Cited by 300Immunotoxicology and immune responsesMonoclonal and Polyclonal Antibodies ResearchT-cell and B-cell Immunology

The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index; 17 of the 50 sources its claims cite were checked for support.

Monoclonal antibody TGN1412 trial failure explained by species differences in CD28 expression on CD4 + effector memory T‐cells

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Eastwood, D, Findlay, L, Poole, S, Bird, C, Wadhwa, M, Moore, M, Burns, C, Thorpe, R, Stebbings, R·2010·British Journal of Pharmacology

Abstract

BACKGROUND AND PURPOSE: In 2006, a life-threatening 'cytokine storm', not predicted by pre-clinical safety testing, rapidly occurred in all six healthy volunteers during the phase I clinical trial of the CD28 superagonist monoclonal antibody (mAb) TGN1412. To date, no unequivocal explanation for the failure of TGN1412 to stimulate profound cytokine release in vitro or in vivo in species used for pre-clinical safety testing has been established. Here, we have identified a species difference almost certainly responsible for this disparate immunopharmacology. EXPERIMENTAL APPROACH: Polychromatic flow cytometry and intracellular cytokine staining were employed to dissect the in vitro immunopharmacology of TGN1412 and other therapeutic mAbs at the cellular level to identify differences between humans and species used for pre-clinical safety testing. KEY RESULTS: In vitro IL-2 and IFN-γ release from CD4+ effector memory T-cells were key indicators of a TGN1412-type response. This mechanism of cytokine release differed from that of other therapeutic mAbs, which can cause adverse reactions, because these other mAbs stimulate cytokine release primarily from natural killer cells. In contrast to humans, CD28 is not expressed on the CD4+ effector memory T-cells of all species used for pre-clinical safety testing, so cannot be stimulated by TGN1412. CONCLUSIONS AND IMPLICATIONS: It is likely that activation of CD4+ effector memory T-cells by TGN1412 was responsible for the cytokine storm. Lack of CD28 expression on the CD4+ effector memory T-cells of species used for pre-clinical safety testing of TGN1412 offers an explanation for the failure to predict a 'cytokine storm' in humans.

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Crossref · 10.1111/j.1476-5381.2010.00922.x

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44 of 44 references verified0 citation errors · 0 not checkable

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39 Own result · 25 Own interpretation · 7 Partly supported · 5 Supported so far · 5 Sources not found · 5 No full text of the sources · 4 Supported · 4 Not checked yet · 3 No basis given · 1 Not supported · 1 Own method · accuracy not yet measured

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  • It may state two separate claims as one. 38
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  • The paper relies on this without support.

    No unequivocal explanation for the failure of TGN1412 to stimulate profound cytokine release in vitro or in vivo in species used for pre-clinical safety testing has been established.

    “To date, no unequivocal explanation for the failure of TGN1412 to stimulate profound cytokine release in vitro or in vivo in species used for pre-clinical safety testing has been established.”
  • The paper relies on this without support.

    The in vitro responses to immobilized TGN1412 reflect the mechanism of the in vivo cytokine storm in humans.

    “To determine if in vitro stimulation with immobilized TGN1412 (Stebbings et al., 2007) induces rapid cytokine expression, with kinetics similar to the 'cytokine storm' caused by this mAb in humans, we looked at early responses within the first 6 h following stimulation using intracellular cytokine staining and RT-PCR for cytokine mRNAs.”
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Metadata

Authors
Eastwood, D., Findlay, L., Poole, S., Bird, C., Wadhwa, M., Moore, M., Burns, C., Thorpe, R., & Stebbings, R.
Affiliations
National Institute for Biological Standards and Control (GB)
Corresponding author
Stebbings, R
Venue
British Journal of Pharmacology
Publisher
Wiley
Published
2010-09-03
Volume
161
Issue
3
Pages
512-526
ISSN
  • 0007-1188 (ISSN-L)
  • 1476-5381
OpenAlex
W1490736032
Cited by
300
References
43
Citations by year
2026: 12 · 2025: 13 · 2024: 18 · 2023: 15 · 2022: 13 · 2021: 16 · 2020: 18 · 2019: 13 · 2018: 20 · 2017: 31 · 2016: 16 · 2015: 19 · 2014: 24 · 2013: 29 · 2012: 27
FWCI
9.89
Type
journal article
Language
en
Open access
Locations
  • British Journal of Pharmacology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Life Sciences › Immunology and Microbiology › Immunology › Immunotoxicology and immune responses
  • Life Sciences › Immunology and Microbiology › Immunology › Monoclonal and Polyclonal Antibodies Research
  • Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
Keywords
TGN1412, cytokine storm, CD4+ effector memory T cells, species differences, IL-2 release, IFN-gamma release, T cell activation, immunopharmacology, adverse drug reactions
MeSH terms
Animals, Antibodies, Monoclonal, Cells, Cultured, Humans, Immunologic Memory, Interferon-gamma, Interleukin-2, Lymphocyte Activation, Macaca, Macaca fascicularis, Species Specificity, T-Lymphocytes, CD4-Positive T-Lymphocytes, Cytokines, Clinical Trials, Phase I as Topic, CD28 Antigens, Toxicity Tests, Antibodies, Monoclonal, Humanized

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