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The humanized non-depleting anti-CD4 monoclonal antibody Tregalizumab (BT-061) is able to selectively activate the suppressive function of regulatory T cells and has been investigated up to phase 2b in clinical trials in patients suffering from rheumatoid arthritis (RA).
A pharmacokinetic-pharmacodynamic model, which is based on clinical data from RA and healthy subjects, used the cell surface CD4-down-modulation as marker of the antibodies' activity. This model surprisingly revealed a stronger effect of Tregalizumab in healthy subjects compared to RA patients. This thesis presents a series of experiments performed to understand this phenomenon.
To counteract oxidative stress, which is strongly associated with RA pathophysiology, the organism employs the small oxidoreductase thioredoxin-1 (Trx1). Therefore, augmented expression and secretion of Trx1 was seen in many studies the synovial fluid and plasma of RA patients. Moreover, the binding site of Tregalizumab is in close proximity to a disulfide bond in domain 2 (D2) of CD4, which is a known target for a reduction by Trx1. So, this thesis also evaluated the influence of Trx1 on binding of Tregalizumab to its target CD4.
With the experiments reported herein, it was possible to demonstrate that specific reduction of the D2 disulfide bond of CD4 by Trx1 led to diminished binding of Tregalizumab to recombinant human soluble CD4 (rh sCD4) and membrane-bound CD4 on T cells from a human leukemia cell line and peripheral blood mononuclear cells (PBMC). Moreover, the experiments revealed that this caused changes in the Tregalizumab-induced CD4 signalling pathway via the lymphocyte-specific protein tyrosine kinase p56Lck.
In summary, this thesis provides evidence that high Trx1 levels in RA patients compared to healthy subjects are a potential valid reason for diminished binding of Tregalizumab to CD4-positive T cells and offers an explanation for the observed decreased CD4 down-modulation in RA patients in comparison with healthy subjects. It emphasizes that binding of Tregalizumab is impaired in a particular way in RA patients.
Cross-sectional findings suggest that volumes of specific hippocampal subfields increase in middle childhood and early adolescence. In contrast, a small number of available longitudinal studies reported decreased volumes in most subfields over this age range. Further, it remains unknown whether structural changes in development are associated with corresponding gains in children’s memory. Here we report cross-sectional age differences in children’s hippocampal subfield volumes together with longitudinal developmental trajectories and their relationships with memory performance. In two waves, 109 participants aged 6–10 years (wave 1: MAge=7.25, wave 2: MAge=9.27) underwent high-resolution magnetic resonance imaging to assess hippocampal subfield volumes (imaging data available at both waves for 65 participants) and completed tasks assessing hippocampus dependent memory processes. We found that cross-sectional age-associations and longitudinal developmental trends in hippocampal subfield volumes were discrepant, both by subfields and in direction. Further, volumetric changes were largely unrelated to changes in memory, with the exception that increase in subiculum volume was associated with gains in spatial memory. Longitudinal and cross-sectional patterns of brain-cognition couplings were also discrepant. We discuss potential sources of these discrepancies. This study underscores that children’s structural brain development and its relationship to cognition cannot be inferred from cross-sectional age comparisons.
CD4+CD25+ regulatory T cells (Tregs) represent a specialized subpopulation of T cells, which are essential for maintaining peripheral tolerance and preventing autoimmunity. The immunomodulatory effects of Tregs depend on their activation status. Here we show that, in contrast to conventional anti-CD4 monoclonal antibodies (mAbs), the humanized CD4-specific monoclonal antibody tregalizumab (BT-061) is able to selectively activate the suppressive properties of Tregs in vitro. BT-061 activates Tregs by binding to CD4 and activation of signaling downstream pathways. The specific functionality of BT-061 may be explained by the recognition of a unique, conformational epitope on domain 2 of the CD4 molecule that is not recognized by other anti-CD4 mAbs. We found that, due to this special epitope binding, BT-061 induces a unique phosphorylation of T-cell receptor complex-associated signaling molecules. This is sufficient to activate the function of Tregs without activating effector T cells. Furthermore, BT-061 does not induce the release of pro-inflammatory cytokines. These results demonstrate that BT-061 stimulation via the CD4 receptor is able to induce T-cell receptor-independent activation of Tregs. Selective activation of Tregs via CD4 is a promising approach for the treatment of autoimmune diseases where insufficient Treg activity has been described. Clinical investigation of this new approach is currently ongoing.
Many cross-sectional findings suggest that volumes of specific hippocampal subfields increase in middle childhood and early adolescence. In contrast, a small number of available longitudinal studies observed decreased volumes in most subfields over this age range. Further, it remains unknown whether structural changes in development are associated with corresponding gains in children’s memory. Here we report cross-sectional age differences in children’s hippocampal subfield volumes together with longitudinal developmental trajectories and their relationships with memory performance. In two waves, 109 healthy participants aged 6 to 10 years (wave 1: MAge=7.25, wave 2: MAge=9.27) underwent high-resolution magnetic resonance imaging to assess hippocampal subfield volumes, and completed cognitive tasks assessing hippocampus dependent memory processes. We found that cross-sectional age-associations and longitudinal developmental trends in hippocampal subfield volumes were highly discrepant, both by subfields and in direction. Further, volumetric changes were largely unrelated to changes in memory, with the exception that increase in subiculum volume was associated with gains in spatial memory. Importantly, the observed longitudinal patterns of brain-cognition coupling could not be inferred from cross-sectional findings. We discuss potential sources of these discrepancies. This study underscores that children’s structural brain development and its relationship to cognition cannot be inferred from cross-sectional age comparisons.
Highlights
The subiculum undergoes volumetric increase between 6-10 years of age
Change across two years in CA1-2 and DG-CA3 was not observed in this age window
Change across two years did not reflect age differences spanning two years
Cross-sectional and longitudinal slopes in stark contrast for hippocampal subfields
Longitudinal brain-cognition coupling cannot be inferred from cross-sectional data