Croote D, Wong JJW, Creeks P, Aruva V, Landers JJ, Kwok M, Jama Z, Hamilton RG, Santos AF, O'Konek JJ, Ferrini R, Thomas GR, and Lowman HB
Background: Existing therapeutic strategies are challenged by long times to achieve effect and often require frequent administration. Peanut-allergic individuals would benefit from a therapeutic that provides rapid protection against accidental exposure within days of administration while carrying little risk of adverse reactions., Objective: Guided by the repertoire of human IgE mAbs from allergic individuals, we sought to develop a treatment approach leveraging the known protective effects of allergen-specific IgG4 antibodies., Methods: We applied our single-cell RNA-sequencing SEQ SIFTER platform (IgGenix, Inc, South San Francisco, Calif) to whole blood samples from peanut-allergic individuals to discover IgE mAbs. These were then class-switched by replacing the IgE constant region with IgG4 while retaining the allergen-specific variable regions. In vitro mast cell activation tests, basophil activation tests, ELISAs, and an in vivo peanut allergy mouse model were used to evaluate the specificity, affinity, and activity of these recombinant IgG4 mAbs., Results: We determined that human peanut-specific IgE mAbs predominantly target immunodominant epitopes on Ara h 2 and Ara h 6 and that recombinant IgG4 mAbs effectively block these epitopes. IGNX001, a mixture of 2 such high-affinity IgG4 mAbs, provided robust protection against peanut-mediated mast cell activation in vitro as well as against anaphylaxis upon intragastric peanut challenge in a peanut allergy mouse model., Conclusions: We developed a peanut-specific IgG4 antibody therapeutic with convincing preclinical efficacy starting from a large repertoire of human IgE mAbs from demographically and geographically diverse individuals. These results warrant further clinical investigation of IGNX001 and underscore the opportunity for the application of this therapeutic development strategy in other food and environmental allergies., Competing Interests: Disclosure statement The study was supported by IgGenix. A.F.S. acknowledges grants from the Medical Research Council (grant nos. MR/M008517/1, MC/PC/18052, and MR/T032081/1), Food Allergy Research and Education, the Immune Tolerance Network/National Institute of Allergy and Infectious Diseases, Asthma UK (grant no. AUK-BC-2015-01), Biotechnology and Biological Sciences Research Council (BBSRC), Rosetrees Trust, and the National Institute for Health and Care Research (NIHR) through the Biomedical Research Centre award to Guy’s and St Thomas’ National Health Service Foundation Trust during the conduct of the study. Disclosure of potential conflict of interest: D. Croote, J. J. W. Wong, P. Creeks, V. Aruva, R. Ferrini, G. R. Thomas, and H. B. Lowman are employees of, and/or stakeholders in, IgGenix. Patent applications assigned to IgGenix have been filed covering aspects of this work. R. G. Hamilton is a consultant for IgGenix. A. F. Santos received personal fees from Thermo Fisher Scientific, Novartis, Allergy Therapeutics, Nestle, and IgGenix; and received research support from IgGenix and Thermo Fisher Scientific through collaboration agreements with King’s College London. The rest of the authors declare that they have no relevant conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)