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Imlifidase as a Potential Treatment for Antibody-Mediated Rejection

  • Kidney Transplantation (ML Henry and R Pelletier, Section Editors)
  • Published:
Current Transplantation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Antibody-mediated rejection (ABMR) is implicated as the leading cause of late kidney allograft failure. Current therapies inadequately control the antibody response and persistent donor-specific antibodies lead to chronic ABMR and allograft failure. Imlifidase is an IgG endopeptidase derived from Streptococcus pyogenes that cleaves human IgG into F(ab’)2 and Fc fragments, thereby protecting against complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity. Favorable outcomes with its use for desensitization in HLA-incompatible kidney transplantation have engendered interest in its use for ABMR.

Recent Findings

The experiences with imlifidase for a variety of antibody-mediated diseases, including anti-glomerular basement membrane disease, thrombotic thrombocytopenic purpura, and desensitization in HLA-incompatible kidney transplantation, are reviewed to provide a rationale for using imlifidase to treat ABMR in kidney transplantation.

Summary

Imlifidase is currently being evaluated in comparison to plasmapheresis in a clinical trial and is a potential therapy for ABMR in kidney transplantation.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Department of Medicine, Division of Nephrology, Transplant Immunotherapy Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Edmund Huang & Stanley C. Jordan

Authors
  1. Edmund Huang
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  2. Stanley C. Jordan
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Corresponding author

Correspondence to Edmund Huang.

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Human and Animal Rights

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

Conflict of Interest

Dr. Huang has received research grants and consulting fees from CareDx, Inc. and Veloxis Pharmaceuticals. He has also received a research grant from CSL-Behring. Dr. Jordan has received research grants and consulting fees from CSL Behring, Amplyx, and Hansa Biopharma. He also has a patent pending for use of interleukin-6 monoclonal antibodies for desensitization and treatment of antibody-mediated rejection.

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This article is part of the Topical Collection on Kidney Transplantation

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Huang, E., Jordan, S.C. Imlifidase as a Potential Treatment for Antibody-Mediated Rejection. Curr Transpl Rep 8, 157–161 (2021). https://doi.org/10.1007/s40472-021-00327-0

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  • DOI: https://doi.org/10.1007/s40472-021-00327-0

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