2023
Prospective Hemophilia Inhibitor PUP Study reveals distinct antibody signatures during FVIII inhibitor eradication
PAUL, Helmut, Verena BERG, Bagirath GANGADHARAN, Joel BOWEN, Petra LEBEAU et. al.Základní údaje
Originální název
Prospective Hemophilia Inhibitor PUP Study reveals distinct antibody signatures during FVIII inhibitor eradication
Autoři
PAUL, Helmut, Verena BERG, Bagirath GANGADHARAN, Joel BOWEN, Petra LEBEAU, Jan BLATNÝ (203 Česká republika, domácí), Christoph MALE, Vlad C RADULESCU, Rosa DIAZ, Maria Elisa MANCUSO, Deborah L BROWN a Birgit M REIPERT
Vydání
Blood advances, AMSTERDAM, ELSEVIER, 2023, 2473-9529
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30205 Hematology
Stát vydavatele
Nizozemské království
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 7.500 v roce 2022
Kód RIV
RIV/00216224:14110/23:00133684
Organizační jednotka
Lékařská fakulta
UT WoS
001001257900001
Klíčová slova anglicky
Hemophilia; FVIII inhibitor
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 29. 2. 2024 08:32, Mgr. Tereza Miškechová
Anotace
V originále
Factor VIII (FVIII) inhibitor formation is a major clinical concern during replacement therapy in patients with hemophilia A. Immune tolerance induction (ITI) is the only therapeutic approach to attempt inhibitor eradication and establishment of long-term immune tolerance to FVIII. Hemophilia Inhibitor Previously Untreated Patient (PUP) Study (HIPS) was a prospective clinical trial to investigate changes in the immune system of PUPs with severe hemophilia A. Five patients who developed persistent FVIII inhibitors during HIPS entered an ITI extension arm (HIPS-ITI). During HIPS-ITI, inhibitor patients received ITI with the same FVIII product (a single source of recombinant, human full-length FVIII) used in HIPS until successful tolerance, declared failure, or a maximum of 2 years after HIPS-ITI enrollment, whichever came first. Blood samples and clinical data were collected monthly. Longitudinal FVIII-binding antibody signatures, associated binding specificities, and apparent affinities were determined for each patient at each sampling time point. ITI was successful or partially successful in 2 patients and failed in 3. Both groups presented with distinct FVIII-specific antibody signatures. ITI success required the disappearance of FVIII inhibitors, which was associated with the eradication or sustained titer minimization of high-affinity FVIII-specific antibodies, particularly of the immunoglobulin G1 (IgG1) and IgG4 subclasses. In contrast, ITI failure, as reflected by FVIII inhibitor persistence, was associated with persistent high-affinity FVIII-specific antibodies. Interestingly, 1 patient with partial ITI success and 1 patient with ITI failure developed apparent oligoreactive FVIII-binding antibodies during ITI. The explanation of the true nature of these antibodies requires more comprehensive follow-ups in future studies. This trial was registered at www.clinicaltrials.gov as #NCT01652027.