Cited by 453Multiple Sclerosis Research StudiesT-cell and B-cell ImmunologyPsoriasis: Treatment and Pathogenesis

Pulsed monoclonal antibody treatment and autoimmune thyroid disease in multiple sclerosis

Coles, Alasdair J, Wing, Mark, Smith, Sheila, Coraddu, Francesca, Greer, Sandra, Taylor, Craig, Weetman, Anthony, Hale, Geoff +3 more·1999·The Lancet

Abstract

Background Multiple sclerosis results from T-cell-dependent inflammatory demyelination of the central nervous system. Our objective was long-term suppression of inflammation with short-term monoclonal antibody treatment.Methods We depleted 95% of circulating lymphocytes in 27 patients with multiple sclerosis by means of a 5-day pulse of the humanised anti-CD52 monoclonal antibody, Campath-1H. Clinical and haematological consequences of T-cell depletion, and in-vitro responses of patients' peripheral-blood mononuclear cells were analysed serially for 18 months after treatment.Findings Radiological and clinical markers of disease activity were significantly decreased for at least 18 months after treatment. However, a third of patients developed antibodies against the thyrotropin receptor and carbimazole-responsive autoimmune hyperthyroidism. The depleted peripheral lymphocyte pool was reconstituted with cells that had decreased mitogen-induced proliferation and interferon gamma secretion in vitro.Interpretation Campath-1H causes the immune response to change from the Th1 phenotype, suppressing multiple sclerosis disease activity, but permitting the generation of antibody-mediated thyroid autoimmunity.

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Crossref · 10.1016/s0140-6736(99)02429-0

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19 of 19 references verified0 citation errors · 0 not checkable

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Authors
Coles, A. J., Wing, M., Smith, S., Coraddu, F., Greer, S., Taylor, C., Weetman, A., Hale, G., Chatterjee, V. K., Waldmann, H., & Compston, A.
Affiliations
  • University of Cambridge (GB)
  • Addenbrooke's Hospital (GB)
  • University of Sheffield (GB)
  • University of Oxford (GB)
Corresponding author
Coles, Alasdair J
Venue
The Lancet
Publisher
Elsevier BV
Published
1999-11
Volume
354
Issue
9191
Pages
1691-1695
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
OpenAlex
W2112044962
Cited by
453
References
19
Citations by year
2026: 2 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 4 · 2020: 13 · 2019: 14 · 2018: 15 · 2017: 11 · 2016: 17 · 2015: 10 · 2014: 16 · 2013: 26 · 2012: 12
FWCI
8.47
Type
journal article
Language
en
Open access
closed
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Funders
Medical Research Council
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
  • Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
Keywords
multiple sclerosis, Campath-1H, anti-CD52 monoclonal antibody, lymphocyte depletion, autoimmune thyroid disease, TSH receptor antibodies, autoimmune hyperthyroidism, T cell depletion, Th1 response, interferon-gamma, lymphocyte proliferation, disease activity
MeSH terms
CD52 Antigen, Alemtuzumab, Adult, Antibodies, Monoclonal, Antibodies, Neoplasm, Antigens, Neoplasm, Drug Administration Schedule, Female, Follow-Up Studies, Glycoproteins, Graves Disease, Humans, Lymphocyte Activation, Male, Methylprednisolone, Thyroiditis, Autoimmune, Antigens, CD, CD4 Antigens, B-Lymphocyte Subsets, T-Lymphocyte Subsets, Receptors, Tumor Necrosis Factor, Th1 Cells, Antirheumatic Agents, Multiple Sclerosis, Chronic Progressive, Pulse Therapy, Drug, Antibodies, Monoclonal, Humanized

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