CN1034055C - 单克隆抗体在制备用于治疗炎症部位的药物中的应用 - Google Patents
单克隆抗体在制备用于治疗炎症部位的药物中的应用 Download PDFInfo
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Abstract
使用单克隆抗体抑制特异性吞噬细胞功能以减小人或其他动物体内组织损伤的方法。选择可结合于吞噬性白细胞上的单克隆抗体、以抑制细胞向体内炎症部位移动，并抑制达到这一区域之激活的白细胞的粘附和扩散，进而阻止这些细胞释放毒性物质。可在导致损伤性炎性反应的病理过程(如因急性冠状动脉血栓形成所致心肌血流中断的恢复过程)之前或早期体内给予单克隆抗体。
Description
本发明涉及体内给予对白细胞粘附促进分子特异的单克隆抗体、以减少因炎性白细胞激活所介导的组织损伤的方法。具体地说，本发明是涉及经体内给予可与人或动物源粒细胞和单核吞噬细胞表面决定基结合的选择性单克隆抗体，从而特异性地抑制某些与心肌血管梗塞过程中组织损伤(但不仅限于此)有关的粘附依赖性白细胞功能，以大幅度减少白细胞对导致人体组织或其他部分损伤之类症信号的炎性反应。
人或动物循环系统中的外周血主要是由红细胞和白细胞组成的。一些科研单位已对白细胞的各种功能及其临床关联产生了很大兴趣。白细胞家族是由嗜中性细胞、单核细胞、嗜曙红细胞、嗜碱细胞和淋巴细胞组成的。淋巴细胞包括T淋巴细胞和B淋巴细胞两种类型，它们又各有许多亚群。因嗜中性细胞、嗜曙红细胞和嗜碱细胞含有胞质颗粒，故统称为“粒性白细胞”。
鉴于嗜中性细胞、单核细胞、嗜曙红细胞和嗜碱细胞在人类免疫系统中的主要功能是吞噬或摄入细菌、微生物及其他外来物质，所以又统称为吞噬细胞。这些细胞由人或动物骨髓中的共同祖细胞产生并循环到外周血中，最后必要时进入组织以控制感染或参予任何类型的炎症性反应。然而，这些吞噬细胞可作为相关联的但独立的系统，又各有其不同的功能。
嗜中性细胞是人和动物外周血中最常见的白细胞。1微升正常人全血平均含有5×103个白细胞，其中包括3075个嗜中性细胞、150个嗜曙红细胞、25个嗜碱细胞、250个单核细胞以及1500个淋巴细胞。
在粒性白细胞或单核吞噬细胞对各种类型的感染或炎症反应时，这些细胞首先被激活，移动到对化学吸引因子如某些细菌产物、补体成分及其他因子反应的适当区域。这种吸引过程称为“趋化性”。一旦进入炎症或感染区域，这些粒性白细胞和单核吞噬细胞必须确保能牢固地附着在它们的靶部位。为此，这些细胞都具有许多促进这种相互作用的特异性细胞表面受体糖蛋白，如补体、Fc和粘连蛋白受体。
细胞表面受体糖蛋白的一个很重要的家族是白细胞粘附分子(LEU-CAM)(CD11/CD18)。该家族至少包括三种各有两个亚单位的细胞表面蛋白。它们有一个共同的分子量为94,000道尔顿的β亚单位，并具有不同的α亚单位。该家族的已知成员包括LFA-1(CD11a/CD18)、Mo1(CD11b/CD18)和P150，94(CD11c/CD18)，并已证明它们是分子量分别为180,000、155,000和150,000道尔顿的α亚单位。已经使用单克隆抗体特异地鉴定了这些细胞表面蛋白。已通过鉴定一种其中白细胞遗传上缺乏这一抗原家族的人类疾病而认识到了该表面糖蛋白家族的生物学重要性(Arnaout，M.A.，Dana，N.，Pitt，J.and Todd，R.F.III.，Deficiency of two human leukocyte surface membraneglycoproteins(Mol and LFA-1)，Fed.Proc.，44：2664-2670，1985)。该疾病的特征在于反复发作的严重细菌感染以及白细胞吞噬作用、嗜中性细胞在塑料平板上扩散、白细胞聚集作用及趋化性等粘附依赖性功能等的缺陷。
因为Mo1糖蛋白具有能够与一种称为iC3b的补体成分(其为第三补体成分的片段)结合的特殊结构，故显示出特殊的重要性(Arnaout，M.A.，Todd，R.F.III，Dana，N.，Melamed，J.，Schlossman，S.F.，and Colten，H.R.，Inhibition of phagocytosis ofcomplement C3 or Ig G-coated particles and of i C3b bindingby monoclonal ant ibodies to a monocyte-granulocyte membraneglycoprotein(Mol)，J.Clin.Invest.，72：171-179，1983)。另外，在吞噬细胞的所有粘附依赖性功能上，Mo1糖蛋白起到极为重要的作用，已有证据表明不同的单克隆抗体均可抑制Mol糖蛋白的功能。
Mo1是一种存在于粒性白细胞、单核吞噬细胞及无表面标志细胞上的细胞表面糖蛋白(Todd，R.F.III，Nadler，L.M.and Schloss-man，S.F.，Antigens on Human Monocytes，Journal of Immunology，126：1435-1442，1981)。人体中，Mo1分子系由两个分子量分别为155,000和94,000道尔顿的蛋白质分子经非共价连接而成的(Todd，R.F.III，van Agthoven，A.，Schlossman，S.F.and Terhorst，C.，Structural analysis of differentiation antigens，Mo1 andMo2 on human monocytes，Hybridoma，1：329-337(1982))。已证明该复合物可介导细胞与其他粒性白细胞、内皮及惰性基质等各种表面的粘附。这些分子的遗传缺陷可因粒性白细胞不能介导抗微生物的炎性反应而导致反复发作性细菌感染。缺少这些分子的病人特征是白细胞计数增加(称为“白细胞增多”)及吞噬细胞功能缺陷，如体外检测表现为对基质的聚集粘附能力、趋化性及对被调理之颗粒的吞噬能力降低或消失。用可溶性炎症介质激活粒性白细胞和单核细胞可增加这些分子的表达(Todd，R.F.III，Arnaout，M.A.，Rosin，R.E.，Crowley，C.A.，Peters，W.A.and Babior，B.M.，The subcellular localiza-tion of Mo1(Mo1α；formerly gp11c)a surface glycoproteinassociated with neutrophil adhesion，J.Clin.Invest.74：1280-1290(1984)；Arnaout，M.A.，Hakim，R.M.，Todd，R.F.，Dana，N.and Colten，H.R.，Increased expression of anadhes ion-promotion surface glycoprotein in the granulocytopeniaof hemodialysis，New Engl.J.Med.，312：457-462(1985))。针对Mo1糖蛋白的单克隆抗体可在体外有效地阻止嗜中性细胞聚集及吞噬作用。在嗜中性细胞介导的肺损伤(急性呼吸窒息综合症(ARDS))大鼠肺模型中，抗Mo1单克隆抗体能显著地抑制由激活的人嗜中性细胞引起的肺上皮损伤(Ismail，G.，Morganroth，H.L.，Todd，R.F.III.and Boxer，L.A.，Prevention of pulmonary injury inisolated perfused rat lungs by activated human neut rophilspreincubated with anti-Mo1 monoclonal antibody，Blood，69：1167-1174，(1987))。
虽然白细胞的炎性反应对于清除入侵的微生物具有极为重要的作用，但有充实和令人信服的证据表明，当炎性吞噬细胞在体内被刺激病理过程后所产生的可溶性发炎因子激活时，这些细胞便引起各种器官和组织的损伤(Harlan，J.M.，Leukocyte Endothelial Interactions，Blood，65：513-525(1985))。激活的嗜中性细胞及单核吞噬细胞在血管内皮细胞上的粘附和扩散以及继后释放毒性氧化代谢产物和蛋白酶的过程，参予了见于某些疾病如急性呼吸窒息综合症(ARDS；肺休克综合症)、肾小球性肾炎的器官损伤以及对局部缺血组织(如心、肠和中枢神经系统)进行再灌注后发生的炎性损伤(Harlan，J.M.，文献同上)。几项研究的结果已经证明心肌很容易遭受被激活之白细胞所介导的炎性反应的攻击。这些研究结果表明，如果在诱发狗的心肌局部缺血并进行再灌注之前用嗜中性细胞特异性抗血清(Romson，J.L.et al.，Reductionof the extent of ischemic myocardial injury by neut rophil depletion in the dog，Circulation，67：1016-1023(1983)或氮芥(Mullane，K.M.et al.，Role of leukocytes in acutemyocardial infarction in anesthetized dogs：Relationship tomyocardial salvage by anti-inflammatory drugs，J.Pharmacal.Exp.Ther.，228：510-522(1984))清除体内循环的粒性白细胞，则其心肌梗塞的面积要比具有正常循环嗜中性细胞计数的狗小得多。许多其它的研究表明抑制嗜中性细胞激活的药剂也可导致心肌梗塞面积的减小。(Romson，J.L.et al..The effect of ibuprofen on accumulationof III-Indium labelled platelets and leukocytes in experimen-tal myocardial infarction，Circulation，66：1002-1011(1982)；Bednar，M.et al.，Nafazatrom-induced salvage of ischemicmyocardium in anesthetized dogs is mediated through inhibitionof neutrophil function，Circ.Res.57：131-141(1985))。
已证明有一种定名为M Y904的单克隆抗体具有抑制粘附依赖性功能的能力，但并不影响与i C3b的结合(Dana，N.，Styrt，B.，Griffin，J.D.，Todd，R.F.III，Klempner，M.S.，and Arnaout，M.A.，Two funct ional domains in the phagocyte membraneglycoprote in Mo1 identified with monoclonal antibodies，J.Immunol.，137：3259-3263(1986))。因此，单克隆抗体M Y904与嗜中性细胞的结合可特异地抑制嗜中性细胞向炎症或感染区域移动。此外，M Y904的这种特异性结合可抑制达到这个区域的激活的嗜中性细胞的粘附和扩散，进而阻断粒性白细胞释放的毒性物质的有害作用。
本发明的方法是利用M Y904单克隆抗体的特异性优点来减少体内损伤。例如在急性冠状动脉血栓形成过程中，可在恢复流向局部缺血心肌的血流之前体内给予M Y904单克隆抗体，以抑制炎性白细胞介导的急性炎性反应。灌注影响外周血或组织中的吞噬细胞群的M Y904抗体可抑制或减缓这些炎性细胞向受感染组织内之炎症部位的移动；另外还可抑制嗜中性细胞在这一区城内的粘附，从而抑制或减小粘附细胞释放的毒性物质的带来的潜在的有害作用。例如，已证明这一方法可在心肌血流恢复之后，大大减轻心肌梗塞区域中的组织损伤。
简单地说，本文将描述显著地减少由炎性吞噬性白细胞介导之组织损伤(例如，但不仅限于心肌梗塞面积)的方法。可在发生由激活的吞噬性白细胞介导的潜在损伤性炎症反应之前或其早期，如在心肌梗塞中使用血栓溶解剂或以手术方法恢复心肌血流(其因急性冠状动脉血栓形成而被阻断)之前，体内给予单克隆抗体M Y904。M Y904单克隆抗体可抑制通常能诱导炎症部位(如在再灌注后伴有组织损伤的心肌局部缺血区域)组织损伤之粒性白细胞和单核吞噬细胞的某些功能。使用M Y904单克隆抗体抑制再灌注心肌损伤的实验表明，在对局部缺血心肌进行再灌注之前体内给予该单克隆抗体可有效地减小预计之心肌梗塞的面积，以致达到一个显著的百分比率。
以下将通过实施例及相应附图来描述本发明的优选实施方案：
图1A中图解显示了在实施本发明的方法中所获得的平均动脉血压(MAP)数据；
图1B图解显示在实施所说的方法中获得的心率(HR)数据；
图1C图解显示在实施所说的方法中所获得的左侧环曲动脉血流(LCX)数据；
图1D图解显示在实施所说的方法中获得的心率血压乘积(RPP)数据；
图2图解显示的数据表明本发明的方法对所产生之心肌梗塞大小的影响；
图3图解显示的数据是作为心电图ST段抬高范围的函数以表达梗塞大小；
图4图解显示的数据表明心肌梗塞过程中循环的嗜中性细胞计数。
本发明方法中所使用的单克隆抗体被定名为M Y904。其为按照Kohler和Millstein(Nature，256：495-497(1975))所述的标准方法以免疫的小鼠脾细胞与人慢性粒细胞白血病(CGL)细胞相融合而产生的。用于免疫程序的粒细胞性白血病细胞是由新近诊断患有CGL(作为诊断判定的一部分)的病人体内得到的。经静脉穿刺采血，并经Ficoll-Hypaque密度梯度离心(1.077g/cc)由粒性白细胞中分离出单核细胞和红血细胞。单核细胞部分包含未成熟的粒性白细胞及母细胞。这些细胞均冷冻保存，并用10×106个融化的单核细胞经腹腔内注射免疫小鼠，每周一次共免疫四周。融合前三天在小鼠尾静脉内注入10×106个以相似方法处理的CGL单核细胞。为进行融合，分离小鼠脾脏并制备脾细胞的单细胞悬液。然后在无血清培养基内将脾细胞与NS-1桨细胞瘤细胞系混合，两者比例是8比1。离心得到细胞沉淀饼，将其悬浮于0.5ml 30％聚乙二醇中并于25℃放置8分钟，将细胞在无血清培养基中洗一次并用HAT培养基稀释，然后分配于微量滴定板的小井内。
输注后14天用免疫荧光筛选法筛选与免疫细胞群体有反应性之产生单克隆抗体的杂交瘤克隆。与CGL细胞及正常人粒性白细胞、单核细胞和大颗粒淋巴细胞部分反应的抗体即鉴定为单克隆抗体M Y904。单克隆抗体M Y904与所有10个被试病人之90％以上的粒性白细胞反应，但不与T淋巴细胞或B淋巴细胞反应。该单克隆抗体可免疫沉淀一种来自表面标记之正常人粒性白细胞的含两个亚单位(分子量分别为155,000道尔顿和94,000道尔顿)的糖蛋白(Dana，N.等，Two functional domainsinthe phagocyte membrane glycoprotein Mo1 identified with monoclonal antibodies，J.Immunol.，137：3259-3263，1986)。单克隆抗体M Y904的反应性分布以及用该单克隆抗体鉴定之抗原的分子量表明该抗原为CD11b/CD18(“Mo1”)糖蛋白。功能研究进一步证明，单克隆抗体M Y904并不抑制与i C3b的结合，但为一种粘附依赖性过程(粒性白细胞在塑料平板上扩散及趋化性)的有效抑制物(Dana等，Twofunctional domains in the phagocyte membrane glycoprotein Mo1identified with monoclonal ant ibodies，J.of Immunol.，137：3259-3263，1986)。与其他抗Mo1单克隆抗体比较，抗体904是唯一只抑制粘附依赖性功能但不抑制与i C3b结合的抗体。其他被试抗体包括单克隆抗体44、903、94、17、OKM10和Leu-15(Dana等，文献同上)。
因此，单克隆抗体M Y904可鉴定Mo1粒性白细胞-单核细胞的细胞表面糖蛋白、并可进一步特异地结合该参予粒性白细胞/单核细胞活性粘附依赖性过程之糖蛋白上的抗原决定基。
能够产生MY904单克隆抗林的杂交细胞系样品已在1988年5月25日寄存于中国典型培养物保藏中心(CCTCC)，寄存号为CCTCCC88009。
体外研究表明，人、犬科动物及亚人类灵长目动物白细胞具有共同的Mo1糖蛋白(Letvin，N.L.，Todd，R.F.III，Palley，L.S.和Griffin，J.D.，Conservation of myeloid surface antigens onprimate granulocytes，Blood，61：408-410，1983)。另外，一份研究报告述及狗的白细胞糖蛋白缺陷综合症与所见人体者相似(Giger，U.，Boxer，L.A.，Simpson，P.A.，Lucchesi，B.R.和Todd，R.F.III，Deficiency of leukocyte surface glycoproteins Mo1，LFA-1 and Leu M5 in a dog with recurrent bacterialinfection，An animal model，Blood，69：1622-1630，1987)。已显示单克隆抗体M Y904能与狗及人白细胞表面糖蛋白的α亚单位(CD11b)结合。而且当体外用佛波醇(phorbol)酯PMA刺激时，M Y904单克隆抗体与正常狗嗜中性细胞的结合并不能有效地抑制嗜中性细胞的体外聚集作用(Giger et al.，文献同上)。可以相信，使用本发明的方法，对患有吞噬细胞介导之炎性反应——如由心肌局部缺血并进行心肌再灌注后而诱发的这种炎性反应的人或动物，体内给予上述单克隆抗体，将会减小心肌损伤，而这一点正是本发明的方法所独具的特征。
在一给予M Y904抗体以减轻心肌再灌注损伤的实施例中，首先是制备一组23只成年狗的动物模型。对动物进行麻醉后，通过在第5肋间区作左胸廓开口术以暴露心脏并将心脏悬吊于心包悬带中。用安装于左环曲冠状动脉内的标定的电磁流量探子连续记录血流量。将导管插入主动脉以记录血压，插入左颈静脉以灌注单克隆抗体并用于采集血样。同时连续记录标准肢体导程11心电图。
将环曲冠装动脉闭锁90分钟以造成心肌局部缺血，然后在血管极度狭窄情况下对心肌进行再灌注。这一方法可终止出血性梗塞形成并减少再灌注诱发的心室纤颤。心肌再灌注6小时后对心脏进行电击除颤并切除之。以心肌梗塞危险区百分比及左心室总面积的百分比来估计梗塞大小。使用Romson等人(The beneficial effects of oral ibuprotein on coronary artery thrombos is and myocardial ischemia in the consciousdog，J.Pharm.and Exp.Therap.，215：271，1980)所述的组织化学染色技术作体外双重灌注。用预先经20mM磷酸钾(pH7.4)缓冲的1.5％氯化三苯基四唑(TPT)溶液灌注装有套管的环曲冠状动脉，同时用引入主动脉的伊文思兰染料灌注冠状循环的其余部分。于37℃、在100毫米汞柱恒定压力下灌注5分钟，两种溶液均分布于各自的结合部位。然后将心脏切成5或6厘米厚的横切片并以面积仪测定梗塞大小。这种可行的测量梗塞大小的方法能通过TPT和心肌脱氢酶之间的组织化学反应将可见的和不可见的心肌组织准确划分开。
使用上述动物模型，研究了两组狗。一组11只动物作为对照组，接受5％人血清白蛋白(单克隆抗体的载体)。第二组9只动物，接受药品级单克隆抗体M Y904，于诱导心肌局部缺血后(对冠状动脉血流再灌注之前45分钟)，经10分钟以上时间(45分钟)静脉内输注1mg/kg。监测M Y904抗体与狗白细胞Mo1抗原的结合情况。所用的单克隆抗体M Y904系由Coulter Immunology Division，Coulter Corporation(Hialeah，Florida)提供。
向狗体内注入M Y904抗体后0、85和120分钟时，分别由实验动物体内采集4ml静脉血加于含EDTA的试管内，并以800g离心5分钟。分离血浆并储存以备继后分析残留单克隆抗体时使用。向细胞沉淀物内加氯化铵以溶解红细胞，并以免疫荧光染色法分析残留白细胞上是否先已存在结合的抗Mo1抗体。将1-2×106个白细胞在单纯缓冲液或含有饱和浓度之小鼠抗Mo1抗体的缓冲液中于4℃保温30分钟。洗涤细胞并在含有饱和浓度结合了荧光素之羊抗小鼠免疫球蛋白的缓冲液内于4℃继续保温30分钟。使用购自Coulter公司(Hialeah，Florida)的EPICS_C型流动血细胞计数器，于选择性开通这些髓样细胞后以流动细胞计数法经测定log前方位角对log直角光散射，来估计体内给予抗Mo1抗体或体外暴露于另外的抗Mo1抗体后抗体与狗嗜中性细胞及单核细胞的结合。以每测定5000个细胞的荧光强度作为单克隆抗体结合的定量量度单位。
为了证明给予M Y904抗Mo1单克隆抗体后足以在被治疗狗的血浆或血清中产生过量抗Mo1抗体，而对血浆(EDTA抗凝血)或血清样品进行分析。这一分析使用了间接免疫荧光分析法，其中将1×10个Mo1阳性试验细胞、钙离子载体A23187刺激的人嗜中性细胞在含有狗血浆或血清(1/2、1/4、1/8、1/16稀释)的缓冲液中于4℃保温30分钟。然后洗细胞并在含有饱和浓度荧光素结合之羊抗小鼠免疫球蛋白的缓冲液中于4℃继续保温30分钟。使用EPICS_仪按上述流动血细胞计数法定量分析结合了单克隆抗体的试验细胞。
为估算心肌组织中嗜中性细胞积聚量，分别由中心梗塞区、危险区内未梗塞组织、梗塞区和危险区之间的心内膜至心外膜边缘带、以及正常未梗塞和未着色的心肌各取50-200mg心肌样品。制备组织匀浆和依照Bradley，P.O.等人(Measurement of cutaneous inflammtion：Estimation of neutrophil content with an enzyme marker，J.Invest.Derm.，78：206-209，1982)所述方法检测髓过氧化物酶含量。Bednar，M.等人(Circ.Res.，57：131-141，1985)、Mullane，K.M.等人(J.Pharmacological Methods，14：157-167，1964)已描述了梗塞后心肌组织的髓过氧化物酶含量与嗜中性细胞浸润之组织学证据之间的相互关联。
为了获得对梗塞程度以及心肌内嗜中性细胞积聚量的组织学估计，而由不知道这一特殊治疗的有独立工作资格的研究者用苏木精和曙红着染得自各心脏之有代表性的组织学切片并进行判断。然后整理所获数据。
为了判断单克隆抗体对分离的嗜中性细胞之聚集作用的影响，使用Ficoll-hypaque梯度技术由未治疗狗的静脉血中分离嗜中性白细胞用缓冲的氯化铵溶解红血细胞并以每毫升107个细胞的浓度重新悬浮于Hank氏平衡盐溶液中。在PAP-3型血小板聚集轮廓记录器(profiler)(BIO/DATA公司，Horsham，PA)中估计细胞的聚集情况。将嗜中性细胞的样品与M Y904及阴性对照抗体预保温，然后用125mg/mlPMA激活之。
将所有数据与各自的对照组比较，其中P值小于0.05者被认为是有意义的。
如前面提到的，在估计抗Mo1单克隆抗体对区域性心肌缺血并再灌注后所致心肌梗塞面积之影响的研究中，开始时使用了23只狗。23只狗中最后作心肌梗塞面积分析者为16只。其余的有3只狗因从心电图改变没有出现心肌缺血的客观指征而被排除，还有3只未治疗的和1只用抗Mo1抗体治疗的狗因发生心室纤颤而被排除。
实验过程中定时测定平均动脉血压(MAP)、心率(HR)、左环曲支(LCX)血流量及心率血压乘积(RPP；MAPXHR/100)，以确定抗体对这些参数的影响。所得数据分别图解显示于图1A、1B、1C和1D中。两个治疗组在实验的基线处及每个时间点上均显示有相似的MAP、HR、RPP和LCX血流量。因此，根据测得的LCX血流量以及所测得的RPP或HR或MAP数值可知，抗体的保护作用并不是由于心脏血液供应的改变，亦不是由于心肌需氧量的改变。
由图2的数据可以看出给予抗Mo1抗体后梗塞大小较对照组减少了46％。相似地，在以占左心室总面积的百分比表示的梗塞范围中，可以看出用单克隆抗体治疗组的梗塞面积要比对照组小得多。左心室发生局部缺血的百分比，即危险区/左心室比例，在各治疗组间是相似的。由图3所示数据可以看出，当以心电图上ST段抬高程度的函数来表达梗塞大小时，描述各治疗组的不同回归曲线之间有着很好的相互关联。这些数据提示，在根据ST段升高测得有一给定的心肌缺血严重性的情况下，对照组所出现的心肌梗塞范围要比单克隆抗体治疗组大。因此，使用单克隆抗体治疗以减小心肌梗塞范围，与局部缺血的严重性无关。
借助免疫荧光分析，所有20个实验对象之嗜中性白细胞所表达的抗原决定基均可用抗Mo1 M Y904单克隆抗体检测出来。对接受了抗Mo1单克隆抗体的9只狗，于给予抗体后不同时间(即给予抗体后40、75和405分钟)对血清或血浆处理的Mo1阳性试验细胞作免疫荧光染色，以分析血清或血浆是否含有残余抗Mo1抗体。这一实验表明输入1mg/kg即可在体内产生过量抗体。发现9只狗中只有6只的白细胞上有可测出的亚饱和量已结合抗体，此可能是由于白细胞在与结合了荧光素的羊抗小鼠免疫球蛋白试剂共同保温前，抗体即已由膜上解离了下来。
图4的数据显示心肌梗塞发生过程中，如在对照组中所见到的，嗜中性白细胞计数一般均有所增加。然而，将两个组进行比较时则可见用抗Mo1抗体治疗即抑制了循环嗜中性白细胞计数的这一早期升高。这些数据连同对血液中过量抗体及与白细胞结合之抗体的检测，进一步证实来自抗体治疗组的嗜中性白细胞并没有从循环中被清除。用抗体处理白细胞所遇到的一个问题是，因为抗体结合到细胞表面而可能使之很快被除去。但这些数据提示，用该抗体处理时并没有导致循环嗜中性白细胞数目的显著降低。
在另一项研究中，以完全相同的方式用阴性对照小鼠Ig G1单克隆抗体，即与狗白细胞无反应性的单克隆抗体治疗第3组5只狗。我们发现于再灌注后所产生的心肌梗塞面积与接受HSA稀释剂的其他对照组没有实质性差异。
由我们的方法所获得的数据表明，使用抗白细胞粘附促进分子Mo1的单克隆抗体M Y904阻止嗜中性细胞粘附，能降低已明确特征化之心肌梗塞动物模型的再灌注损伤。由本发明方法所得数据显示，给于抗Mo1单克隆抗体M Y904能减小心肌梗塞范围，但这并不是由于减轻了心肌缺血的严重性而达到的。因为所有例子中局部缺血的时间都是90分钟，所以M Y904抗体的保护机制很可能是它对嗜中性白细胞粘附作用的影响致使减小了嗜中性细胞介导之局部缺血心肌的损伤。而以前则认为决定心肌梗塞大小的两个主要因素是局部缺血的严重性及缺血的时间长短。
由实施本发明中所获数据可以认识到，如在区域性心肌缺血的45分钟之内，给实验对象使用单克隆抗体M Y904，可以显著减小梗塞面积而且这种作用与局部缺血的严重性无关。另外，这些数据还表明，在发生区域性心肌缺血后用抗Mo1单克隆抗体M Y904抑制白细胞粘附，亦可减轻心肌再灌注损伤(即测得的梗塞面积减小)。与对照组比较，用M Y904单克隆抗体治疗可使心肌梗塞的范围减小46％(以所占梗塞形成危险区面积的百分比表示)。
使用本发明的方法治疗人冠状动脉血栓形成的临床经验表明，对于发生胸前区疼痛或不适的病人，应在30至60分钟之内送到医院急诊。应立即检查病人以根据临床资料证明急性心肌缺血的发生及冠状血管闭塞部位，然后给予临床处置。治疗可包括输注血栓溶解剂(如链激酶或组织纤维蛋白溶酶原激活剂(TPA))，用以溶解可能引起急性冠状血管阻塞的血凝块。另外就是外科治疗，其中是将一气球导管插入循环系统内并指向血凝块区域，以排除阻塞。在进行两种治疗中，恰在出现缺血心肌的再灌注(即恢复冠状动脉血流)之前，给病人静脉内注射一定量的M Y904单克隆抗体。可以静脉内给予单一剂量或多剂量，以尽可能地减少炎性反应。从而M Y904单克隆抗体即以本文所述方式发挥其减少组织损伤(梗塞大小)的作用，而与心肌缺血的严重程度无关。输注M Y904单克隆抗体的作用在于其通过抑制不需要的嗜中性细胞功能，以减小心肌再灌注损伤。
当然，在不违背待批权利要求中所述之发明范围或特征的前提下可以对涉及实践本发明之方法的若干步骤作某些改动。
Claims (8)
1.一种具有下列特点的单克隆抗体在制备用于治疗由吞噬细胞介导的炎症状态造成的炎症部位的药物中的应用：
可与粒细胞和其他吞噬细胞表面上表达的Mo1抗原的CD11/CD18糖蛋白CD11b部分特异性结合；可抑制反映其免疫学炎症反应功能的这样的细胞的CD11/CD18粘附依赖性细胞相互作用，免疫学炎症反应功能有助于这样的损伤；和不能抑制iC3b与粒细胞结合。
2.权利要求1所述的单克隆抗体的应用，其中所说的单克隆抗体被定名为MY904单克隆抗体，该抗体是由具有储存于C.C.T.C.C，保藏号为C88009的杂交细胞系特性的细胞系通过杂交瘤技术生产的。
3.权利要求1和2所述的单克隆抗体的应用，其中所说的单克隆抗体可与这样的细胞表面上表达的Mo1糖蛋白的分子量为155,000道尔顿的肽分子CD11b上的抗原决定簇结合。
4.权利要求1和2所述的单克隆抗体的应用，其中所说的炎症部位位于身体某部分的血管内皮细胞接触面或亚细胞基质处。
5.权利要求1和2所述的单克隆抗体的应用，其中所说的炎症部位是在身体某部分的内皮组织中。
6.权利要求1和2所述的单克隆抗体的应用，其中所说的炎症部位是在该身体部分的关节。
7.权利要求1和2所述的单克隆抗体的应用，其中所说的炎症部位是由心肌梗塞状态而发展的。
8.权利要求1和2所述的单克隆抗体的应用，其中所说的单克隆抗体可与嗜中性细胞的Mo1糖蛋白结合。
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| US4840793A (en) * | 1987-06-11 | 1989-06-20 | Dana-Farber Cancer Institute | Method of reducing tissue damage at an inflammatory site using a monoclonal antibody |
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- 1988-03-07 US US07/165,025 patent/US4935234A/en not_active Expired - Lifetime
- 1988-06-03 WO PCT/US1988/001928 patent/WO1988009672A1/en active IP Right Grant
- 1988-06-03 AT AT88905555T patent/ATE126703T1/de not_active IP Right Cessation
- 1988-06-03 DE DE3854351T patent/DE3854351T2/de not_active Expired - Fee Related
- 1988-06-03 EP EP88905555A patent/EP0371036B1/en not_active Expired - Lifetime
- 1988-06-03 JP JP63505211A patent/JPH02503796A/ja active Pending
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- 1988-06-10 CA CA000569247A patent/CA1317880C/en not_active Expired - Fee Related
- 1988-06-10 CN CN88103476A patent/CN1034055C/zh not_active Expired - Fee Related
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1989
- 1989-12-08 NO NO89894946A patent/NO894946L/no unknown
- 1989-12-08 DK DK620089A patent/DK620089A/da not_active Application Discontinuation
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| JPH02503796A (ja) | 1990-11-08 |
| DK620089A (da) | 1990-02-07 |
| ATE126703T1 (de) | 1995-09-15 |
| AU621304B2 (en) | 1992-03-12 |
| DE3854351T2 (de) | 1996-03-21 |
| WO1988009672A1 (en) | 1988-12-15 |
| US4935234A (en) | 1990-06-19 |
| NO894946L (no) | 1990-01-23 |
| BR8807559A (pt) | 1990-05-22 |
| EP0371036A4 (en) | 1990-06-27 |
| EP0371036B1 (en) | 1995-08-23 |
| EP0371036A1 (en) | 1990-06-06 |
| CN1033242A (zh) | 1989-06-07 |
| CA1317880C (en) | 1993-05-18 |
| AU1946388A (en) | 1989-01-04 |
| DE3854351D1 (de) | 1995-09-28 |
| DK620089D0 (da) | 1989-12-08 |
| NO894946D0 (no) | 1989-12-08 |
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