The Experimental and Clinical Use in Transplantation of Monoclonal Antibodies to CD4 and Other Adhesion Molecules

  • John Powelson
  • A. Benedict Cosimi
Part of the Medical Intelligence Unit book series (MIU.LANDES)


Monoclonal antibody (MoAb) technology has made possible the production of designer proteins specifically reactive with almost any conceivable biological molecule. The CD3 antigen was selected as one of the first targets for MoAb-based immunosuppression because it is present as part of the T-cell receptor (TCR) on all mature T cells. Disabling these cells, the pivotal actors in the alloresponse, was predicted to provide an effective approach to interrupting the rejection response in a more selective manner than that previously provided by polyclonal antilymphocyte preparations. The expected immunosuppressive effectiveness of anti-CD3 MoAb therapy has now been extensively confirmed in numerous clinical trials of OKT3.1-6 Monoclonal antibodies reactive with other epitopes on the TCR have also been found to be capable of reversing allograft rejection.7,8 However, suppressing all T cells indiscriminately increases the risk of infections and malignancies, while not necessarily being essential for effective immunosuppression. Suppressing selected T-cell subsets might provide comparably effective immunosuppression with less potential morbidity than these pan-T-cell reagents. Accordingly, MoAbs have been developed against targets such as the CD4 antigen, expressed on the T-cell subset involved in sensitization to the allograft (CD4+ T cells); and the adhesion molecules, essential elements in the “second signal” required for T-cell activation.


Renal Allograft Cardiac Allograft Allograft Survival Anti Thymocyte Globulin Renal Allograft Recipient 
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© Springer Science+Business Media Dordrecht 1995

Authors and Affiliations

  • John Powelson
  • A. Benedict Cosimi

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