Anti-CD23
Lanny J Rosenwasser1, Jianfeng Meng
1Division of Allergy and Immunology, Department of Medicine, National Jewish Medical and Research Center/University of Colorado Health Sciences Center, Denver, CO, USA. rosenwasserl@njc.org
Insights
Targeting CD23, a key receptor in allergic responses, with Lumiliximab shows promise. This anti-CD23 monoclonal antibody was well-tolerated in a phase I trial for allergic asthma, reducing IgE levels.
Area of Science:
- Immunology
- Allergology
- Pharmacology
Background:
- CD23, the low-affinity IgE receptor, is crucial in IgE-mediated immune responses and allergic diseases.
- Both membrane-bound and soluble CD23 play significant roles in allergic reactions.
- Expression of CD23 is linked to the development of allergic conditions.
Purpose of the Study:
- To evaluate the safety and tolerability of Lumiliximab, an anti-CD23 monoclonal antibody, in patients with allergic asthma.
- To assess the impact of Lumiliximab on total IgE levels and its pharmacokinetic profile.
Main Methods:
- A phase I, placebo-controlled clinical trial was conducted with allergic asthma patients.
- Lumiliximab was administered at various doses, and adverse events were monitored.
- Serum total IgE concentrations and Lumiliximab serum half-life were measured.
Main Results:
- Lumiliximab was well-tolerated with mild adverse events, unrelated to dosage.
- Dose-dependent reductions in mean serum total IgE concentrations were observed.
- The serum half-life of Lumiliximab increased with higher doses.
Conclusions:
- Anti-CD23 therapy, exemplified by Lumiliximab, is a promising candidate for allergic diseases.
- Further confirmation of safety and efficacy in allergic asthma and rhinitis is warranted.
- Potential mechanisms include blocking antigen presentation and reducing pro-inflammatory mediators.
Abstract:
CD23, the low-affinity immunoglobulin (Ig)E receptor (FcepsilonRII), is widely distributed on the surface of various human cells. CD23 mediates numerous IgE-related immune responses (including allergen focusing) by enhancing IgE antigen complex presentation, regulating IgE synthesis, influencing cell differentiation and growth of both B- and T-cells, and stimulating production of pro-inflammatory mediators from monocytes/macrophages, eosinophils, and even airway smooth muscle cells. Both membrane and soluble CD23 play an important role in allergic reactions. Cellular contacts and cytokines modulate its expression in a concerted manner as needed for allergic reactions. Expression of CD23 and soluble CD23 has been associated with allergic diseases. Targeting CD23 with monoclonal antibody (MAb) is a promising candidate therapy in allergic diseases. A newly developed agent known as Lumiliximab, which is an anti-CD23 MAb (Lumiliximab), was demonstrated to be a well-tolerated agent in a phase I clinical trial (a placebo-controlled study with allergic asthma). Adverse events were mild, and no relationship was apparent between the dose of Lumilixilab and the frequency, severity, or type of event. Sustained and dose-dependent decreases in mean serum total IgE concentrations were noted. The serum half-life of Lumilixilab increased from 2 to 10 d with increasing doses. Blocking antigen presentation, preventing costimulation signals, and reducing production of pro-inflammatory mediators are some of the potential mechanisms involved for anti-CD23 activity. Although the safety and clinical efficacy of Lumilixilab in allergic asthma and rhinitis require confirmation, the observed data imply that anti-CD23 is a promising candidate therapy option for future treatment of allergic diseases.
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