Use of type I interferon-inducible mRNAs as pharmacodynamic markers and potential diagnostic markers in trials with sifalimumab, an anti-IFNα antibody, in systemic lupus erythematosus

Arthritis Res Ther. 2010;12 Suppl 1(Suppl 1):S6. doi: 10.1186/ar2887. Epub 2010 Apr 14.

Abstract

Type I interferons are implicated in the pathogenesis of systemic lupus erythematosus (SLE). Type I interferon-inducible mRNAs are widely and concordantly overexpressed in the periphery and involved tissues of a subset of SLE patients, and provide utility as pharmacodynamic biomarkers to aid dose selection, as well as potential indicators of patients who might respond favorably to anti-IFNα therapy in SLE. We implemented a three-tiered approach to identify a panel of type I interferon-inducible mRNAs to be used as potential pharmacodynamic biomarkers to aid dose selection in clinical trials of sifalimumab, an anti-IFNα monoclonal antibody under development for the treatment of SLE. In a single-dose escalation phase 1 trial, we observed a sifalimumab-specific and dose-dependent inhibition of the overexpression of type I interferon-inducible mRNAs in the blood of treated subjects. Inhibition of expression of type I interferon-inducible mRNAs and proteins was also observed in skin lesions of SLE subjects from the same trial. Inhibiting IFNα resulted in a profound downstream effect in these SLE subjects that included suppression of mRNAs of B-cell activating factor belonging to the TNF family and the signaling pathways of TNFα, IL-10, IL-1β, and granulocyte-macrophage colony-stimulating factor in both the periphery and skin lesions. A scoring method based on the expression of type I interferon-inducible mRNAs partitioned SLE patients into two distinct subpopulations, which suggests the possibility of using these type I interferon-inducible genes as predictive biomarkers to identify SLE patients who might respond more favorably to anti-type I interferon therapy.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / pharmacokinetics
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antigen-Antibody Complex / genetics
  • Antigen-Antibody Complex / immunology
  • Biomarkers
  • Clinical Trials, Phase I as Topic / statistics & numerical data*
  • Dendritic Cells / metabolism
  • Dendritic Cells / pathology
  • Dose-Response Relationship, Drug
  • Dose-Response Relationship, Immunologic
  • Gene Expression Regulation / immunology*
  • Genes, Immunoglobulin
  • Humans
  • Immunity, Innate
  • Interferon Type I / physiology*
  • Interferon-alpha / antagonists & inhibitors*
  • Interferon-alpha / blood
  • Interferon-alpha / immunology
  • Lupus Erythematosus, Systemic / classification
  • Lupus Erythematosus, Systemic / diagnosis*
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / genetics
  • Lupus Erythematosus, Systemic / immunology
  • Mice
  • Mice, Transgenic
  • Molecular Targeted Therapy*
  • Prognosis
  • RNA, Messenger / analysis
  • RNA, Messenger / biosynthesis
  • RNA, Messenger / blood*
  • Rheumatic Diseases / blood
  • Signal Transduction / immunology
  • Skin / metabolism
  • Transcriptome*

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antigen-Antibody Complex
  • Biomarkers
  • Interferon Type I
  • Interferon-alpha
  • RNA, Messenger
  • sifalimumab