Transient Epstein-Barr virus reactivation in CD3 monoclonal antibody-treated patients

Blood. 2010 Feb 11;115(6):1145-55. doi: 10.1182/blood-2009-02-204875. Epub 2009 Dec 9.

Abstract

Here we report a unique situation in which an early and synchronized Epstein-Barr virus (EBV) reactivation was induced by a 6-day course of treatment with a humanized CD3-specific monoclonal antibody in patients with recent onset of type 1 diabetes. The virologic and immunologic analysis demonstrated that this reactivation was transient, self-limited, and isolated, associated with the rapid advent of an EBV-specific T-cell response. The anti-CD3 antibody administration induced short-lasting immunosuppression and minor yet clear-cut signs of T-cell activation that preceded viral reactivation. Early posttransplant monitoring of renal and islet allograft recipients showed that no comparable phenomenon was observed after the administration of full-dose immunosuppressive therapy. This EBV reactivation remains of no apparent clinical concern over the long term and should not preclude further development of therapeutic anti-CD3 antibodies. This phenomenon may also direct new research avenues to understand the still ill-defined nature of stimuli triggering EBV reactivation in vivo.

Publication types

  • Clinical Trial, Phase II
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • B-Lymphocytes / immunology
  • CD3 Complex / immunology*
  • DNA, Viral / genetics
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / therapy
  • Diabetes Mellitus, Type 1 / virology
  • Epstein-Barr Virus Infections / immunology
  • Epstein-Barr Virus Infections / therapy*
  • Epstein-Barr Virus Infections / virology
  • Flow Cytometry
  • Graft Survival / immunology*
  • Herpesvirus 4, Human / physiology*
  • Humans
  • Kidney Transplantation
  • Palatine Tonsil / cytology
  • Phenotype
  • Placebos
  • Polymerase Chain Reaction
  • T-Lymphocytes / immunology
  • Viral Load
  • Virus Activation

Substances

  • Antibodies, Monoclonal
  • CD3 Complex
  • DNA, Viral
  • Placebos