VLA-2 blockade in vivo by vatelizumab induces CD4+FoxP3+ regulatory T cells

J Breuer, T Schneider-Hohendorf… - International …, 2019 - academic.oup.com
J Breuer, T Schneider-Hohendorf, P Ostkamp, S Herich, S Rakhade, I Antonijevic, L Klotz…
International Immunology, 2019academic.oup.com
Integrin α2β1, also known as very late antigen (VLA)-2, is a collagen-binding molecule
expressed constitutively on platelets. Vatelizumab, a monoclonal antibody targeting the α2
subunit (CD49b) of VLA-2, was recently investigated for its safety and efficacy during a
Phase 2 clinical study in multiple sclerosis patients, as integrin-mediated collagen binding at
the site of inflammation is central to a number of downstream pro-inflammatory events. In the
course of this study, we could show that VLA-2 is expressed ex vivo on platelets, platelet–T …
Abstract
Integrin α2β1, also known as very late antigen (VLA)-2, is a collagen-binding molecule expressed constitutively on platelets. Vatelizumab, a monoclonal antibody targeting the α2 subunit (CD49b) of VLA-2, was recently investigated for its safety and efficacy during a Phase 2 clinical study in multiple sclerosis patients, as integrin-mediated collagen binding at the site of inflammation is central to a number of downstream pro-inflammatory events. In the course of this study, we could show that VLA-2 is expressed ex vivo on platelets, platelet–T-cell aggregates, as well as a small population of highly activated memory T cells. Even though the clinical trial did not meet its primary clinical end-point (reduction in the cumulative number of new contrast-enhancing lesions on magnetic resonance imaging (MRI)), we observed enhanced frequencies of regulatory T cells (TREG) following vatelizumab treatment. Elevated TREG frequencies might be explained by the inhibition of p38 mitogen-activated protein kinase (MAPK) signaling, which is critically involved in the polarization of T helper 17 (TH17) cells and is activated by the α2 integrin cytoplasmic domain. Our findings suggest that blockade of VLA-2 might be a way to safely shift the TH17/TREG balance by inducing TREGin vivo.
Oxford University Press