1. Off-target platelet activation in macaques unique to a therapeutic monoclonal antibody.
- Author
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Santostefano MJ, Kirchner J, Vissinga C, Fort M, Lear S, Pan WJ, Prince PJ, Hensley KM, Tran D, Rock D, Vargas HM, Narayanan P, Jawando R, Rees W, Reindel JF, Reynhardt K, and Everds N
- Subjects
- Administration, Intravenous, Animals, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal metabolism, Antibodies, Monoclonal pharmacokinetics, Blood Platelets metabolism, Humans, Hypotension blood, Hypotension chemically induced, Immunoglobulin Fab Fragments metabolism, Immunoglobulin Fc Fragments metabolism, Macaca fascicularis, Male, Papio, Platelet Aggregation drug effects, Protein Binding, Serotonin metabolism, Syncope blood, Syncope chemically induced, Thrombocytopenia blood, Thrombocytopenia chemically induced, Thromboxane B2 metabolism, Antibodies, Monoclonal toxicity, Blood Platelets drug effects, Platelet Activation drug effects
- Abstract
AMG X, a human neutralizing monoclonal antibody (mAb) against a soluble human protein, caused thrombocytopenia, platelet activation, reduced mean arterial pressure, and transient loss of consciousness in cynomolgus monkeys after first intravenous administration. In vitro, AMG X induced activation in platelets from macaque species but not from humans or baboons. Other similar mAbs against the same pharmacological target failed to induce these in vivo and in vitro effects. In addition, the target protein was known to not be expressed on platelets, suggesting that platelet activation occurred through an off-target mechanism. AMG X bound directly to cynomolgus platelets and required both the Fab and Fc portion of the mAb for platelet activation. Binding to platelets was inhibited by preincubation of AMG X with its pharmacological target or with anti-human Fc antibodies or by preincubation of platelets with AMG X F(ab')(2) or human immunoglobulin (IVIG). AMG X F(ab')(2) did not activate platelets. Thus, platelet activation required both recognition/binding of a platelet ligand with the Fab domain and interaction of platelet Fc receptors (i.e., FcγRIIa) with the Fc domain. These findings reflect the complexity of the mechanism of action of mAbs and the increasing awareness of potential for unintended effects in preclinical species.
- Published
- 2012
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