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Engelberts PJ, Hiemstra IH, de Jong B, Schuurhuis DH, Meesters J, Beltran Hernandez I, Oostindie SC, Neijssen J, van den Brink EN, Horbach GJ, Verploegen S, Labrijn AF, Salcedo T, Schuurman J, Parren PWHI, Breij ECW. DuoBody-CD3xCD20 induces potent T-cell-mediated killing of malignant B cells in preclinical models and provides opportunities for subcutaneous dosing. EBioMedicine 2020; 52:102625. [PMID: 31981978 PMCID: PMC6992935 DOI: 10.1016/j.ebiom.2019.102625] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/20/2019] [Accepted: 12/26/2019] [Indexed: 12/22/2022] Open
Abstract
Background DuoBody®-CD3xCD20 (GEN3013) is a full-length human IgG1 bispecific antibody (bsAb) recognizing CD3 and CD20, generated by controlled Fab-arm exchange. Its Fc domain was silenced by introduction of mutations L234F L235E D265A. Methods T-cell activation and T-cell-mediated cytotoxicity were measured by flow cytometry following co-culture with tumour cells. Anti-tumour activity of DuoBody-CD3xCD20 was assessed in humanized mouse models in vivo. Non-clinical safety studies were performed in cynomolgus monkeys. Findings DuoBody-CD3xCD20 induced highly potent T-cell activation and T-cell-mediated cytotoxicity towards malignant B cells in vitro. Comparison of DuoBody-CD3xCD20 to CD3 bsAb targeting alternative B-cell antigens, or to CD3xCD20 bsAb generated using alternative CD20 Ab, emphasized its exceptional potency. In vitro comparison with other CD3xCD20 bsAb in clinical development showed that DuoBody-CD3xCD20 was significantly more potent than three other bsAb with single CD3 and CD20 binding regions and equally potent as a bsAb with a single CD3 and two CD20 binding regions. DuoBody-CD3xCD20 showed promising anti-tumour activity in vivo, also in the presence of excess levels of a CD20 Ab that competes for binding. In cynomolgus monkeys, DuoBody-CD3xCD20 demonstrated profound and long-lasting B-cell depletion from peripheral blood and lymphoid organs, which was comparable after subcutaneous and intravenous administration. Peak plasma levels of DuoBody-CD3xCD20 were lower and delayed after subcutaneous administration, which was associated with a reduction in plasma cytokine levels compared to intravenous administration, while bioavailability was comparable. Interpretation Based on these preclinical studies, a clinical trial was initiated to assess the clinical safety of subcutaneous DuoBody-CD3xCD20 in patients with B-cell malignancies. Funding Genmab
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MESH Headings
- Animals
- Antibodies, Bispecific/genetics
- Antibodies, Bispecific/immunology
- Antibodies, Bispecific/pharmacology
- Antibody Specificity/immunology
- Antibody-Dependent Cell Cytotoxicity
- Antigens, CD20/metabolism
- Antineoplastic Agents, Immunological/pharmacology
- CD3 Complex/metabolism
- Cell Line, Tumor
- Cytotoxicity, Immunologic
- Disease Models, Animal
- Dose-Response Relationship, Drug
- Female
- Humans
- Leukemia, B-Cell/drug therapy
- Leukemia, B-Cell/etiology
- Leukemia, B-Cell/pathology
- Lymphocyte Activation/immunology
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/etiology
- Lymphoma, B-Cell/pathology
- Macaca fascicularis
- Mice
- Mutation
- Recombinant Proteins
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Xenograft Model Antitumor Assays
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Affiliation(s)
| | | | | | | | | | | | - Simone C Oostindie
- Genmab, Utrecht, The Netherlands; Dept of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | | | | | | | | | | | - Paul W H I Parren
- Genmab, Utrecht, The Netherlands; Dept of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
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Wentink M, van Bodegom-Vos L, Brouns B, Arwert H, Houdijk S, Kewalbansing P, Boyce L, Vliet Vlieland T, de Kloet A, Meesters J. How to improve eRehabilitation programs in stroke care? A focus group study to identify requirements of end-users. BMC Med Inform Decis Mak 2019; 19:145. [PMID: 31349824 PMCID: PMC6660703 DOI: 10.1186/s12911-019-0871-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 07/04/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND A user-centered design approach for eHealth interventions improves their effectiveness in stroke rehabilitation. Nevertheless, insight into requirements of end-users (patients/informal caregivers and/or health professionals) for eRehabilitation is lacking. The aim of this study was to identify end-user requirements for a comprehensive eHealth program in stroke rehabilitation. METHODS Eight focus groups were conducted to identify user requirements; six with patients/informal caregivers and two with health professionals involved in stroke rehabilitation (rehabilitation physicians, physiotherapists, occupational therapists, psychologists, team coordinators, speech therapist). The focus groups were audiotaped and transcribed in full. Direct content analysis was used to identify the end-user requirements for stroke eHealth interventions concerning three categories: accessibility, usability and content. RESULTS In total, 45 requirements for the accessibility, usability and content of a stroke eRehabilitation program emerged from the focus groups. Most requirements concerned content (27 requirements), followed by usability (12 requirements) and accessibility (6 requirements). Patients/informal caregivers and health professionals each identified 37 requirements, respectively, with 29 of them overlapping. CONCLUSIONS Requirements between stroke patients/informal caregivers and health professionals differed on several aspects. Therefore, involving the perspectives of all end users in the design process of stroke eRehabilitation programs is needed to achieve a user-centered design. TRIAL REGISTRATION The study was approved by the Medical Ethical Review Board of the Leiden University Medical Center [P15.281].
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Affiliation(s)
- Manon Wentink
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands.
- Basalt, The Hague, The Netherlands.
- Faculty of Health, Amsterdam University for Applied Sciences, Amsterdam, The Netherlands.
| | - L van Bodegom-Vos
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - B Brouns
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
- Basalt, The Hague, The Netherlands
- Faculty of Health, Nutrition and Sports, The Hague University for Applied Sciences, The Hague, The Netherlands
| | - H Arwert
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
- Basalt, The Hague, The Netherlands
| | | | | | - L Boyce
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
- Basalt, Leiden, The Netherlands
| | - T Vliet Vlieland
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
- Basalt, The Hague, The Netherlands
- Basalt, Leiden, The Netherlands
| | - A de Kloet
- Basalt, The Hague, The Netherlands
- Faculty of Health, Nutrition and Sports, The Hague University for Applied Sciences, The Hague, The Netherlands
| | - J Meesters
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
- Basalt, The Hague, The Netherlands
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van Markus-Doornbosch F, Peeters E, van der Pas S, Vlieland TV, Meesters J. Physical activity after mild traumatic brain injury: What are the relationships with fatigue and sleep quality? Eur J Paediatr Neurol 2019; 23:53-60. [PMID: 30522904 DOI: 10.1016/j.ejpn.2018.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/02/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To determine self-reported physical activity (PA) levels and relationships with fatigue and sleep quality in adolescents and young adults after mild traumatic brain injury (mTBI). SETTING Follow-up 6-18 months after visiting the emergency department of one of 2 general hospitals. PARTICIPANTS Forty-nine adolescents and young adults aged 12-25 years (mean 18.4 years), 22 (45%) male with mTBI. DESIGN Cross-sectional survey study. MAIN OUTCOME MEASURES The Activity Questionnaire for Adults and Adolescents (AQuAA), with results dichotomized into meeting or not meeting Dutch Health Enhancing PA recommendations (D-HEPA), the Checklist Individual Strength (CIS, 4 subscores) and the Pittsburgh Sleep Quality Index (PSQI, total score) were administered. RESULTS Twenty-five participants (51%) did not meet the D-HEPA recommendations. After adjusting for sex, BMI and age, not meeting the recommendations was associated with a higher CIS Total Score (OR 1.04 95%CI 1.01, 1.07) but not with PSQI Total Score (OR 0.99, 95%CI 0.80, 1.21). CONCLUSIONS In adolescents and young adults with mTBI the level of reported PA is associated with fatigue but not with sleep quality. It remains to be established whether interventions aiming to promote PA should primarily be focused on PA or fatigue or both.
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Affiliation(s)
- F van Markus-Doornbosch
- Sophia Rehabilitation, The Hague, The Netherlands; Leiden University Medical Centre, Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden, The Netherlands.
| | - E Peeters
- Haga Teaching Hospital, Juliana Children's Hospital, The Hague, The Netherlands
| | - S van der Pas
- Leiden University Medical Centre, Medical Statistics, Department of Biomedical Data Sciences, Leiden, The Netherlands
| | - T Vliet Vlieland
- Sophia Rehabilitation, The Hague, The Netherlands; Leiden University Medical Centre, Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden, The Netherlands; Rijnlands Rehabilitation Centre, Leiden, The Netherlands
| | - J Meesters
- Sophia Rehabilitation, The Hague, The Netherlands; Leiden University Medical Centre, Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden, The Netherlands
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Meesters J, Beckers L, Francque S, Roeyen G, De Greef K, Hartman V, Michielsen P, Dams K, Vanwolleghem T. Cytomegalovirus pleuropericarditis after orthotopic liver transplantation. Acta Gastroenterol Belg 2018; 81:427-429. [PMID: 30350533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cytomegalovirus (CMV) reactivation is a common complication after liver transplantation. In patients with CMV infection, indicated by a positive CMV DNA titer, the presence of any clinical symptom is termed CMV disease. The most common organ affected in CMV disease is the gastrointestinal tract, causing esophagitis, gastritis, enteritis or colitis. CMV infection of the pleura and pericard has been reported in immunocompromised patients, but is rarely seen following liver transplantation.We report a case of a 59-year-old male who developed CMV pleuropericarditis after liver transplantation. Initial ganciclovir treatment did not improve the patient's symptoms and therapy was switched to Foscarnet which ultimately resulted in resolution of infection. However, a few weeks after Foscarnet cessation, the patient again developed bilateral pleural effusion. Ultimate biochemical and clinical response was achieved with IV ganciclovir treatment. The patient was discharged from the hospital with oral Valganciclovir for 3 weeks and has since remained relapse free for >1 year.
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Affiliation(s)
- J Meesters
- Antwerp University Hospital, Department of Gastroenterology and Hepatology
| | - L Beckers
- Antwerp University Hospital, Department of Gastroenterology and Hepatology
| | - S Francque
- Antwerp University Hospital, Department of Gastroenterology and Hepatology
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp
| | - G Roeyen
- Antwerp University Hospital, Department of Hepatobiliary Surgery
| | - K De Greef
- Antwerp University Hospital, Department of Hepatobiliary Surgery
| | - V Hartman
- Antwerp University Hospital, Department of Hepatobiliary Surgery
| | - P Michielsen
- Antwerp University Hospital, Department of Gastroenterology and Hepatology
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp
| | - K Dams
- Antwerp University Hospital, Department of Intensive Care
| | - T Vanwolleghem
- Antwerp University Hospital, Department of Gastroenterology and Hepatology
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp
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Wentink MM, Meesters J, Berger MAM, de Kloet AJ, Stevens E, Band GPH, Kromme CH, Wolterbeek R, Goossens PH, Vliet Vlieland TPM. Adherence of stroke patients with an online brain training program: the role of health professionals’ support. Top Stroke Rehabil 2018; 25:359-365. [DOI: 10.1080/10749357.2018.1459362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- M. M. Wentink
- Sophia Rehabilitation, The Hague, The Netherlands
- Faculty of Health, Nutrition and Sports, The Hague University of Applied Sciences, The Hague, The Netherlands
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
- Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - J. Meesters
- Sophia Rehabilitation, The Hague, The Netherlands
- Faculty of Health, Nutrition and Sports, The Hague University of Applied Sciences, The Hague, The Netherlands
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
| | - M. A. M. Berger
- Faculty of Health, Nutrition and Sports, The Hague University of Applied Sciences, The Hague, The Netherlands
| | - A. J. de Kloet
- Sophia Rehabilitation, The Hague, The Netherlands
- Faculty of Health, Nutrition and Sports, The Hague University of Applied Sciences, The Hague, The Netherlands
| | - E. Stevens
- Helen Dowling Institute, Bilthoven, The Netherlands
| | - G. P. H. Band
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - C. H. Kromme
- Sophia Rehabilitation, The Hague, The Netherlands
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
| | - R. Wolterbeek
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
| | - P. H. Goossens
- Sophia Rehabilitation, The Hague, The Netherlands
- Rijnlands Rehabilitation Centre, Leiden, The Netherlands
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
| | - T. P. M. Vliet Vlieland
- Sophia Rehabilitation, The Hague, The Netherlands
- Rijnlands Rehabilitation Centre, Leiden, The Netherlands
- Department of Orthopaedics, Rehabilitation Medicine and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
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Hammond A, Meesters J, Vliet Vlieland T, Peeters A, Tennant A, Tyson S, Nordenskiold U, Prior Y. AB1056 Psychometric Testing of The Dutch Evaluation of Daily Activities Questionnaire in Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Leichtenberg C, Meesters J, Verdegaal S, Kaptein B, Koster L, Kroon H, Nelissen R, Vliet Vlieland T, van der Esch M. SAT0441 Prevalence of Self-Reported Knee Joint Instability and Its Association with Radiographic Features in Severe Knee Osteoarthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wentink MM, Berger MAM, de Kloet AJ, Meesters J, Band GPH, Wolterbeek R, Goossens PH, Vliet Vlieland TPM. The effects of an 8-week computer-based brain training programme on cognitive functioning, QoL and self-efficacy after stroke. Neuropsychol Rehabil 2016; 26:847-65. [DOI: 10.1080/09602011.2016.1162175] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Groeneveld I, Meesters J, Arwert H, Roux-Otter N, Ribbers G, Bennekom C, Goossens P, Vlieland T. Practice variation in the structure of stroke rehabilitation in four rehabilitation centres in the Netherlands. J Rehabil Med 2016; 48:287-92. [DOI: 10.2340/16501977-2054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Claassen A, Vliet Vlieland T, Meesters J, Pellegrom S, Noordman J, Kaarls-Ohms B, Peters A, Vooijs J, Willemsen-de Mey G, van den Ende C. PARE0009 Factors Influencing the Use of a Self-Management Care Booklet for Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meesters J, Koele R, van Gestel M, Smeets R, Vliet Vlieland T. SAT0645-HPR Which Problems in Functioning Are Identified Before and Improve After a Multidisciplinary Rehabilitation Program for Chronic Musculoskeletal Pain? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Meesters J, Pont W, Beaart-Van De Voorde L, Stamm T, Vliet Vlieland T. Do rehabilitation tools cover the perspective of patients with rheumatoid arthritis? A focus group study using the ICF as a reference. Eur J Phys Rehabil Med 2014; 50:171-184. [PMID: 23698472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Despite the advocated use of rehabilitation tools in clinical rehabilitation of with rheumatoid arthritis (RA) patients, little is known about the representation of the patient perspective in these tools. AIM Aim of the study was to explore the experiences of RA patients with rehabilitation and the coverage by rehabilitation tools. DESIGN AND POPULATION Qualitative focus group study with RA patients about experiences with rehabilitation. SETTING Rheumatology rehabilitation clinic of a Dutch university hospital. METHODS Focus groups were tape recorded and transcribed verbatim. From the meaningful units, concepts were extracted and linked to the International Classification of Functioning, Disability and Health (ICF). Rehabilitation tools validated for RA were identified using a structured literature search. Using the ICF as common framework, we determined for each concept identified in the focus groups the coverage by each rehabilitation tool. RESULTS Nineteen patients participated in 4 focus groups. Fifty-one concepts were identified in 368 meaningful units derived from the transcribed data. From the literature the ICF Core Sets for RA, Canadian Occupational Performance Measure, Rehabilitation Activities Profile and WHO Disability Assessment Schedule II were elected. The concepts from the focus groups were best covered by the ICF Core Sets (44 out of 51; 86%), followed by the WHODAS II (39%), RAP (35%) and COPM (16%). CONCLUSION With the exception of the ICF Core Sets for RA, current rehabilitation tools poorly cover the RA patients' perception on rehabilitation. CLINICAL REHABILITATION IMPACT The ICF Core Sets can serve as a checklist to guide multidisciplinary assessment, goal-setting and evaluation in RA rehabilitation.
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Affiliation(s)
- J Meesters
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands -
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Hagel S, Lindqvist E, Petersson I, Meesters J, Klokkerud M, Aanerud G, Stovgaard I, Hørslev-Petersen K, Strömbeck B, Vlieland T, Bremander A. Which patients improve the most after arthritis rehabilitation? A study of predictors in patients with inflammatory arthritis in Northern Europe, the STAR-ETIC collaboration. J Rehabil Med 2014; 46:250-7. [DOI: 10.2340/16501977-1267] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Meesters J. SP0183 Social Media in Rheumatic and Musculoskeletal Diseases: The Importance of the Patient Perspective and Mapping Resources. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meesters J, Pont W, Beaart-van de Voorde L, Stamm T, Vliet Vlieland T. OP0081 Concepts important to patients with rheumatoid arthritis in rehabilitation and their coverage by rehabilitation tools. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ndosi M, Bremander A, Hamnes B, Horton M, Kukkurainen ML, Machado P, Marques A, Meesters J, Stamm T, Tennant A, Torre-Aboki JDL, Vliet Vlieland T, Zangi H, Hill J. OP0283 Validation of the Educational Needs Assessment Tool as a Generic Instrument for Rheumatic Diseases in 7 European Countries. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rispens T, Meesters J, den Bleker TH, Ooijevaar-De Heer P, Schuurman J, Parren PWHI, Labrijn A, Aalberse RC. Fc-Fc interactions of human IgG4 require dissociation of heavy chains and are formed predominantly by the intra-chain hinge isomer. Mol Immunol 2012; 53:35-42. [PMID: 22784992 DOI: 10.1016/j.molimm.2012.06.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 06/14/2012] [Accepted: 06/15/2012] [Indexed: 01/13/2023]
Abstract
Human IgG4 antibodies are remarkable not only because they can dynamically exchange half-molecules (Fab-arm exchange) but also for their ability to interact with the Fc part of IgG4 and other IgG subclasses. This rheumatoid factor-like binding of IgG4 does not appear to take place spontaneously, because it is only observed to solid-phase or antigen-bound IgG. We hypothesized that Fc-Fc interactions might involve (partial) dissociation of heavy chains. We investigated the molecular basis of these Fc-Fc interactions, and found that the structural features important for the exchange reaction also control the Fc binding activity. In particular, if arginine-409 in the CH(3)-CH(3) interface in IgG4 is mutated to lysine (the equivalent in IgG1), Fc-Fc interactions are formed 3 orders of magnitude less efficiently compared to the wild-type. This mutation was previously found to increase the CH(3)-CH(3) interaction strength in IgG4. Furthermore, of the two hinge isomers of IgG4, the intra-chain (non-covalently linked) form was found to form Fc-Fc interactions, but not the inter-chain form. Together, these results demonstrate that Fc-Fc interactions of IgG4 involve (partial or complete) dissociation of heavy chains. The promiscuity to other IgG subclasses suggests that IgG4 might act as scavenger to IgG molecules with impaired structural integrity.
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Labrijn AF, Rispens T, Meesters J, Rose RJ, den Bleker TH, Loverix S, van den Bremer ETJ, Neijssen J, Vink T, Lasters I, Aalberse RC, Heck AJR, van de Winkel JGJ, Schuurman J, Parren PWHI. Species-Specific Determinants in the IgG CH3 Domain Enable Fab-Arm Exchange by Affecting the Noncovalent CH3–CH3 Interaction Strength. J I 2011; 187:3238-46. [DOI: 10.4049/jimmunol.1003336] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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