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Biotech / Medical : VD's Model Portfolio & Discussion Thread
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To: scaram(o)uche who wrote (9510)1/30/2003 1:07:20 PM
From: Icebrg  Read Replies (1) of 9719
 
>> If Antegren works MLN02 should also do so for the two IBD-indications, where it is tested. <<

>Nope. Antegren covers two important integrins, only one of which is hit by MLN02. I discussed this somewhere, maybe the psoriasis thread?>

I am not completely in agreement with you here. But, please note I wrote "should".

Antegren binds to both alfa4-beta1 and alfa4-beta7, while MLN02 only binds to alfa4-beta7. The strange thing is that it is MAdCAM-1 (which alfa4-beta7 is supposed to bind to) that is much more common in the gut and that is "considered" the most important adhesion molecules used by inflammatory cells to enter the tissue. Loose quote from:

(Antiadhesion Molecule Therapy in Inflammatory Bowel Disease; Gert Van Assche and Paul Rutgeerts - Inflammatory Bowel Diseases 8(4):291–300 © 2002 Crohn’s & Colitis Foundation of America, Inc.)

In the NEJM editorial in the issue where the natalizumab trials were discussed, it was suggested:

The effects of natalizumab in patients with Crohn’s disease are likely to involve inhibition of the binding of alfa4beta7 to MAdCAM-1. MAdCAM-1 is selectively expressed in venules in the gut and gut-associated lymphoid tissues. Its expression is enhanced in inflammatory bowel disease. Animal models of colitis have shown that antibodies to alfa4-beta7 or MAdCAM-1 attenuate T-cell–mediated intestinal inflammation. However, VCAM-1 is also induced in inflammatory bowel disease and predominates in some animal models of experimental colitis. The extent to which natalizumab exerts its therapeutic effects by inhibiting alfa4-beta1 in addition to its blockade of alfa4-beta7 remains to be determined.

So, the fact that natalizumab seems to work "better" in Crohn's than the MLNM/DNA mAb does, is not what one would expect to see. That is why I wrote "should". And please also note that the MLN02 results were not really conclusive - they were just very disappointing.

Erik
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