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Characterization and attenuation of hIgM CDC activity. Rituximab and the corresponding anti-CD20 hIgM hexamer were incubated with Wil-2S cells in the presence of 20% human serum for 2 h. Extent of cell death was evaluated by addition of Alamar blue (a). The P436G mutant shows attenuated CDC compared to the anti-CD20 IgM hexamer (b). Alignment of hIgG1 with hIgM highlighting the prolines critical for effective engagement with complement (c).
