mimetic cofactor activity of a bispecific antibody topdfWord文件下载.docx
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YoshikiKawabe2;
TomoyukiIgawa2;
HiroyukiTsunoda1;
KeijiNogami3;
MidoriShima3;
KunihiroHattori11ResearchDivision,ChugaiPharmaceuticalCo.,Ltd.,Kamakura,Kanagawa,Japan;
2ResearchDivision,ChugaiPharmaceuticalCo.,Ltd.,Gotemba,Shizuoka,Japan;
3DepartmentofPediatrics,NaraMedicalUniversity,Kashihara,Nara,JapanSummaryEmicizumab,ahumanisedbispecificantibodyrecognisingfactors(F)
IX/IXaandX/Xa,canaccelerateFIXa-catalysedFXactivationbybridg-ingFIXaandFXinamannersimilartoFVIIIa.However,detailsoftheemicizumab–antigeninteractionshavenotbeenreportedsofar.Inthisstudy,wefirstshowedbysurfaceplasmonresonanceanalysisthatemicizumabboundFIX,FIXa,FX,andFXawithmoderateaffin-ities(KD=
1.58,
1.52,
1.85,and0.978µ
M,respectively).Wenextshowedbyimmunoblottinganalysisthatemicizumabrecognisedtheantigens’epidermalgrowthfactor(EGF)-likedomains.Wethenper-formedKD-basedsimulationofequilibriumstatesinplasmaforquantitativelypredictingthewaysthatemicizumabwouldinteractwiththeantigens.ThesimulationpredictedthatonlyasmallpartofplasmaFIX,FX,andemicizumabwouldformantigen-bridgingFIX–emicizumab–FXternaryplex,ofwhichconcentrationwouldformabell-shapedrelationshipwithemicizumabconcentration.The
bell-shapedconcentrationdependencywasreproducedbyplasmathrombingenerationassays,suggestingthattheplasmaconcen-trationoftheternaryplexwouldcorrelatewithemicizumab’sco-factoractivity.Thesimulationalsopredictedthatat10.0–100µ
g/mlofemicizumab–levelsshowninapreviousstudytobeclinicallyeffec-tive–themajorityofplasmaFIX,FX,andemicizumabwouldexistasmonomers.Inconclusion,emicizumabbindsFIX/FIXaandFX/FXawithmicromolaraffinitiesattheirEGF-likedomains.TheKD-basedsimu-lationpredictedthattheantigen-bridgingternaryplexformedincirculatingplasmawouldcorrelatewithemicizumab’scofactoractiv-ity,andthemajorityofFIXandFXwouldbefreeandavailableforothercoagulationreactions.KeywordsCoagulationfactors,drugdesign,factorVIII,haemophiliatherapyCorrespondenceto:
Financialsupport:
TakehisaKitazawaThisstudywassupportedbyChugaiPharmaceuticalCo.,Ltd.ResearchDivisionChugaiPharmaceuticalCo.,Ltd.Received:
January15,
xx200Kajiwara,KamakuraAcceptedafterminorrevision:
March25,
xxKanagawa247–8530,JapanEpubaheadofprint:
April28,
xxTel.:
+81467472260,Fax:
+81467467795s:
//doi.org/10.1160/TH17-01-0030E-mail:
kitazawatkh@chugai-pharm.co.jpThrombHaemost
xx;
117:
1348–1357Institutionwheretheworkwascarriedout:
ResearchDivision,ChugaiPharmaceuticalCo.,Ltd.SupplementaryMaterialtothisarticleisavailableonlineat.thrombosis-onlineZZZ.IntroductionRoutineadministrationofexogenousfactor(F)
VIIIforbleedingprophylaxisinpatientswithhaemophiliaA–apracticewidespreadmainlyindevelopedcountries–improvespatients’qualityoflifebyreducingbleedingepisodesandbleeding-relatedplications(1,2).However,thetreatmentstillhassomedrawbacks,includingim-perfectcontrolofbleedinginpatientswhodevelopalloantibodiestoFVIIIandthenecessityofadministrationviafrequentintra-venousinjections(2,3).Tooveresuchdrawbacks,weex-ploredtheideaofcreatinganantibodyfunctioningasaFVIIIco-
factor,whichwebelievedwouldbeapromisingapproachbecauseIgGantibodiesgenerallyhavealonghalf-life,highsubcutaneousbioavailability,andamolecularstructureorantigenicitydifferentfromthatofFVIII(4).Inthe1990s,severalpioneeringresearchersrevealedthewaysthatFVIIIainteractswithbothFIXaandFX,whichwouldfacilitateaccelerationofFIXa-catalysedFXactivation(5–7).Theseinteractionswerefurtherunveiledthroughthe2000sand
xxs(8–10),andconsequentlyFVIIIaisnowknowntohavemultiplecontactswithbothFIXaandFX(Figure1A).TheideabehindourFVIIIa-mimeticcofactorantibodywastocreateananti-FIXa/FXbispecificantibodythatplacesthetwoantigensLicenseterms:
CC-BY-NC-ND(s:
//creativemons.org/licenses/by-nc-nd/
4.0)©
Schattauer
xxKitazawaetal.Emicizumab’scofactoractivitydependsonitsantigen-bridgingability1349Figure1:
SchematicillustrationsoftheinteractionsofFVIIIaoremicizumabwithFIX/FIXaandFX/FXa.A)
InteractionsofFVIIIawithFIXaandFXre-portedpreviously(5–10).B)
Interactionsofemi-cizumabwithFIX/FIXaandFX/FXa.Theillus-trationsdonotnecess-arilyindicateprecisemolecularstructures.(FIXaandFX)
inaspatiallyappropriatepositiontoaccelerateFIXa-catalysedFXactivationinthesamemannerthatFVIIIashoulddo(4).Afterlongresearch,weeventuallyidentifiedapo-tenthumanisedbispecificantibody,termedACE910oremicizu-mab(11).Aswehadintended,emicizumabexertedapotentFVIIIa-mimeticcofactoractivityinvitroandinvivo(11–13),andableedingpreventiveeffectataround10–100µ
g/mlofplasmaemi-cizumabinthepatientpartofthephase1clinicalstudy(14).Asisobvious,however,emicizumabisnotthesameasFVIII/FVIIIaandthushassomecharacteristicsdifferentfromthoseof
FVIII/FVIIIa.Weconsideredthedifferenceintheirbindingprop-ertiesasoneofthenon-negligiblepointstobetakenintoaccount.Inthisstudy,weelucidatedemicizumab’sbindingaffinities(KD)
tothebothantigensbyusingsurfaceplasmonresonance(SPR)
analysisandexploredepitopesontheantigensbyusingimmuno-blottinganalysis.WethenusedthedeterminedKDvaluestosimu-lateequilibriumstatesinplasmainordertopredictthewaysthatemicizumabwouldinteractwiththeantigensquantitatively,andtodiscusshowemicizumabandtheantigenswouldbehave.©
xxLicenseterms:
4.0)
1350Kitazawaetal.Emicizumab’scofactoractivitydependsonitsantigen-bridgingabilityMaterialsandmethodsAntibodiesandcoagulationfactorsEmicizumab(ahumanisedbispecificIgG4antibodyrecognisingFIX/FIXaandFX/FXa)
wasrebinantlyproducedfromaChi-nesehamsterovarycellline(15).Anti-FIX/FIXaoranti-FX/FXamonospecifictwo-armedIgG4antibodieseachhavingoneoftheantigenbindingfragmentsofemicizumab(emicizumabFab)
weretransientlyexpressedinHEK293cellsandpurified(11).ExceptforFVIIIusedinSuppl.Table1(availableonlineat.thrombosis-onlineZZZ),allcoagulationfactorsusedwerehumanplasma-de-rived(EnzymeResearchLaboratories,SouthBend,IN,USA).SPRanalysisWeanalysedtheinteractionsofFIX,FIXa,FX,andFXawiththecorrespondingvariableregionofemicizumabbyusingaBiacoreT200SPRsystem(GEHealthcare,Uppsala,Sweden).First,weim-mobilisedMabSelectSuReLigand(rebinantProteinA;
GEHealthcare)
ontoaCM4sensorchip(GEHealthcare)
thathadbeenpre-activatedwithNHSandECD,andpre-deactivatedwithethanolamine-HClusinganAmineCouplingKit(GEHealthcare).Tocapturethetestantibodiesonthesensorchip,weinjectedtheanti-FIX/FIXaoranti-FX/FXamonospecifictwo-armedIgG4anti-bodyhavingeitheroftheemicizumabFabintoflowcell2,andna-talizumab(Biogen,Cambridge,MA,USA)
ascontrolhumanisedIgG4antibodyintoflowcell
1.Wenextinjectedeachanalyte(0asbaseline,80,160,320,640,or1280nMofFIX,FIXa,FX,orFXa),whichhadbeendissolvedinrunningbuffer(10mMHEPES,150mMNaCl,0.05vol%SurfactantP20,
2.5mMCaCl2
[pH
7.4]),intobothflowcellsonthesensorsurfaceataflowrateof30µ
l/minute(min)
tomonitortheassociationphasefor120sec-onds(s)
andthenthedissociationphasefor30swiththerunningbuffer.Thedatawereanalysedbythe1:
1bindingmodelintheBia-coreT200Evaluationsoftware(version
1.0,GEHealthcare).
andperformedSDS-PAGEinanon-reducedcondition.Forim-munoblottinganalyses,weusedtheanti-FIX/FIXaoranti-FX/FXamonospecifictwo-armedIgG4antibodieshavingeitheroftheemi-cizumabFabsasthetestantibody,anddetectedtheantigen–anti-bodybindingbyhorseradishperoxidase-labelledrebinantPro-teinL(Actigen,Cambridge,UK)
andaperoxidaseimmunoblottingsubstrate(NacalaiTesque,Kyoto,Japan).ELISAWecoatedwellsof96-wellimmunoplates(ThermoFisherScientific,Waltham,MA,USA)
withFVII,FIX,FX,FXII,orProteinC(EnzymeResearchLaboratories)
at1µ
g/mlinphosphatebufferedsaline.Afterwashingthewellswithtrisbufferedsalinecontaining1mMCaCl2and0.05vol%Tween®
20(Bio-Rad,Hercules,CA,USA)
(TBS-Ca/tween),weblockedthewellswith30mg/mlbovineserumalbumin(BSA)
dissolvedinTBS-Ca/tween(TBS-Ca/tween/BSA).Aftertheblocking,weappliedvariedconcentrationsofemicizumabdilutedwithTBS-Ca/tween/BSAtothewellsforthereactionofthecoatedtestprotein-emicizumabinteraction.AfterwashingthewellswithTBS-Ca/tween,weappliedanalkalinephosphatase-labelledmousehuman-γ4-chain-specificantibody(SouthernBiotech,Bir-mingham,AL,USA)
dilutedwithTBS-Ca/tween/BSA.Afterwash-ingthewellsagainwithTBS-Ca/tween,weappliedphosphatasesubstrate(Kirkegaardaprecursorofemicizumab)
reportedpre-viously(4).Antigens’domainsrecognisedbyemicizumabNext,wedeterminedbyimmunoblottinganalysisthedomainineachantigenthatemicizumabrecognises.SincehBS23hadrecog-nisedthelightchainsofFIX/FIXaandFX/FXa(4),wefocusedontherespectivelightchains.ForFIX/FIXa,weappliedplasma-de-rived
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