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Departments of Microbiology and Immunology and Medicine, Albert Einstein College of Medicine, Bronx, NY 10461; and
Departments of Pathology and Pediatrics, Childrens Memorial Medical Center, Northwestern University Medical School, Chicago, IL 60614
Ab-based therapies have undergone a renaissance in recent years,
but infusion-related reactions are a significant clinical problem.
Administration of certain mAbs to Swiss Webster mice infected with
Cryptococcus neoformans can result in acute lethal
toxicity (ALT) characterized by cardiovascular collapse. The ability of
a mAb to produce ALT is isotype dependent and occurs with IgG1 but not
IgG3. To investigate this phenomenon, we measured spleen and liver
cytokine responses and platelet-activating factor (PAF) content in mice
given C. neoformans glucuronoxylomannan (GXM) followed
by specific Ab of IgG1 or IgG3 isotype. We found no evidence to suggest
that the differences in IgG1 and IgG3 toxicity were due to differences
in chemokine or cytokine response. In contrast, liver and spleen tissue
PAF content was significantly greater in mice IgG1. Furthermore, our
results show differences in the response to IgG1- and IgG3-GXM
complexes regarding: 1) macrophage-inflammatory protein-1
and
monocyte chemoattractant protein-1 regulation, 2) splenic and hepatic
PAF content, and 3) hepatic PAF content in infected mice.
IgG1-associated ALT appears to be the result of greater production of
PAF in response to IgG1-GXM complex formation. The results are
consistent with the view that IgG1 and IgG3 interact with different Fc
receptors. Our findings strongly suggest that the mechanism for
Ab-mediated ALT is different from the cytokine release syndrome
described after administration of other therapeutic
mAbs.
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