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       #Post#: 1187--------------------------------------------------
       (AAN) Alemtuzumab's immunosuppressive effect doesn't last more t
       han 48 months
       By: agate Date: April 23, 2016, 8:30 pm
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       Presented at the annual AAN conference in Vancouver, BC, in
       April 2016:
       [quote]S2.008 - Alemtuzumab Long Term Immunological Study: The
       Immunosuppressive Effect Does Not Last More Than 48 Months
       
       Luca Durelli,1Stefania De Mercanti,1Simona Rolla,2Angele
       Cucci,1Valentina Bardina,2Eleonora Cocco,3Anton Vladic,4Silva
       Soldo-Butkovic,5Mario Habek,4Ivan Adamec,4Pietro Annovazzi,6Dana
       Horakova,7Franco Novelli,2Marinella Clerico8
       1Orbassano, Italy, 2Torino, Italy, 3Cagliari, Italy, 4Zagreb,
       Croatia, 5Osijek, Croatia, 6Gallarate, Italy, 7Prague, Czech
       Republic, 8Orbassano (TO), Italy
       Disclosures
       L. Durelli: None. S. De Mercanti: None. S. Rolla: None. A.
       Cucci: None. V. Bardina: None. E. Cocco: None. A. Vladic: None.
       S. Soldo-Butkovic: None. M. Habek: None. I. Adamec: None. P.
       Annovazzi: ; Dr Annovazzi received personal compensation for
       consulting, speaking and serving on a scientific advisory board
       from Biogen Idec, Novartis and Teva pharmaceuticals. D.
       Horakova: ; Support for research activities from Biogen Idec. F.
       Novelli: None. M. Clerico: None.
       OBJECTIVE:
       Phenotypic and functional analysis of CD4+ T cell subsets and of
       immunologically relevant molecules mRNA serum levels after
       alemtuzumab in relapsing remitting multiple sclerosis(RRMS)
       patients: A four-year follow-up.
       BACKGROUND:
       Alemtuzumab induces a long-standing lymphopenia, particularly of
       T CD4+ subset, and it is highly effective in RRMS
       DESIGN/METHODS:
       Multicenter follow-up of 29 alemtuzumab-treated RRMS patients
       from 6 European sites in the CARE-MS I and CARE-MS II trials.
       Patients received two courses of alemtuzumab at month 0 and 12.
       Clinical and immunological evaluation were performed at months
       0, 6, 12, 18, 24, 36 and 48. The percentages of Treg, Th1 and
       Th17 cells in the peripheral blood mononuclear cells(PBMC) were
       evaluated by FACS analysis. mRNA levels of cytokines,
       chemokines, chemokine receptors and transcriptional factors with
       pro-inflammatory (IL-1β, IL-2, IL-6, IL-12, IL-17A, IL-17F,
       IL-21, IL-22, IL-23, IL-26, IFN-γ, Tbet, RORC, TNF-α,
       CCR3, CCR4, CCR5, CCR6, CXCR3, CXCL10, CCL20, VLA4) or
       anti-inflammatory function (IL-10, IL-27, TGF-β and FoxP3)
       were quantified by TaqManŽ low density array(TLDA) real-time
       polymerase chain reaction in whole blood. Treg suppressor
       activity on Myelin basic protein(MBP)-specific Th17 and Th1
       cells was assessed by IL-17 and IFN-γ ELISPOT on total PBMC
       and PBMC depleted of CD25highT cells.
       RESULTS:
       No patient received further alemtuzumab courses after the first
       two years. CD4+ lymphocyte percentage decreased and slowly
       returned to basal levels only at Month 48. Within this
       population, no significant variation was observed in Th1 and
       Th17 cells, with the exception of an increase of Th17 cells in
       patients with a documented relapse. Treg cells percentage and
       suppressive function significantly increased at Month 24 and
       returned to baseline levels within Month 48.
       CONCLUSIONS:
       The long-term follow-up of immune system reconstitution showed
       that alemtuzumab effects lasted not more that 48 months.
       Clinical and MRI follow-up could suggest the need for repeated
       alemtuzumab courses.[/quote]
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