The IgE humoral response in OKT3-treated patients. Incidence and fine specificity

Transplantation
D AbramowiczM Goldman

Abstract

We recently described a case of anaphylaxis occurring at the time of retreatment with OKT3 of a renal allograft recipient in whom, for the first time, high anti-OKT3 IgE levels were documented. This led us to examine a large series of sera from 181 OKT3-treated patients to better define the frequency of IgE sensitization, its fine specificity (anti-isotypic and/or anti-idiotypic) and its relation to the appearance of IgG anti-OKT3 antibodies (Abs). Six patients out of the 181 assayed have developed anti-OKT3 IgE Abs as detected by ELISA. The earliest time of appearance of IgE anti-OKT3 Abs was 10 days after starting OKT3 (range, 10-25). The IgE response peaked by day 18 (range, 11-35) and had usually disappeared at 3 months after treatment. A more careful dissection of the fine specificity of the IgE response revealed that three of the four patients tested had developed an exclusive anti-idiotypic response. In the last patient, an anti-isotypic component was present since anti-OKT3 IgE Abs also reacted with control IgG2a, IgG2b, and IgG3 monoclonal antibodies. Importantly, anti-OKT3 IgE Abs were only detected in heavily sensitized patients also showing high titers of IgG specific Abs by ELISA (> or = 1/1000) as well as "blockin...Continue Reading

References

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Citations

Oct 7, 2006·The Journal of Pharmacology and Experimental Therapeutics·Andrew B NormanWilliam J Ball
Sep 18, 2007·Current Opinion in Allergy and Clinical Immunology·Paolo CampiPascal Demoly
Jan 29, 2011·Néphrologie & thérapeutique·Eric ThervetChristophe Legendre
Dec 20, 2007·Transplantation Proceedings·H SasakiT Takahashi
Jul 17, 2003·Current Opinion in Allergy and Clinical Immunology·Keith Lenchner, Leslie C Grammer

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Anaphylaxis

Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death.