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2016 ; 64
(5
): 1699-1710
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A novel high mobility group box 1 neutralizing chimeric antibody attenuates
drug-induced liver injury and postinjury inflammation in mice
#MMPMID27474782
Lundbäck P
; Lea JD
; Sowinska A
; Ottosson L
; Fürst CM
; Steen J
; Aulin C
; Clarke JI
; Kipar A
; Klevenvall L
; Yang H
; Palmblad K
; Park BK
; Tracey KJ
; Blom AM
; Andersson U
; Antoine DJ
; Erlandsson Harris H
Hepatology
2016[Nov]; 64
(5
): 1699-1710
PMID27474782
show ga
Acetaminophen (APAP) overdoses are of major clinical concern. Growing evidence
underlines a pathogenic contribution of sterile postinjury inflammation in
APAP-induced acute liver injury (APAP-ALI) and justifies development of
anti-inflammatory therapies with therapeutic efficacy beyond the therapeutic
window of the only current treatment option, N-acetylcysteine (NAC). The
inflammatory mediator, high mobility group box 1 (HMGB1), is a key regulator of a
range of liver injury conditions and is elevated in clinical and preclinical
APAP-ALI. The anti-HMGB1 antibody (m2G7) is therapeutically beneficial in
multiple inflammatory conditions, and anti-HMGB1 polyclonal antibody treatment
improves survival in a model of APAP-ALI. Herein, we developed and investigated
the therapeutic efficacy of a partly humanized anti-HMGB1 monoclonal antibody
(mAb; h2G7) and identified its mechanism of action in preclinical APAP-ALI. The
mouse anti-HMGB1 mAb (m2G7) was partly humanized (h2G7) by merging variable
domains of m2G7 with human antibody-Fc backbones. Effector function-deficient
variants of h2G7 were assessed in comparison with h2G7 in vitro and in
preclinical APAP-ALI. h2G7 retained identical antigen specificity and comparable
affinity as m2G7. 2G7 treatments significantly attenuated APAP-induced serum
elevations of alanine aminotransferase and microRNA-122 and completely abrogated
markers of APAP-induced inflammation (tumor necrosis factor, monocyte
chemoattractant protein 1, and chemokine [C-X-C motif] ligand 1) with prolonged
therapeutic efficacy as compared to NAC. Removal of complement and/or Fc receptor
binding did not affect h2G7 efficacy. CONCLUSION: This is the first report
describing the generation of a partly humanized HMGB1-neutralizing antibody with
validated therapeutic efficacy and with a prolonged therapeutic window, as
compared to NAC, in APAP-ALI. The therapeutic effect was mediated by HMGB1
neutralization and attenuation of postinjury inflammation. These results
represent important progress toward clinical implementation of HMGB1-specific
therapy as a means to treat APAP-ALI and other inflammatory conditions.
(Hepatology 2016;64:1699-1710).
|Acetaminophen/adverse effects
[MESH]
|Analgesics, Non-Narcotic/adverse effects
[MESH]
|Animals
[MESH]
|Antibodies, Neutralizing/*therapeutic use
[MESH]
|Antipyretics/adverse effects
[MESH]
|Chemical and Drug Induced Liver Injury/*drug therapy/etiology
[MESH]