State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing, 100190, China.
School of Chemistry and Chemical Engineering, University of Chinese Academy of Science, Beijing, 100049, China.
Signal Transduct Target Ther. 2023 Jan 25;8(1):30. doi: 10.1038/s41392-022-01273-8.
Passive immunotherapy is one of the most promising interventions for Alzheimer's disease (AD). However, almost all immune-modulating strategies fail in clinical trials with unclear causes although they attenuate neuropathology and cognitive deficits in AD animal models. Here, we showed that Aβ-targeting antibodies including their lgG1 and lgG4 subtypes induced microglial engulfment of neuronal synapses by activating CR3 or FcγRIIb via the complex of Aβ, antibody, and complement. Notably, anti-Aβ antibodies without Fc fragment, or with blockage of CR3 or FcγRIIb, did not exert these adverse effects. Consistently, Aβ-targeting antibodies, but not their Fab fragments, significantly induced acute microglial synapse removal and rapidly exacerbated cognitive deficits and neuroinflammation in APP/PS1 mice post-treatment, whereas the memory impairments in mice were gradually rescued thereafter. Since the recovery rate of synapses in humans is much lower than that in mice, our findings may clarify the variances in the preclinical and clinical studies assessing AD immunotherapies. Therefore, Aβ-targeting antibodies lack of Fc fragment, or with reduced Fc effector function, may not induce microglial synaptic pruning, providing a safer and more efficient therapeutic alternative for passive immunotherapy for AD.
被动免疫疗法是治疗阿尔茨海默病(AD)最有前途的干预措施之一。然而,尽管它们在 AD 动物模型中减轻了神经病理学和认知缺陷,但几乎所有的免疫调节策略在临床试验中都失败了,原因尚不清楚。在这里,我们表明,Aβ 靶向抗体,包括其 IgG1 和 IgG4 亚型,通过 Aβ、抗体和补体复合物激活 CR3 或 FcγRIIb,诱导小胶质细胞吞噬神经元突触。值得注意的是,没有 Fc 片段的抗 Aβ 抗体,或阻断 CR3 或 FcγRIIb 的抗体,不会产生这些不良反应。一致地,Aβ 靶向抗体,但不是它们的 Fab 片段,显著诱导 APP/PS1 小鼠治疗后急性小胶质细胞突触去除,并迅速加重认知缺陷和神经炎症,而小鼠的记忆损伤此后逐渐得到恢复。由于人类突触的恢复率远低于小鼠,我们的发现可能解释了评估 AD 免疫疗法的临床前和临床研究中的差异。因此,缺乏 Fc 片段的 Aβ 靶向抗体,或具有降低的 Fc 效应功能的抗体,可能不会诱导小胶质细胞突触修剪,为 AD 的被动免疫治疗提供更安全、更有效的治疗选择。