Novel monoclonal antibodies for therapy of multiple sclerosis
EXPERT OPINION ON BIOLOGICAL THERAPY
Authors: Knier, Benjamin; Hemmer, Bernhard; Korn, Thomas
Abstract
Introduction: Monoclonal antibodies play an important role in the therapy of different autoimmune diseases. With the introduction of natalizumab, the importance of monoclonal antibodies in the therapy of multiple sclerosis (MS) has dramatically increased during the past years. Areas covered: In this review, we will focus on newly approved and emerging antibodies for MS therapy. Based on published original articles and citable meeting abstracts, we will discuss their mode of action as well as data on efficacy and safety. Expert opinion: Natalizumab was a breakthrough in MS therapy. However, side effects of this monoclonal antibody limit its use. The risk/benefit ratios of new biologicals in MS therapy are not yet clear. High-yield process daclizumab might qualify as first-line MS therapy, unless hepatotoxicity becomes a relevant safety concern. Alemtuzumab has been approved for MS therapy in Europe but will be reserved for selected patients with highly active disease due to frequent induction of potentially dangerous secondary autoimmune phenomena. Ocrelizumab will likely also be licensed as a second-line therapy in highly active MS. Neutralizing antibodies to interleukin (IL)-17A and blocking antibodies to leucine rich repeat and Ig domain containing 1 might be the most interesting upcoming new antibodies as both offer a new and pathophysiologically relevant approach in MS therapy.
Ancestry-specific and sex-specific risk alleles identified in a genome-wide gene-by-alcohol dependence interaction study of risky sexual behaviors
AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS
Authors: Polimanti, Renato; Zhao, Hongyu; Farrer, Lindsay A.; Kranzler, Henry R.; Gelernter, Joel
Abstract
We previously mapped loci for the genome-wide association studies (GWAS) and genome-wide gene-by-alcohol dependence interaction (GW-GxAD) analyses of risky sexual behaviors (RSB). This study extends those findings by analyzing the ancestry- and sex-specific AD-stratified effects on RSB. We examined the concordance of findings for the AD-stratified GWAS and the GW-GxAD analysis of RSB, with concordance defined as genome-wide significance in one analysis and at least nominal significance in the second analysis. A total of 2,173 African-American (AA) and 1,751 European-American (EA) subjects were investigated. Information regarding RSB (lifetime experiences of unprotected sex and multiple sexual partners) and DSM-IV diagnosis of lifetime AD were derived from the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). In our ancestry- and sex-specific analyses, we identified four independent genome-wide significant (GWS) loci (p<5*10(-8)) and one suggestive locus (p<6*10(-8)). In men, we observed a GWS signal in FAM162A (rs2002594, p=4.96*10(-8)). In women, there was a suggestive locus in PLGRKT (rs3824435, p=5.52*10(-8)). In AAs, there was a GWS signal in GRK5 (rs1316543, p=1.25*10(-9)). In AA men, we observed an intergenic GWS signal (rs12898370, p=4.49*10(-8)) near LINGO1. In EA men, there was a GWS signal in CCSER1 (rs62313897; p=7.93*10(-10)). The loci identified in this GWAS implicate molecular mechanisms related to psychiatric illness and personality features, suggesting that the interplay between AD and RSB is mediated by alleles associated with behavioral traits.