RHA™ anti-Peanut Ara h2 monoclonal antibody, clone 1B

Introduction Methotrexate intoxication following high-dose methotrexate-induced acute kidney injury is a life-threatening complication. Glucarpidase can quickly reduce extracellular methotrexate to safe levels, but the effectiveness and safety of its use in different episodes of nephrotoxicity remain an unknown area. Case Report A 30-year-old male diagnosed with acute lymphoblastic T-cell lymphoma received methotrexate 5 g/m2 intravenous (IV) as part of the first consolidation cycle. On Consolidation 3, he restarted methotrexate at a dose of 3 g/m2 IV showing slow methotrexate elimination, associated myelosuppression, and hepatic toxicity. Glucarpidase was administered (total dose of 2000 International Units (IU)). No adverse events were observed, and his renal function returned to normal. One hundred and six days later, he was diagnosed with leptomeningeal and cerebellar relapse and treatment with methotrexate 3,5 g/m2 IV day 1 and cytosine arabinoside (Ara-C) 2 g/m2 IV twice per day days 1, 3, and 5 was started. At 36 h from methotrexate infusion, serum creatinine increased up to 1.89 mg/dL and methotrexate concentration was 100 mu mol/L. Management and Outcome:Ara-C was suspended, and a second administration of glucarpidase (2000 IU) was dispensed. No adverse events were noticed, methotrexate levels decreased and renal function progressively improved, recovering completely three weeks later. Discussion The effectiveness and safety of the use of glucarpidase in different episodes of nephrotoxicity remain an unknown area, and the rate and consequences of antiglucarpidase antibody formation remain poorly understood. This case report is, to our knowledge, the first case of a second administration of glucarpidase in a different cycle of high-dose methotrexate in an adult patient.

A highly sensitive disposable amperometric magnetoimmunosensor for the rapid determination of Ara h 2 protein, one of the major peanut allergens, is reported. The approach uses a sandwich configuration involving selective capture and detector antibodies and carboxylic acid-modified magnetic beads (HOOC-MBs). Detector antibodies are labeled with HRP-conjugated secondary antibodies and the MBs bearing the immunoconjugates are magnetically captured on surface of a disposable screen-printed carbon electrode (SPCE). The affinity reactions are monitored amperometrically at -0.20 V (vs a Ag pseudo-reference electrode) in the presence of hydroquinone (HQ) as electron transfer mediator and upon addition of H2O2 as the enzyme substrate. The developed magnetoimmunosensor exhibits a wide range of linearity between 87 and 10,000 pg mL(-1) Ara h 2 with a detection limit of 26 pg mL(-1) as well as a great selectivity against other non-target proteins. The magnetoimmunosensing platform was successfully applied for the detection of Ara h 2 in different food extracts. After an appropriate sample dilution no matrix effects were observable. The developed methodology was able to detect trace amounts of the peanut allergen (0.0005% or 5.0 mg kg(-1)) in wheat flour spiked samples. The results correlated properly with those provided by a commercial ELISA kit. (C) 2016 Elsevier B.V. All rights reserved.