New therapy with antibodies effective in chronic anemia
A German research team contributed to the development of an innovative antibody as a potential new therapy for chronic anemia in dialysis patients. The added value of the approach lies in the lower required dose of erythropoietin and the associated minimization of the cardiovascular risk. The Innsbruck team worked with the pharmaceutical company Kymab. Under the direction of Igor Theurl from the University Clinic for Internal Medicine, the researchers have now tested the new human monoclonal antibody KY1070. The effectiveness was proven in Innsbruck in an animal model that can be transferred to kidney damage requiring dialysis.
Medicine and new therapy against anemia
Chronic anemia is a common problem among dialysis patients. In addition to the functional iron deficiency caused by chronic inflammation, the damaged kidneys in these patients lead to insufficient production of the hormone erythropoietin (EPO), the most important hormone for blood formation. The administration of EPO is therefore a cornerstone in the therapy against anemia. Despite the maximum dosage, the formation of the oxygen transport protein hemoglobin in dialysis patients remains limited due to the development of resistance to EPO. Medicine has also linked EPO to increased mortality from cardiovascular problems. This warning creates an additional dilemma for dialysis patients, as kidney failure itself is associated with an increased cardiovascular risk.
The antibody for the new therapy works in such a way that it inhibits the regulator of iron in the blood. In animals that did not respond adequately to EPO, the combination with the antibody enabled a sufficient increase in hemoglobin. In addition, a lower dose was sufficient to combat anemia, which, given the side effects of EPO, is an important basis for use in dialysis patients. The researchers have published their results in the renowned journal BLOOD. Medicine can use the therapeutic potential of the new antibody either as a monotherapy or in combination with EPO. The antibody affects the transmission of signals for the formation of hepcidin. As a result, there is a new therapy that offers long-term inhibition of the production of hepcidin. Thus, this approach enables sufficient iron, which is essential for the formation of red blood cells.
Possible treatment
According to the study authors, the effects of combination therapy are multifactorial. The main advantage of the combined treatment lies in the reduction in the dose of erythropoietin. In this way, the cardiovascular risk does not increase further, while at the same time a sufficient amount of iron is available. In addition, the researchers were able to show that the inhibition of hepcidin increases the expression of the iron transport protein ferroportin on the blood-forming cells in the bone marrow. Together with EPO, this leads to more effective blood formation, according to Igor Theurl.
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