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Abstract
Antibody drugs exert therapeutic effects via a range of mechanisms, including competitive inhibition, allosteric modulation, and immune effector mechanisms. Facilitated dissociation is an additional mechanism where antibody-mediated “disruption” of stable high-affinity macromolecular complexes can potentially enhance therapeutic efficacy. However, this mechanism is not well understood or utilized therapeutically. Here, we investigate and engineer the weak disruptive activity of an existing therapeutic antibody, omalizumab, which targets IgE antibodies to block the allergic response. We develop a yeast display approach to select for and engineer antibody disruptive efficiency and generate potent omalizumab variants that dissociate receptor-bound IgE. We determine a low resolution cryo-EM structure of a transient disruption intermediate containing the IgE-Fc, its partially dissociated receptor and an antibody inhibitor. Our results provide a conceptual framework for engineering disruptive inhibitors for other targets, insights into the failure in clinical trials of the previous high affinity omalizumab HAE variant and anti-IgE antibodies that safely and rapidly disarm allergic effector cells.
Facilitated dissociation is a mechanism where antibody-mediated disruption of high-affinity complexes can enhance the therapeutic effects of a drug. Here the authors present a yeast display approach to select and engineer omalizumab variants that dissociate receptor-bound IgE to accelerate its inhibition of the allergic response.
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1 Stanford University School of Medicine, Department of Structural Biology, Stanford, USA (GRID:grid.168010.e) (ISNI:0000000419368956); Stanford University School of Medicine, Progam in Immunology, Stanford, USA (GRID:grid.168010.e) (ISNI:0000000419368956); Sean N. Parker Center for Allergy Research at Stanford University, Stanford, USA (GRID:grid.168010.e) (ISNI:0000000419368956)
2 University Hospital Bern, Department of Rheumatology and Immunology, Bern, Switzerland (GRID:grid.411656.1) (ISNI:0000 0004 0479 0855); University of Bern, Department of BioMedical Research, Bern, Switzerland (GRID:grid.5734.5) (ISNI:0000 0001 0726 5157)
3 Stanford University School of Medicine, Department of Structural Biology, Stanford, USA (GRID:grid.168010.e) (ISNI:0000000419368956)
4 Stanford University School of Medicine, Department of Molecular and Cellular Physiology, Stanford, USA (GRID:grid.168010.e) (ISNI:0000000419368956)
5 Stanford University School of Medicine, Department of Structural Biology, Stanford, USA (GRID:grid.168010.e) (ISNI:0000000419368956); Stanford University School of Medicine, Department of Molecular and Cellular Physiology, Stanford, USA (GRID:grid.168010.e) (ISNI:0000000419368956)