Monoclonal antibodies for the diagnosis and treatment of transplant rejection.
Extensive experience with antibodies to lymphocytes for immunosuppression suggested the need for better means of evaluating alterations of peripheral blood lymphocytes during treatment. Improved immunosuppression was also anticipated if more precise control of selected lymphocyte populations could be achieved. The advent of monoclonal antibodies has permitted progress in both of these areas. For evaluation of the immune status of patients, the ratio between the numbers of the subclass of T lymphocytes having helper/inducer properties and those having suppressor/cytotoxic activity (OKT4+/OKT8+ cells) has been explored. Transplant rejection is more common in the presence of normal cell ratios than when ratios are reversed. In the former situation, however, when rejection occurs it is much more readily reversed than in the latter. Monoclonal antibodies have been used to treat transplant rejection in both nonhuman primates and in patients. Patient trials have so far been confined to the use of the pan-T-cell antibody OKT3. This has proved to be the most effective agent available for the reversal of acute cellular rejection in human kidney transplants. The problems of recurrent rejection activity after treatment and of antibody formation to the monoclonal antibody itself are being examined.
D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D006084:Graft Rejection; D006801:Humans; D016030:Kidney Transplantation; D007958:Leukocyte Count; D013601:T-Lymphocytes / Q000276:immunology*
D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum