Department of Biomedical Engineering, Duke University, Durham, NC, 27708, USA.
Department of Surgery, Duke University School of Medicine, Durham, NC, 27710, USA.
Adv Sci (Weinh). 2022 Apr;9(11):e2103672. doi: 10.1002/advs.202103672. Epub 2022 Feb 8.
Protein therapeutics, except for antibodies, have a short plasma half-life and poor stability in circulation. Covalent coupling of polyethylene glycol (PEG) to protein drugs addresses this limitation. However, unlike previously thought, PEG is immunogenic. In addition to induced PEG antibodies, ≈70% of the US population has pre-existing anti-PEG antibodies. Both induced and preexisting anti-PEG antibodies result in accelerated drug clearance, reduced clinical efficacy, and severe hypersensitivity reactions that have limited the clinical utility of uricase, an enzyme drug for treatment for refractory gout that is decorated with a PEG corona. Here, the authors synthesize a poly(oligo(ethylene glycol) methyl ether methacrylate) (POEGMA) conjugate of uricase that decorates the protein with multiple polymer chains to create a corona to solve these problems. The resulting uricase-POEGMA is well-defined, has high bioactivity, and outperforms its PEG counterparts in its pharmacokinetics (PK). Furthermore, the conjugate does not induce anti-POEGMA antibodies and is not recognized by anti-PEG antibodies. These findings suggest that POEGMA conjugation may provide a solution to the immunogenicity and antigenicity limitations of PEG while improving upon its PK benefits. These results transcend uricase and can be applied to other PEGylated therapeutics and the broader class of biologics with suboptimal PK.
蛋白质疗法(除抗体外)在血浆中的半衰期短,在循环中稳定性差。聚乙二醇(PEG)与蛋白质药物的共价偶联解决了这一限制。然而,与之前的观点不同,PEG 具有免疫原性。除了诱导的 PEG 抗体外,约 70%的美国人口存在预先存在的抗 PEG 抗体。诱导和预先存在的抗 PEG 抗体都会导致药物清除加速、临床疗效降低和严重的过敏反应,这限制了尿酸酶(一种用于治疗难治性痛风的酶药物,用 PEG 冠修饰)的临床应用。在这里,作者合成了尿酸酶的聚(聚(乙二醇)甲基醚甲基丙烯酸酯)(POEGMA)缀合物,该缀合物用多条聚合物链修饰蛋白质,形成冠来解决这些问题。所得的尿酸酶-POEGMA 具有明确的结构、高生物活性,并且在药代动力学(PK)方面优于其 PEG 对应物。此外,该缀合物不会诱导抗 POEGMA 抗体,也不会被抗 PEG 抗体识别。这些发现表明,POEGMA 缀合可能提供了解决 PEG 的免疫原性和抗原性限制的方法,同时提高了其 PK 益处。这些结果超越了尿酸酶,可以应用于其他 PEG 化治疗药物和具有不理想 PK 的更广泛的生物制剂类。
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