CD4+ T-cell-directed antibody responses are maintained in patients with psoriasis receiving alefacept: results of a randomized study.
BACKGROUND
Alefacept, human LFA-3/IgG(1) fusion protein, selectively reduces memory-effector (CD45RO(+)) T cells, a source of the pathogenic mediators of psoriasis.


OBJECTIVE
To evaluate the effect of alefacept on immune function, T-cell-dependent humoral responses to a neoantigen (PhiX174) and recall antigen (tetanus toxoid) were assessed.


METHODS
Patients with psoriasis were randomized to the control group or to receive alefacept (7.5 mg intravenously weekly for 12 weeks). The alefacept group received PhiX174 immunizations at weeks 6, 12, 20, and 26 and tetanus toxoid at week 21; control subjects received PhiX174 at weeks 6 and 12 and tetanus at week 10.


RESULTS
Mean anti-PhiX174 titers were comparable in both groups. There was no difference in the percentage of responders (anti-PhiX174 IgG >/=30% of the total anti-PhiX174) between the alefacept group and the control group (86% and 82%, respectively; P =.73). The percentage of patients with anti-tetanus toxoid titer increases >/=2 times baseline also was similar (alefacept, 89%; control 91%).


CONCLUSIONS
A single 12-week course of alefacept did not impair primary or secondary antibody responses to a neoantigen or memory responses to a recall antigen. The selective immunomodulatory effect of alefacept against a potentially pathogenic T-cell subset is associated with maintenance of a significant aspect of immune function (antibody response) to fight infection and respond to vaccinations.
Gottlieb
Alice B
AB
Clinical Research Center, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08901-0019, USA. gottliab@umdnj.edu
Casale
Thomas B
TB
Frankel
Ellen
E
Goffe
Bernard
B
Lowe
Nicholas
N
Ochs
Hans D
HD
Roberts
Janet L
JL
Washenik
Ken
K
Vaishnaw
Akshay K
AK
Gordon
Kenneth B
KB
D000328:Adult; D000368:Aged; D000077944:Alefacept; D000937:Antigen-Antibody Reactions; D001323:Autoantibodies / Q000187:drug effects* / Q000276:immunology*; D010584:Bacteriophage phi X 174 / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology*; D011993:Recombinant Fusion Proteins / Q000494:pharmacology / Q000627:therapeutic use*; D013745:Tetanus Toxoid / Q000276:immunology
D001323:Autoantibodies; D011993:Recombinant Fusion Proteins; D013745:Tetanus Toxoid; D000077944:Alefacept