Torque Teno virus control by the classical pathway of complement
activation -- a retrospective analysis from a first-in-human trial
utilizing sutimlimab
Abstract
Torque Teno virus (TTV) load is linked with the functionality of its
host’s immune system and has been proposed as a potential monitoring
tool for immune-modulating therapy. However, the immunological
mechanisms of TTV control are incompletely understood. To assess the
effect of the classical complement pathway on TTV, 64 healthy volunteers
and 10 kidney transplant recipients treated with the anti-C1s antibody
sutimlimab were analyzed for serum TTV copy numbers (c/mL) by qPCR.
Overall, a correlation was observed between the decrease in complement
activity caused by sutimlimab and the TTV load increase (ρ = −0.367,
p < 0.001). Subgroup analysis indicated a trend toward
TTV load increase in healthy volunteers following the highest sutimlimab
dose compared to baseline (100 mg/kg body weight; median 3.5 log
10 c/mL, interquartile range [IQR] 2.8–4.4 versus
2.9 log 10 c/mL, 0.8–3.5; p = 0.063).
Administering multiple lower doses (30 mg/kg) also showed a trend toward
TTV load increase in healthy volunteers (1.8 log 10
c/mL, 0–2.3 versus 1.9, 1.3–2.8; p = 0.054) and a significant
increase in transplant recipients (3.5 log 10 c/mL,
3.0–6.1 versus 4.1, 3.5–6.4; p = 0.004). This report suggests a
role for the classical complement pathway in controlling TTV load.