Helplessness as a strategy for avoiding antiglobulin responses to therapeutic monoclonal antibodies

Ther Immunol. 1994 Dec;1(6):303-12.

Abstract

The antiglobulin (anti-Ig) response to therapeutic monoclonal antibodies (mAbs) poses a significant obstacle to their routine application in man. Whilst humanization has lessened the problem, repeated courses of humanized mAbs still sensitise some patients. Previous work suggested that unresponsiveness to cell-binding (therapeutic) mAbs could not be achieved due to an unexpected immunogenicity of their idiotypes (ids). The current work examines this phenomenon in more detail using CBA/Ca mice receiving rat antimouse CD8 mAbs as a model system. It is shown that the anti-Ig response is dependent on CD4+ T-cells. Furthermore, for at least some mAbs, most helper epitopes appear to reside within the mAb c-region. Consequently, when tolerance is induced to c-region (isotype), the anti-id response is extremely weak (induced helplessness). For one (weakly immunogenic) CD8 mAb concomitant administration of a CD4 mAb was sufficient to induce tolerance, whereas for another (more immunogenic) CD8 mAb, tolerance could only be achieved by prior concomitant exposure to both a CD4 mAb and an isotype-matched non-cell-binding mAb. The general applicability of these results is discussed and extrapolated to the clinical situation. Non-cell-binding variants of therapeutic mAbs could be usefully exploited to generate therapeutic unresponsiveness to any clinically useful mAb.

MeSH terms

  • Animals
  • Antibodies, Anti-Idiotypic / immunology*
  • Antibodies, Monoclonal / immunology*
  • Antibodies, Monoclonal / therapeutic use
  • CD4 Antigens / immunology
  • CD8 Antigens / immunology
  • Female
  • Immune Tolerance*
  • Immunoglobulin Idiotypes / immunology
  • Lymphocyte Cooperation
  • Male
  • Mice
  • Mice, Inbred CBA
  • Peptides / immunology
  • T-Lymphocytes / immunology*
  • T-Lymphocytes, Helper-Inducer / immunology*

Substances

  • Antibodies, Anti-Idiotypic
  • Antibodies, Monoclonal
  • CD4 Antigens
  • CD8 Antigens
  • Immunoglobulin Idiotypes
  • Peptides