Indication: Thymoglobulin® (anti-thymocyte globulin (rabbit)) is indicated for the prophylaxis and treatment of acute rejection in patients receiving a kidney transplant. Thymoglobulin is to be used in conjunction with concomitant immunosuppression.
Indication: Thymoglobulin® (anti-thymocyte globulin (rabbit)) is indicated for the prophylaxis and treatment of acute rejection in patients receiving a kidney transplant. Thymoglobulin is to be used in conjunction with concomitant immunosuppression.

About Thymoglobulin®

Thymoglobulin May Suppress the Immune Response Through Multiple Pathways1

The mechanism of action by which Thymoglobulin suppresses the immune response is not fully understood, but may include1:

  • T-cell clearance from the circulation
  • Modulation of T-cell activation, homing, and cytotoxic activities

Thymoglobulin includes antibodies against T-cell markers such as CD2, CD3, CD4, CD8, CD11a, CD18, CD25, CD44, CD45, HLA-DR, HLA Class I heavy chains, and β2 microglobulin.1


Potential Mechanisms of Action of Thymoglobulin

T-Cell Clearance From the Circulation

Thymoglobulin may deplete T cells through 3 different mechanisms:

  • Apoptosis via activation-induced cell death2-5
  • Antibody-dependent cell-mediated cytotoxicity4,6
  • Complement-dependent cytotoxicity4,6

The clinical significance of these mechanisms is unknown.


Mean T-cell Counts Following Initiation of Thymoglobulin Therapy

Based on data collected from 12 patients in the phase 3 trial, T-cell depletion is usually observed within a day from initiating Thymoglobulin therapy.1

Mean T-Cell counts following initiation of Thymoglobulin therapy chart

Modulation of T-Cell Activation, Homing, and Cytotoxic Activities

Thymoglobulin may modulate immunosuppression through the following mechanisms:

  • Downmodulation of the expression of several molecules that control T-cell activation (ie, TCR/CD3, CD4, CD8, CD25, CD45, HLA class I, HLADR)1,6
  • Binding to selectins and integrin families (CD11a, CD18), thereby preventing T-cell homing1,6-8
  • Prevention of cytotoxic activities1,6

See the Data
From Thymoglobulin Clinical Studies.
Learn More

Important Safety Information for Thymoglobulin
[Anti-thymocyte Globulin (Rabbit)]:

WARNING: IMMUNOSUPPRESSION. Thymoglobulin should only be used by physicians experienced in immunosuppressive therapy in transplantation.

Important Safety Information for Thymoglobulin [Anti-thymocyte Globulin (Rabbit)]:

WARNING: IMMUNOSUPPRESSION. Thymoglobulin should only be used by physicians experienced in immunosuppressive therapy in transplantation.

Click here for full Prescribing Information including Boxed WARNING.

References:
  1. Thymoglobulin [prescribing information]. Cambridge, MA: Genzyme Corporation; 2017.
  2. Woodside KJ, Hu M, Gugliuzza KK, Hunter GC, Daller JA. T-lymphocyte apoptosis is increased by non-interleukin-2-dependent induction in human mixed lymphocyte cultures. Transplant Proc. 2005;37(4):1949-1952.
  3. Bonnefoy-Berard N, Genestier L, Preville X, Revillard JP. TNF alpha and CD95-L contribute to apoptosis of activated lymphocytes triggered by ATGs. Transplant Proc. 1999;31(1-2):775-777.
  4. Genestier L, Fournel S, Flacher M, Assossou O, Revillard JP, Bonnefoy-Berard N. Induction of Fas (Apo-1, CD95)-mediated apoptosis of activated lymphocytes by polyclonal antithymocyte globulins. Blood. 1998;91(7):2360- 2368.
  5. Abbas AK, Lichtman AH, Pillai S. Cellular and Molecular Immunology. 7th ed. Philadelphia: Saunders/Elsevier; 2012.
  6. Murphy K. Chapter 2: Innate immunity: the first lines of defense and Chapter 10: The humoral immune response. Janeway's Immunobiology. 8th ed. New York, NY: Garland Science; 2012:37-74; 387-428.
  7. Michallet MC, Preville X, Flacher M, Fournel S, Genestier L, Revillard JP. Functional antibodies to leukocyte adhesion molecules in antithymocyte globulins. Transplantation. 2003;75(5):657-662.
  8. Haidinger M, Geyeregger R, Poglitsch M, et al. Antithymocyte globulin impairs T-cell/antigen-presenting cell interaction: disruption of immunological synapse and conjugate formation. Transplantation. 2007;84(1):117-121.