Complement activation determines the therapeutic activity of rituximab in vivo

N Di Gaetano, E Cittera, R Nota, A Vecchi… - The Journal of …, 2003 - journals.aai.org
N Di Gaetano, E Cittera, R Nota, A Vecchi, V Grieco, E Scanziani, M Botto, M Introna, J Golay
The Journal of Immunology, 2003journals.aai.org
Rituximab is an anti-CD20 chimeric mAb effective for the treatment of B-NHL. It can lyse
lymphoma cells in vitro through both C-and Ab-dependent cellular cytotoxicity. The
mechanism of action of rituximab in vivo is however still unclear. We have set up a new in
vivo model in nonimmunodeficient mice by stable transduction of the human CD20 cDNA in
the murine lymphoma line EL4. Animals injected iv with the EL4-CD20+ lymphoma cells
died within 30 days with evident liver, spleen, and bone marrow involvement, confirmed by …
Abstract
Rituximab is an anti-CD20 chimeric mAb effective for the treatment of B-NHL. It can lyse lymphoma cells in vitro through both C-and Ab-dependent cellular cytotoxicity. The mechanism of action of rituximab in vivo is however still unclear. We have set up a new in vivo model in nonimmunodeficient mice by stable transduction of the human CD20 cDNA in the murine lymphoma line EL4. Animals injected iv with the EL4-CD20+ lymphoma cells died within 30 days with evident liver, spleen, and bone marrow involvement, confirmed by immunohistochemistry and PCR analysis. A single injection of rituximab or the murine anti-CD20 Ab 1F5, given ip 1 day after the tumor, cured 100% of the animals. Indeed, at week 4 after tumor cell inoculation, CD20+ cells were undetectable in all organs analyzed in rituximab-treated animals, as determined by immunohistochemistry and PCR. Rituximab had no direct effect on tumor growth in vitro. Depletion of either NK cells or neutrophils or both in tumor-injected animals did not affect the therapeutic activity of the drug. Similarly, rituximab was able to eradicate tumor cells in athymic nude mice, suggesting that its activity is T cell independent. In contrast, the protective activity of rituximab or the 1F5 Ab was completely abolished in syngeneic knockout animals lacking C1q, the first component of the classical pathway of C (C1qa−/−). These data demonstrate that C activation is fundamental for rituximab therapeutic activity in vivo.
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