Effect of plasma exchange in accelerating natalizumab clearance and restoring leukocyte function

摘要: Background: Accelerating the clearance of therapeutic monoclonal antibodies (mAbs) from body may be useful to address uncommon but serious complications treatment, such as progressive multifocal leukoencephalopathy (PML). Treatment PML requires immune reconstitution. Plasma exchange (PLEX) accelerate mAb clearance, restoring function inhibited proteins and increasing number or leukocytes entering CNS. We evaluated efficacy PLEX in accelerating natalizumab (a therapy for multiple sclerosis [MS] Crohn disease) α4-integrin desaturation. Restoration leukocyte transmigratory capacity was using an vitro blood–brain barrier (ivBBB). Methods: Twelve patients with MS receiving underwent three 1.5-volume sessions over 5 8 days. Natalizumab concentrations saturation were assessed daily throughout times subsequent 2 weeks, comparing results same previous month. Peripheral blood mononuclear cell (PBMC) migration (induced by chemokine CCL2) across ivBBB a subset six without PLEX. Results: Serum reduced mean 92% baseline 1 week after ( p Conclusions: accelerated natalizumab, at below μg/mL, desaturation observed. Also, CCL2-induced transmigration increased Therefore, effective effector natalizumab-treated patients.