TGlobulin25 (Rabbit Anti-Thymocyte Immunoglobulin) for the Prevention and Treatment of Acute Kidney Transplant Rejection in Kidney Transplant Recipients
How does TGlobulin25 work?
Kidney transplantation is a key treatment and often the best option for end-stage kidney failure. Because the immune system recognizes the transplanted kidney as a foreign organ, there is a significant risk of acute rejection. Thus, the use of immunosuppressive medications is essential to maintain the viability of the transplanted tissue.
Antibodies against T-cells and other immunosuppressants have a marked impact on patient survival and graft preservation. TGlobulin25 is a rabbit immunoglobulin directed against human thymocytes containing cytotoxic antibodies that specifically target antigens present on T-lymphocytes, which act against the graft. Consequently, TGlobulin25 is utilized in patients who have undergone kidney transplantation to prevent and treat acute graft rejection.
Pharmacodynamics
TGlobulin25 contains antibodies against human T-lymphocytes. The mechanism of action of TGlobulin25 in immune suppression is not entirely understood; however, it is hypothesized that the immune suppression occurs through the following pathways:
Depletion of circulating T-lymphocytes
Reduction of activation, homing, and cytotoxic effects of T-lymphocytes
The reduction of T-lymphocytes is likely the primary mechanism of immune suppression induced by TGlobulin25. This decrease in lymphocyte populations is both peripheral and central. The reduction of peripheral T-lymphocytes can be observed 24 hours after the first infusion of the drug. In laboratory conditions, this decrease in T-lymphocytes occurs through various mechanisms such as apoptosis, complement-dependent lysis, and antibody-dependent cellular toxicity.
Decreased Activation, Homing, and Cytotoxic Effects of T-lymphocytes
The reduction or modulation of T-cell activation and cytotoxic activities may result from the impact of TGlobulin25 on TCR/CD3, CD4, CD8, CD25, and CD45 molecules. The binding of TGlobulin25 to selectins and integrin families (CD11a, CD18) may lead to decreased homing of T-lymphocytes.
TGlobulin25 has antibodies against T-lymphocyte markers such as CD2, CD3, CD4, CD8, CD11a, CD18, CD25, CD44, CD45, HLA-DR, heavy chains of HLA class I, and β2-microglobulin
