title: Pexelizumab -- a C5 complement inhibitor for use in both acute myocardial infarction and cardiac surgery with cardiopulmonary bypass.
abstract: Myocardial injury and dysfunction in acute infarction and during cardiac surgery with cardiopulmonary bypass (CPB) are associated with an undesirable systemic inflammatory response, in which the complement cascade plays a major role. In animal models C5 inhibition has been found to significantly reduce myocardial infarct size and decrease cellular necrosis and apoptosis. Pexelizumab (Alexion Pharmaceuticals, Inc., Cheshire, CT, USA) is a humanized, monoclonal, single-chain antibody fragment that inhibits C5, thereby blocking its cleavage into active forms. Prospective, randomised, double-blind, placebo-controlled trials using pexelizumab during percutaneous coronary intervention following acute myocardial infarction (AMI), or in patients undergoing coronary artery bypass graft (CABG) with CPB, have demonstrated a reduction in morbidity and mortality. Thus, pexelizumab represents a promising therapeutic option with sustained benefit both in AMI and during CABG with CPB.
authors.affiliation: Division of Cardiothoracic Surgery, University of Washington, 1959 NE Pacific Seattle, Washington, WA 98195, USA. fleisig@u.washington.edu
authors.forename: Ani J
authors.initials: AJ
authors.lastname: Fleisig
authors.forename: Edward D
authors.initials: ED
authors.lastname: Verrier
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D002315:Cardiopulmonary Bypass; D003182:Complement C5 / Q000037:antagonists & inhibitors* / Q000276:immunology; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery; D004195:Disease Models, Animal; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D011183:Postoperative Complications / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D057127:Single-Chain Antibodies; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000517:prevention & control
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003182:Complement C5; D057127:Single-Chain Antibodies; C402724:pexelizumab