Effect of B-cell depletion using anti-CD20 therapy on inhibitory antibody formation to human FVIII in hemophilia A mice

Blood. 2011 Feb 17;117(7):2223-6. doi: 10.1182/blood-2010-06-293324. Epub 2010 Dec 15.

Abstract

We herein tested the effect of B-cell depletion on tolerance induction to factor VIII (FVIII) in a mouse model of hemophilia A. Two subclasses of anti-mouse CD20 monoclonal antibodies with differential depletion effects were used. Thus, IgG1 anti-CD20 selectively depleted follicular B cells and spared marginal zone B cells, whereas IgG2a anti-CD20 efficiently depleted both. In FVIII primed mice, a single dose of either IgG1 or IgG2a anti-CD20 pretreatment prevented the increase in inhibitor formation in the majority of treated mice by subsequent daily, high-dose FVIII intravenous injection as a model for immune tolerance induction. However, the IgG1, but not the IgG2a, anti-CD20 pretreatment led to a significant increase of regulatory T cells in the spleen. Importantly, 3 months after the partial B-cell depletion with IgG1 anti-CD20, the FVIII-specific hyporesponsive state remained. We suggest a tolerogenic role of the remaining marginal zone B cells as a potential mechanism for anti-CD20 therapy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Antibodies, Monoclonal / administration & dosage
  • Antigens, CD20 / immunology*
  • B-Lymphocytes / immunology*
  • Disease Models, Animal
  • Factor VIII / antagonists & inhibitors*
  • Factor VIII / genetics
  • Factor VIII / immunology*
  • Hemophilia A / genetics
  • Hemophilia A / immunology*
  • Hemophilia A / therapy*
  • Humans
  • Immune Tolerance
  • Immunoglobulin G / administration & dosage
  • Lymphocyte Depletion*
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Mice, Transgenic
  • Recombinant Proteins / antagonists & inhibitors
  • Recombinant Proteins / genetics
  • Recombinant Proteins / immunology
  • T-Lymphocytes, Regulatory / immunology

Substances

  • Antibodies, Monoclonal
  • Antigens, CD20
  • Immunoglobulin G
  • Recombinant Proteins
  • F8 protein, human
  • Factor VIII