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2018 ; 13
(4
): e0195909
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English Wikipedia
Design and preclinical characterization of ALXN1210: A novel anti-C5 antibody
with extended duration of action
#MMPMID29649283
Sheridan D
; Yu ZX
; Zhang Y
; Patel R
; Sun F
; Lasaro MA
; Bouchard K
; Andrien B
; Marozsan A
; Wang Y
; Tamburini P
PLoS One
2018[]; 13
(4
): e0195909
PMID29649283
show ga
Eculizumab, a monoclonal antibody (mAb) directed against complement protein C5,
is considered to be the current standard of care for patients with paroxysmal
nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome. This study
describes the generation and preclinical attributes of ALXN1210, a new
long-acting anti-C5 mAb, obtained through select modifications to eculizumab to
both largely abolish target-mediated drug disposition (TMDD) and increase
recycling efficiency via the neonatal Fc receptor (FcRn). To attenuate the effect
of TMDD on plasma terminal half-life (t1/2), histidine substitutions were
engineered into the complementarity-determining regions of eculizumab to enhance
the dissociation rate of the mAb:C5 complex in the acidic early endosome relative
to the slightly basic pH of blood. Antibody variants with optimal pH-dependent
binding to C5 exhibited little to no TMDD in mice in the presence of human C5. To
further enhance the efficiency of FcRn-mediated recycling of the antibody, two
additional substitutions were introduced to increase affinity for human FcRn.
These substitutions yielded an additional doubling of the t½ of surrogate
anti-mouse C5 antibodies with reduced TMDD in transgenic mice expressing the
human FcRn. In conclusion, ALXN1210 is a promising new therapeutic candidate
currently in clinical development for treatment of patients with PNH and atypical
hemolytic uremic syndrome.