Maptimmune BV, The Hague, The Netherlands.
Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
J Alzheimers Dis. 2021;80(2):813-829. doi: 10.3233/JAD-201334.
Alzheimer's disease (AD) and other tauopathies are neurodegenerative disorders characterized by cellular accumulation of aggregated tau protein. Tau pathology within these disorders is accompanied by chronic neuroinflammation, such as activation of the classical complement pathway by complement initiation factor C1q. Additionally, about half of the AD cases present with inclusions composed of aggregated alpha-synuclein called Lewy bodies. Lewy bodies in disorders such as Parkinson's disease and Lewy body dementia also frequently occur together with tau pathology.
Immunotherapy is currently the most promising treatment strategy for tauopathies. However, the presence of multiple pathological processes within tauopathies makes it desirable to simultaneously target more than one disease pathway.
Herein, we have developed three bispecific antibodies based on published antibody binding region sequences. One bispecific antibody binds to tau plus alpha-synuclein and two bispecific antibodies bind to tau plus C1q.
Affinity of the bispecific antibodies to their targets compared to their monospecific counterparts ranged from nearly identical to one order of magnitude lower. All bispecific antibodies retained binding to aggregated protein in patient-derived brain sections. The bispecific antibodies also retained their ability to inhibit aggregation of recombinant tau, regardless of whether the tau binding sites were in IgG or scFv format. Mono- and bispecific antibodies inhibited cellular seeding induced by AD-derived pathological tau with similar efficacy. Finally, both Tau-C1q bispecific antibodies completely inhibited the classical complement pathway.
Bispecific antibodies that bind to multiple pathological targets may therefore present a promising approach to treat tauopathies and other neurodegenerative disorders.
阿尔茨海默病(AD)和其他 tau 病是神经退行性疾病,其特征是细胞内聚集的 tau 蛋白积累。这些疾病中的 tau 病理学伴随着慢性神经炎症,例如补体起始因子 C1q 激活经典补体途径。此外,大约一半的 AD 病例存在称为路易体的聚集的 alpha-突触核蛋白组成的包涵体。帕金森病和路易体痴呆等疾病中的路易体也常与 tau 病理学一起发生。
免疫疗法是目前治疗 tau 病最有前途的治疗策略。然而,tau 病中存在多种病理过程,使得同时针对多个疾病途径成为理想选择。
本文中,我们基于已发表的抗体结合区序列开发了三种双特异性抗体。一种双特异性抗体结合 tau 加 alpha-突触核蛋白,两种双特异性抗体结合 tau 加 C1q。
与单特异性抗体相比,双特异性抗体对其靶标的亲和力范围从几乎相同到相差一个数量级。所有双特异性抗体都保留了与源自患者大脑切片中的聚集蛋白的结合能力。双特异性抗体还保留了抑制重组 tau 聚集的能力,无论 tau 结合位点是 IgG 还是 scFv 形式。单特异性和双特异性抗体以相似的效力抑制 AD 来源的病理性 tau 诱导的细胞播种。最后,两种 Tau-C1q 双特异性抗体完全抑制了经典补体途径。
因此,结合多个病理靶标的双特异性抗体可能是治疗 tau 病和其他神经退行性疾病的一种有前途的方法。