response to itolizumab were also evaluated. Additionally, lymphocyte infiltration and epidermis hyperplasia were studied in five patients. A significant reduction in T cell proliferation capacity and number of IFN-γ-producing T cells was found in treated patients. Serum levels of interleukin-6, tumor necrosis factor and IFN-γ showed an overall trend toward reduction. No anti-idiotypic antibody response was detected. A significant reduction in the epidermis hyperplasia was observed in analyzed patients. These results support the relevance of the CD6 molecule as a therapeutic target for the treatment of this disease.
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Affiliation(s)
| | | | - Dasha Fuentes
- National Center for Laboratory Animal Breeding; Havana, Cuba
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12
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Washburn NR, Prata JE, Friedrich EE, Ramadan MH, Elder AN, Sun LT. Polymer-conjugated inhibitors of tumor necrosis factor-α for local control of inflammation. BIOMATTER 2013; 3:e25597. [PMID: 23903893 PMCID: PMC3749284 DOI: 10.4161/biom.25597] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 06/27/2013] [Accepted: 06/29/2013] [Indexed: 12/24/2022]
Abstract
Burns, chronic wounds, osteoarthritis, and uveitis are examples of conditions characterized by local, intense inflammatory responses that can impede healing or even further tissue degradation. The most powerful anti-inflammatory drugs available are often administered systemically, but these carry significant side effects and are not compatible for patients that have underlying complications associated with their condition. Conjugation of monoclonal antibodies that neutralize pro-inflammatory cytokines to high molecular weight hydrophilic polymers has been shown to be an effective strategy for local control of inflammation. Lead formulations are based on antibody inhibitors of tumor necrosis factor-α conjugated to hyaluronic acid having molecular weight greater than 1 MDa. This review will discuss fundamental aspects of medical conditions that could be treated with these conjugates and design principles for preparing these cytokine-neutralizing polymer conjugates. Results demonstrating that infliximab, an approved inhibitor of tumor necrosis factor-α, can be incorporated into the conjugates using a broad range of water-soluble polymers are also presented, along with a prospectus for clinical translation.
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Affiliation(s)
- Newell R. Washburn
- Department of Biomedical Engineering; Carnegie Mellon University; Pittsburgh, PA USA
- Department of Chemistry; Carnegie Mellon University; Pittsburgh, PA USA
| | - Joseph E. Prata
- Department of Chemistry; Carnegie Mellon University; Pittsburgh, PA USA
| | - Emily E. Friedrich
- Department of Biomedical Engineering; Carnegie Mellon University; Pittsburgh, PA USA
| | | | - Allison N. Elder
- Department of Chemistry; Carnegie Mellon University; Pittsburgh, PA USA
| | - Liang Tso Sun
- Department of Biomedical Engineering; Carnegie Mellon University; Pittsburgh, PA USA
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13
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Stella A, Van Belle K, De Jonghe S, Louat T, Herman J, Rozenski J, Waer M, Herdewijn P. Synthesis of a 2,4,6-trisubstituted 5-cyano-pyrimidine library and evaluation of its immunosuppressive activity in a Mixed Lymphocyte Reaction assay. Bioorg Med Chem 2013; 21:1209-18. [PMID: 23347804 DOI: 10.1016/j.bmc.2012.12.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 12/20/2012] [Accepted: 12/21/2012] [Indexed: 10/27/2022]
Abstract
A series of novel pyrimidine analogues were synthesized and evaluated for immunosuppressive activity in the Mixed Lymphocyte Reaction assay, which is well-known as the in vitro model for in vivo rejection after organ transplantation. Systematic variation of the substituents at positions 2, 4 and 6 of the pyrimidine scaffold led to the discovery of 2-benzylthio-5-cyano-6-(4-methoxyphenyl)-4-morpholinopyrimidine with an IC(50) value of 1.6 μM in the MLR assay.
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Affiliation(s)
- Alessandro Stella
- KU Leuven, Interface Valorisation Platform, Kapucijnenvoer 33, 3000 Leuven, Belgium
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A clinical exploratory study with itolizumab, an anti-CD6 monoclonal antibody, in patients with rheumatoid arthritis. RESULTS IN IMMUNOLOGY 2012; 2:204-11. [PMID: 24371585 DOI: 10.1016/j.rinim.2012.11.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 11/01/2012] [Accepted: 11/14/2012] [Indexed: 11/21/2022]
Abstract
T cells are involved in the pathogenesis of rheumatoid arthritis (RA). CD6 is a co-stimulatory molecule, predominantly expressed on lymphocytes, that has been linked to autoreactive responses. The purpose of this study was to evaluate the safety, immunogenicity and preliminary efficacy of itolizumab, a humanized anti-CD6 monoclonal antibody, in patients with active rheumatoid arthritis. Fifteen patients were enrolled in a phase I, open-label, dose-finding study. Five cohorts of patients received a weekly antibody monotherapy with a dose-range from 0.1 to 0.8 mg/kg. Itolizumab showed a good safety profile, with no severe or serious adverse events reported so far. No signs or symptoms associated with immunosuppression were observed in the study. Objective clinical responses were achieved in more than 80% of patients after treatment completion, and these responses tend to be sustained afterwards. This clinical study constitutes the first evidence of the safety and positive clinical effect of a monotherapy using an anti-CD6 antibody in patients with rheumatoid arthritis.
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Key Words
- ACR, American College of Rheumatology
- AE, adverse events
- CD6
- CRP, C reactive protein
- DMARD, disease-modifying antirheumatic drug
- ESR, eritrosedimentation rate
- Exploratory study
- NSAIDs, nonsteroidal antiinflammatory drugs
- RA, rheumatoid arthritis
- RF, rheumatoid factor
- Rheumatoid arthritis
- SAE, serious adverse event.
- T lymphocyte
- iv, intravenous
- mAbs, monoclonal antibodies
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Oh JR, Song HC, Kang SR, Yoo SW, Kim J, Chong A, Min JJ, Bom HS, Lee SS, Park YW. The Clinical Usefulness of (18)F-FDG PET/CT in Patients with Systemic Autoimmune Disease. Nucl Med Mol Imaging 2011; 45:177-84. [PMID: 24900001 DOI: 10.1007/s13139-011-0094-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 06/22/2011] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Individuals with systemic autoimmune disease have an increased susceptibility to both inflammation and malignancy. The aim of this study was to evaluate the clinical usefulness of (18)F-FDG PET/CT in patients with systemic autoimmune disease. METHODS Forty patients diagnosed with systemic autoimmune disease were enrolled. Diagnostic accuracy of FDG PET/CT for detecting malignancy was assessed. FDG PET/CT findings, including maximum standardized uptake (SUVmax) of lymphadenopathy (LAP), liver, bone marrow, spleen, joint and muscles, were considered for the characterization of LAPs. RESULTS FDG PET/CT could detect metabolically activated lesions in 36 out of 40 patients (90%) including inflammatory lesions in 28 out of 32 patients (88%). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET/CT for the detection of malignancy were 100, 67, 70, 25, and 100%, respectively. Multiple LAPs were found in 25 of 40 patients (63%), and comprised three malignancies, four cases of tuberculosis, and 18 reactive changes. A SUVmax ratio of bone marrow to liver below 0.78 could distinguish malignancy from tuberculosis + reactive change (AUC = 1.000, sensitivity: 100%, specificity: 100%). The SUVmax ratio of spleen to liver in the reactive group was also significantly higher than that in the malignancy group (P = 0.014). SUVmax of LAP in the TB group was significantly higher than that in the reactive group (P = 0.040). CONCLUSIONS PET/CT is useful in detecting and differentiating inflammation and malignancy in patients with systemic autoimmune disease. Frequent false-positive interpretations can be minimized by consideration of FDG uptake in bone marrow and spleen.
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Affiliation(s)
- Jong-Ryool Oh
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Ho-Chun Song
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Sae-Ryung Kang
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Su-Woong Yoo
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Jahae Kim
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Ari Chong
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Jung-Joon Min
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Hee-Seung Bom
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 8 Hakdong, Dongku, Gwangju 501-757 South Korea
| | - Shin-Seok Lee
- Department of Rheumatology, Chonnam National University Hospital, Gwangju, South Korea
| | - Yong-Wook Park
- Department of Rheumatology, Chonnam National University Hospital, Gwangju, South Korea
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16
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Kremer D, Aktas O, Hartung HP, Küry P. The complex world of oligodendroglial differentiation inhibitors. Ann Neurol 2011; 69:602-18. [PMID: 21520230 DOI: 10.1002/ana.22415] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Myelination is a central nervous system (CNS) process wherein oligodendrocyte-axon interactions lead to the establishment of myelin sheaths that stabilize, protect, and electrically insulate axons. In inflammatory demyelinating diseases such as multiple sclerosis (MS), the degeneration and eventual loss of functional myelin sheaths slows and blocks saltatory conduction in axons, which results in clinical impairment. However, remyelination can occur, and lesions can be partially repaired, resulting in clinical remission. The recruitment and activation of resident oligodendrocyte precursor cells (OPCs) play a critical role in the repair process because these cells have the capacity to differentiate into functional myelinating cells. Mature oligodendrocytes, however, are thought to have lost the capacity to develop new myelin sheaths and frequently undergo programmed cell death in MS. The endogenous capacity to generate new oligodendrocytes in MS is limited, and this is predominantly due to the presence of inhibitory components that block OPC differentiation and maturation. Here, we present an overview of recently identified negative regulators of oligodendroglial differentiation and their potential relevance for CNS repair in MS. Because currently available immunomodulatory drugs for MS mainly target inflammatory cascades outside the brain and fail to repair existing lesions, achieving more efficient lesion repair constitutes an important goal for future MS therapies.
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Affiliation(s)
- David Kremer
- Department of Neurology, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
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De Jonghe S, Marchand A, Gao LJ, Calleja A, Cuveliers E, Sienaert I, Herman J, Clydesdale G, Sefrioui H, Lin Y, Pfleiderer W, Waer M, Herdewijn P. Synthesis and in vitro evaluation of 2-amino-4-N-piperazinyl-6-(3,4-dimethoxyphenyl)-pteridines as dual immunosuppressive and anti-inflammatory agents. Bioorg Med Chem Lett 2011; 21:145-9. [DOI: 10.1016/j.bmcl.2010.11.053] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 11/09/2010] [Accepted: 11/09/2010] [Indexed: 10/18/2022]
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Carter PH, Hynes J. N-aryl pyrazoles, indazoles and azaindazoles as antagonists of CC chemokine receptor 1: patent cooperation treaty applications WO2010/036632, WO2009/134666 and WO2009/137338. Expert Opin Ther Pat 2010; 20:1609-18. [DOI: 10.1517/13543776.2010.518144] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Sun LT, Buchholz KS, Lotze MT, Washburn NR. Cytokine binding by polysaccharide-antibody conjugates. Mol Pharm 2010; 7:1769-77. [PMID: 20726535 DOI: 10.1021/mp100150z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Cytokine-neutralizing antibodies are used in treating a broad range of inflammatory conditions. We demonstrate that monoclonal antibodies against interleukin-1β and tumor necrosis factor-α were still active when conjugated to high molecular weight polysaccharides. These polysaccharides are hydrophilic, but their size makes them unable to circulate in the bloodstream when delivered to tissues, opening up the possibility of localized treatment of inflammatory conditions. To explore this new class of protein-polysaccharide conjugates, we covalently modified interleukin-1β and tumor necrosis factor-α monoclonal antibodies with high molecular weight hyaluronic acid and carboxymethylcellulose. Rigorous purification using dialysis with a 300 kDa-cutoff membrane removed unconjugated monoclonal antibodies. We characterized the composition of the constructs and demonstrated using molecular binding affinity measurements and cell assays that the conjugates were capable of binding proinflammatory cytokines. The binding affinities of both the unconjugated antibodies for their cytokines were measured to be approximately 120 pM. While all conjugates had pM-level binding constants, they ranged from 40 pM for the hyaluronic acid-(anti-interleukin-1β) conjugate to 412 pM for the carboxymethylcellulose-(anti-interleukin-1β) conjugate. Interestingly, the dissociation time constants varied more than the association time constants, suggesting that conjugation to a high molecular weight polysaccharide did not interfere with the formation of the antibody-cytokine complex but could stabilize or destabilize it once formed. Conjugation of cytokine-neutralizing antibodies to high molecular weight polymers represents a novel method of delivering anticytokine therapeutics that may avoid many of the complications associated with systemic delivery.
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Affiliation(s)
- Liang Tso Sun
- Departments of Biomedical Engineering and Chemistry, Carnegie Mellon University, Pittsburgh, PA 15213, USA
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Biosensors with label-free detection designed for diagnostic applications. Anal Bioanal Chem 2010; 398:2403-12. [DOI: 10.1007/s00216-010-3906-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 06/07/2010] [Accepted: 06/07/2010] [Indexed: 01/15/2023]
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