CD4+ T-cell-directed antibody responses are maintained in patients with psoriasis receiving alefacept:: Results of a randomized study
CD4+ T-cell-directed antibody responses are maintained in patients with psoriasis receiving alefacept:: Results of a randomized study
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DOI：
10.1016/s0190-9622(03)01836-x
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发表时间：
2003-11-01
影响因子：
13.8
通讯作者：
Gordon, KB
中科院分区：
文献类型：
--
作者：
Gottlieb, AB;Casale, TB;Gordon, KB
Alefacept，人LFA-3/IgG，融合蛋白，选择性降低记忆效应子目的：探讨阿法塞对银屑病患者免疫功能、T细胞依赖性体液免疫应答的影响及对新抗原（phiX 174）和回忆抗原（recall antigen）的作用方法：银屑病患者随机分为对照组和阿法塞组（7-5 mg，每周1次，静脉注射，共12周）。alefacept组在第6、12、20和26周接受phiX 174免疫接种，在第21周接受破伤风类毒素免疫接种;对照组在第6和12周接受phiX 174免疫接种，在第10周接受破伤风类毒素免疫接种。两组的平均抗phiX 174滴度相当。阿法塞组和对照组之间应答者的百分比（抗phiX 174 IgG大于或等于总抗phiX 174的30%）没有差异（分别为86%和82%; P = 0.73）。抗破伤风类毒素滴度增加大于或等于基线2倍的患者百分比也相似（阿法塞，89%;对照组91%）。一个12周疗程的alefacept不会损害对新抗原的一级或二级抗体反应或对回忆抗原的记忆反应。阿法塞对潜在致病性T细胞亚群的选择性免疫调节作用与维持免疫功能的重要方面（抗体应答）以对抗感染和对疫苗接种作出应答有关。
Background Alefacept, human LFA-3/IgG, 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 greater than or equal to30% 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 greater than or equal to2 times baseline also was similar (alefacept, 89%; control 91%).Conclusion. 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.