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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Acta+Neuropathol
2013 ; 125
(6
): 829-40
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C1q-targeted monoclonal antibody prevents complement-dependent cytotoxicity and
neuropathology in in vitro and mouse models of neuromyelitis optica
#MMPMID23677375
Phuan PW
; Zhang H
; Asavapanumas N
; Leviten M
; Rosenthal A
; Tradtrantip L
; Verkman AS
Acta Neuropathol
2013[Jun]; 125
(6
): 829-40
PMID23677375
show ga
Neuromyelitis optica (NMO) is an autoimmune disorder with inflammatory
demyelinating lesions in the central nervous system, particularly in the spinal
cord and optic nerve. NMO pathogenesis is thought to involve binding of
anti-aquaporin-4 (AQP4) autoantibodies to astrocytes, which causes
complement-dependent cytotoxicity (CDC) and downstream inflammation leading to
oligodendrocyte and neuronal injury. Vasculocentric deposition of activated
complement is a prominent feature of NMO pathology. Here, we show that a
neutralizing monoclonal antibody against the C1q protein in the classical
complement pathway prevents AQP4 autoantibody-dependent CDC in cell cultures and
NMO lesions in ex vivo spinal cord slice cultures and in mice. A monoclonal
antibody against human C1q with 11 nM binding affinity prevented CDC caused by
NMO patient serum in AQP4-transfected cells and primary astrocyte cultures, and
prevented complement-dependent cell-mediated cytotoxicity (CDCC) produced by
natural killer cells. The anti-C1q antibody prevented astrocyte damage and
demyelination in mouse spinal cord slice cultures exposed to AQP4 autoantibody
and human complement. In a mouse model of NMO produced by intracerebral injection
of AQP4 autoantibody and human complement, the inflammatory demyelinating lesions
were greatly reduced by intracerebral administration of the anti-C1q antibody.
These results provide proof-of-concept for C1q-targeted monoclonal antibody
therapy in NMO. Targeting of C1q inhibits the classical complement pathway
directly and causes secondary inhibition of CDCC and the alternative complement
pathway. As C1q-targeted therapy leaves the lectin complement activation pathway
largely intact, its side-effect profile is predicted to differ from that of
therapies targeting downstream complement proteins.