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Generation of anti-hirudin antibodies in heparin-induced thrombocytopenic patients treated with r-hirudin.
- Source :
-
Circulation [Circulation] 1999 Oct 05; Vol. 100 (14), pp. 1528-32. - Publication Year :
- 1999
-
Abstract
- Background: Hirudin is a small protein with strong thrombin inhibition that may be antigenic. The generation and disappearance of anti-hirudin antibodies were investigated in patients with heparin-induced thrombocytopenia who were treated with recombinant hirudin (r-hirudin) for >/=5 days.<br />Methods and Results: The IgA, IgE, IgG, and IgM isotypes of anti-hirudin antibodies were determined by ELISA before and after the start of r-hirudin therapy. A total of 56% of patients (13 of 23) developed >/=1 antibody isotype during therapy. No IgE antibodies were generated. IgA, IgG, and IgM antibodies were detected in 30% (7 of 23), 52% (12 of 23), and 17% (4 of 23) of patients, respectively. Four patients generated only IgG, 2 patients developed either IgM or IgG and IgM, 5 patients IgG and IgA, and 2 patients IgG, IgM, and IgA antibodies. IgM antibodies disappeared within 8 days of the cessation of r-hirudin. IgA and IgG antibodies disappeared within 1 year in all but 1 patient. Binding of purified IgG to r-hirudin in IgG antibody-positive patients (n=7) was demonstrated by competitive ELISA for r-hirudin. Of the 7 IgG antibody samples, 1 each neutralized or enhanced the anticoagulant activity of r-hirudin.<br />Conclusions: R-hirudin may be antigenic in patients with heparin-induced thrombocytopenia. More comprehensive investigations will be required to determine the biological relevance of this and to establish the antibody-generation pattern in other diseases.
- Subjects :
- Adult
Aged
Aged, 80 and over
Enzyme-Linked Immunosorbent Assay
Humans
Immunoglobulin G immunology
Immunoglobulin Isotypes blood
Middle Aged
Recombinant Proteins immunology
Thrombocytopenia chemically induced
Antibodies blood
Anticoagulants adverse effects
Antithrombins immunology
Heparin adverse effects
Hirudins immunology
Thrombocytopenia drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4539
- Volume :
- 100
- Issue :
- 14
- Database :
- MEDLINE
- Journal :
- Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 10510056
- Full Text :
- https://doi.org/10.1161/01.cir.100.14.1528