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Table 1 Biological effects of Alemtuzumab

From: Alemtuzumab for multiple sclerosis: the new concept of immunomodulation

Effects Mechanisms References
Fast and long-lasting immune suppression Rapid and complete depletion of circulating T and B lymphocytes; limited effect on lymphoid organs.
Differentiated CD20, CD4 and CD8 lymphocyte repopulation (B before T, T4 before T8)
Long-lasting re-modelling of the lymphocyte network: earlier appearance of regulatory B and T cells, later appearance of Th1 and Th17.
Anti-inflammatory changes in the cytochine network.
More tolerogenic immune network during reconstitution.
Hu et al., 2009 [29]
Thompson et al., 2010 [38]
Jones et al., 2009 [30]
Zhang et al., 2013 [42]
Turner et al., 2013 [40]
Havari et al., 2015 [25]
Wang et al., 2015 [43]
Wang et al., 2015 [43]
Watanabe et al., 2006 [44]
Decrease in brain inflammation and neurodegeneration Almost complete suppression of brain inflammation.
Increased production of neurotrophic/growth factors by antigen-specific T cells.
Jones et al., 2010 [31]
Turner et al., 2015 [41]
No impact on immune competence Immunocompetent cells in the lymphoid organs are largely preserved.
B and T cell response against bacterial and viral antigens are maintained during therapy.
Innate immunity is not affected.
Hu et al., 2009 [29]
Buggins et al., 2002 [6]
McCarthy et al., 2013 [34]
Clark et al., 2012 [7]
Turner et al., 2013 [40]
Cytokine release syndrome Transient, cytolysis-related release of pro-inflammatory acute-phase cytokines (TNF, IL-1, IL-6). Breslin et al., 2007 [4]
Wing et al., 1996 [45]
Bugelski et al., 2009 [5]