Alemtuzumab and multiple sclerosis: therapeutic application.
BACKGROUND
The cause and cure for multiple sclerosis (MS) remain unknown. Immunomodulatory agents are only partially effective and many patients do not tolerate the side effects or fail them. Immunosuppressive agents act non-specifically and are associated with serious complications. An emerging group of biologic agents with great potential for treatment of immune-mediated disorders such as MS are monoclonal antibodies. A review of alemtuzumab in MS is presented.


METHODS
Mechanisms of action of alemtuzumab and the results of Phase II clinical trials in MS.


RESULTS
Alemtuzumab is a humanized mAb, which targets the surface molecule CD52 on all T cell populations and other cellular components of the immune system such as thymocytes, B cells, and monocytes. Alemtuzumab, which is administered intravenously, depletes T as well as B lymphocyte populations for extended periods. Adverse effects in MS patients such as thyroid disorders and idiopathic thrombocytopenic purpura are discussed.


CONCLUSIONS
Alemtuzumab may hold great promise for treatment of MS patients and serve as an option for patients refractory to immunomodulatory therapies. Due to its unique mechanism of action and profound effect on MS disease activity it enhances our knowledge about pathogenic mechanisms of MS.
Minagar
Alireza
A
Louisiana State University Health Sciences Center, Department of Neurology, 1501 Kings Highway, Shreveport, LA 71130, USA. aminag@lsuhsc.edu
Alexander
J Steven
JS
Sahraian
Mohammad Ali
MA
Zivadinov
Robert
R
D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000503:physiopathology
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000074323:Alemtuzumab