Note: Descriptions are shown in the official language in which they were submitted.
WO92/2103] PCT/EP91/00881
6~S
`. 1.
Proc~dure for detecting and preparing anti-IgE
autoantibodies and u~e of thPse antibodies as active
agents in diagnostic and therapeutic compositions
The present invention concerns a met:hod for
aetecting anti-IgE autoantibodiec in bodyf'uids, z ~ethod
for preparing auto-anti-IgE antibodies and the use of
these antibodies for diagnostic and therapeutic purposes.
The existence of antibodies directed against
distinct immunoglobulin isotypes is well documented. For
io example, anti-IgE autoantibodies have been described as
rheumatoid factors and have been associated with disease
( Magnusson C.G.M., Vaerman J.P., Int.Arch.Allergy appl.
Immunol. 79(1986), 149, Stevens W.J., Bridts C.H., J.
Allergy clin. Immunol., 73(1984), 276, Iganas M.,
Johansson S.GØ, Bennich H. ,Int. Archs. Allergy
Appl.Immunol. 65(1981), 51).
Anti-IgE~autoantibodies were first described in
1972 ~Williams R.C., Griffith R.W., Emmons J.D., Field
R.C., ~.Clin.Invest: 51(1972), 955-1003). Later such
specific anti-IgE autoantibodies were reported in
conjunction with different atopic disorders (Nawata Y.,
Koike T., Hosokawa H., Tomoika H. Yoshida S., J Immunol.
135(1985), 478; Nawata Y. Koike T., Yanagisawa T.,
Iwamoto I. Itaya T., Yoshida S., Tomioka H., Clin.Exp.
Immunol. 58(1984), 348; Koike T., Nawata Y., Tsutsumi A.,
Tomoika H., Allergy Today 2(1987), 4i and Gruber B.L.,
Baeza M.L., Marchese M.J., Agnello V., Xaplan A.P., J,
Invest. Dermatol. 90(1988), 213) as well as in non-atopic
diseases with elevated serum IgE levels (Stadler B.M.,
Nakajima K., Yang X., De Weck A.L., Int. Arch. Allergy
Appl. Immunol. 88(1989) 206-208). However, high levels
of anti-IgE-autoantibodies were also encountered in
normal lnduviduals (Stadler BoM~ ~ Nakajima K., Yang X.,
De Weck A.L., Int. Arch. Allergy Appl. Immunol. 88(1989);
WO92/21031 PCT/EP91/008~1
~,Z Q8,~6 ~ 5 2 1-^
206-208, Wilson P.B., Fairfleld J.E., Beech N., Int.
Archs. Allergy Appl. Immunol. 84(1987) 198).
In in-vitro experiments anti-IgE-autoantibodies
have been shown to trigger histamine release from human
basophils, tissue mast cells and passively sensitized
human bone marrow cells (Marone G., Casolaro V.,
Paganelli R., Quinti I., J. Invest. Dermatol., 93(1989)
246-252; Quinti I., Brozek C., Wood N., Geha R.S., Leung
D.Y.M., ~. Allergy Clin. Immunol. 77(1986),586-594).
However, in other instances, anti-IgE autoantibodies
failed to trigger histamine release from blood basophils
(Nakajima K., de Wec~ A.L., Stadler B.M., Allergy
44(1989), 187-191; Kemeny D.M., Tomoika H., Tsutsu~i A.,
Koike T., Lessof M.H., Lee T.H., Clin. Exper. Allergy
1~ 20(1990), 67-69; Devey M.E., Wilson D.V., Wheeler A.W.,
Clin. Allergy 6(1976), 227-236). The pathophysiological
role of anti-IgE autoantibodies in allergic diseases has
remained unclear up to now, essentially because the
methods used to detèct them, such as ultracentrifugation, ;
are technically difficult and not suitable for large
scale investigations. Accordingly, no clear picture has
em`erged yet from literature about the harmful or possible
beneficial role of anti-IgE-autoantibodies in humans.
The object of the present invention is thus to
provide a simple and reliable method for a quantitative
detection of anti-IgE-autoantibodies.
An object of the present invention is also a
method for distinction of functional categories of human
anti-IgE-autoantibodies for an assessment of their
function in ~llergic and other diseases associated with
anti-IgE-autoantibodies.
Another object of the present invention is a
method for the selection of human plasmas comprising
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WO92/21031 PCT/EP91/OO~X1
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, 3
anti-IgE-autoantibodies being useful for preparing
therapeutic agents against allergic and other IgE
associated diseases.
Another object of the present invention consists
- in pro~iding a method for purification of ant -IgE
autoantibodies having specific properties.
Another object of the present invention is the
in-vivo production of selected anti-IgE-autoantibodies of
desired properties by active immunisation by using
selected recombinant IgE fragments.
The present invention comprises the subjects
according to the definition in the appended claims.
It was found that auto-anti-IgE antibodies can be
detected either in free form or in the form of IgE-IgG
complexes. Their fine specifity can be located with the
use of recombinant IgE fragments
The invention is illustrated by the appended
figures mentioned below and described in detail by the
following Examples, concerning only special embodiments
of the invention.
Fig. la shows the principle of a direct assa~ for
detection of anti-IgE antibodies.
Fig. lb shows the principle of a sandwich assay
for the detection of IgE/anti-IgE autoantibody immune
complexes.
Fig. lc shows the principle of a competitive
assay for deternlining the specifity of anti-IgE
autoantibodies.
WO92/21031 PCT/EP91/00~1
6~&~S 4 ! . .
Fig 2. is a diagram corresponding to Table ~
which shows the intradermal reaction of Rh monkey to
anti-IgE antibodies.
Fig. 3 is a diagram corresponding to Table 5
showing the effect of various human sera containing
various amounts of anti-IgE antibodies on histamine
release induced by Le27 moAb anti-IgE on "stripped" human
basophils resensitized by rIgE (CH l-~).
Fig. 4 is a diagram showing the effect of various
sera containing various amounts of anti-IgE antibodies on
Rhesus skin reaction to Le 27 moAb anti-IgE.
Fig. 5 is a diagram showing the effect of human
anti-IgE antibodies (pool) purified by passage on
immunosorbent columns made of various rIgE (CH 1-4 or CH
3-4) on Le 27 induced skin reaction in Rhesus monkeys.
Fig. 6 is a diagramm showing the effect of human
serum after treatment with mixtures of allergen/IgG anti-
allergen (postr.) versus pretreatment serum (pretr,) and
serum of a classically desensitized patient on histamine
release induced by allergen.
Fig. 7 is a diagram showing the effect of serum
of Rhesus immunized with rIgE (Immun.) versus
pretreatment (pretr.) serum and serum of Rhesus immunized
with allergen on the histamine release induced by
allergen
~ xample 1
This is a test with a plastic strip coated with
nitrocellulose which uses purified IgE myelomas, chimeric
IgE antibodies, recombinant IgE fragments and/or IgE
synthetic peptides and monoclonal anti-IgE antibodies in
., . . ~, , : , .
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W~92/21031 PCT/EP91/00881 ~,
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order to assess the presence and fine specifity of auto-
anti IgE antibodies in direct assay (Fig. la).
In this type of assay, IgE materials are
deposited on the solid phase material, usually in the
5 form of a l to 2 ~l dct, at a concentration varying
between lO0 to lO00 ~g/ml. Following blocking by neutral
protein of the adjacent solid phase areas, the strip
(consisting preferably from PVC coated with
nitrocellulose) is incubated with the serum sample to be
investigated at a dilution of l:l to l:lO for a period of
l - 18 h. After suitable washings, the strip is
incubated with a horse radish peroxidase (HRP) labelled
monoclonal anti-IgG antibody, which is non-crossreactive
with IgE and/or any of the IgE materials dotted. When
using monoclonal antibodies against IgG subclasses (e.g.
IgGl, 2, 3, 4) or other immunoglobulin classes (e.g. A,
M), the various classes of Ig anti-IgE can be deter~lned.
This second incubation is usually for a period of l to 2
h and is followed by incubation with chromogen. In the
case of HRP labelling, the preferred chromogen is a
mixture of 2-4 chloronaphtol and hydrogen peroxide. The
ensuing blue dots may be measured quantitatively by a
suitable refractometer.
An example of direct detection of IgG auto-anti-
IgE antibodies in various samples or plasmas is shown inTable l.
Example 2
This is a nitrocellulose/PVC strip test which
uses various monoclonal anti-IgE antibodies to assess the
presence of auto-anti-IgE antibodies in the form of
immune complexes, in a sandwich assay (Fig lb).
In that case, the materials dotted are well
defined monoclonal anti-IgE antibodies specific for
WO92/2103~ PCT/EP91/00881
~ 8 ~6 ~ S 6
various epitopes on the IgE molecule. Following
incubation with serum samples to be investigated, whereby
free IgE and IgE contained in immune complexes will be
captured, a second incubation with HRP-labelled
monoclonal anti-IgG will detect IgE/IgG anti-IgE immune
complexes. Timing and quantitative evaluation of
reactions are essentially like in the Example l above.
An example of detection of such IgG anti-IgE
immune complexes in serum samples and plasma pools is
shown in Table l.
Example 3
This is a nitrocellulose/PVC strip test, to
detect the fine specifity of anti-IgE antibodies, in free
or complexed form, using IgE myelomas, IgE recombinant
peptides and anti-IgE monoclonal antibodies in
competitive assays (Fig lc).
In this procedure, IgE myelomas and/or
recombinant IgE peptides are first dotted on the solid
phase. Following incubation with the serum sample to be
investigated for 2 to 18 h and suitable washings, a
second incubation occurs with selected HRP-labelled Anti-
IgE monoclonal antibodies. If the serum sample comprises
IgE antibodies of the same epitope specifity as the HRP
labelled anti-IgE antibody, the reaction will be
inhibited. At present, at least five different epitopes
have been identified on the IgE molecule in this way.
An example of detection of auto-anti-IgE
antibodies with variable specifities in human serum is
given in Table 2. This procedure enables identification
of patterns of specificities, which may be linked to some
specific IgE functions and form the basis of selection
for immunoglobulin preparations of therapeutic use. Such
identification procedures allow the preparation o~ anti-
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WO92/21031 PCT/EP91/008~1 1
~ 7 ~ 6~5
allergic human auto-anti-IgE antibodies being active in
blocking allergic diseases.
Besides their immunochemical detection and fine
specifity determination by the above-described
techniques, auto-anti-IgE ~ntibodies can ~lso be
investigated by functional assays, such as the release of
histamine and/or sulfido leukotrienes from blood
basophils, the effect on the binding of IgE to
lymphocytes, the killing effect on IgE bearing B
lymphocytes and the effect on IgE synthesis.
In doing so it was discovered that the auto-anti-
IgE antibodies have widely different functional
properties and that these functions are linked to the
fine specifity, to the avidity and possibly also to the
l~ class or subclass of auto-anti-IgE antibodies produced.
The conjunction of these various assays has demonstrated
indeed that some auto-anti-IgE antibodies play an
important pathological role, while other appears on the
contrary to be beneficial.
The above-described immunochemical assays provide
a rational and efficient basis for different therapeutic
approaches and development of corresponding therapeutic
products, as illustrated below.
- Depending on their content of auto-anti-IgE
antibodies, appropriate plasmas can be selected being
suitable for preparing anti-allergic immunoglobulin
preparations. In such a procedure, plasmas obtained by
blood donation or plasmapheresis are screened for their
content in anti-IgE free or complexed antibodies by the
above-described immunochemical tests: According ta their
content in such antibodies and their specifity, they are
pooled and tested also for some functional properties
(e.g. histamine release). The selected plasmas are then
,
WO~/21031 ~ rr~ PCT/EP91/00881
.
~Q~366
processed for preparing of immunoglobulin fractions by
classical techniques in the art (e.g. alcohol fraction or
ion exchange chromatography).
Example 4
S Human plasmas obtained by plasmapheresis are
submitted to the Immunodot test for detection of anti-IgE
antibodies (Table 3) and/or sulfido leukotrienes. The
plasmas are also investigated for their capacity to
induce histamine release ~rom human basophils (Table 3).
The plasmas possessing no, low or high levels of anti-
IgE-antibodies and no or high histamine releasing
activity are pooled and immunoglobulin fractions prepared
by ion exchange chromatography. When tested on Rhesus
monkeys (Table 4 and the corresponding Fig. 2 ) by
intradermal injection, it can be seen that human
immunoglobulin preparations devoid of auto-anti-IgE
antibodies do not elicit allergic reactions. On the
contrary, auto-anti-IgE antibodies with anaphylactogenic
properties do so (Table 4). Some of the sera containing
anaphylactogenic and non anaphylactogenic anti-IgE
antibodies can inhibit the skin reaction induced in
Rhesus monXeys by murine monoclonal anti-IgE-ab Le 27
(Fig. 4).
When used on blood basophils in histamine release
assay, some sera or Ig preparations devoid of
anaphylactogenic anti-IgE antibodies will block the
effect of anaphylactogenic anti-IgE antibodies (Table 5
and the corres~onding Fig. 3 ). A similar inhibiting
effect of Ig preparations can be observed on the
immediate wheal and erythema skin reaction induced by
anaphylactogenic anti-IgE antibodies, demonstrating
thereby their therapeutic potential.
:. , . - : . ~ .
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WO92/21031 2~6~5 PCT/EP91/00881
Sheep anti-IgE antibodies directed against human
IgE have also the property to kill IgE-bearing cells
which express the IgE receptor (CD 23). Similarly, some
human anti-IgE antibodies possess similar potential in
vitro, presumably exerting thereby an inhibiting effect
on IgE synthesis in vivo.
Since the desired therapeutic properties of some
anti-IgE-antibodies are associated with their fine
specifity, which can be assessed by interaction with IgE
recombinant fragments and anti-IgE monoclonal antibodies,
as described above, it was attempted to obtain purified
immunoglobulin preparations of desired anti-IgE
specificity by passing selected plasmas over affinity
chromatography columns prepared wlth relevant IgE
recombinant fragments.
Example 5
Plasmas containing anti-IgE antibodies selected
by the Immunodot test described above are passed over
chromatography columns prepared with recombinant IgE-
fragments. The Ig preparations are then processedaccording to techniques well known in the art.
Such Ig preparations show in functional tests in
humans and monkeys (Fig. 5) the desired protective
properties, in preventing allergic reactions. Indeed,
the preparation of purified auto-anti-IgE antibodies
obtained from selected plasmapheresis and passed over
appropriate IgE recombinant peptide columns is able to
block his~amine release from leukocytes of allergic
patients challenged by allergen or anti-IgE. It is also
capable of blocking the histamine release from leukocytes
first 'istripped" of their own IgE by acid ~reatment,
reloaded with with recombinant IgE fragment and
challenged with anaphylactogenic anti-IgE monoclonal
WO9~/21031 PCT/EP91/00881
z~6~
k.~ .
antibodies (Table 5). It can inhibit in Rhesus monkeys
the skin reactions induced by murine monoclonal anti-IgE
Le 27 antibodies (Fig. 5).
Classically, IgG antibodies specific for
allergen, such as encountered spontaneously in some
highly allergic patients or raised by repeated injections
of allergen during hyposensitization therapy are
considered to be beneficial and to function in-vivo as
blocking antibodies (Devey M.E., Wilson D.V., Wheeler
A.W., Clin. Allergy 6(1976), 227-236; D~urup R., Malling
H.J., Soendergaard I., Weeke B., J. Allergy Clin.
Immunol. 76(1985), 46-55). It must be emphasized,
however, that the beneficial role of such antibodies is
disputed and that little correlation exists between the
level of IgG anti-allergen antibodies reached during
hyposensitization and the clinical benefit of that
treatment (Golden D.B.K., Meyers D.A., Kagey-Sobotka A., -
Valentine M.D., Lichtenstein L.M., J. Allergy clin.
Immunol. 69(1982), 489-493).
This has induced some authors to attempt another
approach, namely the use of anti-idiotypic immunization
(Saint-Remy J.M.R., Lebecque S.J., Lebrun P.M.,
Jacquemin M.G., Eur. J. Immunol. 18(1988), 1009-1014).
This consists in raising anti-allergen IgG antibodies in
2S patients, purifying such antibodies on allergen affinity
chromatography columns and reinjecting to the patient
with his own antibodies complexed in vitro with allergen
(US-A-4 740 371). This procedure has been claimed to
provide clinical benefit to various categories of
3~ allergic patients suffering ~rom IgE-associated diseases.
It was surprisingly ound t~at in fact the
majority of apparently allergen-specific IgG antibodies
isolated by suc~ procedure as passing through an allergen
affinity chromatography column are not allergen-specific
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WO92/21031 PCT/EPgl/008~1 ~
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IgG, as hitherto believed, but allergen-specific IgE
bound to IgG auto-anti-IgE.
In other words, immunization with IgG anti-IgE
complexed to allergen-specific IgE and allergen induces
in allergic patients the benefi ci21 immunologica' chang~s
associated with immunotherapy. Since, as seen above, the
functional effects of IgG auto anti-IgE may be very
different according to thelr fine specifity, it became
imperative to evaluate these therapeutic methods in terms
of specific anti-IgE-antibodies.
Example 6
Plasmas from hypersensitized patients are
selected on the basis of their apparent IgG specifity for
allergens (e.g. such as grass pollen), on the basis of
allergen-specific IgG tests and analyzed for the presence
of auto-anti-IgE antibodies.
Plasma pools rich or devoid of auto-anti-IgE
antibodies are used as source of immunoglobulin
preparations, which are then injected complexed with
Z0 allergen intradermally. In such a case, the preparation
of complexes between allegen-specific IgG in a plasma
pool and increasing doses of allergen follows an
empirical schedule dictated by the patient's sensitivity
to the corresponding allergen. For a grass pollen
mixture, a preferred schedule is given in Table 7. The
effect in allergenic individuals is assessed by
intradermal provocation and histamine release (Fig. 6).
As can be seen from this Figure, the effect of such a
treatment is to raise antibodies which will diminish the
reactivity of the patients and of their cells to
allergens.
This technique can in principle be used also for
fostering other immune responses which may rest upon IgE
WO92/21031 PCT/EP91/008~1
l2 ~,
activities, such as the immune defense against some
parasites. The presence of blocking antibodies fo~ IgE
has been for example described in filiarosis.
Therefore active immunization with IgE
recombinant fragments, in order to raise beneficial anti-
IgE antibodies in allergic patients (IgE-vaccine) becomes
possible.
Since it was found, as described above, that some
of the naturally occuring anti-IgE-antibodies are
beneficial in allergic patients, and that the benefit is
associated with fine specifity for some IgE epitopes, it
can be attempted to raise similar anti-IgE antibodies
actively, by immunization with appropriate IgE fragments,
which would contain only the epitopes associated with
with a beneficial anti-IgE response.
Accordingly, allergen complexed IgE, recombinant
IgE or fragments of IgE prepared by recombinant
techniques and selected for their association with
beneficial anti-IgE are brought in suitable form for
immunization and injected into experimental animals.
Anti-IgE antibodies of the desired specifity having the
desired blocking anti-allergic activity can be produced
actively.
Example 7
Recombinant IgE peptides of various sizes and
encompassing various domains of the IgE heavy chain are
produced according to combinations of procedures known in
the art.
These fragments can be used as well for
diagnostic purposes, in establishing Immunodot assays for
detection of auto-anti-IgE antibodies, as in purifying
these antibodies by affinity chromatography columns.
" '
r ~ Z~ 8~605 P CT/ EP91/00881
: 13
In the third form o:E application described here,
selected fragments containing the selected domains CHl-
~are used for immunization of rabbits and Rhesus monkeys.
As shown in Table 6, the antibodies raised have
che functional properties required, based on the -revious
analysis of similar but naturally occurring human auto-
anti-IgE antibodies. In particular, these antibodies are
able to recognize IgE and IgE fragments. These antlbodies
have also the capacity to block histamine release induced
by anaphylactogenic anti-IgE monoclonal antibodies or
allergen (Fig. 7).
Using not entirely purified recombinant IgE
peptides, a secondary effect of immunization with such
peptides is to increase the natural level of IgG
antibodies against E.coli. This may not as such be
undesirable, but can be avoided by using purer "IgE
vaccine".
WO 92/21031 2~$~ PCr/EP91/008Xl
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Table 2: Analysis of fine IgE epitope specificity by competit1ve assays
IRevealing anti-IgE monoclonal Antibodies HRP labelledl
¦Dotted¦ Serum ~loAb 1 ~ Ab 2 I ?~10Ab ~ I MoAb 4 1 ~ b 5 .MG~ 6 ¦
¦ IgE I sample ¦(~-CHl) ¦(Le27) ¦(B5w17) l(U-CH4) ~ -C~5) , 4E-;
¦IgE PSI None I Pos. I Pos. I POs. i POs. i POs. Pos.
I ¦ A(a-l) INegativel Pos. ¦ POs. I Pos. I Pos- Pos.
¦ ¦ B(a-2) I Pos. ¦Negativel Pos. I Pos. I Pos. i Pos.
¦D(a-1+3)INegativeI Pos ¦NegativeI Pos I Pos Pos
I ¦ E(a-Sj j Pos. I Pos. _ I Pos. I Pos. INegative~ Pos.
¦CH1-4 I None I Pos. I Pos. I Pos. I Pos. I Pos. Nec.
¦ ¦ A(a-l) INegativel Pos. I Pos. I PS. ! POS. Nec.
¦ ¦ B(a-2) I Pos. INegativel Pos. I Pos. , Pos. Nec.
¦ ¦ C(a-3) I Pos. ¦ Pos. ¦Negativel Pos. I Pos. i Nec.
¦ ¦D(a-1~3)lNegativel Pos. INegative! Pos I Pos. I Nec
¦ ¦ E(a-5) I Pos. I Pos. I Pos. I Pos. lNegativel Nes.
¦CH2-4 I None I Neg. I Pos. ~ Pos. I Pos. I Pos. Nea.
~a-l) I Neg. I Pos. Pos. I Pcs. I Pos. Nea.
¦¦ B(a-2) I Neg. jNegativel Pos. I Pos. I Pos. Nea.
¦¦ C~a-3) I Neg. I Pos. ¦Negativel Pos. i Pos. I Ne~.
¦¦D(a-1~3)l Neg. I Pos. INegativel Pos. I Pos. , Nec.
¦ ¦ _(a-5) I Neg- I Pos. I POs. I Pos. INegative' Neg.
¦ I A(a-l) I Neg I Neg I Pos. Pos I Pos , Nea
I I B(a-2) I Neg. I Neg. ~1- Pos Pos. I Pos. Ne-.
¦ ¦ C(a-3) I Neg. i Neg.~ INegativel Pos. I Pos. Ne5-
¦ ¦D(a-1+3)1 Neg. I Nea. INegativel Pos I Pos. i Nea.
E(a-5) I Neg. ¦ Nec. I POs. I Pos. INegative! Nec.
¦CH4 I None I Neg. ¦ Neg. ~ I Pos. I Ne5- ~ Neg.
¦ ¦ A(a-l) I Neg. ~ ~gr~t___g- I Pos. I Nea. i Nes.
¦ ¦ B(a-2) I Nea I Nea. I Neq. I Pos. ! Nea. ~ Neg.
I ¦ C(a-3) ~ Neg I Neg I Neg. ! Ps. I Neg. Nec.
¦ ¦D(a-1+3)1 Neg. ! Neg. I Neg. I Pos. Neg. , Neg. I
¦ ¦ E(a-5) I Neg. I Neg. I Neg. I Pos. I Neg. ! Ne5-
Neg.: Negative because epitope not present on IgE fragmen- otted
Negative: Negative due to interference with auto anti-IgE o- same
specificity
gE Epitopes 1-4 present on respecitve fragments
present between 3 and 4
6 conformational present only on total IgE
Sera A-E containing auto antl-IgE antibodies of various, sinsle or
mixed specificities
Table 2 Determination of fine epitope specificity of anti-IgE
antibodies by competitive assays
WO 92/21031 ~ 866~i 1 r; PCr/EP91/008X1
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WO 92/21031 ~ PCT/EP91/008Xl
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Table 4: Intradermal reactions of Rh monkeys to ant~-IgE antibodies
Vi34 I Vi30 ¦ Vi4 ! B62 ¦ 645 I VI14 I VI42 ¦ C87 ~ D84
IHistamine I 4.0 1 6.0 1 ?6-2 1 12.4 1 9~ 7 1 7-9 l~3-- l2 .
¦Le27 1 1.5 ¦ 4.0 1 12.8 I nd 1 2.9 1 ;.4 1 5,2 1 8,0 ! 9,8
IBSWl7 ¦ 0 ¦ 4.8 ¦9.7 ¦ nd ¦ 2.0 j 6.3 ¦ 2.6 ¦ 5.0 ¦ &-3
IPOO1 A ¦ 1.5 ¦ 6.0 ¦6.0 ¦ 6.0 1 0.8 1 3.7 1 0-6 ¦ 9.8 1 5.8 ¦
Pool B I 1.0 ¦ 2.0 14.3 ¦ 3.2 ¦ 2-2 1 '-9 j 0 ¦ 6.i ¦ 7-3 ¦
IPOO1 C I O I O IO 1 1.3 1 0 1 I ! 2.3 1 1.5 l
-
Table 5: Effect of various human sera containing various amounts
of anti-IgE antibodies on histamine release induced by
Le27 moAb anti-IgE on "stripped" human basophils
resensitized by rIgE(CHl-4)
% ~istamine Release upon add of Contents
Le27 ¦ Serum I Serum+Ee I Anti-IgE
I
¦Donor 1 ¦ 42-5 ¦ 4-7 1 8.9 ¦ 27.
Donor 2 ¦ 39.6 ¦ 24.5 ¦ 32.5 ¦ 35.4
Donor 3 ¦ 26.7 ¦ 13.7 1 14.5 ¦ 29.6 ¦
Donor 4 ¦ 28.9 ¦ 2.0 ¦ 8.7 ¦ 8.7
Donor 5 ¦ 35.4 ¦ 1.5 ¦ 32.4 ¦ 0.7
.
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Table 7: Schedule and amounts of allergen and antibody to beused as complexes for hyposensitization therapy
Week An~ibody* Allergen
(mcg) (ng)
0 0.02 - 0.06 4 - 16
2 0.04 - 0.16 8 - 32
4 0.08 - 0.32 16 - 64
6 0.16 - 0.64 32 - 128
8 0.32 - 1.28 64 - 256
0.64 - 2.56 128 - 512
12 1.28 - 5.12 256 - 1024
to be continued as maintenance dose every 2nd week for one year.
This schedule is only an example which may be modified according
to antibody and allergen s,renghts. In principle, enough anti-
body must be added to the allergen in order to neutralize it for
an in vitro allergen challenge of sensitized basophils and pre-
vent mediator release under such conditions.
As antibody are used allergen-specific i'IgG an~ibodies", which
contain as well antiallergen IgE complexed with IgG anti-IgE
autoantibodies.
: . . : . . .~:
