Anti-CD4 and anti-CD2 monoclonal antibody infusions in subjects with multiple sclerosis. Immunosuppressive effects and human anti-mouse responses

The immunologic responses to anti-T4 and anti-T11 mAb infusions were assessed in subjects with chronic progressive multiple sclerosis as part of phase I clinical studies. Eight subjects received five daily infusions (0.2 mg/kg/day) of either anti-T11 (CD2) or anti-T4 (CD4) murine mAb. It was found that in vivo anti-T cell mAb infusions specifically suppress in vitro measurements of the human immune response; anti-T11 mAb blocked T cell activation via the CD2 SRBC-binding protein, and anti-T4 mAb infusions abolished PWM-induced Ig synthesis without lysis of the CD4+ T cell subpopulations. With repeated infusions of the anti-T11 mAb in three subjects, anti-mouse antibodies were found in the circulation. Although the majority of human anti-mouse antibody was not isotype specific, significant anti-idiotypic-like activity was observed after repeated infusions in two of three subjects. The human anti-mouse antibodies were almost exclusively of the IgG isotype. The magnitude of the human anti-mouse response was significantly less after administration of either anti-T11 or anti-T4 as compared with anti-T12 mAb. Murine anti-T cell mAb can provide a specific, benign form of acute immunosuppression in humans. However, repeated administration of these reagents in more chronic diseases can result in anti-Id-like antibodies that block binding of the anti-T cell mAb to the T cell surface.