FcγRI blockade and modulation for immunotherapy

Abstract

 Splenectomy and corticosteroids are the treatment of choice for patients with immune thrombocytopenic purpura (ITP). However, for the 10%–15% of patients who do not respond to conventional therapy, high-dose i.v. IgG can induce life-saving transient responses. The benefits of i.v. IgG have been attributed to Fc receptor blockade; however, the involvement of the individual Fc receptors for IgG (FcγR) in ITP remain to be more completely defined. Recently a mAb, designated mAb H22, which recognizes an epitope on FcγRI (CD64) outside the ligand-binding domain, was humanized. Because mAb H22 is a human IgG1 and FcγRI has a high affinity for human IgG1 antibodies, we predicted that mAb H22 would bind to the FcγRI ligand-binding site through its Fc domain and to its external FcγRI epitope through both Fab domains. These studies demonstrate that mAb H22 blocked FcγRI-mediated phagocytosis of opsonized red blood cells more effectively than an irrelevant IgG. Moreover, cross-linking FcγRI with mAb H22 down-modulated FcγRI expression on monocytes, an effect seen within 2 h.