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Precision-Cut Tumor Slices (PCTS) as an Ex Vivo Model in Immunotherapy Research 精确切割肿瘤切片(PCTS)作为免疫治疗研究中的离体模型
IF 4.7 Q3 IMMUNOLOGY Pub Date : 2022-04-06 DOI: 10.3390/antib11020026
P. Dimou, S. Trivedi, Maria Liousia, Reena R D'Souza, A. Klampatsa
Precision-cut tumor slices (PCTS) have recently emerged as important ex vivo human tumor models, offering the opportunity to study individual patient responses to targeted immunotherapies, including CAR-T cell therapies. In this review, an outline of different human tumor models available in laboratory settings is provided, with a focus on the unique characteristics of PCTS. Standard PCTS generation and maintenance procedures are outlined, followed by an in-depth overview of PCTS utilization in preclinical research aiming to better understand the unique functional characteristics of cytotoxic T cells within human tumors. Furthermore, recent studies using PCTS as an ex vivo model for predicting patient responses to immunotherapies and other targeted therapies against solid tumors are thoroughly presented. Finally, the advantages and limitations of the PCTS models are discussed. PCTS are expected to gain momentum and be fully utilized as a significant tool towards better patient stratification and personalized medicine.
精确切割肿瘤切片(PCTS)最近成为重要的离体人类肿瘤模型,为研究个体患者对靶向免疫疗法(包括CAR-T细胞疗法)的反应提供了机会。在这篇综述中,概述了在实验室环境中可用的不同人类肿瘤模型,重点介绍了PCTS的独特特征。本文概述了标准的PCTS生成和维持程序,然后深入概述了PCTS在临床前研究中的应用,旨在更好地了解人类肿瘤中细胞毒性T细胞的独特功能特征。此外,最近的研究使用PCTS作为体外模型来预测患者对实体瘤免疫治疗和其他靶向治疗的反应。最后,讨论了PCTS模型的优点和局限性。PCTS有望获得动力,并充分利用作为更好的患者分层和个性化医疗的重要工具。
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引用次数: 4
Effects of Monovalent Salt on Protein-Protein Interactions of Dilute and Concentrated Monoclonal Antibody Formulations 一价盐对稀释和浓缩单克隆抗体制剂蛋白-蛋白相互作用的影响
IF 4.7 Q3 IMMUNOLOGY Pub Date : 2022-03-31 DOI: 10.3390/antib11020024
A. Xu, Nicholas J. Clark, Joey Pollastrini, Maribel Espinoza, Hyo-Jin Kim, Sekhar R. Kanapuram, B. Kerwin, M. Treuheit, S. Krueger, A. Mcauley, J. E. Curtis
In this study, we used sodium chloride (NaCl) to extensively modulate non-specific protein-protein interactions (PPI) of a humanized anti-streptavidin monoclonal antibody class 2 molecule (ASA-IgG2). The changes in PPI with varying NaCl (CNaCl) and monoclonal antibody (mAb) concentration (CmAb) were assessed using the diffusion interaction parameter kD and second virial coefficient B22 measured from solutions with low to moderate CmAb. The effective structure factor S(q)eff measured from concentrated mAb solutions using small-angle X-ray and neutron scattering (SAXS/SANS) was also used to characterize the PPI. Our results found that the nature of net PPI changed not only with CNaCl, but also with increasing CmAb. As a result, parameters measured from dilute and concentrated mAb samples could lead to different predictions on the stability of mAb formulations. We also compared experimentally determined viscosity results with those predicted from interaction parameters, including kD and S(q)eff. The lack of a clear correlation between interaction parameters and measured viscosity values indicates that the relationship between viscosity and PPI is concentration-dependent. Collectively, the behavior of flexible mAb molecules in concentrated solutions may not be correctly predicted using models where proteins are considered to be uniform colloid particles defined by parameters derived from low CmAb.
在这项研究中,我们使用氯化钠(NaCl)广泛调节人源抗链霉亲和素单克隆抗体2类分子(ASA-IgG2)的非特异性蛋白-蛋白相互作用(PPI)。采用扩散相互作用参数kD和第二病毒系数B22对低至中等CmAb溶液进行测定,评估PPI随NaCl (CNaCl)和单克隆抗体(CmAb)浓度的变化。利用小角x射线和中子散射(SAXS/SANS)从浓缩单抗溶液中测量的有效结构因子S(q)eff也用于表征PPI。我们的研究结果发现,净PPI的性质不仅随着CNaCl的变化而变化,而且随着CmAb的增加而变化。因此,从稀释和浓缩单抗样品中测量的参数可能导致对单抗配方稳定性的不同预测。我们还比较了实验确定的粘度结果与相互作用参数预测的结果,包括kD和S(q)eff。相互作用参数和测量粘度值之间缺乏明确的相关性,表明粘度和PPI之间的关系依赖于浓度。总的来说,柔性单抗分子在浓缩溶液中的行为可能无法使用模型正确预测,其中蛋白质被认为是由低CmAb衍生的参数定义的均匀胶体颗粒。
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引用次数: 6
Diagnostic Performance of PD-L1 versus PD-1 Expression in Circulating CD20 Cells in Diffuse Large B-Cell Lymphoma PD-L1与PD-1在循环CD20细胞中表达对弥漫性大B细胞淋巴瘤的诊断作用
IF 4.7 Q3 IMMUNOLOGY Pub Date : 2022-02-16 DOI: 10.3390/antib11010015
M. Saber
This study aimed to investigate PD-L1 and PD-1 expression in circulating CD20+ cells in diffuse larger B-cell lymphoma (DLBCL) and to evaluate the predictive and diagnostic performance of PD-L1 versus PD-1 expression in circulating CD20+ cells in DLBCL. Percentages of CD20+, PD-L1+CD20+, and PD-1+CD20+ cells were measured by flow cytometry in 40 DLBCL blood samples and 19 healthy controls. The DLBCL patient group was subdivided into 20 newly diagnosed patients with no treatment yet and 20 patients that had finished six cycles of CHOP therapy. Percentages of PD-L1+CD20+ and PD-1+CD20+ cells were highly significantly increased in pre-therapy patients in comparison to healthy volunteers (p < 0.001). Meanwhile, a significant decrease in percentages of PD-L1+CD20+ and PD-1+CD20+ was observed in post-CHOP therapy patients in comparison to pre-therapy patients (p < 0.001). PD-L1+CD20+ cells were significantly decreased in post-therapy patients when compared to normal controls (p < 0.001), while not for PD-1+CD20+ cells. A strong significant positive correlation between percentages of PD-L1+CD20+ and PD-1+CD20+ was detected in DLBCL patients (p < 0.001). In the pre-therapy group, high PD-L1+CD20+ and PD-1+CD20+ percentages were correlated with serum LDH levels (p = 0.021, p < 0.001). High percentages of PD-1+CD20+ were found in DLBCL patients with splenomegaly (p = 0.027). The results revealed that patients with advanced tumor stages, poor ECOG performance, and non-GCB DLBCL type had increased percentages of PD-L1+CD20+ and PD-1+CD20+ cells. Moreover, PD-L1+CD20+ % and PD-1+CD20+ % were significantly increased in DLBCL patients with bone marrow involvement or B symptoms. The superiority of PD-L1+CD20+ over PD-1+CD20+ was more profound in DLBCL prediction [AUC: 1.0] and in discriminating newly diagnosed patients [AUC: 1.0]. The findings suggest that increased PD-L1/PD-1 expression in peripheral CD20 cells may serve as a companion diagnostic marker for DLBCL. Moreover, percentages of PD-L1+CD20+ cells have better diagnostic performance with higher sensitivity and specificity than PD-1+CD20+ %.
本研究旨在研究弥漫性大B细胞淋巴瘤(DLBCL)中循环CD20+细胞中PD-L1和PD-1的表达,并评估PD-L1与PD-1在DLBCL中循环CD200+细胞中表达的预测和诊断性能。在40个DLBCL血液样本和19个健康对照中,通过流式细胞术测量CD20+、PD-L1+CD20+和PD-1+CD20+细胞的百分比。DLBCL患者组被细分为20名尚未接受治疗的新诊断患者和20名已完成六个周期CHOP治疗的患者。治疗前患者的PD-L1+CD20+和PD-1+CD20+细胞的百分比与健康志愿者相比显著增加(p<0.001),与治疗前相比,CHOP治疗后患者的PD-L1+CD20+和PD-1+CD20+的百分比显著降低(p<0.001)。与正常对照组相比,治疗后患者中的PD-L1+CD20+细胞显著减少(p<001),而PD-1+CD20/细胞则没有。DLBCL患者中PD-L1+CD20+和PD-1+CD20+的百分比呈极显著的正相关(p<0.001),高PD-L1+CD20+和PD-1+CD20+百分比与血清LDH水平相关(p=0.021,p<0.001)。在脾肿大的DLBCL患者中发现高PD-1+CD20/百分比(p=0.027)。此外,在有骨髓受累或B症状的DLBCL患者中,PD-L1+CD20+%和PD-1+CD20+%显著增加。PD-L1+CD20+比PD-1+CD20+在DLBCL预测[AUC:1.0]和鉴别新诊断患者[AUC:1.0]方面的优势更为显著。研究结果表明,外周CD20细胞中PD-L1/PD-1表达的增加可能是DLBCL的辅助诊断标志物。此外,百分比的PD-L1+CD20+细胞比PD-1+CD20+%具有更好的诊断性能,具有更高的灵敏度和特异性。
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引用次数: 2
Anti-SARS-CoV-2 Omicron Antibodies Isolated from a SARS-CoV-2 Delta Semi-Immune Phage Display Library 从SARS-CoV-2 Delta半免疫噬菌体展示文库中分离到抗SARS-CoV-2组粒抗体
IF 4.7 Q3 IMMUNOLOGY Pub Date : 2022-02-10 DOI: 10.3390/antib11010013
Ivette Mendoza-Salazar, Keyla M Gómez-Castellano, Edith González-González, Ramsés A. Gamboa-Suasnavart, S. D. Rodríguez-Luna, Giovanni Santiago-Casas, María I. Cortés-Paniagua, S. Pérez-Tapia, J. C. Almagro
This report describes the discovery and characterization of antibodies with potential broad SARS-CoV-2 neutralization profiles. The antibodies were obtained from a phage display library built with the VH repertoire of a convalescent COVID-19 patient who was infected with SARS-CoV-2 B.1.617.2 (Delta). The patient received a single dose of Ad5-nCoV vaccine (Convidecia™, CanSino Biologics Inc.) one month before developing COVID-19 symptoms. Four synthetic VL libraries were used as counterparts of the immune VH repertoire. After three rounds of panning with SARS-CoV-2 receptor-binding domain wildtype (RBD-WT) 34 unique scFvs, were identified, with 27 cross-reactive for the RBD-WT and RBD Delta (RBD-DT), and seven specifics for the RBD-WT. The cross-reactive scFvs were more diverse than the RBD-WT specific ones, being encoded by several IGHV genes from the IGHV1 and IGHV3 families combined with short HCDR3s. Six cross-reactive scFvs and one RBD-WT specific scFv were converted to human IgG1 (hIgG1). Out of the seven antibodies, six blocked the RBD-WT binding to angiotensin converting enzyme 2 (ACE2), suggesting these antibodies may neutralize the SARS-CoV-2 infection. Importantly, one of the antibodies also recognized the RBD from the B.1.1.529 (Omicron) isolate, implying that the VH repertoire of the convalescent patient would protect against SARS-CoV-2 Wildtype, Delta, and Omicron. From a practical viewpoint, the triple cross-reactive antibody provides the substrate for developing therapeutic antibodies with a broad SARS-CoV-2 neutralization profile.
本报告描述了具有潜在广泛的严重急性呼吸系统综合征冠状病毒2型中和特征的抗体的发现和表征。抗体是从噬菌体展示库中获得的,该库用感染了SARS-CoV-2 B.1.617.2(德尔塔)的新冠肺炎康复患者的VH库构建。患者接受了单剂Ad5-nCoV疫苗(Convidecia™, CanSino Biologics股份有限公司在出现新冠肺炎症状前一个月。使用四个合成的VL文库作为免疫VH库的对应物。在用严重急性呼吸系统综合征冠状病毒2型受体结合结构域野生型(RBD-WT)进行三轮筛选后,鉴定出34种独特的单链抗体,其中27种对RBD-WT和RBD-Delta(RBD-DT)具有交叉反应性,7种对RBD-WT具有特异性。交叉反应scFv比RBD-WT特异性scFv更具多样性,由IGHV1和IGHV3家族的几个IGHV基因与短HCDR3结合编码。将6个交叉反应性scFv和1个RBD-WT特异性scFv转化为人IgG1(hIgG1)。在七种抗体中,有六种阻断了RBD-WT与血管紧张素转换酶2(ACE2)的结合,这表明这些抗体可能中和严重急性呼吸系统综合征冠状病毒2型感染。重要的是,其中一种抗体还识别了B.1.1.529(奥密克戎)分离株的RBD,这意味着恢复期患者的VH基因库可以抵御严重急性呼吸系统综合征冠状病毒2型野生型、德尔塔和奥密克龙。从实用的角度来看,三重交叉反应抗体为开发具有广泛的严重急性呼吸系统综合征冠状病毒2型中和特征的治疗性抗体提供了底物。
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引用次数: 6
Cryopreservation of Natural Killer Cells Pre-Complexed with Innate Cell Engagers 天然杀伤细胞与天然细胞接合物预复合的冷冻保存
IF 4.7 Q3 IMMUNOLOGY Pub Date : 2022-02-09 DOI: 10.3390/antib11010012
U. Reusch, Kristina Ellwanger, Ivica Fucek, Thomas Müller, Ute Schniegler-Mattox, J. Koch, M. Tesar
Innate cell engager (ICE®) constructs are bispecific tetravalent antibodies targeting specific tumor antigens and simultaneously engaging natural killer (NK) cell and macrophage receptors for the destruction of tumor cells. Pre-complexing of ICE® constructs with adoptive NK cells is a novel approach to enhance NK cell activity. The suitability of such complexes for cryopreservation, whilst retaining the biological activity and specificity, may enable the development of off-the-shelf NK cell products. This study investigates the binding affinity of ICE® constructs targeting EpCAM and NK cell receptors CD16A, NKG2D, or NKp46 to the corresponding antigens, the ICE® antitumor activity, and feasibility of cryopreservation. Cell surface retention assays using primary NK cells confirmed a substantially slower ICE® construct dissociation kinetics compared with control molecules, suggesting the formation of durable complexes independently of the CD16A polymorphism. The high-affinity NK cell and EpCAM/CD16A ICE® complexes were superior to those engaging NKG2D or NKp46 receptors when tested for the NK-cell-mediated elimination of EpCAM-expressing tumor cells. Moreover, the potency and efficacy of these complexes were unaffected after a single freeze–thaw cycle. CD16A-selective ICE® drug candidates complexed with NK cells hold promise as novel cryopreserved off-the-shelf NK cell products with chimeric antigen receptor-like NK cell properties, capable of effective depletion of tumor cells.
先天性细胞接合器(ICE®)构建物是针对特定肿瘤抗原的双特异性四价抗体,同时结合自然杀伤细胞(NK)和巨噬细胞受体来破坏肿瘤细胞。ICE®构建物与过继NK细胞的预络合是一种增强NK细胞活性的新方法。这种复合物适合冷冻保存,同时保留生物活性和特异性,可能使开发现成的NK细胞产品成为可能。本研究探讨了针对EpCAM和NK细胞受体CD16A、NKG2D或NKp46的ICE®构建物与相应抗原的结合亲和力、ICE®抗肿瘤活性以及冷冻保存的可行性。使用原代NK细胞进行的细胞表面保留试验证实,与对照分子相比,ICE®构建的解离动力学要慢得多,这表明ICE®构建的持久复合物的形成独立于CD16A多态性。高亲和力NK细胞和EpCAM/CD16A ICE®复合物在NK细胞介导的EpCAM表达肿瘤细胞的消除测试中优于NKG2D或NKp46受体。此外,这些复合物的效力和功效在单次冻融循环后不受影响。cd16a选择性ICE®候选药物与NK细胞复合物有望成为新型冷冻保存的现成NK细胞产品,具有嵌合抗原受体样NK细胞特性,能够有效地消耗肿瘤细胞。
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引用次数: 3
Functional Changes of Therapeutic Antibodies upon Exposure to Pro-Oxidative Agents 治疗性抗体暴露于促氧化剂后的功能变化
IF 4.7 Q3 IMMUNOLOGY Pub Date : 2022-02-02 DOI: 10.3390/antib11010011
M. Lecerf, Robin V. Lacombe, Alexia Kanyavuz, J. Dimitrov
Therapeutic monoclonal antibodies have exerted a transformative impact on clinical practice in last two decades. However, development of a therapeutic antibody remains a complex process. Various physiochemical and functional liabilities can compromise the production or the therapeutic efficacy of antibodies. One of these liabilities is the susceptibility to oxidation. In the present study, we portrayed an oxidation-dependent vulnerability of immunoglobulins that can be of concern for therapeutic antibodies. By using a library of 119 monoclonal IgG1 molecules, containing variable domain matching clinical-stage antibodies, we demonstrated that a substantial number of these molecules acquired antigen-binding polyreactivity upon exposure to ferrous ions. Statistical analyses revealed that the potential for induction of polyreactivity by the redox-active metal ions correlated with a higher number of somatic mutations in V genes encoding variable domains of heavy and light immunoglobulin chains. Moreover, the sensitive antibodies used with biased frequencies particular V gene families encoding variable domains of their light chains. Besides the exposure to ferrous ions the induction of polyreactivity of therapeutic antibodies occurred after contact with an unrelated pro-oxidative substance—hypochlorite ions. Our data also revealed that induction of polyreactivity by pro-oxidative agents did not impact the binding of antibodies to their cognate antigens. The results from this study may contribute for better selection of antibody therapeutics with suitable developability profiles.
治疗性单克隆抗体在过去二十年中对临床实践产生了变革性的影响。然而,治疗性抗体的开发仍然是一个复杂的过程。各种生理化学和功能缺陷会损害抗体的产生或治疗效果。其中一个缺点是易氧化。在目前的研究中,我们描绘了免疫球蛋白的氧化依赖性脆弱性,可以关注治疗性抗体。通过使用包含可变结构域匹配临床阶段抗体的119个单克隆IgG1分子文库,我们证明了大量这些分子在暴露于亚铁离子时获得抗原结合的多反应性。统计分析显示,氧化还原活性金属离子诱导多反应性的潜力与编码重、轻免疫球蛋白链可变结构域的V基因的较高体细胞突变数量相关。此外,敏感抗体使用偏频特定的V基因家族编码其轻链的可变结构域。除了暴露于亚铁离子外,治疗性抗体的多反应性发生在与不相关的促氧化物质-次氯酸盐离子接触后。我们的数据还显示,由促氧化剂诱导的多反应性并不影响抗体与其同源抗原的结合。本研究结果可能有助于更好地选择具有合适发展概况的抗体治疗方法。
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引用次数: 6
Construction of a Humanized Artificial VHH Library Reproducing Structural Features of Camelid VHHs for Therapeutics 再现骆驼VHH结构特征的人源化人工VHH文库的构建
IF 4.7 Q3 IMMUNOLOGY Pub Date : 2022-01-30 DOI: 10.3390/antib11010010
Taihei Murakami, Shigefumi Kumachi, Y. Matsunaga, Miwa Sato, Kanako Wakabayashi-Nakao, Hidekazu Masaki, R. Yonehara, Maiko Motohashi, N. Nemoto, Masayuki Tsuchiya
A variable domain of heavy chain antibody (VHH) has different binding properties than conventional antibodies. Conventional antibodies prefer binding to the convex portion of the antigen, whereas VHHs prefer epitopes, such as crevices and clefts on the antigen. Therefore, developing candidates with the binding characteristics of camelid VHHs is important. Thus, To this end, a synthetic VHH library that reproduces the structural properties of camelid VHHs was constructed. First, the characteristics of VHHs were classified according to the paratope formation based on crystal structure analyses of the complex structures of VHHs and antigens. Then, we classified 330 complementarity-determining region 3 (CDR3) structures of VHHs from the Protein Data Bank (PDB) into three loop structures: Upright, Half-Roll, and Roll. Moreover, these structures depended on the number of amino acid residues within CDR3. Furthermore, in the Upright loops, several amino acid residues in the FR2 are involved in the paratope formation, along with CDR3, suggesting that the FR2 design in the synthetic library is important. A humanized synthetic VHH library, comprising two sub-libraries, Upright and Roll, was constructed and named PharmaLogical. A validation study confirmed that our PharmaLogical library reproduces VHHs with the characteristics of the paratope formation of the camelid VHHs, and shows good performance in VHH screening.
重链抗体的可变结构域(VHH)具有与常规抗体不同的结合特性。常规抗体更喜欢与抗原的凸起部分结合,而VHH更喜欢表位,如抗原上的缝隙和裂口。因此,开发具有骆驼VHH结合特性的候选者是重要的。因此,为此,构建了一个复制骆驼VHH结构特性的合成VHH文库。首先,通过对VHH和抗原复杂结构的晶体结构分析,根据副表位的形成对VHH的特征进行了分类。然后,我们将来自蛋白质数据库(PDB)的330个VHH的互补决定区3(CDR3)结构分类为三个环结构:直立、半滚和滚。此外,这些结构取决于CDR3内氨基酸残基的数量。此外,在直立环中,FR2中的几个氨基酸残基与CDR3一起参与副表位的形成,这表明合成文库中的FR2设计是重要的。构建了一个人源化合成VHH文库,包括两个子文库Upright和Roll,并命名为PharmaLogical。一项验证研究证实,我们的PharmaLogical文库复制了具有骆驼VHH副表位形成特征的VHH,并在VHH筛选中表现出良好的性能。
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引用次数: 8
Acknowledgment to Reviewers of Antibodies in 2021 2021年抗体评审员致谢
IF 4.7 Q3 IMMUNOLOGY Pub Date : 2022-01-26 DOI: 10.3390/antib11010009
Rigorous peer-reviews are the basis of high-quality academic publishing [...]
严格的同行评议是高质量学术出版的基础[…]
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引用次数: 0
Applications of Antibody-Based Antigen Delivery Targeted to Dendritic Cells In Vivo 基于抗体的树突状细胞抗原递送在体内的应用
IF 4.7 Q3 IMMUNOLOGY Pub Date : 2022-01-25 DOI: 10.3390/antib11010008
Jessica Bourque, D. Hawiger
Recombinant immunoglobulins, derived from monoclonal antibodies recognizing the defined surface epitopes expressed on dendritic cells, have been employed for the past two decades to deliver antigens to dendritic cells in vivo, serving as critical tools for the investigation of the corresponding T cell responses. These approaches originated with the development of the recombinant chimeric antibody against a multilectin receptor, DEC-205, which is present on subsets of murine and human conventional dendritic cells. Following the widespread application of antigen targeting through DEC-205, similar approaches then utilized other epitopes as entry points for antigens delivered by specific antibodies to multiple types of dendritic cells. Overall, these antigen-delivery methodologies helped to reveal the mechanisms underlying tolerogenic and immunogenic T cell responses orchestrated by dendritic cells. Here, we discuss the relevant experimental strategies as well as their future perspectives, including their translational relevance.
重组免疫球蛋白来源于识别树突状细胞表面表位的单克隆抗体,在过去的二十年里,重组免疫球蛋白一直被用于向体内的树突状细胞递送抗原,作为研究相应T细胞反应的关键工具。这些方法起源于针对多集素受体(DEC-205)的重组嵌合抗体的开发,该受体存在于小鼠和人类常规树突状细胞亚群中。随着抗原靶向通过DEC-205的广泛应用,类似的方法随后利用其他表位作为抗原的入口点,由特异性抗体递送到多种类型的树突状细胞。总的来说,这些抗原递送方法有助于揭示树突状细胞介导的耐受性和免疫原性T细胞反应的机制。在这里,我们讨论了相关的实验策略以及它们的未来前景,包括它们的翻译相关性。
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引用次数: 5
Antibodies against Platelet Factor 4 and Their Associated Pathologies: From HIT/HITT to Spontaneous HIT-Like Syndrome, to COVID-19, to VITT/TTS 血小板因子4抗体及其相关病理学:从HIT/HITT到自发性HIT-样综合征,再到新冠肺炎,再到VIT/TTS
IF 4.7 Q3 IMMUNOLOGY Pub Date : 2022-01-21 DOI: 10.3390/antib11010007
E. Favaloro, Leonardo Pasalic, G. Lippi
Antibodies against platelet factor 4 (PF4), a protein released from alpha-granules of activated platelets, may cause a number of pathophysiological conditions. The most commonly known is heparin-induced thrombocytopenia (HIT), which develops in a small proportion of people treated with the anticoagulant drug heparin. Notably, PF4 binds with high affinity to heparin, and in HIT, complexes of PF4/H may, in a small proportion of susceptible patients, trigger the development of anti-PF4 antibodies and subsequent platelet activation and aggregation, ultimately leading to the development of pathological thrombosis at sites of vessel occlusion. Of more modern interest, antibodies against PF4 may also arise in patients with COVID-19 (Coronavirus Disease 2019) or in patients who have been vaccinated against COVID-19, especially in recipients of adenovirus-based vaccines. For this latter group of patients, the terms VITT (vaccine-induced [immune] thrombotic thrombocytopenia) and TTS (thrombotic thrombocytopenia syndrome) have been coined. Another category associated with this pathophysiology comprises those in whom a precipitating event is not clear; this category is referred to as ‘spontaneous HIT-like syndrome’. Despite its name, it arises as an HIT-mimicking disorder but without antecedent heparin exposure. In this narrative review, we describe the development of antibodies against PF4, and associated pathophysiology, in such conditions.
血小板因子4 (PF4)是一种从活化血小板α颗粒中释放的蛋白质,其抗体可引起许多病理生理状况。最常见的是肝素诱发的血小板减少症(HIT),在一小部分接受抗凝药物肝素治疗的患者中发生。值得注意的是,PF4与肝素具有高亲和力结合,在HIT中,PF4/H复合物可能在一小部分易感患者中引发抗PF4抗体的产生和随后的血小板活化和聚集,最终导致血管闭塞部位的病理性血栓形成。更令人感兴趣的是,针对PF4的抗体也可能出现在COVID-19(2019冠状病毒病)患者或接种过COVID-19疫苗的患者中,特别是在腺病毒疫苗的接受者中。对于后一组患者,术语VITT(疫苗诱导的[免疫性]血栓性血小板减少症)和TTS(血栓性血小板减少综合征)已被创造出来。与这种病理生理学相关的另一类包括:突发事件不明确;这种类型被称为“自发性hit样综合征”。尽管它的名字,它是一种模仿hit的障碍,但没有肝素暴露的先例。在这篇叙述性综述中,我们描述了在这种情况下抗PF4抗体的发展和相关的病理生理。
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引用次数: 11
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Antibodies
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