Abstract. Rituximab (chimeric anti-CD20 mAb) is currently used in the treatment of B-NHL and B cell malignancies, alone or in combination with chemotherapy. However, subsets of patients do not initially respond and/or develop resistance to additional treatments. Hence, there is a need to develop more effective anti-CD20 mAbs that may improve clinical response. BM-ca is a novel humanized anti-CD20 mAb that was tested against several B-NHL cell lines and was compared to several anti-CD20 mAbs (Rituximab, ofatumumab, 2H7, B1 and B-Ly1). BM-ca was shown to strongly induce both homotypic cell aggregation and redistribution of CD20 to membrane lipid rafts. BM-ca was also able to induce programmed cell death (apoptosis) without the need for cross-linking and demonstrated potent complement-dependent cytotoxicity (CDC). BM-ca was more cytotoxic than rituximab even in malignant B cells expressing low amounts of membrane CD20. Type I anti-CD20 mAbs typically induce minimal levels of homotypic cell aggregation and apoptosis but strong localization of CD20 to lipid rafts and potent CDC. Type II anti-CD20 mAbs typically exert the reverse activities. Noteworthy, BM-ca exhibits properties that are shared by both type I and type II anti-CD20 mAbs, which may reflect the recognition of a new CD20 epitope and/or exhibit different molecular signaling. Overall, the present data show that BM-ca is a novel anti-CD20 mAb that may be classified as a type I/II. The therapeutics efficacy of BM-ca awaits its use in clinical trials.
IntroductionThe use of rituximab as a single agent or in combination with cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone (CHOP), is now a standard therapy for nonHodgkin's lymphoma (NHL) (1,2). NHL patients do not always completely respond to rituximab therapy, however, and a subset of patients who initially responded become resistant or less responsive to further treatment (3). Despite a great number of reports, the in vivo mechanisms responsible to predict the clinical outcome in NHL after anti-CD20 treatment remain elusive. Complement-dependent cytotoxicity (CDC), antibody-dependent cellular cytotoxicity (ADCC) and apoptosis are all potential cytotoxic mechanisms, although it is unclear which mechanism is important in vivo. Redistribution of CD20 to membrane lipid rafts by anti-CD20 results in the clustering of antibody molecules and enhancing C1q binding, the first step in the CDC induction mechanism (4). In addition to these above cytotoxic mechanisms, homotypic cell aggregation has been reported to be involved in antibody-induced cytotoxicity as well as the induction of apoptosis (5-7).CD20 antibodies have been classified as type I or type II depending on their functional characteristics. Type I exhibits strong CDC activity but weak apoptosis whereas type II shows the opposite, i.e., weak CDC and strong apoptosis. Type I antibodies have the ability to redistribute CD20 to membrane lipid rafts whereas type II do not. Further, type I induce little homotypic cell aggregation whereas homotypic ce...