LONDON, ENGLAND -- Oct. 2, 1998 -- Injecting patients with antibodies against their own immune cells may be useful in the treatment of severe chronic asthma, researchers working in the United Kingdom and the United States report in this week’s issue of The Lancet.

Asthma is caused by inflammation in the airways of the lungs. In large part, this inflammation is mediated by a type of immune cell called the eosinophil, large numbers of which are found in the airways of asthma patients. These cells, in turn, are stimulated by chemical signals from another type of immune cell, the CD4 T lymphocyte, so called because they carry a molecule on their surface that has been designated CD4.

Dr. Onn Kon of the London Chest Hospital, London, England and co-workers used a genetically-engineered monoclonal antibody against the CD4 molecule, called keliximab, to treat patients with severe chronic asthma. The researchers hoped the antibodies would reduce the number of CD4 cells and lessen inflammation.

In the study, 22 patients were divided into three different dosage groups. In each group, two patients received an inactive placebo while the rest received either 0.5 mg/kg, 1.5 mg/kg, or 3.0 mg/kg of the antibody. The patients recorded their symptoms in a daily diary and every morning and evening did a pulmonary function test called a peak expiratory flow (PEF) measurement, which ordinarily tends to be low in asthma. Their CD4 T-cell counts and pulmonary function were also checked at serial follow-up checks.

Compared with patients treated with placebo, the CD4 T cell counts of patients receiving the antibody fell in all dosage groups, but the drops were greater and more long-lasting in the 3·0 mg/kg group. The home PEF measurements were also significantly better in this group, but symptoms scores reported in the daily diaries were not significantly different.

"Our findings raise the possibility that T-cell directed treatment may be an alternative approach to the treatment of severe asthma," the researchers write.

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