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Neutralizing antibodies against calcitonin
A Grauer1, H H Reinel, R Ziegler
1Abteilung Innere Medizin I, Universität Heidelberg, Germany.
Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|September 1, 1993
Summary
Neutralizing antibodies against salmon calcitonin (sCT) are common and can cause resistance. Antibodies against human calcitonin (hCT) are rare but warrant monitoring for treatment effectiveness.
Area of Science:
- Endocrinology
- Immunology
- Pharmacology
Background:
- Calcitonin (CT) treats Paget's disease and postmenopausal osteoporosis (PMO).
- Salmon calcitonin (sCT) is widely used, but antibody formation is common (>70%), with debated clinical significance regarding resistance.
- Human calcitonin (hCT) antibody formation is rarely reported.
Purpose of the Study:
- To investigate the clinical significance of antibody formation against sCT and hCT.
- To identify neutralizing antibodies against calcitonin in patients undergoing treatment.
- To correlate antibody formation with secondary resistance to calcitonin therapy.
Main Methods:
- An in vitro bioassay using a human breast cancer cell line (T 47 D) measured CT-mediated cyclic AMP (cAMP) production.
- Serum samples from patients treated with sCT or hCT were analyzed for binding and neutralizing antibodies.
- Patients with PMO treated with hCT were specifically assessed for antibody development.
Main Results:
- A subset of patients with antibodies against sCT exhibited neutralizing activity linked to secondary resistance.
- Neutralizing antibodies against hCT were detected in 1 of 33 PMO patients, with low activity and no expected clinical sequelae.
- Neutralizing antibody formation is frequent with sCT treatment but rare with hCT treatment.
Conclusions:
- Neutralizing antibody formation against calcitonin is common with sCT but rare with hCT.
- Monitoring for neutralizing antibodies is recommended for patients on long-term sCT or hCT treatment for PMO and Paget's disease.
- Monitoring helps evaluate the therapeutic effect and potential for secondary resistance in calcitonin therapy.