Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea.
Institute of Human Genetics, Korea University College of Medicine, Seoul, Republic of Korea.
BioDrugs. 2021 Mar;35(2):147-157. doi: 10.1007/s40259-021-00471-0. Epub 2021 Feb 19.
Association of FcRn molecules to the Fc region of IgG in acidified endosomes and subsequent dissociation of the interaction in neutral pH serum enables IgG molecules to be recycled for prolonged serum persistence after internalization by endothelial cells, rather than being degraded in the serum and in the lysosomes inside the cells. Exploiting this intracellular trafficking and recycling mechanism, many researchers have engineered the Fc region to further extend the serum half-lives of therapeutic antibodies by optimizing the pH-dependent IgG Fc-FcRn interaction, and have generated various Fc variants exhibiting significantly improved circulating half-lives of therapeutic IgG antibodies. In order to estimate pharmacokinetic profiles of IgG Fc variants in human serum, not only a variety of in vitro techniques to determine the equilibrium binding constants and instantaneous rate constants for pH-dependent FcRn binding, but also diverse in vivo animal models including wild-type mouse, human FcRn transgenic mouse (Tg32 and Tg276), humanized mouse (Scarlet), or cynomolgus monkey have been harnessed. Currently, multiple IgG Fc variants that have been validated for their prolonged therapeutic potency in preclinical models have been successfully entered into human clinical trials for cancer, infectious diseases, and autoimmune diseases.
FcRn 分子与 IgG 的 Fc 区域结合,在酸性内体中,随后在中性 pH 血清中解离相互作用,使 IgG 分子在被内皮细胞内化后能够循环利用,从而延长血清半衰期,而不是在血清和细胞内溶酶体中降解。利用这种细胞内运输和再循环机制,许多研究人员对 Fc 区域进行了工程改造,通过优化 pH 依赖性 IgG Fc-FcRn 相互作用,进一步延长治疗性抗体的血清半衰期,产生了各种 Fc 变体,显著提高了治疗性 IgG 抗体的循环半衰期。为了评估 IgG Fc 变体在人血清中的药代动力学特征,不仅使用了各种体外技术来确定 pH 依赖性 FcRn 结合的平衡结合常数和瞬时速率常数,还利用了包括野生型小鼠、人 FcRn 转基因小鼠(Tg32 和 Tg276)、人源化小鼠(Scarlet)或食蟹猴在内的各种体内动物模型。目前,已经在临床前模型中验证了多种具有延长治疗效力的 IgG Fc 变体,这些变体已成功进入癌症、传染病和自身免疫性疾病的人体临床试验。