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Nonneutralizing FVIII-specific antibody signatures in patients with hemophilia A and in healthy donors. | LitMetric

AI Article Synopsis

  • * The study analyzed and compared anti-FVIII antibody profiles among severe and nonsevere hemophilia A patients (without inhibitors) and healthy donors, focusing on different types of antibodies (IgM, IgG1-4, IgA) and their characteristics.
  • * Results showed that hemophilia A patients had higher levels and affinities of IgG1 and IgA antibodies compared to healthy individuals, with notable differences based on hepatitis C virus (HCV) antibody status, suggesting varying immune responses in patients versus healthy controls. *

Article Abstract

Previous studies identified nonneutralizing FVIII-specific antibodies in the circulation of severe and nonsevere hemophilia A (sHA and nsHA) patients without FVIII inhibitors and also in some healthy individuals. To gain a better understanding of the nature of these nonneutralizing antibody responses, we analyzed and compared anti-FVIII antibody signatures in 3 study cohorts: previously treated sHA as well as nsHA patients without FVIII inhibitors, and healthy donors. FVIII-binding IgM, IgG1-4, and IgA antibodies were differentiated, FVIII-specificity was assessed, and associated apparent affinity constants were determined. Our results indicate that the nonneutralizing FVIII-specific antibody response in all study cohorts is dominated by IgG1 and IgA. Prevalences, titers, and affinities of these nonneutralizing antibodies were higher in the hemophilia A cohorts than in healthy donors. Stratification for the anti-hepatitis C virus (HCV) antibody status demonstrated the presence of FVIII-specific IgA with elevated titers in sHA patients with an active or past HCV infection when compared with HCV antibody-positive nsHA patients or HCV antibody-negative patients and healthy donors. Increased titers and affinities of FVIII-specific IgG1 antibodies were observed in a considerable number of hemophilia A patients as opposed to healthy subjects independently of the patients' anti-HCV antibody status. Overall, our findings support the hypothesis that the generation of nonneutralizing anti-FVIII antibodies in healthy individuals and in noninhibitor hemophilia A patients might be based on similar immune mechanisms. However, differences in prevalences, titers, and affinities of these antibodies indicate distinct differences in the antibody evolution between healthy individuals and patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8945293PMC
http://dx.doi.org/10.1182/bloodadvances.2021005745DOI Listing

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