Recombinant and plasma-derived factor VIII products induce distinct splenic cytokine microenvironments in hemophilia A mice

M Qadura, B Waters, E Burnett… - Blood, The Journal …, 2009 - ashpublications.org
M Qadura, B Waters, E Burnett, R Chegeni, S Bradshaw, C Hough, M Othman, D Lillicrap
Blood, The Journal of the American Society of Hematology, 2009ashpublications.org
The use of plasma-derived factor VIII (pdFVIII) concentrates in hemophilia A has been
reported to result in reduced anti-FVIII antibody formation. In this study, we have investigated
whether the cytokine microenvironment induced by pdFVIII has an influence on reducing
anti-FVIII antibody titers in hemophilic mice. Microarray and confirmatory quantitative reverse
transcription polymerase chain reaction (RT-PCR) experiments show that pdFVIII infusion
causes a different transcriptional profile in dendritic cells than recombinant FVIII (rFVIII). Both …
Abstract
The use of plasma-derived factor VIII (pdFVIII) concentrates in hemophilia A has been reported to result in reduced anti-FVIII antibody formation. In this study, we have investigated whether the cytokine microenvironment induced by pdFVIII has an influence on reducing anti-FVIII antibody titers in hemophilic mice. Microarray and confirmatory quantitative reverse transcription polymerase chain reaction (RT-PCR) experiments show that pdFVIII infusion causes a different transcriptional profile in dendritic cells than recombinant FVIII (rFVIII). Both treatments caused up-regulation of proinflammatory gene expression, but rFVIII and pdFVIII treatments promote expression of genes that induce Th1 and Th2 responses, respectively. Moreover, administration of rFVIII or pdFVIII concentrates resulted in distinct T-cell splenic cytokine microenvironments. rFVIII induced the release of Th1 cytokines and IL-10, whereas pdFVIII induced the release of Th2 cytokines and transforming growth factor-β. We have also observed high titers of anti–human von Willebrand factor (VWF) antibodies in the pdFVIII-treated mice and propose that this results from antigenic competition. We further investigated the role of this phenomenon using infusions of FVIII and increasing concentrations of recombinant human factor IX (FIX). These studies show an inverse relationship between increasing concentrations of FIX and the production of anti-FVIII antibodies. In summary, these studies report new mechanisms that contribute to reduced anti-FVIII antibody development in hemophilia A after pdFVIII infusions.
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