enlimomab

Enlimomab is a murine IgG2a monoclonal antibody designed to target human Intercellular Adhesion Molecule-1 (ICAM-1, also known as CD54). Its primary intended mechanism of action is to inhibit leukocyte adhesion to the vascular endothelium, thereby reducing leukocyte extravasation and inflammatory tissue injury. While initially showing promise in early clinical trials for conditions such as refractory rheumatoid arthritis, acute rejection after kidney and liver allograft transplantations, and partial thickness burn injury, a large Phase 3 clinical trial for acute ischemic stroke demonstrated negative outcomes, including increased mortality and adverse events like infections and fever. These adverse effects were partly attributed to the drug's murine origin, leading to immunogenicity (human anti-mouse antibody response), and an unintended complement-dependent activation of neutrophils.