Treatment of Rheumatoid Arthritis by Selective Inhibition of T-Cell Activation with Fusion Protein CTLA4Ig

Joel M. Kremer, René Westhovens, Marc Léon, Eduardo Di Giorgio, Rieke Alten, Serge Steinfeld, Anthony S. Russell, Maxime Dougados, Paul Emery, Isaac Nuamah,

New England Journal of Medicine · 2003 · 1.1K citations · 31 references

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Concepts

TL;DR

Rheumatoid arthritis requires new therapies; while current treatments target macrophage products, T cells also play a key role, and CTLA4Ig is the first costimulation blocker being evaluated. CTLA4Ig binds CD80/CD86 on antigen‑presenting cells, blocking CD28 engagement on T cells and preventing their activation. A preliminary study suggests CTLA4Ig may be effective for treating rheumatoid arthritis.

Abstract

Effective new therapies are needed for rheumatoid arthritis. Current therapies target the products of activated macrophages; however, T cells also have an important role in rheumatoid arthritis. A fusion protein — cytotoxic T-lymphocyte–associated antigen 4–IgG1 (CTLA4Ig) — is the first in a new class of drugs known as costimulation blockers being evaluated for the treatment of rheumatoid arthritis. CTLA4Ig binds to CD80 and CD86 on antigen-presenting cells, blocking the engagement of CD28 on T cells and preventing T-cell activation. A preliminary study showed that CTLA4Ig may be effective for the treatment of rheumatoid arthritis.

References

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