Monoclonal anti-D antibodies to prevent alloimmunization: lessons from clinical trials.
In the past 20 years, numerous monoclonal anti-D antibodies have been developed in order to replace the human plasma derived anti-D immunoglobulins, using different in vitro functional assays as screening methods. Some of these monoclonal antibodies have been evaluated in exploratory in vivo clinical trials, notably for their ability to mediate the clearance of D-positive red cells. A review of these reported trials is presented and the results are analyzed in the light of the newly published hypothesis conferring an important role to some Fc-FcgammaR interactions and to the glycosylation-dependent potency of the monoclonal anti-D antibodies.
Béliard
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LFB, 3, avenue des Tropiques, BP 305, Les Ulis, 91958 Courtaboeuf cedex, France. beliard@lfb.fr
D000818:Animals; D000911:Antibodies, Monoclonal / Q000737:chemistry / Q000627:therapeutic use*; D000920:Antibody-Dependent Cell Cytotoxicity; D002986:Clinical Trials as Topic; D003602:Cytotoxicity, Immunologic; D005260:Female; D006031:Glycosylation; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology / Q000627:therapeutic use; D007518:Isoantibodies / Q000737:chemistry / Q000627:therapeutic use*; D008297:Male; D051379:Mice; D016688:Mice, Inbred NOD; D016513:Mice, SCID; D023421:Models, Animal; D008954:Models, Biological; D002679:Pan troglodytes; D010587:Phagocytosis; D011247:Pregnancy; D011499:Protein Processing, Post-Translational; D017452:Receptors, IgG / Q000276:immunology; D012203:Rh Isoimmunization / Q000517:prevention & control*; D018029:Rho(D) Immune Globulin; D013329:Structure-Activity Relationship; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D007074:Immunoglobulin G; D007518:Isoantibodies; C061961:RHO(D) antibody; D017452:Receptors, IgG; D018029:Rho(D) Immune Globulin