title: CD4+ T cell response to factor VIII in hemophilia A, acquired hemophilia, and healthy subjects.
abstract: These studies have begun to clarify the complex cellular mechanisms involved in the immune response to factor VIII. Although vigorous sensitization of CD4+ cells occurs in healthy subjects, the absence of clinically significant levels of inhibitor antibodies is likely related to the prompt down-regulation of the immune response. It may also be possible that the specific epitope repertoire recognized by CD4+ cells plays a role in the outcome of the immune response to factor VIII. Further characterization and comparison of the CD4+ repertoire in healthy subjects with that of hemophilia patients with and without inhibitors will help clarify which mechanism explains the absence of productive inhibitor synthesis in certain individuals. Also, it might identify CD4+ epitopes recognized by T helper cells that are essential for inhibitor synthesis. Additional studies to further characterize the role of Th1 and Th2 cells in the immune response to factor VIII may also be needed for the design of novel therapeutic strategies aimed at preventing inhibitor development.
authors.affiliation: Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis/St. Paul 55108, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Reding
authors.forename: H
authors.initials: H
authors.lastname: Wu
authors.forename: M
authors.initials: M
authors.lastname: Krampf
authors.forename: D K
authors.initials: DK
authors.lastname: Okita
authors.forename: B M
authors.initials: BM
authors.lastname: Diethelm-Okita
authors.forename: N S
authors.initials: NS
authors.lastname: Key
authors.forename: B M
authors.initials: BM
authors.lastname: Conti-Fine
mesh_terms: D000906:Antibodies; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D000939:Epitopes; D005169:Factor VIII / Q000276:immunology*; D006467:Hemophilia A / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance; D019151:Peptide Library; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
chemical_list: D000906:Antibodies; D000939:Epitopes; D019151:Peptide Library; D005169:Factor VIII