Abstract

In clinical trials with early Alzheimer’s patients, administration of anti-amyloid antibodies reduced amyloid deposits, suggesting that immunotherapies may be promising disease-modifying interventions against Alzheimer’s disease (AD). Specific forms of amyloid beta (Aβ) peptides, for example post-translationally modified Aβ peptides with a pyroglutamate at the N-terminus (pGlu3, pE3), are attractive antibody targets, due to pGlu3-Aβ’s neo-epitope character and its propensity to form neurotoxic oligomeric aggregates. We have generated a novel anti-pGlu3-Aβ antibody, PBD-C06, which is based on a murine precursor antibody that binds with high specificity to pGlu3-Aβ monomers, oligomers and fibrils, including mixed aggregates of unmodified Aβ and pGlu3-Aβ peptides. PBD-C06 was generated by first grafting the murine antigen binding sequences onto suitable human variable light and heavy chains. Subsequently, the humanized antibody was de-immunized and site-specific mutations were introduced to restore original target binding, to eliminate complement activation and to improve protein stability. PBD-C06 binds with the same specificity and avidity as its murine precursor antibody and elimination of C1q binding did not compromise Fcγ-receptor binding or in vitro phagocytosis. Thus, PBD-C06 was specifically designed to target neurotoxic aggregates and to avoid complement-mediated inflammatory responses, in order to lower the risk for vasogenic edemas in the clinic.

Highlights

  • Alzheimer’s disease (AD) is a neurodegenerative disease that accounts for 60–70% of dementia patients

  • Since amyloid β (Aβ) deposits can be detected many years before pathological and behavioral AD symptoms occur and types of familial AD are caused by processing of amyloid precursor protein (APP) and clearance of Aβ13, much focus has been devoted to the development of disease-modifying therapies (DMTs) against Aβ

  • The most promising DMTs against AD are based on immunotherapy7,9, including monoclonal antibodies that recognize specific epitopes within the Aβ peptide and preferentially bind to either Aβ monomers, oligomers or fibrils

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Summary

Introduction

Alzheimer’s disease (AD) is a neurodegenerative disease that accounts for 60–70% of dementia patients. Since Aβ deposits can be detected many years before pathological and behavioral AD symptoms occur and types of familial AD are caused by processing of APP and clearance of Aβ13, much focus has been devoted to the development of DMTs against Aβ These include inhibitors against the proteolytic enzymes gamma-secretase and beta-secretase involved in Aβ peptide genesis. The most promising DMTs against AD are based on immunotherapy, including monoclonal antibodies that recognize specific epitopes within the Aβ peptide and preferentially bind to either Aβ monomers, oligomers or fibrils Some of these antibodies have been engineered to avoid the induction of vasogenic edemas, which are identified as amyloid-related imaging abnormalities ARIA-Edema (ARIA-E) and ARIA-microHemorrhage/ Hemosiderosis (ARIA-H). A first QC inhibitor, PQ912, has completed early clinical trial in AD patients and is currently entering advanced clinical development

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