Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, Chapel Hill, NC 27599, USA.
Int J Mol Sci. 2021 Mar 17;22(6):3048. doi: 10.3390/ijms22063048.
As an essential modulator of IgG disposition, the neonatal Fc receptor (FcRn) governs the pharmacokinetics and functions many therapeutic modalities. In this review, we thoroughly reexamine the hitherto elucidated biological and thermodynamic properties of FcRn to provide context for our assessment of more recent advances, which covers antigen-binding fragment (Fab) determinants of FcRn affinity, transgenic preclinical models, and FcRn targeting as an immune-complex (IC)-clearing strategy. We further comment on therapeutic antibodies authorized for treating SARS-CoV-2 (bamlanivimab, casirivimab, and imdevimab) and evaluate their potential to saturate FcRn-mediated recycling. Finally, we discuss modeling and simulation studies that probe the quantitative relationship between in vivo IgG persistence and in vitro FcRn binding, emphasizing the importance of endosomal transit parameters.
作为 IgG 分布的重要调节因子,新生儿 Fc 受体(FcRn)控制着许多治疗方式的药代动力学和功能。在这篇综述中,我们彻底重新审视了迄今为止阐明的 FcRn 的生物学和热力学特性,为我们对最近进展的评估提供了背景,这些进展涵盖了 FcRn 亲和力的抗原结合片段(Fab)决定簇、转基因临床前模型,以及将 FcRn 作为免疫复合物(IC)清除策略的靶向作用。我们还评论了已获授权用于治疗 SARS-CoV-2 的治疗性抗体(bamlanivimab、casirivimab 和 imdevimab),并评估了它们饱和 FcRn 介导的再循环的潜力。最后,我们讨论了探究体内 IgG 持续时间与体外 FcRn 结合之间定量关系的建模和模拟研究,强调了内体转运参数的重要性。