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Nephrol Dial Transplant (2004) 19: 297-300
© ERA–EDTA 2004; all rights reserved

Editorial Comments

Monoclonal antibodies in renal transplantation: old and new

Dirk R. J. Kuypers and Yves F. C. Vanrenterghem

Department of Nephrology and Renal Transplantation, University of Leuven, Belgium

Correspondence and offprint requests to: Dirk Kuypers, Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. Email: dirk.kuypers@uz.kuleuven.ac.be

Keywords: Campath1-H; CTLA4Ig; kidney transplantation; monoclonal antibodies

The first 150 words of the full text of this article appear below.

The first monoclonal antibody (MoAb) used for prevention and treatment of allograft rejection was OKT3, a murine antibody directed against the 20 000 Da molecular subunit linked to the T-cell antigen receptor [1]. Although several studies demonstrated the efficacy of OKT3 in the prevention and treatment of acute rejection (AR), its widespread clinical use was hampered by a number of serious side effects that can be summarized in four categories. The first, administration of the drug is often accompanied by a cytokine-release syndrome with high fever, chills, arterial hypertension and even pulmonary oedema as result of capillary leak. Secondly, a substantial number of patients will develop antibodies against the xenogeneic epitope that are responsible for decreased efficacy. Thirdly, cross-reactions with non-target tissue may produce thrombocytopenia and neutropenia or aseptic meningo-encephalitis. Lastly, a higher incidence of infectious complications and malignancies has been reported, suggesting over-immunosuppression.

More recently, through molecular . . . [Full Text of this Article]

Monoclonal antibodies against the interleukin-2 receptor (anti-IL2-R-MoAb's)

Efalizumab

Monoclonal antibodies directed against the co-stimulatory signals

The lymphocyte depleting anti-CD52 MoAb Campath-1H (Alemtuzumab)

Conclusion


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