Partial and transient modulation of the CD3–T‐cell receptor complex, elicited by low‐dose regimens of monoclonal anti‐CD3, is sufficient to induce disease remission …

DS Mehta, RA Christmas, H Waldmann… - …, 2010 - Wiley Online Library
DS Mehta, RA Christmas, H Waldmann, M Rosenzweig
Immunology, 2010Wiley Online Library
It has been established that a total of 250 μg of monoclonal anti‐mouse CD3 F (ab′) 2
fragments, administered daily (50 μg per dose), induces remission of diabetes in the non‐
obese diabetic (NOD) mouse model of autoimmune diabetes by preventing β cells from
undergoing further autoimmune attack. We evaluated lower‐dose regimens of monoclonal
anti‐CD3 F (ab′) 2 in diabetic NOD mice for their efficacy and associated
pharmacodynamic (PD) effects, including CD3–T‐cell receptor (TCR) complex modulation …
Summary
It has been established that a total of 250 μg of monoclonal anti‐mouse CD3 F(ab′)2 fragments, administered daily (50 μg per dose), induces remission of diabetes in the non‐obese diabetic (NOD) mouse model of autoimmune diabetes by preventing β cells from undergoing further autoimmune attack. We evaluated lower‐dose regimens of monoclonal anti‐CD3 F(ab′)2 in diabetic NOD mice for their efficacy and associated pharmacodynamic (PD) effects, including CD3–T‐cell receptor (TCR) complex modulation, complete blood counts and proportions of circulating CD4+, CD8+ and CD4+ FoxP3+ T cells. Four doses of 2 μg (total dose 8 μg) induced 53% remission of diabetes, similarly to the 250 μg dose regimen, whereas four doses of 1 μg induced only 16% remission. While the 250 μg dose regimen produced nearly complete and sustained modulation of the CD3 –TCR complex, lower doses, spaced 3 days apart, which induced similar remission rates, elicited patterns of transient and partial modulation. In treated mice, the proportions of circulating CD4+ and CD8+ T cells decreased, whereas the proportions of CD4+ FoxP3+ T cells increased; these effects were transient. Mice with greater residual β‐cell function, estimated using blood glucose and C‐peptide levels at the initiation of treatment, were more likely to enter remission than mice with more advanced disease. Thus, lower doses of monoclonal anti‐CD3 that produced only partial and transient modulation of the CD3–TCR complex induced remission rates comparable to higher doses of monoclonal anti‐CD3. Accordingly, in a clinical setting, lower‐dose regimens may be efficacious and may also improve the safety profile of therapy with monoclonal anti‐CD3, potentially including reductions in cytokine release‐related syndromes and maintenance of pathogen‐specific immunosurveillance during treatment.
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