The innate mononuclear phagocyte network depletes B lymphocytes through Fc receptor–dependent mechanisms during anti-CD20 antibody immunotherapy

J Uchida, Y Hamaguchi, JA Oliver, JV Ravetch… - The Journal of …, 2004 - rupress.org
J Uchida, Y Hamaguchi, JA Oliver, JV Ravetch, JC Poe, KM Haas, TF Tedder
The Journal of experimental medicine, 2004rupress.org
Anti-CD20 antibody immunotherapy effectively treats non-Hodgkin's lymphoma and
autoimmune disease. However, the cellular and molecular pathways for B cell depletion
remain undefined because human mechanistic studies are limited. Proposed mechanisms
include antibody-, effector cell–, and complement-dependent cytotoxicity, the disruption of
CD20 signaling pathways, and the induction of apoptosis. To identify the mechanisms for B
cell depletion in vivo, a new mouse model for anti-CD20 immunotherapy was developed …
Anti-CD20 antibody immunotherapy effectively treats non-Hodgkin's lymphoma and autoimmune disease. However, the cellular and molecular pathways for B cell depletion remain undefined because human mechanistic studies are limited. Proposed mechanisms include antibody-, effector cell–, and complement-dependent cytotoxicity, the disruption of CD20 signaling pathways, and the induction of apoptosis. To identify the mechanisms for B cell depletion in vivo, a new mouse model for anti-CD20 immunotherapy was developed using a panel of twelve mouse anti–mouse CD20 monoclonal antibodies representing all four immunoglobulin G isotypes. Anti-CD20 antibodies rapidly depleted the vast majority of circulating and tissue B cells in an isotype-restricted manner that was completely dependent on effector cell Fc receptor expression. B cell depletion used both FcγRI- and FcγRIII-dependent pathways, whereas B cells were not eliminated in FcR common γ chain–deficient mice. Monocytes were the dominant effector cells for B cell depletion, with no demonstrable role for T or natural killer cells. Although most anti-CD20 antibodies activated complement in vitro, B cell depletion was completely effective in mice with genetic deficiencies in C3, C4, or C1q complement components. That the innate monocyte network depletes B cells through FcγR-dependent pathways during anti-CD20 immunotherapy has important clinical implications for anti-CD20 and other antibody-based therapies.
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