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] |