1
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Li Z, Nagy A, Lindner D, Duff K, Garcia E, Ay H, Rondon JC, Yel L. Tolerability and Safety of Large-Volume Hyaluronidase-Facilitated Subcutaneous Immunoglobulin 10% Administered with or without Dose Ramp-Up: A Phase 1 Study in Healthy Participants. J Clin Immunol 2024; 44:148. [PMID: 38896141 PMCID: PMC11186899 DOI: 10.1007/s10875-024-01742-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 05/24/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE Facilitated subcutaneous immunoglobulin (fSCIG; immune globulin infusion 10% [human] with recombinant human hyaluronidase [rHuPH20]) permits high-volume subcutaneous immunoglobulin (SCIG) infusion, shorter infusion times and reduced dosing frequency relative to conventional SCIG. It is initiated by gradually increasing infusion volumes over time (dose ramp-up) to achieve target dose level (TDL). Whether ramp-up strategies have tolerability or safety advantages over direct initiation at full TDL has not been evaluated clinically. METHODS This phase 1 open-label study assessed tolerability and safety of fSCIG 10% with accelerated or no ramp-up compared with conventional ramp-up in healthy adults (NCT04578535). Participants were assigned to one of the three ramp-up arms to achieve TDLs of 0.4 or 1.0 g/kg/infusion. The primary endpoint was the proportion of infusions completed without interruption or infusion rate reduction owing to treatment-emergent adverse events (TEAEs). Safety was assessed as a secondary endpoint. RESULTS Of 51 participants enrolled, 50 (98.0%) tolerated all fSCIG 10% infusions initiated (n = 174). Infusion rate was reduced in one participant owing to headache in the 0.4 g/kg/infusion conventional ramp-up arm. Study discontinuations were higher in the no ramp-up arm (70%) versus the conventional (0%) and accelerated (22%) arms at the 1.0 g/kg/infusion TDL. Safety outcomes did not substantially differ between treatment arms. CONCLUSION The favorable tolerability and safety profiles of fSCIG 10% in healthy participants support initiating treatment with fSCIG 10% with accelerated ramp-up at TDLs up to 1.0 g/kg. Data support no ramp-up at TDLs close to 0.4 g/kg but additional data are needed for higher doses.
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Affiliation(s)
- Zhaoyang Li
- Takeda Development Center Americas, Inc, Cambridge, MA, USA.
| | - Andras Nagy
- Baxalta Innovations GmbH, a Takeda company, Vienna, Austria
| | - Dirk Lindner
- Takeda Development Center Americas, Inc, Cambridge, MA, USA
| | - Kim Duff
- Takeda Development Center Americas, Inc, Cambridge, MA, USA
| | - Enrique Garcia
- Takeda Development Center Americas, Inc, Cambridge, MA, USA
| | - Hakan Ay
- Takeda Development Center Americas, Inc, Cambridge, MA, USA
| | | | - Leman Yel
- Takeda Development Center Americas, Inc, Cambridge, MA, USA
- University of California, Irvine, CA, USA
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2
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Mahomed S. Broadly neutralizing antibodies for HIV prevention: a comprehensive review and future perspectives. Clin Microbiol Rev 2024; 37:e0015222. [PMID: 38687039 DOI: 10.1128/cmr.00152-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
SUMMARYThe human immunodeficiency virus (HIV) epidemic remains a formidable global health concern, with 39 million people living with the virus and 1.3 million new infections reported in 2022. Despite anti-retroviral therapy's effectiveness in pre-exposure prophylaxis, its global adoption is limited. Broadly neutralizing antibodies (bNAbs) offer an alternative strategy for HIV prevention through passive immunization. Historically, passive immunization has been efficacious in the treatment of various diseases ranging from oncology to infectious diseases. Early clinical trials suggest bNAbs are safe, tolerable, and capable of reducing HIV RNA levels. Although challenges such as bNAb resistance have been noted in phase I trials, ongoing research aims to assess the additive or synergistic benefits of combining multiple bNAbs. Researchers are exploring bispecific and trispecific antibodies, and fragment crystallizable region modifications to augment antibody efficacy and half-life. Moreover, the potential of other antibody isotypes like IgG3 and IgA is under investigation. While promising, the application of bNAbs faces economic and logistical barriers. High manufacturing costs, particularly in resource-limited settings, and logistical challenges like cold-chain requirements pose obstacles. Preliminary studies suggest cost-effectiveness, although this is contingent on various factors like efficacy and distribution. Technological advancements and strategic partnerships may mitigate some challenges, but issues like molecular aggregation remain. The World Health Organization has provided preferred product characteristics for bNAbs, focusing on optimizing their efficacy, safety, and accessibility. The integration of bNAbs in HIV prophylaxis necessitates a multi-faceted approach, considering economic, logistical, and scientific variables. This review comprehensively covers the historical context, current advancements, and future avenues of bNAbs in HIV prevention.
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Affiliation(s)
- Sharana Mahomed
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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3
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Gréa T, Jacquot G, Durand A, Mathieu C, Gasser A, Zhu C, Banerjee M, Hucteau E, Mallard J, Lopez Navarro P, Popescu BV, Thomas E, Kryza D, Sidi-Boumedine J, Ferrauto G, Gianolio E, Fleith G, Combet J, Brun S, Erb S, Cianferani S, Charbonnière LJ, Fellmann L, Mirjolet C, David L, Tillement O, Lux F, Harlepp S, Pivot X, Detappe A. Subcutaneous Administration of a Zwitterionic Chitosan-Based Hydrogel for Controlled Spatiotemporal Release of Monoclonal Antibodies. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023:e2308738. [PMID: 38105299 DOI: 10.1002/adma.202308738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/14/2023] [Indexed: 12/19/2023]
Abstract
Subcutaneous (SC) administration of monoclonal antibodies (mAbs) is a proven strategy for improving therapeutic outcomes and patient compliance. The current FDA-/EMA-approved enzymatic approach, utilizing recombinant human hyaluronidase (rHuPH20) to enhance mAbs SC delivery, involves degrading the extracellular matrix's hyaluronate to increase tissue permeability. However, this method lacks tunable release properties, requiring individual optimization for each mAb. Seeking alternatives, physical polysaccharide hydrogels emerge as promising candidates due to their tunable physicochemical and biodegradability features. Unfortunately, none have demonstrated simultaneous biocompatibility, biodegradability, and controlled release properties for large proteins (≥150 kDa) after SC delivery in clinical settings. Here, a novel two-component hydrogel comprising chitosan and chitosan@DOTAGA is introduced that can be seamlessly mixed with sterile mAbs formulations initially designed for intravenous (IV) administration, repurposing them as novel tunable SC formulations. Validated in mice and nonhuman primates (NHPs) with various mAbs, including trastuzumab and rituximab, the hydrogel exhibited biodegradability and biocompatibility features. Pharmacokinetic studies in both species demonstrated tunable controlled release, surpassing the capabilities of rHuPH20, with comparable parameters to the rHuPH20+mAbs formulation. These findings signify the potential for rapid translation to human applications, opening avenues for the clinical development of this novel SC biosimilar formulation.
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Affiliation(s)
- Thomas Gréa
- Institut Lumière Matière, UMR 5306, Université Claude Bernard Lyon1-CNRS, University of Lyon, Villeurbanne Cedex, 69622, France
- Université Claude Bernard Lyon 1, INSA Lyon, Jean Monnet University, CNRS, UMR 5223 Ingénierie des Matériaux Polymères (IMP), Villeurbanne Cedex, 69622, France
| | - Guillaume Jacquot
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Nano-H, St Quentin Fallavier, 38070, France
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
| | - Arthur Durand
- Institut Lumière Matière, UMR 5306, Université Claude Bernard Lyon1-CNRS, University of Lyon, Villeurbanne Cedex, 69622, France
- MexBrain, 13 avenue Albert Einstein, Villeurbanne, 69100, France
| | - Clélia Mathieu
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
| | - Adeline Gasser
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
| | - Chen Zhu
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
- Equipe de Synthèse Pour l'Analyse, Institut Pluridisciplinaire Hubert Curien (IPHC), UMR 7178 CNRS/University of Strasbourg, Strasbourg, Cedex 2 67087, France
| | - Mainak Banerjee
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
- Equipe de Synthèse Pour l'Analyse, Institut Pluridisciplinaire Hubert Curien (IPHC), UMR 7178 CNRS/University of Strasbourg, Strasbourg, Cedex 2 67087, France
| | - Elyse Hucteau
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Biomedicine Research Centre of Strasbourg (CRBS), Mitochondria, oxidative stress, and muscular protection laboratory (UR 3072), Strasbourg, 67000, France
| | - Joris Mallard
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Biomedicine Research Centre of Strasbourg (CRBS), Mitochondria, oxidative stress, and muscular protection laboratory (UR 3072), Strasbourg, 67000, France
| | - Pedro Lopez Navarro
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
| | - Bogdan V Popescu
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
| | - Eloise Thomas
- LAGEPP University Claude Bernard Lyon 1, CNRS UMR 5007, Villeurbanne Cedex, 69622, France
| | - David Kryza
- LAGEPP University Claude Bernard Lyon 1, CNRS UMR 5007, Villeurbanne Cedex, 69622, France
- Imthernat Plateform, Hospices Civils of Lyon, Lyon, 69002, France
| | - Jacqueline Sidi-Boumedine
- LAGEPP University Claude Bernard Lyon 1, CNRS UMR 5007, Villeurbanne Cedex, 69622, France
- Imthernat Plateform, Hospices Civils of Lyon, Lyon, 69002, France
| | - Giuseppe Ferrauto
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, 10124, Italy
| | - Eliana Gianolio
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, 10124, Italy
| | - Guillaume Fleith
- Université de Strasbourg, CNRS, Institut Charles Sadron (UPR 22), 23 rue du Loess, 67034, Strasbourg Cedex 2, BP 84047, France
| | - Jérôme Combet
- Université de Strasbourg, CNRS, Institut Charles Sadron (UPR 22), 23 rue du Loess, 67034, Strasbourg Cedex 2, BP 84047, France
| | | | - Stéphane Erb
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
- Laboratoire de Spectrométrie de Masse BioOrganique, IPHC UMR 7178, University of Strasbourg, CNRS, Strasbourg, 67087, France
- Infrastructure Nationale de Protéomique ProFI - FR2048, Strasbourg, 67087, France
| | - Sarah Cianferani
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
- Laboratoire de Spectrométrie de Masse BioOrganique, IPHC UMR 7178, University of Strasbourg, CNRS, Strasbourg, 67087, France
- Infrastructure Nationale de Protéomique ProFI - FR2048, Strasbourg, 67087, France
| | - Loïc J Charbonnière
- Equipe de Synthèse Pour l'Analyse, Institut Pluridisciplinaire Hubert Curien (IPHC), UMR 7178 CNRS/University of Strasbourg, Strasbourg, Cedex 2 67087, France
| | - Lyne Fellmann
- SILABE, Université of Strasbourg, fort Foch, Niederhausbergen, 67207, France
| | - Céline Mirjolet
- Radiation Oncology Department, Preclinical Radiation Therapy and Radiobiology Unit, Centre Georges-François Leclerc, Unicancer, Dijon, 21000, France
- TIReCS team, INSERM UMR 1231, Dijon, 21000, France
| | - Laurent David
- Université Claude Bernard Lyon 1, INSA Lyon, Jean Monnet University, CNRS, UMR 5223 Ingénierie des Matériaux Polymères (IMP), Villeurbanne Cedex, 69622, France
| | - Olivier Tillement
- Institut Lumière Matière, UMR 5306, Université Claude Bernard Lyon1-CNRS, University of Lyon, Villeurbanne Cedex, 69622, France
| | - François Lux
- Institut Lumière Matière, UMR 5306, Université Claude Bernard Lyon1-CNRS, University of Lyon, Villeurbanne Cedex, 69622, France
- University Institute of France (IUF), Paris, 75231, France
| | - Sébastien Harlepp
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
| | - Xavier Pivot
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
| | - Alexandre Detappe
- Institute of Cancerology Strasbourg Europe (ICANS), Strasbourg, 67000, France
- Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, 67000, France
- Equipe de Synthèse Pour l'Analyse, Institut Pluridisciplinaire Hubert Curien (IPHC), UMR 7178 CNRS/University of Strasbourg, Strasbourg, Cedex 2 67087, France
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4
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Jia X, Shi M, Wang Q, Hui J, Shofaro JH, Erkhembayar R, Hui M, Gao C, Gantumur MA. Anti-Inflammatory Effects of the 35kDa Hyaluronic Acid Fragment (B-HA/HA35). J Inflamm Res 2023; 16:209-224. [PMID: 36686276 PMCID: PMC9846287 DOI: 10.2147/jir.s393495] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023] Open
Abstract
Background Hyaluronic acid (HA) and HA fragments interact with a variety of human body receptors and are involved in the regulation of various physiological functions and leukocyte trafficking in the body. Accordingly, the development of an injectable HA fragment with good tissue permeability, the identification of its indications, and molecular mechanisms are of great significance for its clinical application. The previous studies showed that the clinical effects of injectable 35kDa B-HA result from B-HA binding to multiple receptors in different cells, tissues, and organs. This study lays the foundation for further studies on the comprehensive clinical effects of injectable B-HA. Methods We elaborated on the production process, bioactivity assay, efficacy analyses, and safety evaluation of an injectable novel HA fragment with an average molecular weight of 35 kDa (35 kDa B-HA), produced by recombinant human hyaluronidase PH20 digestion. Results The results showed that 35 kDa B-HA induced human erythrocyte aggregation (rouleaux formation) and accelerated erythrocyte sedimentation rates through the CD44 receptor. B-HA application and injection treatment significantly promoted the removal of mononuclear cells from the site of inflammation and into the lymphatic circulation. At a low concentration, 35 kDa B-HA inhibited production of reactive oxygen species and tumor necrosis factor by neutrophils; at a higher concentration, 35 kDa B-HA promoted the migration of monocytes. Furthermore, 35 kDa B-HA significantly inhibited the migration of neutrophils with or without lipopolysaccharide treatment, suggesting that in local tissues, higher concentrations of 35 kDa B-HA have antiinflammatory effects. After 99mTc radiolabeled 35 kDa B-HA was intravenously injected into mice, it quickly entered into the spleen, liver, lungs, kidneys and other organs through the blood circulation. Conclusion This study demonstrated that the HA fragment B-HA has good tissue permeability and antiinflammatory effects, laying a theoretical foundation for further clinical studies.
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Affiliation(s)
- XiaoXiao Jia
- College of Life Science, Northeast Agricultural University, Harbin, People’s Republic of China
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People’s Republic of China
| | - Ming Shi
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, People’s Republic of China
| | - Qifei Wang
- College of Life Science, Northeast Agricultural University, Harbin, People’s Republic of China
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People’s Republic of China
| | - Jessica Hui
- Center for Cancer Cell Therapy, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Joshua Hui Shofaro
- College of Life Science, Northeast Agricultural University, Harbin, People’s Republic of China
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People’s Republic of China
| | - Ryenchindorj Erkhembayar
- Department of International Cyber Education, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Mizhou Hui
- College of Life Science, Northeast Agricultural University, Harbin, People’s Republic of China
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, People’s Republic of China
| | - Chenzhe Gao
- College of Life Science, Northeast Agricultural University, Harbin, People’s Republic of China
| | - Munkh-Amgalan Gantumur
- College of Life Science, Northeast Agricultural University, Harbin, People’s Republic of China
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5
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Printz MA, Sugarman BJ, Paladini RD, Jorge MC, Wang Y, Kang DW, Maneval DC, LaBarre MJ. Risk Factors, Hyaluronidase Expression, and Clinical Immunogenicity of Recombinant Human Hyaluronidase PH20, an Enzyme Enabling Subcutaneous Drug Administration. AAPS J 2022; 24:110. [PMID: 36266598 DOI: 10.1208/s12248-022-00757-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Multiple FDA-approved and clinical-development stage therapeutics include recombinant human hyaluronidase PH20 (rHuPH20) to facilitate subcutaneous administration. As rHuPH20-reactive antibodies potentially interact with endogenous PH20, we investigated rHuPH20 immunogenicity risk through hyaluronidase tissue expression, predicted B cell epitopes, CD4+ T cell stimulation indices and related these to observed clinical immunogenicity profiles from 18 clinical studies. Endogenous hyaluronidase PH20 expression in humans/mice was assessed by reverse transcriptase-polymerase chain reaction (RT-PCR), quantitative RT-PCR, and deep RNA-Seq. rHuPH20 potential T cell epitopes were evaluated in silico and confirmed in vitro. Potential B cell epitopes were predicted for rHuPH20 sequence in silico, and binding of polyclonal antibodies from various species tested on a rHuPH20 peptide microarray. Clinical immunogenicity data were collected from 2643 subjects. From 57 human adult and fetal tissues previously screened by RT-PCR, 22 tissue types were analyzed by deep RNA-Seq. Hyaluronidase PH20 messenger RNA expression was detected in adult human testes. In silico analyses of the rHuPH20 sequence revealed nine T cell epitope clusters with immunogenic potential, one cluster was homologous to human leukocyte antigen. rHuPH20 induced T cell activation in 6-10% of peripheral blood mononuclear cell donors. Fifteen epitopes in the rHuPH20 sequence had the potential to cross-react with B cells. The cumulative treatment-induced incidence of anti-rHuPH20 antibodies across clinical studies was 8.8%. Hyaluronidase PH20 expression occurs primarily in adult testes. Low CD4+ T cell activation and B cell cross-reactivity by rHuPH20 suggest weak rHuPH20 immunogenicity potential. Restricted expression patterns of endogenous PH20 indicate low immunogenicity risk of subcutaneous rHuPH20.
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Affiliation(s)
- Marie A Printz
- Halozyme Therapeutics, Inc., 11388 Sorrento Valley Rd, San Diego, California, 92121, USA.
| | - Barry J Sugarman
- Formerly with Halozyme Therapeutics, Inc., San Diego, California, USA
| | | | - Michael C Jorge
- Formerly with Halozyme Therapeutics, Inc., San Diego, California, USA
| | - Yan Wang
- Halozyme Therapeutics, Inc., 11388 Sorrento Valley Rd, San Diego, California, 92121, USA
| | - David W Kang
- Halozyme Therapeutics, Inc., 11388 Sorrento Valley Rd, San Diego, California, 92121, USA
| | - Daniel C Maneval
- Formerly with Halozyme Therapeutics, Inc., San Diego, California, USA
| | - Michael J LaBarre
- Halozyme Therapeutics, Inc., 11388 Sorrento Valley Rd, San Diego, California, 92121, USA
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6
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Alternative Routes of Administration for Therapeutic Antibodies—State of the Art. Antibodies (Basel) 2022; 11:antib11030056. [PMID: 36134952 PMCID: PMC9495858 DOI: 10.3390/antib11030056] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background: For the past two decades, there has been a huge expansion in the development of therapeutic antibodies, with 6 to 10 novel entities approved each year. Around 70% of these Abs are delivered through IV injection, a mode of administration allowing rapid and systemic delivery of the drug. However, according to the evidence presented in the literature, beyond the reduction of invasiveness, a better efficacy can be achieved with local delivery. Consequently, efforts have been made toward the development of innovative methods of administration, and in the formulation and engineering of novel Abs to improve their therapeutic index. Objective: This review presents an overview of the routes of administration used to deliver Abs, different from the IV route, whether approved or in the clinical evaluation stage. We provide a description of the physical and biological fundamentals for each route of administration, highlighting their relevance with examples of clinically-relevant Abs, and discussing their strengths and limitations. Methods: We reviewed and analyzed the current literature, published as of the 1 April 2022 using MEDLINE and EMBASE databases, as well as the FDA and EMA websites. Ongoing trials were identified using clinicaltrials.gov. Publications and data were identified using a list of general keywords. Conclusions: Apart from the most commonly used IV route, topical delivery of Abs has shown clinical successes, improving drug bioavailability and efficacy while reducing side-effects. However, additional research is necessary to understand the consequences of biological barriers associated with local delivery for Ab partitioning, in order to optimize delivery methods and devices, and to adapt Ab formulation to local delivery. Novel modes of administration for Abs might in fine allow a better support to patients, especially in the context of chronic diseases, as well as a reduction of the treatment cost.
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7
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Tseng V, Collum SD, Allawzi A, Crotty K, Yeligar S, Trammell A, Ryan Smith M, Kang BY, Sutliff RL, Ingram JL, Jyothula SSSK, Thandavarayan RA, Huang HJ, Nozik ES, Wagner EJ, Michael Hart C, Karmouty-Quintana H. 3'UTR shortening of HAS2 promotes hyaluronan hyper-synthesis and bioenergetic dysfunction in pulmonary hypertension. Matrix Biol 2022; 111:53-75. [PMID: 35671866 PMCID: PMC9676077 DOI: 10.1016/j.matbio.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 01/27/2023]
Abstract
Pulmonary hypertension (PH) comprises a diverse group of disorders that share a common pathway of pulmonary vascular remodeling leading to right ventricular failure. Development of anti-remodeling strategies is an emerging frontier in PH therapeutics that requires a greater understanding of the interactions between vascular wall cells and their extracellular matrices. The ubiquitous matrix glycan, hyaluronan (HA), is markedly elevated in lungs from patients and experimental models with PH. Herein, we identified HA synthase-2 (HAS2) in the pulmonary artery smooth muscle cell (PASMC) layer as a predominant locus of HA dysregulation. HA upregulation involves depletion of NUDT21, a master regulator of alternative polyadenylation, resulting in 3'UTR shortening and hyper-expression of HAS2. The ensuing increase of HAS2 and hyper-synthesis of HA promoted bioenergetic dysfunction of PASMC characterized by impaired mitochondrial oxidative capacity and a glycolytic shift. The resulting HA accumulation stimulated pro-remodeling phenotypes such as cell proliferation, migration, apoptosis-resistance, and stimulated pulmonary artery contractility. Transgenic mice, mimicking HAS2 hyper-synthesis in smooth muscle cells, developed spontaneous PH, whereas targeted deletion of HAS2 prevented experimental PH. Pharmacological blockade of HAS2 restored normal bioenergetics in PASMC, ameliorated cell remodeling phenotypes, and reversed experimental PH in vivo. In summary, our results uncover a novel mechanism of HA hyper-synthesis and downstream effects on pulmonary vascular cell metabolism and remodeling.
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Affiliation(s)
- Victor Tseng
- Respiratory Medicine, Ansible Health Mountain View, CA
| | - Scott D Collum
- Department of Biochemistry and Molecular Biology, McGovern Medical School, University of Texas Health Science Center at Houston Houston, TX
| | | | - Kathryn Crotty
- Emory University Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine Atlanta, GA
| | - Samantha Yeligar
- Emory University Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine Atlanta, GA
| | - Aaron Trammell
- Emory University Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine Atlanta, GA
| | - M Ryan Smith
- Emory University Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine Atlanta, GA
| | - Bum-Yong Kang
- Emory University Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine Atlanta, GA; Atlanta Veteran Affairs Health Care System Decatur, GA
| | - Roy L Sutliff
- Emory University Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine Atlanta, GA; Atlanta Veteran Affairs Health Care System Decatur, GA
| | | | - Soma S S K Jyothula
- Divisions of Critical Care, Pulmonary & Sleep Medicine, McGovern Medical School, University of Texas Health Science Center at Houston Houston, TX; Debakey Heart & Vascular Center, Houston Methodist Hospital, Houston TX, USA
| | | | - Howard J Huang
- Debakey Heart & Vascular Center, Houston Methodist Hospital, Houston TX, USA
| | - Eva S Nozik
- University of Colorado Anschutz Medical Campus, Department of Pediatrics Aurora, CO
| | - Eric J Wagner
- University of Rochester Medical Center, School of Medicine and Dentistry Rochester, NY
| | - C Michael Hart
- Emory University Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine Atlanta, GA; Atlanta Veteran Affairs Health Care System Decatur, GA.
| | - Harry Karmouty-Quintana
- Department of Biochemistry and Molecular Biology, McGovern Medical School, University of Texas Health Science Center at Houston Houston, TX; Divisions of Critical Care, Pulmonary & Sleep Medicine, McGovern Medical School, University of Texas Health Science Center at Houston Houston, TX.
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8
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Al Ojaimi Y, Blin T, Lamamy J, Gracia M, Pitiot A, Denevault-Sabourin C, Joubert N, Pouget JP, Gouilleux-Gruart V, Heuzé-Vourc'h N, Lanznaster D, Poty S, Sécher T. Therapeutic antibodies - natural and pathological barriers and strategies to overcome them. Pharmacol Ther 2021; 233:108022. [PMID: 34687769 PMCID: PMC8527648 DOI: 10.1016/j.pharmthera.2021.108022] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 02/06/2023]
Abstract
Antibody-based therapeutics have become a major class of therapeutics with over 120 recombinant antibodies approved or under review in the EU or US. This therapeutic class has experienced a remarkable expansion with an expected acceleration in 2021-2022 due to the extraordinary global response to SARS-CoV2 pandemic and the public disclosure of over a hundred anti-SARS-CoV2 antibodies. Mainly delivered intravenously, alternative delivery routes have emerged to improve antibody therapeutic index and patient comfort. A major hurdle for antibody delivery and efficacy as well as the development of alternative administration routes, is to understand the different natural and pathological barriers that antibodies face as soon as they enter the body up to the moment they bind to their target antigen. In this review, we discuss the well-known and more under-investigated extracellular and cellular barriers faced by antibodies. We also discuss some of the strategies developed in the recent years to overcome these barriers and increase antibody delivery to its site of action. A better understanding of the biological barriers that antibodies have to face will allow the optimization of antibody delivery near its target. This opens the way to the development of improved therapy with less systemic side effects and increased patients' adherence to the treatment.
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Affiliation(s)
- Yara Al Ojaimi
- UMR 1253, iBrain, Inserm, 37000 Tours, France; University of Tours, 37000 Tours, France
| | - Timothée Blin
- University of Tours, 37000 Tours, France; UMR 1100, CEPR, Inserm, 37000 Tours, France
| | - Juliette Lamamy
- University of Tours, 37000 Tours, France; GICC, EA7501, 37000 Tours, France
| | - Matthieu Gracia
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), Montpellier F-34298, France
| | - Aubin Pitiot
- University of Tours, 37000 Tours, France; UMR 1100, CEPR, Inserm, 37000 Tours, France
| | | | - Nicolas Joubert
- University of Tours, 37000 Tours, France; GICC, EA7501, 37000 Tours, France
| | - Jean-Pierre Pouget
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), Montpellier F-34298, France
| | | | | | - Débora Lanznaster
- UMR 1253, iBrain, Inserm, 37000 Tours, France; University of Tours, 37000 Tours, France
| | - Sophie Poty
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier (ICM), Montpellier F-34298, France
| | - Thomas Sécher
- University of Tours, 37000 Tours, France; UMR 1100, CEPR, Inserm, 37000 Tours, France
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Knowles SP, Printz MA, Kang DW, LaBarre MJ, Tannenbaum RP. Safety of recombinant human hyaluronidase PH20 for subcutaneous drug delivery. Expert Opin Drug Deliv 2021; 18:1673-1685. [PMID: 34585991 DOI: 10.1080/17425247.2021.1981286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The glycosaminoglycan hyaluronan forms a gel-like substance, which presents a barrier to bulk fluid flow in the subcutaneous (SC) space, limiting SC drug delivery volume and administration rates. Recombinant human hyaluronidase PH20 (rHuPH20) acts locally to temporarily remove this barrier, facilitating rapid SC delivery of large volumes and/or high doses of sequentially or co-administered therapeutics. AREAS COVERED An extensive clinical and post-marketing dataset of safety and immunogenicity of rHuPH20 in its current applications with approved therapeutics demonstrates that rHuPH20 acts locally, without measurable systemic absorption at the SC doses used in the approved products, and is well tolerated in combination with several co-administered therapeutic agents across diverse patient groups. The immunogenicity profile demonstrates no adverse effects associated with treatment-emergent rHuPH20 antibody responses. Immunogenicity to monoclonal antibodies co-formulated with rHuPH20 shows no clinical difference between SC and intravenous administration. Safety assessments of patient subsets for special populations, including children, elderly patients, and pregnant women, raise no additional safety concerns. EXPERT OPINION The benefits of SC administration for patients and healthcare systems often outweigh those of intravenous administration, driving future initiation of SC-only drug development programs. Injection devices allowing large-volume SC administration could be facilitated by incorporating co-formulated biologics containing rHuPH20.
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Dispersive effects and focused biodistribution of recombinant human hyaluronidase PH20: A locally acting and transiently active permeation enhancer. PLoS One 2021; 16:e0254765. [PMID: 34292990 PMCID: PMC8297837 DOI: 10.1371/journal.pone.0254765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 07/02/2021] [Indexed: 11/19/2022] Open
Abstract
Background Recombinant human hyaluronidase PH20 (rHuPH20) facilitates the dispersion and absorption of subcutaneously administered therapeutic agents. This study aimed to characterize the transient, local action of rHuPH20 in the subcutaneous (SC) space using focused biodistribution and dye dispersion studies conducted in mice. Materials and methods To evaluate the biodistribution of rHuPH20, mice were intradermally administered rHuPH20 (80 U). The enzymatic activity of rHuPH20 was analyzed in the skin, lymph nodes, and plasma. Animal model sensitivity was determined by intravenous administration of rHuPH20 (80 U) to the tail vein. To evaluate local dispersion, mice received an intradermal injection of rHuPH20 followed by an intradermal injection of Trypan Blue dye at a contralateral site 45 minutes later. Dye dispersion was measured using a digital caliper. Results After intradermal rHuPH20 injection, enzymatic activity was detected within the skin near the injection site with levels decreasing rapidly after 15 minutes. There was no clear evidence of systemic exposure after administration of rHuPH20, and no discernible rHuPH20 activity was observed in lymph or plasma as a function of time after dosing. In the dye dispersion study, delivery of rHuPH20 at one site did not impact dye dispersion at a distal skin site. Conclusion These observations support the classification of rHuPH20 as a transiently active and locally acting permeation enhancer.
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