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Models for assessing immunogenicity and efficacy of new therapeutics for the treatment of haemophilia.

Abstract
Inhibitor development remains a challenge to appropriate haemophilia treatment. This challenge is being addressed, in part, by an expanding knowledge of the mechanisms that drive inhibitor development including how elements of the innate immune response play a role in inhibitor development. There are promising therapies that may suppress an active immune response. Models to assess the immune responses are becoming ever more sophisticated. Newer models can be used at the preclinical level to evaluate the role of MHC-class II presentation of antigens in both in vitro cell culture studies and in vivo in transgenic mice that express either the protein to be studied or that express human MHC-class II proteins. Parallel to work designed to reduce or reverse inhibitors is development of improved therapies including bypassing agents to treat patients with inhibitors. With these new treatment modalities comes the problem of assessing efficacy at the preclinical level. Models to evaluate bleeding are being developed that may give a more subtle assessment of bypassing agents. These models represent in part an attempt to incorporate the role of ongoing bleeding into the evaluation. Overall, these newer models have great potential in preclinical studies to evaluate the risk of inhibitor development of new therapeutics and to assess the functionality of these new therapeutics.
AuthorsJean-Marie Saint-Remy, Birgit M Reipert, Dougald M Monroe
JournalHaemophilia : the official journal of the World Federation of Hemophilia (Haemophilia) Vol. 18 Suppl 4 Pg. 43-7 (Jul 2012) ISSN: 1365-2516 [Electronic] England
PMID22726082 (Publication Type: Journal Article)
Copyright© 2012 Blackwell Publishing Ltd.
Chemical References
  • Antigens, CD
  • Blood Coagulation Factor Inhibitors
  • Coagulants
  • Factor VIII
Topics
  • Animals
  • Antigens, CD (analysis, immunology)
  • Blood Coagulation Factor Inhibitors (immunology)
  • Coagulants (immunology, therapeutic use)
  • Disease Models, Animal
  • Dogs
  • Factor VIII (immunology, therapeutic use)
  • Hemophilia A (drug therapy, immunology)
  • Humans
  • Immune Tolerance
  • Mice

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