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Zanolimumab is a fully human monoclonal antibody that targets the CD4 antigen expressed on a subset of T cells. It was developed as an immunosuppressive and antineoplastic agent for the treatment of diseases such as rheumatoid arthritis, psoriasis, melanoma, cutaneous T-cell lymphoma (CTCL), and peripheral T-cell lymphoma. Zanolimumab binds to the CD4 molecule on T cells and interferes with its interaction with major histocompatibility complex class II (MHC-II), leading to dose-dependent inhibition of T cell activation. The drug inhibits signaling via the T cell receptor (TCR) and transmits direct inhibitory signals to downregulate activation. Additionally, zanolimumab induces killing of CD4+ T cells through antibody-dependent cellular cytotoxicity (ADCC) without complement-dependent cytotoxicity. Despite promising early results in CTCL and other indications, all clinical development was ultimately discontinued due to lack of significant efficacy in some indications or strategic reasons[1][2][4][5][10].
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