1. Long lasting neutralization of C5 by SKY59, a novel recycling antibody, is a potential therapy for complement-mediated diseases
- Author
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Kunihiro Hattori, Yuichiro Shimizu, Takaaki Miura, Taku Fukuzawa, Takeru Nambu, Yoshinori Tsuboi, Futa Mimoto, Jun-ichi Nezu, Mitsuko Shibuya, Kiyofumi Honda, Manabu Wada, Norihito Shibahara, Siok Wan Gan, Zenjiro Sampei, Genki Nakamura, Tetsushi Sakiyama, Meiri Shida-Kawazoe, Atsuhiko Maeda, Yoshiki Kawabe, Kiyoshi Habu, Yoshinao Ruike, Tomoyuki Igawa, Takehisa Kitazawa, Hitoshi Tai, Hiroyuki Tsunoda, Yuu Okura, Akihisa Sakamoto, Shinya Ishii, Yuki Iwayanagi, Tatsuhiko Tachibana, Akira Hayasaka, Yuji Hori, Kenta Haraya, and Machiko Irie
- Subjects
0301 basic medicine ,Protein Conformation ,medicine.drug_class ,Science ,Hemoglobinuria, Paroxysmal ,Crystallography, X-Ray ,Monoclonal antibody ,Humanized antibody ,Article ,03 medical and health sciences ,0302 clinical medicine ,Antigen ,Atypical hemolytic uremic syndrome ,medicine ,Animals ,Humans ,Multidisciplinary ,biology ,business.industry ,Complement C5 ,Eculizumab ,medicine.disease ,Antibodies, Neutralizing ,Complement system ,Macaca fascicularis ,030104 developmental biology ,Immunology ,Paroxysmal nocturnal hemoglobinuria ,biology.protein ,Medicine ,Antibody ,business ,Protein Binding ,030215 immunology ,medicine.drug - Abstract
Dysregulation of the complement system is linked to the pathogenesis of a variety of hematological disorders. Eculizumab, an anti-complement C5 monoclonal antibody, is the current standard of care for paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS). However, because of high levels of C5 in plasma, eculizumab has to be administered biweekly by intravenous infusion. By applying recycling technology through pH-dependent binding to C5, we generated a novel humanized antibody against C5, SKY59, which has long-lasting neutralization of C5. In cynomolgus monkeys, SKY59 suppressed C5 function and complement activity for a significantly longer duration compared to a conventional antibody. Furthermore, epitope mapping by X-ray crystal structure analysis showed that a histidine cluster located on C5 is crucial for the pH-dependent interaction with SKY59. This indicates that the recycling effect of SKY59 is driven by a novel mechanism of interaction with its antigen and is distinct from other known pH-dependent antibodies. Finally, SKY59 showed neutralizing effect on C5 variant p.Arg885His, while eculizumab does not inhibit complement activity in patients carrying this mutation. Collectively, these results suggest that SKY59 is a promising new anti-C5 agent for patients with PNH and other complement-mediated disorders.
- Published
- 2017