Impact of imlifidase treatment on immunoglobulins in an HLA-hypersensitized lupus nephritis patient with anti-SSA/SSB antibodies after kidney transplantation: A case report
Bacterial recombinant cysteine protease Ides (imlifidase, Idefirix®, Hansa Biopharma) is used to prevent humoral transplant rejection in highly HLA-sensitized recipients, and to control IgG-mediated autoimmune diseases. We report the case of a 51 years old woman suffering from lupus nephritis with e...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Journal of Translational Autoimmunity |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589909023000369 |
| _version_ | 1797388740907237376 |
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| author | Jean Milhès Olivier Marion Benedicte Puissant Caroline Carlé Charlène Bouthemy Arnaud Del Bello Nassim Kamar Yves Renaudineau Nicolas Congy-Jolivet |
| author_facet | Jean Milhès Olivier Marion Benedicte Puissant Caroline Carlé Charlène Bouthemy Arnaud Del Bello Nassim Kamar Yves Renaudineau Nicolas Congy-Jolivet |
| author_sort | Jean Milhès |
| collection | DOAJ |
| description | Bacterial recombinant cysteine protease Ides (imlifidase, Idefirix®, Hansa Biopharma) is used to prevent humoral transplant rejection in highly HLA-sensitized recipients, and to control IgG-mediated autoimmune diseases. We report the case of a 51 years old woman suffering from lupus nephritis with end stage kidney disease, grafted for the second time and pre-treated with imlifidase. The patient was HLA-hypersensitized (calculated Panel Reactive Antibodies [Abs], cPRA>99 %) and has three preformed Donor Specific Antibodies (DSA). Circulating immunoglobulins were monitored at initiation (0, 6, 36, 72 and 96 h), and at Ab recovery one and two months following imlifidase injection. From baseline, the higher depletion was reported after 36h for total IgG (−75 %) and IgG subclasses (−87 % for IgG1, IgG2 and IgG3, -78 % for IgG4), while no significant impact on IgA and IgM was observed. Anti-SSA 60 kDa and anti-SSB auto-Abs quickly decreased after imlifidase injection (−96 % for both after 36 h) as well as post-vaccinal specific IgG (−95 % for tetanus toxoid, −97 % for pneumococcus and −91 % for Haemophilus influenzae Abs after 36 h). At the Ab recovery phase, total IgG and anti-SSA60/SSB Abs reached their initial level at two months. Regarding alloreactive Abs, anti-HLA Abs including the three DSA showed a dramatic decrease after injection with 100 % depletion from baseline after 36 h as assessed by multiplex single bead antigen assay, leading to negative crossmatches using both lymphocytotoxicity (LCT) and flow cell techniques. DSA rebound at recovery was absent and remained under the positivity threshold (MFI = 1000) after 6 months. The findings from this case report are that imlifidase exerts an early depleting effect on all circulating IgG, while IgG recovery may depend in part from imlifidase's capacity to target memory B cells. |
| first_indexed | 2024-03-08T22:45:12Z |
| format | Article |
| id | doaj.art-599ca32b462f429dac31a94480971ce2 |
| institution | Directory Open Access Journal |
| issn | 2589-9090 |
| language | English |
| last_indexed | 2024-03-08T22:45:12Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Translational Autoimmunity |
| spelling | doaj.art-599ca32b462f429dac31a94480971ce22023-12-17T06:41:22ZengElsevierJournal of Translational Autoimmunity2589-90902023-12-017100223Impact of imlifidase treatment on immunoglobulins in an HLA-hypersensitized lupus nephritis patient with anti-SSA/SSB antibodies after kidney transplantation: A case reportJean Milhès0Olivier Marion1Benedicte Puissant2Caroline Carlé3Charlène Bouthemy4Arnaud Del Bello5Nassim Kamar6Yves Renaudineau7Nicolas Congy-Jolivet8Immunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, FranceNephrology and Organ Transplantation Department, Rangueil Toulouse University Hospital, Toulouse, FranceImmunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, France; INSERM UMR 1291 - CNRS UMR 5051, Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), University Toulouse III, Toulouse, FranceImmunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, France; INSERM UMR 1291 - CNRS UMR 5051, Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), University Toulouse III, Toulouse, FranceImmunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, FranceNephrology and Organ Transplantation Department, Rangueil Toulouse University Hospital, Toulouse, FranceNephrology and Organ Transplantation Department, Rangueil Toulouse University Hospital, Toulouse, FranceImmunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, France; INSERM UMR 1291 - CNRS UMR 5051, Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), University Toulouse III, Toulouse, France; Corresponding author. Institut Fédératif de Biologie, Laboratoire d’Immunologie, CHU Purpan, 330 Avenue de Grande Bretagne, 31000, Toulouse, France.Immunology Laboratory Department, Institut Fédératif de Biologie, Purpan, Toulouse University Hospital Center, Toulouse, France; UMR 1037 INSERM Team 20 / Université Toulouse III Paul Sabatier, Toulouse Cancerology Research Center (CRCT), Toulouse, FranceBacterial recombinant cysteine protease Ides (imlifidase, Idefirix®, Hansa Biopharma) is used to prevent humoral transplant rejection in highly HLA-sensitized recipients, and to control IgG-mediated autoimmune diseases. We report the case of a 51 years old woman suffering from lupus nephritis with end stage kidney disease, grafted for the second time and pre-treated with imlifidase. The patient was HLA-hypersensitized (calculated Panel Reactive Antibodies [Abs], cPRA>99 %) and has three preformed Donor Specific Antibodies (DSA). Circulating immunoglobulins were monitored at initiation (0, 6, 36, 72 and 96 h), and at Ab recovery one and two months following imlifidase injection. From baseline, the higher depletion was reported after 36h for total IgG (−75 %) and IgG subclasses (−87 % for IgG1, IgG2 and IgG3, -78 % for IgG4), while no significant impact on IgA and IgM was observed. Anti-SSA 60 kDa and anti-SSB auto-Abs quickly decreased after imlifidase injection (−96 % for both after 36 h) as well as post-vaccinal specific IgG (−95 % for tetanus toxoid, −97 % for pneumococcus and −91 % for Haemophilus influenzae Abs after 36 h). At the Ab recovery phase, total IgG and anti-SSA60/SSB Abs reached their initial level at two months. Regarding alloreactive Abs, anti-HLA Abs including the three DSA showed a dramatic decrease after injection with 100 % depletion from baseline after 36 h as assessed by multiplex single bead antigen assay, leading to negative crossmatches using both lymphocytotoxicity (LCT) and flow cell techniques. DSA rebound at recovery was absent and remained under the positivity threshold (MFI = 1000) after 6 months. The findings from this case report are that imlifidase exerts an early depleting effect on all circulating IgG, while IgG recovery may depend in part from imlifidase's capacity to target memory B cells.http://www.sciencedirect.com/science/article/pii/S2589909023000369Systemic lupus erythematosusKidney allograftIdesImmunoglobulinsDonor specific antibodiesAnti-SSA/SSB antibodies |
| spellingShingle | Jean Milhès Olivier Marion Benedicte Puissant Caroline Carlé Charlène Bouthemy Arnaud Del Bello Nassim Kamar Yves Renaudineau Nicolas Congy-Jolivet Impact of imlifidase treatment on immunoglobulins in an HLA-hypersensitized lupus nephritis patient with anti-SSA/SSB antibodies after kidney transplantation: A case report Journal of Translational Autoimmunity Systemic lupus erythematosus Kidney allograft Ides Immunoglobulins Donor specific antibodies Anti-SSA/SSB antibodies |
| title | Impact of imlifidase treatment on immunoglobulins in an HLA-hypersensitized lupus nephritis patient with anti-SSA/SSB antibodies after kidney transplantation: A case report |
| title_full | Impact of imlifidase treatment on immunoglobulins in an HLA-hypersensitized lupus nephritis patient with anti-SSA/SSB antibodies after kidney transplantation: A case report |
| title_fullStr | Impact of imlifidase treatment on immunoglobulins in an HLA-hypersensitized lupus nephritis patient with anti-SSA/SSB antibodies after kidney transplantation: A case report |
| title_full_unstemmed | Impact of imlifidase treatment on immunoglobulins in an HLA-hypersensitized lupus nephritis patient with anti-SSA/SSB antibodies after kidney transplantation: A case report |
| title_short | Impact of imlifidase treatment on immunoglobulins in an HLA-hypersensitized lupus nephritis patient with anti-SSA/SSB antibodies after kidney transplantation: A case report |
| title_sort | impact of imlifidase treatment on immunoglobulins in an hla hypersensitized lupus nephritis patient with anti ssa ssb antibodies after kidney transplantation a case report |
| topic | Systemic lupus erythematosus Kidney allograft Ides Immunoglobulins Donor specific antibodies Anti-SSA/SSB antibodies |
| url | http://www.sciencedirect.com/science/article/pii/S2589909023000369 |
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