What is the role of monoclonal antibodies in immunosuppression after pediatric transplantation?

Updated: Oct 18, 2019
  • Author: Randy P Prescilla, MD; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Answer

Answer

Monoclonal antibodies [10]

  • Anti-CD3 monoclonal antibodies: Muromonab-CD3 (Orthoclone OKT3) is a mouse monoclonal antibody against CD3. It binds to T-cell receptor-associated CD3 complex and depletes and alters T-cells. It is used for induction and to treat rejection, although its use has declined since newer immunosuppressive drugs have reduced rejection episodes.

  • Anti–interleukin (IL)-2 receptor (anti-CD25) antibodies: Daclizumab (Zenapax) and basiliximab (Simulect) are anti-CD25 monoclonal antibodies that are widely used for induction in patients with low-to-moderate risk of rejection. Less T-cell depletion is observed with these agents. Moderate success and minimal toxic effects are achieved in combination with calcineurin inhibitors. [11]  Daclizumab was withdrawn from the United States market because of diminished use and emergence of other effective therapies.

  • Anti-CD52 antibodies: Alemtuzumab (Campath-1H) is a humanized anti-CD52 monoclonal antibody that is approved for use in chronic lymphocytic leukemia. [29, 30] The target, CD52, is a glycoprotein expressed on lymphocytes, monocytes, macrophages, and natural killer cells. The drug causes extensive lympholysis by inducing apoptosis of targeted cells.

  • Anti-CD20 antibodies: Rituximab (Rituxan), an anti-CD20 monoclonal antibody, is approved for the treatment of certain types of non-Hodgkin lymphoma [31, 32] and to reduce the signs and symptoms of moderate to severe rheumatoid arthritis.


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