Abstract
BACKGROUND—Standard therapy for severe, immune mediated, ocular inflammation has significant side effects, and may fail to control the disease. T cell directed monoclonal antibody (mAb) therapy can provide long term remission of inflammatory disease in experimental models. The Campath-1H mAb was administered to patients with severe, refractory, ocular inflammation. METHODS—10 patients with severe, refractory, non-infectious ocular inflammatory disease were treated with Campath-1H mAb. This is a fully humanised mAb which recognises the pan-lymphocyte antigen CD52. RESULTS AND DISCUSSION—Following Campath-1H therapy, all 10 patients showed an initial resolution of their ocular symptoms and signs. Long lasting remissions were achieved in eight patients, in whom baseline immunosuppression could subsequently be reduced to minimal levels. The possible mechanisms of action of Campath-1H therapy are discussed.
Full Text
The Full Text of this article is available as a PDF (91.8 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Coles A. J., Wing M. G., Molyneux P., Paolillo A., Davie C. M., Hale G., Miller D., Waldmann H., Compston A. Monoclonal antibody treatment exposes three mechanisms underlying the clinical course of multiple sclerosis. Ann Neurol. 1999 Sep;46(3):296–304. doi: 10.1002/1531-8249(199909)46:3<296::aid-ana4>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
- Dick A. D., Azim M., Forrester J. V. Immunosuppressive therapy for chronic uveitis: optimising therapy with steroids and cyclosporin A. Br J Ophthalmol. 1997 Dec;81(12):1107–1112. doi: 10.1136/bjo.81.12.1107. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hale G., Xia M. Q., Tighe H. P., Dyer M. J., Waldmann H. The CAMPATH-1 antigen (CDw52). Tissue Antigens. 1990 Mar;35(3):118–127. doi: 10.1111/j.1399-0039.1990.tb01767.x. [DOI] [PubMed] [Google Scholar]
- Isaacs J. D., Hale G., Waldmann H., Dick A. D., Haynes R., Forrester J. V., Watson P., Meyer P. A. Monoclonal antibody therapy of chronic intraocular inflammation using Campath-1H. Br J Ophthalmol. 1995 Nov;79(11):1054–1055. doi: 10.1136/bjo.79.11.1054. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Isaacs J. D., Waldmann H. Regaining self-control--regulation and immunotherapy. Br J Rheumatol. 1998 Sep;37(9):926–929. doi: 10.1093/rheumatology/37.9.926. [DOI] [PubMed] [Google Scholar]
- Isaacs J. D., Watts R. A., Hazleman B. L., Hale G., Keogan M. T., Cobbold S. P., Waldmann H. Humanised monoclonal antibody therapy for rheumatoid arthritis. Lancet. 1992 Sep 26;340(8822):748–752. doi: 10.1016/0140-6736(92)92294-p. [DOI] [PubMed] [Google Scholar]
- Lockwood C. M., Thiru S., Stewart S., Hale G., Isaacs J., Wraight P., Elliott J., Waldmann H. Treatment of refractory Wegener's granulomatosis with humanized monoclonal antibodies. QJM. 1996 Dec;89(12):903–912. doi: 10.1093/qjmed/89.12.903. [DOI] [PubMed] [Google Scholar]
- Newman D. K., Isaacs J. D., Watson P. G., Meyer P. A., Hale G., Waldmann H. Prevention of immune-mediated corneal graft destruction with the anti-lymphocyte monoclonal antibody, CAMPATH-1H. Eye (Lond) 1995;9(Pt 5):564–569. doi: 10.1038/eye.1995.140. [DOI] [PubMed] [Google Scholar]
- Waldmann H., Cobbold S. How do monoclonal antibodies induce tolerance? A role for infectious tolerance? Annu Rev Immunol. 1998;16:619–644. doi: 10.1146/annurev.immunol.16.1.619. [DOI] [PubMed] [Google Scholar]
- Xia M. Q., Hale G., Lifely M. R., Ferguson M. A., Campbell D., Packman L., Waldmann H. Structure of the CAMPATH-1 antigen, a glycosylphosphatidylinositol-anchored glycoprotein which is an exceptionally good target for complement lysis. Biochem J. 1993 Aug 1;293(Pt 3):633–640. doi: 10.1042/bj2930633. [DOI] [PMC free article] [PubMed] [Google Scholar]