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Treatment of recalcitrant plaque psoriasis with a humanized non-depleting antibody to CD4.

Abstract
The presence of activated CD4(+) T lymphocytes in psoriatic skin plaques suggests an immune-mediated pathogenesis for the disease. Six patients with recalcitrant plaque psoriasis (PASI>12) received a humanized non-depleting monoclonal antibody to CD4 (ORTHOCLONE OKT(R)cdr4a). The antibody was well tolerated. Four weeks from treatment, the mean decrease in PASI score was 46%. In three patients disease remission was prolonged for up to 6 months and, in one case, up to 1 year post-treatment. In all patients, circulating CD4+ T-cell counts remained normal and peripheral OKTcdr4a-coated CD4+ lymphocytes were detected up to 10 days after antibody infusion. These results point to the relevance of CD4+ lymphocytes in psoriasis. They also emphasize that depletion of CD4+ cells is not mandatory to achieve therapeutic effectiveness.
AuthorsH Bachelez, B Flageul, L Dubertret, S Fraitag, R Grossman, N Brousse, D Poisson, R W Knowles, M C Wacholtz, T P Haverty, L Chatenoud, J F Bach
JournalJournal of autoimmunity (J Autoimmun) Vol. 11 Issue 1 Pg. 53-62 (Feb 1998) ISSN: 0896-8411 [Print] England
PMID9480723 (Publication Type: Journal Article)
CopyrightCopyright 1998 Academic Press Limited.
Chemical References
  • Antibodies, Anti-Idiotypic
  • Antibodies, Monoclonal
  • CD4 Antigens
  • OKT4A monoclonal antibody
Topics
  • Adult
  • Animals
  • Antibodies, Anti-Idiotypic (biosynthesis)
  • Antibodies, Monoclonal (adverse effects, genetics, pharmacokinetics, therapeutic use)
  • CD4 Antigens (blood)
  • CD4 Lymphocyte Count
  • CD4-CD8 Ratio
  • CD4-Positive T-Lymphocytes (pathology)
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Lymphocyte Depletion
  • Male
  • Mice
  • Monitoring, Immunologic
  • Psoriasis (immunology, metabolism, pathology, therapy)
  • Recurrence
  • Severity of Illness Index
  • Skin (chemistry, metabolism, pathology)
  • T-Lymphocytes (metabolism)

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