Abstract

BackgroundPyroglutamate-3 Aβ (pGlu-3 Aβ) is an N-terminally truncated and post-translationally modified Aβ species found in Alzheimer’s disease (AD) brain. Its increased peptide aggregation propensity and toxicity make it an attractive emerging treatment strategy for AD. We address the question of how the effector function of an anti-pGlu-3 Aβ antibody influences the efficacy of immunotherapy in mouse models with AD-like pathology.MethodsWe compared two different immunoglobulin (Ig) isotypes of the same murine anti-pGlu-3 Aβ mAb (07/1 IgG1 and 07/2a IgG2a) and a general N-terminal Aβ mAb (3A1 IgG1) for their ability to clear Aβ and protect cognition in a therapeutic passive immunotherapy study in aged, plaque-rich APPSWE/PS1ΔE9 transgenic (Tg) mice. We also compared the ability of these antibodies and a CDC-mutant form of 07/2a (07/2a-k), engineered to avoid complement activation, to clear Aβ in an ex vivo phagocytosis assay and following treatment in APPSLxhQC double Tg mice, and to activate microglia using longitudinal microPET imaging with TSPO-specific 18F-GE180 tracer following a single bolus antibody injection in young and old Tg mice.ResultsWe demonstrated significant cognitive improvement, better plaque clearance, and more plaque-associated microglia in the absence of microhemorrhage in aged APPSWE/PS1ΔE9 Tg mice treated with 07/2a, but not 07/1 or 3A1, compared to PBS in our first in vivo study. All mAbs cleared plaques in an ex vivo assay, although 07/2a promoted the highest phagocytic activity. Compared with 07/2a, 07/2a-k showed slightly reduced affinity to Fcγ receptors CD32 and CD64, although the two antibodies had similar binding affinities to pGlu-3 Aβ. Treatment of APPSLxhQC mice with 07/2a and 07/2a-k mAbs in our second in vivo study showed significant plaque-lowering with both mAbs. Longitudinal 18F-GE180 microPET imaging revealed different temporal patterns of microglial activation for 3A1, 07/1, and 07/2a mAbs and no difference between 07/2a-k and PBS-treated Tg mice.ConclusionOur results suggest that attenuation of behavioral deficits and clearance of amyloid is associated with strong effector function of the anti-pGlu-3 Aβ mAb in a therapeutic treatment paradigm. We present evidence that antibody engineering to reduce CDC-mediated complement binding facilitates phagocytosis of plaques without inducing neuroinflammation in vivo. Hence, the results provide implications for tailoring effector function of humanized antibodies for clinical development.

Highlights

  • Pyroglutamate-3 Aβ is an N-terminally truncated and post-translationally modified Aβ species found in Alzheimer’s disease (AD) brain

  • We previously reported that preventive immunization with the murine anti-pGlu-3 Aβ IgG1 07/1 mAb improved cognition and reduced plaques in young APPSWE/PS1ΔE9 Tg mice when administered at an early stage of plaque deposition [12]. (Note that human and mouse Immunoglobulin G (IgG) isotypes are not directly homologous: Human IgG1 is comparable with mouse IgG2a due to similar ability to bind to Fcγ receptors and activate the complement system [23])

  • The targeting of pGlu-3 Aβ by passive immunotherapy differs from other Aβ antibody treatments in various aspects: (i) pGlu-3 Aβ is a highly pathologic and neurotoxic species, (ii) the targeting of the N-terminal Aβ modification efficiently rules out binding to parent molecules (e.g., APP and non-modified beta CTF), preventing potential side effects, and (iii) pGlu-3 Aβ is undetectable in plasma; there is no “peripheral capture” of the drug expected in the circulation [12]

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Summary

Introduction

Pyroglutamate-3 Aβ (pGlu-3 Aβ) is an N-terminally truncated and post-translationally modified Aβ species found in Alzheimer’s disease (AD) brain. In October 2019, Biogen announced that upon analysis of the full data set of all participants, aducanumab reached its primary endpoint of clinical benefit (CDR-SB) in a large Phase III clinical trial (EMERGE), and while not significant in another large Phase III (ENGAGE) study, post hoc analysis showed slowing of cognitive decline for those in the high dose treatment group (press release Oct 22, 2019; CTAD 2019, San Diego). Both studies showed dose- and timedependent lowering of cerebral amyloid. Aducanumab would be the first-ever disease modifying treatment for mild cognitive impairment and early-stage Alzheimer’s disease

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