Imlifidase as a Potential Treatment for Antibody-Mediated Rejection

AbstractPurpose of ReviewAntibody-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 fromStreptococcus 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 FindingsThe 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.SummaryImlifidase is currently being evaluated in comparison to plasmapheresis in a clinical trial and is a potential therapy for ABMR in kidney transplantation.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research