antibody therapy

抗体疗法
  • 文章类型: Journal Article
    多发性骨髓瘤(MM)的发病率在全球范围内激增,特别是在拉丁美洲国家,这是由于人口老龄化和预期寿命延长。这篇系统综述分析了流行病学,患者特征,在选定的拉丁美洲国家,MM的治疗结果:巴西,墨西哥,哥伦比亚,阿根廷,智利,秘鲁,乌拉圭。PubMed和拉丁美洲和加勒比健康科学文献(LILACS),会议摘要(2019年6月至2022年6月),和GLOBOCAN注册表(2010年1月至2022年6月)进行了电子搜索。定性分析采用了乔安娜·布里格斯研究所的批判性评估工具。在586篇筛选的文章中,26符合纳入标准。参与者的平均年龄为54至67岁。GLOBOCAN数据显示,对于MM来说,巴西和乌拉圭的发病率最高和最低,5年患病率,和死亡率,分别。免疫球蛋白G是检测到的最常见的亚型。III期经常被诊断出来。虽然许多批准的药物是可用的,双特异性抗体有望作为未来的治疗,有限的访问,尤其是CAR-T细胞疗法仍然是一个值得关注的问题。在拉丁美洲,MM的发病率正在增加。资源限制和成本阻碍了获得新药和治疗方案。了解疾病模式和患者特征对于改善这些国家的MM管理至关重要。
    The incidence of multiple myeloma (MM) has surged globally, particularly in Latin American countries, and is attributable to an aging population and increased life expectancy. This systematic review analyzes the epidemiology, patient characteristics, and treatment outcomes for MM in selected Latin American countries: Brazil, Mexico, Colombia, Argentina, Chile, Peru, and Uruguay. PubMed and the Latin American and Caribbean Health Sciences Literature (LILACS), conference abstracts (between June 2019 and June 2022), and GLOBOCAN registry (January 2010 to June 2022) were electronically searched. Qualitative analysis employed the Joanna Briggs Institute\'s critical appraisal tool. Among the 586 screened articles, 26 met the inclusion criteria. The participants\' median age ranged from 54 to 67 years. GLOBOCAN data revealed that for MM, Brazil and Uruguay had the highest and lowest incidence, 5-year prevalence, and mortality, respectively. Immunoglobulin G was the most common subtype detected. Stage III was frequently diagnosed. Though many approved drugs are available and bispecific antibodies hold promise as a future therapy, limited access, especially for CAR-T cell-based therapy remains a concern. The incidence of MM is increasing in Latin America. Resource constraints and costs hinder access to novel drugs and regimens. Understanding disease patterns and patient characteristics is vital to improve MM management in these countries.
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  • 文章类型: Journal Article
    作为空气交换的场所,肺组织长期暴露于大量的外来病原体。因此,肺已经发展出精致而复杂的免疫系统。除了它们的物理和化学屏障作用,肺上皮细胞可通过表达Toll样受体(TLRs)和其他模式识别受体,随着细胞因子的分泌。新的证据表明,肺上皮细胞可以产生和分泌免疫球蛋白(Ig),包括IgM,IgA,或IgG,从而执行抗体功能。此外,已经发现恶性转化的肺上皮细胞产生高水平的Ig,主要是IgG,不能实现抗体的作用,而是进行促进肿瘤的活动。结构分析表明,由于独特的糖基化修饰,肺癌细胞产生的IgG的生物学活性与正常肺上皮细胞产生的Ig的生物学活性不同。具体来说,唾液酸化IgG(SIA-IgG),以在IgyCH1的Asn162位点的非传统N-糖基化修饰为特征,在肿瘤干细胞中高度表达。已经证明SIA-IgG依赖于这种独特的唾液酸化修饰来促进肿瘤发生。转移,和免疫逃避。目前的研究结果证明,肺上皮细胞产生的Ig具有多方面的生物学活性,包括生理条件下的免疫防御功能,同时在恶性转化过程中获得促进肿瘤的活性。这些见解作为新的生物标志物和靶标,具有诊断和治疗肺癌的潜力。
    As the locus for air exchange, lung tissue is perpetually exposed to a significant quantity of foreign pathogens. Consequently, lung has developed a refined and intricate immune system. Beyond their physical and chemical barrier roles, lung epithelial cells can contribute to immune defence through the expression of Toll-like receptors (TLRs) and other pattern recognition receptors, along with the secretion of cytokines. Emerging evidence demonstrates that lung epithelial cells can generate and secrete immunoglobulins (Igs), including IgM, IgA, or IgG, thus performing antibody function. Moreover, malignantly transformed lung epithelial cells have been discovered to produce high levels of Ig, predominantly IgG, which do not fulfill the role of antibodies, but instead carries out tumour-promoting activity. Structural analysis has indicated that the biological activity of IgG produced by lung cancer cells differs from that of Igs produced by normal lung epithelial cells due to the unique glycosylation modification. Specifically, the sialylated IgG (SIA-IgG), characterised by a non-traditional N-glycosylation modification at the Asn162 site of Igγ CH1, is highly expressed in tumour stem cells. It has been demonstrated that SIA-IgG relies on this unique sialylation modification to promote tumorigenesis, metastasis, and immune evasion. Current results have proven that the Ig produced by lung epithelial cells has multifaceted biological activities, including immune defence functions under physiological conditions, while acquiring tumour-promoting activity during malignant transformation. These insights possess potential for the diagnosis and treatment of lung cancer as novel biomarkers and targets.
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  • 文章类型: Journal Article
    细胞培养物中抗体中和的效力已被用作选择针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的抗体进行临床开发的关键标准。由于其他方面也可能影响体内保护程度,我们比较了两种针对SARS-CoV-2受体结合域(RBD)不同表位的中和单克隆抗体(TRES6和4C12)在恒河猴预防性治疗中的疗效.用TRES6治疗的所有四只动物在用AlphaSARS-CoV-2变体鼻口咽攻击后2天上呼吸道的病毒载量降低。挑战后2天开始,赋予对TRES6抗性的突变在两只恒河猴中占主导地位,两种动物都无法保持减少的病毒载量。与其在攻击当天较低的血清中和滴度一致,与TRES6相比,使用4C12进行预防在第2天抑制病毒载量的效率较低.然而,挑战一周后,4C12治疗动物下呼吸道的平均病毒载量低于TRES6组,并且在鼻或咽拭子的病毒分离株中未检测到赋予4C12耐药性的突变.因此,抗性的遗传障碍似乎是抗SARS-CoV-2单克隆抗体预防效果的关键参数。此外,呼吸道分泌物中的抗体浓度与血清中的抗体浓度的比较显示,与它们在上呼吸道分泌物中的出现相比,4C12抗体在呼吸道分泌物中的分布减少,并且抗体在支气管肺泡灌洗液中的出现延迟。IMPORTANCE单克隆抗体是预防和治疗急性病毒感染的有力工具。因此,它们是首批获得许可用于治疗严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)的治疗剂之一.通常,选择用于临床开发的抗体的主要标准是它们在细胞培养物中的中和效力。通过比较针对SARS-CoV-2的Spike蛋白的两种抗体,我们现在观察到,在细胞培养物中更有效地中和SARS-CoV-2的抗体在较小程度上抑制了受攻击的恒河猴的病毒载量。攻击病毒的突变体异常迅速出现,失去了对抗体的敏感性,被确定为抗体在恒河猴中功效降低的主要原因。因此,病毒对抗体抗性的遗传障碍也影响其功效。
    The potency of antibody neutralization in cell culture has been used as the key criterion for selection of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for clinical development. As other aspects may also influence the degree of protection in vivo, we compared the efficacy of two neutralizing monoclonal antibodies (TRES6 and 4C12) targeting different epitopes of the receptor binding domain (RBD) of SARS-CoV-2 in a prophylactic setting in rhesus monkeys. All four animals treated with TRES6 had reduced viral loads in the upper respiratory tract 2 days after naso-oropharyngeal challenge with the Alpha SARS-CoV-2 variant. Starting 2 days after challenge, mutations conferring resistance to TRES6 were dominant in two of the rhesus monkeys, with both animals failing to maintain reduced viral loads. Consistent with its lower serum neutralization titer at the day of challenge, prophylaxis with 4C12 tended to suppress viral load at day 2 less efficiently than TRES6. However, a week after challenge, mean viral loads in the lower respiratory tract in 4C12-treated animals were lower than in the TRES6 group and no mutations conferring resistance to 4C12 could be detected in viral isolates from nasal or throat swabs. Thus, genetic barrier to resistance seems to be a critical parameter for the efficacy of prophylaxis with monoclonal antibodies against SARS-CoV-2. Furthermore, comparison of antibody concentrations in respiratory secretions to those in serum shows reduced distribution of the 4C12 antibody into respiratory secretions and a delay in the appearance of antibodies in bronchoalveolar lavage fluid compared to their appearance in secretions of the upper respiratory tract.IMPORTANCEMonoclonal antibodies are a powerful tool for the prophylaxis and treatment of acute viral infections. Hence, they were one of the first therapeutic agents licensed for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Oftentimes, the main criterion for the selection of antibodies for clinical development is their potency of neutralization in cell culture. By comparing two antibodies targeting the Spike protein of SARS-CoV-2, we now observed that the antibody that neutralized SARS-CoV-2 more efficiently in cell culture suppressed viral load in challenged rhesus monkeys to a lesser extent. Extraordinary rapid emergence of mutants of the challenge virus, which had lost their sensitivity to the antibody, was identified as the major reason for the reduced efficacy of the antibody in rhesus monkeys. Therefore, the viral genetic barrier to resistance to antibodies also affects their efficacy.
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  • 文章类型: Journal Article
    CD99被证明是T急性淋巴细胞白血病(T-ALL)抗体治疗的潜在靶标。通过某些单克隆抗体(mAb)连接CD99诱导T-ALL凋亡。然而,在抗CD99mAb参与后导致T-ALL凋亡的分子基础仍然难以捉摸。在这项研究中,使用我们产生的抗CD99单克隆抗体克隆MT99/3(单克隆抗体MT99/3),mAbMT99/3接合强烈诱导T-ALL细胞系凋亡,但不是在非恶性外周血细胞。通过转录组分析,在mAbMT99/3结扎,13个凋亡相关基因,包括FOS,TNF,FASLG,BCL2A1,JUNB,SOCS1,IL27RA,PTPN6,PDGFA,NR4A1,SGK1,LPAR5和LTB,显着上调。然后,由mAbMT99/3识别的CD99的表位在CD99的残基60-70处被鉴定为VDGENDDPRPP,这从未被报道过。据我们所知,这是在T-ALL中使用抗CD99mAb进行的第一个转录组数据。这些发现为CD99与T-ALL的凋亡有关提供了新的见解。与mAbMT99/3诱导凋亡相关的新表位和凋亡相关基因的鉴定可以作为T-ALL的新治疗靶标。抗CD99mAb克隆MT99/3可能是进一步开发用于T-ALL疗法的治疗性抗体的候选者。
    CD99 was demonstrated to be a potential target for antibody therapy on T-acute lymphoblastic leukemia (T-ALL). The ligation of CD99 by certain monoclonal antibodies (mAbs) induced T-ALL apoptosis. However, the molecular basis contributing to the apoptosis of T-ALL upon anti-CD99 mAb engagement remains elusive. In this study, using our generated anti-CD99 mAb clone MT99/3 (mAb MT99/3), mAb MT99/3 engagement strongly induced apoptosis of T-ALL cell lines, but not in non-malignant peripheral blood cells. By transcriptome analysis, upon mAb MT99/3 ligation, 13 apoptosis-related genes, including FOS, TNF, FASLG, BCL2A1, JUNB, SOCS1, IL27RA, PTPN6, PDGFA, NR4A1, SGK1, LPAR5 and LTB, were significantly upregulated. The epitope of CD99 recognized by mAb MT99/3 was then identified as the VDGENDDPRPP at residues 60-70 of CD99, which has never been reported. To the best of our knowledge, this is the first transcriptome data conducted in T-ALL with anti-CD99 mAb engagement. These findings provide new insights into CD99 implicated in the apoptosis of T-ALL. The identification of a new epitope and apoptosis-related genes that relate to the induction of apoptosis by mAb MT99/3 may serve as a new therapeutic target for T-ALL. The anti-CD99 mAb clone MT99/3 might be a candidate for further development of a therapeutic antibody for T-ALL therapy.
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  • 文章类型: Journal Article
    治疗或预防病毒感染的新疗法至关重要,正如最近在COVID-19大流行期间观察到的那样。这里,我们提出了一种基于单克隆抗体的治疗策略,该抗体阻断宿主受体Siglec-1/CD169与嵌入病毒包膜的神经节苷脂之间的特异性相互作用.抗体基于其高特异性是治疗传染病的绝佳选择,强靶向亲和力,毒性相对较低。通过一个人性化的过程,我们优化了单克隆抗体以消除序列缺陷,并进行了生物物理鉴定.我们证明它们保持其阻断病毒进入骨髓细胞的能力。如果我们要最大限度地努力开发新的治疗策略,那么在发现阶段的这些分子改进是关键。针对CD169的人源化单克隆抗体为治疗由含有神经节苷脂的包膜病毒引起的感染提供了新的机会,这对人类健康构成了持续的威胁。与当前结合感染性颗粒上抗原的中和抗体相反,我们的抗体可以防止几种类型的包膜病毒与宿主细胞相互作用,因为它们靶向宿主CD169蛋白,从而成为一种潜在的泛抗病毒治疗。
    New therapies to treat or prevent viral infections are essential, as recently observed during the COVID-19 pandemic. Here, we propose a therapeutic strategy based on monoclonal antibodies that block the specific interaction between the host receptor Siglec-1/CD169 and gangliosides embedded in the viral envelope. Antibodies are an excellent option for treating infectious diseases based on their high specificity, strong targeting affinity, and relatively low toxicity. Through a process of humanization, we optimized monoclonal antibodies to eliminate sequence liabilities and performed biophysical characterization. We demonstrated that they maintain their ability to block viral entry into myeloid cells. These molecular improvements during the discovery stage are key if we are to maximize efforts to develop new therapeutic strategies. Humanized monoclonal antibodies targeting CD169 provide new opportunities in the treatment of infections caused by ganglioside-containing enveloped viruses, which pose a constant threat to human health. In contrast with current neutralizing antibodies that bind antigens on the infectious particle, our antibodies can prevent several types of enveloped viruses interacting with host cells because they target the host CD169 protein, thus becoming a potential pan-antiviral therapy.
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  • 文章类型: Journal Article
    可变剪接(AS)是一种重要的分子生物学机制,由复杂的机制调节,涉及大量的顺式和反式作用元件。此外,AS是组织特异性的,在各种病理中发生改变,包括传染性,炎症,和肿瘤疾病。最近开发的免疫肿瘤疗法包括单克隆抗体(mAb)和嵌合抗原受体(CAR)T细胞靶向,其中,免疫检查点(ICP)分子。尽管已经证明了治疗上的成功,只有有限数量的患者从这些治疗中获得了长期获益,观察到肿瘤实体相关的差异缓解率.有趣的是,由AS产生的常见免疫治疗靶标的剪接变体能够完全逃脱和/或降低基于mAb和/或CAR的肿瘤免疫疗法的功效。因此,治疗前对肿瘤标本中靶向分子的剪接模式的分析可能有助于纠正分层,从而通过抗体组选择和抗体剂量增加治疗成功率。此外,某些剪接因子的表达与患者的预后有关,从而突出了他们推定的预后潜力。解决了悬而未决的问题,以将发现转化为临床应用。本文就AS在肿瘤疾病中的作用作一综述,它的分子机制,临床相关性,和治疗反应。
    Alternative splicing (AS) is an important molecular biological mechanism regulated by complex mechanisms involving a plethora of cis and trans-acting elements. Furthermore, AS is tissue specific and altered in various pathologies, including infectious, inflammatory, and neoplastic diseases. Recently developed immuno-oncological therapies include monoclonal antibodies (mAbs) and chimeric antigen receptor (CAR) T cells targeting, among others, immune checkpoint (ICP) molecules. Despite therapeutic successes have been demonstrated, only a limited number of patients showed long-term benefit from these therapies with tumor entity-related differential response rates were observed. Interestingly, splice variants of common immunotherapeutic targets generated by AS are able to completely escape and/or reduce the efficacy of mAb- and/or CAR-based tumor immunotherapies. Therefore, the analyses of splicing patterns of targeted molecules in tumor specimens prior to therapy might help correct stratification, thereby increasing therapy success by antibody panel selection and antibody dosages. In addition, the expression of certain splicing factors has been linked with the patients\' outcome, thereby highlighting their putative prognostic potential. Outstanding questions are addressed to translate the findings into clinical application. This review article provides an overview of the role of AS in (tumor) diseases, its molecular mechanisms, clinical relevance, and therapy response.
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  • 文章类型: Journal Article
    尽管在健康疫苗接种者中,2019年严重冠状病毒病(COVID-19)和与COVID-19相关的住院通常是可以预防的,免疫抑制患者对COVID-19疫苗的免疫原性反应较差,感染SARS-CoV-2和住院的风险仍然很高.此外,单克隆抗体治疗受到已经连续逃脱中和的新型SARS-CoV-2变体的出现的限制。在这种情况下,有兴趣了解从自然感染SARS-CoV-2和接种SARS-CoV-2疫苗(“vax-plasma”)的人收集的COVID-19恢复期血浆相关的临床益处。因此,我们报告了386例诊断为COVID-19并接受当代COVID-19特异性治疗的免疫功能低下门诊患者(标准治疗组)和一个亚组的临床结局,这些亚组还接受了高滴度COVID-19恢复期血浆的伴随治疗(vax血浆组),特别关注住院率.vax血浆组的总住院率为2.2%(225例患者中的5例),标准治疗组为6.2%(161例患者中的10例),相对风险降低65%(P=0.046)。未接种疫苗的患者的疗效证据不能从这些数据推断,因为94%(386名患者中的361名)的患者接种了疫苗。在接种免疫抑制和COVID-19疫苗的患者中,在COVID-19特异性疗法中添加vax血浆或非常高滴度的COVID-19恢复期血浆可降低疾病进展导致住院的风险。重要的SARS-CoV-2演变,新的关注变种(VOCs)已经出现,逃避可用的抗尖峰单克隆抗体,特别是在免疫抑制患者中。然而,高滴度的COVID-19恢复期血浆由于其广谱免疫调节特性,继续对VOC有效。因此,我们报告了386例接受COVID-19特异性治疗的免疫功能低下门诊患者的临床结局,其中一个亚组也接受了疫苗强化的恢复期血浆治疗.我们发现,在免疫受损的COVID-19门诊患者中,给予疫苗加强的恢复期血浆与住院发生率显着降低相关。我们的数据增加了当代数据,提供了支持高滴度恢复期血浆作为免疫功能低下患者的抗体替代疗法的临床实用性的证据。
    Although severe coronavirus disease 2019 (COVID-19) and hospitalization associated with COVID-19 are generally preventable among healthy vaccine recipients, patients with immunosuppression have poor immunogenic responses to COVID-19 vaccines and remain at high risk of infection with SARS-CoV-2 and hospitalization. In addition, monoclonal antibody therapy is limited by the emergence of novel SARS-CoV-2 variants that have serially escaped neutralization. In this context, there is interest in understanding the clinical benefit associated with COVID-19 convalescent plasma collected from persons who have been both naturally infected with SARS-CoV-2 and vaccinated against SARS-CoV-2 (\"vax-plasma\"). Thus, we report the clinical outcome of 386 immunocompromised outpatients who were diagnosed with COVID-19 and who received contemporary COVID-19-specific therapeutics (standard-of-care group) and a subgroup who also received concomitant treatment with very high titer COVID-19 convalescent plasma (vax-plasma group) with a specific focus on hospitalization rates. The overall hospitalization rate was 2.2% (5 of 225 patients) in the vax-plasma group and 6.2% (10 of 161 patients) in the standard-of-care group, which corresponded to a relative risk reduction of 65% (P = 0.046). Evidence of efficacy in nonvaccinated patients cannot be inferred from these data because 94% (361 of 386 patients) of patients were vaccinated. In vaccinated patients with immunosuppression and COVID-19, the addition of vax-plasma or very high titer COVID-19 convalescent plasma to COVID-19-specific therapies reduced the risk of disease progression leading to hospitalization.IMPORTANCEAs SARS-CoV-2 evolves, new variants of concern (VOCs) have emerged that evade available anti-spike monoclonal antibodies, particularly among immunosuppressed patients. However, high-titer COVID-19 convalescent plasma continues to be effective against VOCs because of its broad-spectrum immunomodulatory properties. Thus, we report clinical outcomes of 386 immunocompromised outpatients who were treated with COVID-19-specific therapeutics and a subgroup also treated with vaccine-boosted convalescent plasma. We found that the administration of vaccine-boosted convalescent plasma was associated with a significantly decreased incidence of hospitalization among immunocompromised COVID-19 outpatients. Our data add to the contemporary data providing evidence to support the clinical utility of high-titer convalescent plasma as antibody replacement therapy in immunocompromised patients.
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  • 文章类型: Journal Article
    基于单克隆抗体的治疗剂在治疗多种人类疾病方面取得了显著成功。然而,传统的全身给药方法在靶组织渗透性不足方面有局限性,高成本,重复管理,等。已经开发了新技术来解决这些限制并进一步增强抗体治疗。通过呼吸道局部抗体递送,胃肠道,眼和血脑屏障在增加局部浓度和克服屏障方面显示出有希望的结果。从质粒DNA表达的核酸编码抗体,病毒载体或mRNA递送平台还提供优于重组蛋白的优势,如持续表达,快速发作,和更低的成本。这篇综述总结了抗体递送方法的最新进展,并重点介绍了具有扩大抗体治疗应用潜力的创新技术。
    Monoclonal antibody-based therapeutics have achieved remarkable success in treating a wide range of human diseases. However, conventional systemic delivery methods have limitations in insufficient target tissue permeability, high costs, repeated administrations, etc. Novel technologies have been developed to address these limitations and further enhance antibody therapy. Local antibody delivery via respiratory tract, gastrointestinal tract, eye and blood-brain barrier have shown promising results in increasing local concentrations and overcoming barriers. Nucleic acid-encoded antibodies expressed from plasmid DNA, viral vectors or mRNA delivery platforms also offer advantages over recombinant proteins such as sustained expression, rapid onset, and lower costs. This review summarizes recent advances in antibody delivery methods and highlights innovative technologies that have potential to expand therapeutic applications of antibodies.
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  • 文章类型: Journal Article
    恢复期血浆(CP)在大流行的早期成为COVID-19的潜在治疗方法。虽然住院患者的疗效一直不佳,CP在疾病的第一阶段可能是有益的。尽管出现了多个新的变体,没有试验涉及CP变异特异性抗体滴度的分析.
    我们招募了在症状发作后10天内住院的COVID-19患者,采用双盲方法,以1:1:1的比例随机分配给他们接受200ml恢复期血浆,其中针对祖先菌株(武汉样变体)的中和抗体(NAb)滴度高(HCP)或低(LCP)滴度或安慰剂。主要终点包括插管,皮质类固醇治疗症状加重,和安全性评估为严重不良事件。对于预先计划的临时分析,根据输注CP'sNAb滴度与感染受者的变异体,即同源HCP(hHCP)或LCP(hLCP)的滴度,对患者进行重新分组.
    57名患者中,18收到HCP,19个LCP和20个安慰剂,所有小组都比计划的要小。主要终点没有发现显著差异。在临时分析中,HHCPrecipients需要的呼吸支持明显减少,与接受hLCP(9/23;39.1%)或安慰剂(8/20;40%)相比,似乎给予皮质类固醇的频率更低(1/14;7.1%),(p=0.077)。
    我们的双盲,对于早期住院的COVID-19患者,安慰剂对照的CP治疗试验的效力仍然不足,无法得出任何确切的结论。有趣的是,然而,通过同源-接受者\'变体特异性-CP滴度重组建议对hHCP的益处。我们鼓励对正在进行/以前的大型CP研究进行类似的重新分析。
    ClinTrials.gov标识符:NCT0473040。
    UNASSIGNED: Convalescent plasma (CP) emerged as potential treatment for COVID-19 early in the pandemic. While efficacy in hospitalised patients has been lacklustre, CP may be beneficial at the first stages of disease. Despite multiple new variants emerging, no trials have involved analyses on variant-specific antibody titres of CP.
    UNASSIGNED: We recruited hospitalised COVID-19 patients within 10 days of symptom onset and, employing a double-blinded approach, randomised them to receive 200 ml convalescent plasma with high (HCP) or low (LCP) neutralising antibody (NAb) titre against the ancestral strain (Wuhan-like variant) or placebo in 1:1:1 ratio. Primary endpoints comprised intubation, corticosteroids for symptom aggravation, and safety assessed as serious adverse events. For a preplanned ad hoc analysis, the patients were regrouped by infused CP\'s NAb titers to variants infecting the recipients i.e. by titres of homologous HCP (hHCP) or LCP (hLCP).
    UNASSIGNED: Of the 57 patients, 18 received HCP, 19 LCP and 20 placebo, all groups smaller than planned. No significant differences were found for primary endpoints. In ad hoc analysis, hHCPrecipients needed significantly less respiratory support, and appeared to be given corticosteroids less frequently (1/14; 7.1%) than those receiving hLCP (9/23; 39.1%) or placebo (8/20; 40%), (p = 0.077).
    UNASSIGNED: Our double-blinded, placebo-controlled CP therapy trial remained underpowered and does not allow any firm conclusions for early-stage hospitalised COVID-19 patients. Interestingly, however, regrouping by homologous - recipients\' variant-specific - CP titres suggested benefits for hHCP. We encourage similar re-analysis of ongoing/previous larger CP studies.
    UNASSIGNED: ClinTrials.gov identifier: NCT0473040.
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  • 文章类型: Journal Article
    部分原因是种族差异和临床研究中代表性不足,Black多发性骨髓瘤患者的最佳治疗方法尚不明确.按种族对GRIFFIN的最终分析表明,与单独的RVd相比,在来那度胺/硼替佐米/地塞米松(RVd)中添加达雷木单抗(D)可在符合黑人和白人移植资格的新诊断患者中提供临床益处。然而,黑人患者更有可能因治疗引起的不良事件而停用≥1种药物。总之,这些研究结果表明,在黑人和白人患者中使用D-RVd一线治疗是有益的,并强调了所有患者获得公平治疗的重要性.
    Due in part to racial disparities and underrepresentation in clinical studies, optimal therapies for Black patients with multiple myeloma remain undefined. This final analysis of GRIFFIN by race showed that the addition of daratumumab (D) to lenalidomide/bortezomib/dexamethasone (RVd) provides clinical benefit among both Black and White transplant-eligible newly diagnosed patients compared with RVd alone. However, Black patients were more likely to discontinue ≥1 drug due to treatment-emergent adverse events. In summary, these findings suggest a benefit of D-RVd front-line therapy among Black and White patients and underscore the importance of equitable treatment access for all patients.
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