In early December 2020, the American Society of Hematology (ASH) held their Annual Meeting and Exposition. During the meeting, many companies presented data on clinical trials and treatments related to hematologic topics. One such biotechnology company, Equillium, presented both an oral and poster presentation on itolizumab for graft-versus-host disease (GvHD). Both presentations, which explore how itolizumab affects the function of effector T cells, can be found on Equillium’s website.

Itolizumab

In conditions like GvHD, pro-inflammatory effector T cells become over-activated. GvHD usually occurs following hematopoietic stem cell transplants (HSCTs). When T cells are over-activated, the transplanted immune system begins mistakenly attacking host tissue. Itolizumab is a monoclonal antibody designed to inhibit this activation. The American Cancer Society describes monoclonal antibodies as:

man-made proteins that act like human antibodies in the immune system.

In this case, itolizumab targets the CD6-ALCAM pathway, which prompts and mediates effector T cell activation. By targeting CD6, itolizumab inhibits the activation of these pro-inflammatory cells. Thus, GvHD symptoms reduce.

Both presentations discuss how itolizumab suppresses CD4, CD6, and CD8 T cell activation. Additionally, itolizumab prevents the over-activation of TH1 and TH17. Moving forward, this could provide a beneficial way to benefit patients and reduce mortality associated with GvHD.

Read the source press release here.

Graft-versus-Host Disease (GvHD)

Graft-versus-host disease (GvHD) is a complication which sometimes occurs following stem cell or bone marrow transplants from a donor. However, the transplanted stem cells or bone marrow sometimes view the new body as foreign; an inflammatory and immune-mediated attack follows, prompting GvHD symptoms. This complication can be acute, occurring within 6 months of transplant, or chronic, occurring over 3 months following a transplant but lasting a lifetime. For those who respond to steroid treatment, the 5-year-survival rate is 53%. For those who do not respond to treatment, the 5-year-mortality rate is estimated at around 95%.

Symptoms of an acute complication include:

• Jaundice (yellowing of the skin and eyes)
• Nausea and vomiting
• Abdominal cramps
• Diarrhea
• A red, burning rash, typically found on the trunk, palms, or soles of the feet
• Appetite loss
• Changes in liver function

Chronic symptoms include:

• Dry eyes or mouth
• Changes in vision
• Muscle and joint pain
• Painful mouth and throat ulcers
• Fatigue
• Muscle weakness
• A red, burning rash
• Difficulty eating
• Hard, brittle nails
• Hair loss
• Jaundice
• Unintended weight loss
• Shortness of breath / difficulty breathing