The Effect of Tocilizmab Treatment (TCZ-Rx) on Total IgG and Anti-CMV-IgG Levels in HLA-Sensitized (HS) Kidney Transplant Patients.
Transplant Immunology Lab, Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA.
Meeting: 2016 American Transplant Congress
Abstract number: D27
Keywords: Antibodies, IgG, Immunoglobulins (Ig), Immunosuppression
Session Information
Session Name: Poster Session D: Antibody Mediated Rejection: Session #2
Session Type: Poster Session
Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: TCZ has anti-B cell and anti-inflammatory properties. We have reported its successful use for pre-transplant (Tx) desensitization (DES) and treatment of ABMR. We also showed suppression of antibody production by TCZ in bone marrow and spleen cells in a HLA-sensitized mouse model, suggesting its effect on plasma cells. Here we measured the levels of total IgG and anti-CMV-IgG, likely produced by plasma cells, in patients treated with TCZ, to assess the effect of TCZ on IgG production.
Methods: Archived plasma or serum samples obtained pre- and post-Rx (up to 24M post-Rx) from 16 TCZ and 18 rituximab (RIT, Control)-Rx patients were submitted for total-IgG and anti-CMV-IgG by ELISA. Of 16 TCZ (8mg/kg, 6x, monthly)-Rx patients, 5 received TCZ as DES followed by Tx, and the remaining did so only post-Tx. All RIT patients received RIT as DES w/ or wo/ additional RIT post-Tx. The change in the levels pre- (0M) vs. post-Rx (6, 9 and 12M) was compared in both groups.
Results: The result is shown in figures. Briefly, in 16 TCZ patients, the average total IgG significantly decreased at 6M post-1st TCZ dose (end of the Rx) compared to pre-Rx levels and most patients showed the reduction. However, the levels returned to pre-Rx levels at 9M. In contrast, the total IgG levels in the RIT group did not significantly change up to 12M post-Rx. Anti-CMV-IgG levels did not change in both groups during the 12M post-Rx period 
.
Conclusions: TCZ-Rx reduced total IgG levels by 20% by the end of Rx. However, the effect did not persist after cessation of Rx. TCZ may have minimal effect on anti-viral antibody production, suggesting its minimal effect on anti-viral antibody producing plasma cells in TCZ-Rx patients. This might help to reduce a risk for viral infection in this patient population.
CITATION INFORMATION: Shin B.-H, Ge S, Choi J, Kahwaji J, Vo A, Petrosyan A, Jordan S, Toyoda M. The Effect of Tocilizmab Treatment (TCZ-Rx) on Total IgG and Anti-CMV-IgG Levels in HLA-Sensitized (HS) Kidney Transplant Patients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Shin B-H, Ge S, Choi J, Kahwaji J, Vo A, Petrosyan A, Jordan S, Toyoda M. The Effect of Tocilizmab Treatment (TCZ-Rx) on Total IgG and Anti-CMV-IgG Levels in HLA-Sensitized (HS) Kidney Transplant Patients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-effect-of-tocilizmab-treatment-tcz-rx-on-total-igg-and-anti-cmv-igg-levels-in-hla-sensitized-hs-kidney-transplant-patients/. Accessed May 11, 2025.« Back to 2016 American Transplant Congress