Complement activation determines the therapeutic activity of rituximab in vivo

J Immunol. 2003 Aug 1;171(3):1581-7. doi: 10.4049/jimmunol.171.3.1581.

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 i.v. 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 i.p. 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Antibody-Dependent Cell Cytotoxicity / genetics
  • Antibody-Dependent Cell Cytotoxicity / immunology*
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / therapeutic use*
  • Cell Division / genetics
  • Cell Division / immunology
  • Cell Survival / genetics
  • Cell Survival / immunology
  • Complement C1q / deficiency
  • Complement C1q / genetics
  • Complement C1q / physiology
  • Complement Pathway, Classical / genetics
  • Complement Pathway, Classical / immunology*
  • Humans
  • Lymphocyte Depletion
  • Lymphoma / immunology*
  • Lymphoma / pathology
  • Lymphoma / prevention & control
  • Lymphoma / therapy*
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Mice, Nude
  • Neoplasm Metastasis / immunology
  • Neoplasm Metastasis / prevention & control
  • Neoplasm Metastasis / therapy
  • Neoplasm Transplantation
  • Neutrophils / pathology
  • Rituximab
  • Tumor Cells, Cultured

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Rituximab
  • Complement C1q