IgG-degrading enzyme of Streptococcus pyogenes (IdeS) prevents disease progression and facilitates improvement in a rabbit model of Guillain-Barré syndrome

Wang, Yu‐Zhong; Shi, Qiguang; Lv, Hui; Hu, Ming; Wang, Weifang; Wang, Quanquan; Qiao, Baojun; Zhang, Guorong; Lv, Zhanyun; Kjellman, Christian; Järnum, Sofia; Winstedt, Lena; Zhang, Yong; Wen, Jia; Hao, Yanlei; Yuki, Nobuhiro

doi:10.1016/j.expneurol.2017.02.010

Cited by 25 publications

(14 citation statements)

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“…For example, ultrasound imaging of the peripheral nerves is emerging as a potential diagnostic tool and might require further comment in future versions of this guideline. In relation to treatment, the efficacy of complement inhibitors, IgG-cleaving enzymes and a second course of IVIg is being investigated 78,111,112 . Little is known about how to measure and predict long-term outcome in patients with GBS, and validation studies of known prognostic models (for example, mEGOS and EGRIS) and research into new outcome measures are needed.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and management of Guillain–Barré syndrome in ten steps

et al. 2019

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Guillain–Barré syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and 2015 in Latin America. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, especially in the context of an outbreak, we have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline is based on current literature and expert consensus, and has a ten-step structure to facilitate its use in clinical practice. We first provide an introduction to the diagnostic criteria, clinical variants and differential diagnoses of GBS. The ten steps then cover early recognition and diagnosis of GBS, admission to the intensive care unit, treatment indication and selection, monitoring and treatment of disease progression, prediction of clinical course and outcome, and management of complications and sequelae.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and management of Guillain–Barré syndrome in ten steps

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“…IgG‐degrading enzyme of Streptococcus pyogenes (IdeS) is an endopeptidase that specifically cleaves IgG. It has been demonstrated to effectively treat autoimmune diseases (Nandakumar et al , ; Johansson et al , ; Yang et al , ; Wang et al , ), in addition to utility in pre‐transplant chronic kidney disease (CKD) patients with high levels of anti‐human leucocyte antigen (HLA) antibodies (Jordan et al , ).…”

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confidence: 99%

Administration of immunoglobulin G‐degrading enzyme of Streptococcus pyogenes (IdeS) for persistent anti‐ADAMTS13 antibodies in patients with thrombotic thrombocytopenic purpura in clinical remission

et al. 2018

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“…Application de la susceptibilité au clivage de la région charnière à la réduction de la pathogénicité d'(auto-)anticorps En clinique, il est possible de tirer profit du mécanisme de clivage des anticorps dans le cas où le traitement repose sur l'élimination d'anticorps pathogènes. Dans un modèle animal du syndrome de Guillain-Barré impliquant des anticorps pathogènes développé chez le lapin, il a en effet été montré que la survie des animaux traités par l'IdeS de Streptococcus pyogenes (qui clive les anticorps) était augmentée en comparaison de celle de lapins contrôles [37]. L'utilisation de protéases est donc envisageable dans des maladies nécessitant une élimination rapide des anticorps responsables de la pathologie.…”

Section: Mécanismes D'échappement Aux Thérapies Dépendantes D'une Régunclassified

La région charnière des anticorps thérapeutiques

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La région charnière est une courte séquence des chaînes lourdes (H) d’anticorps liant le Fab (fragment antigen binding) au Fc (fragment crystallisable). Les propriétés fonctionnelles des quatre sous-classes d’immunoglobulines d’isotype G (IgG) résultent en partie des différences de séquence de leurs régions charnières. En effet, certains acides aminés de la partie C-terminale de ces régions charnières (« partie basse ») sont situés au sein ou à proximité des sites de liaison de la molécule C1q de la voie classique du complément et des récepteurs pour la région Fc des IgG (RFcγ) sur les chaînes H d’IgG. Les régions charnières sont également sensibles au clivage protéolytique par de nombreuses protéases du microenvironnement tumoral et/ou inflammatoire pouvant altérer les réponses fonctionnelles. Le format optimal de la charnière reste donc un défi majeur pour le développement de nouveaux anticorps thérapeutiques.

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IgG-degrading enzyme of Streptococcus pyogenes (IdeS) prevents disease progression and facilitates improvement in a rabbit model of Guillain-Barré syndrome

Cited by 25 publications

References 16 publications

Diagnosis and management of Guillain–Barré syndrome in ten steps

Diagnosis and management of Guillain–Barré syndrome in ten steps

Administration of immunoglobulin G‐degrading enzyme of Streptococcus pyogenes (IdeS) for persistent anti‐ADAMTS13 antibodies in patients with thrombotic thrombocytopenic purpura in clinical remission

La région charnière des anticorps thérapeutiques

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