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      Avidity in antibody effector functions and biotherapeutic drug design

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          Abstract

          Antibodies are the cardinal effector molecules of the immune system and are being leveraged with enormous success as biotherapeutic drugs. A key part of the adaptive immune response is the production of an epitope-diverse, polyclonal antibody mixture that is capable of neutralizing invading pathogens or disease-causing molecules through binding interference and by mediating humoral and cellular effector functions. Avidity — the accumulated binding strength derived from the affinities of multiple individual non-covalent interactions — is fundamental to virtually all aspects of antibody biology, including antibody–antigen binding, clonal selection and effector functions. The manipulation of antibody avidity has since emerged as an important design principle for enhancing or engineering novel properties in antibody biotherapeutics. In this Review, we describe the multiple levels of avidity interactions that trigger the overall efficacy and control of functional responses in both natural antibody biology and their therapeutic applications. Within this framework, we comprehensively review therapeutic antibody mechanisms of action, with particular emphasis on engineered optimizations and platforms. Overall, we describe how affinity and avidity tuning of engineered antibody formats are enabling a new wave of differentiated antibody drugs with tailored properties and novel functions, promising improved treatment options for a wide variety of diseases.

          Abstract

          Antibody function is dependent on avidity — the accumulated strength of multiple affinity interactions between the antibody, antigen, cell surface receptors and other antibodies. In this Review, Oostindie et al. discuss the role of avidity in eliciting antibody functional responses and review the current engineering strategies for manipulating avidity interactions in antibody-based therapies.

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          Most cited references222

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          Is Open Access

          Antibody cocktail to SARS-CoV-2 spike protein prevents rapid mutational escape seen with individual antibodies

          Antibodies targeting the spike protein of SARS-CoV-2 present a promising approach to combat the COVID19 pandemic; however, concerns remain that mutations can yield antibody resistance. We investigate the development of resistance against four antibodies to the spike protein that potently neutralize SARS-CoV-2, individually as well as when combined into cocktails. These antibodies remain effective against spike variants that have arisen in the human population. However, novel spike mutants rapidly appeared following in vitro passaging in the presence of individual antibodies, resulting in loss of neutralization; such escape also occurred with combinations of antibodies binding diverse but overlapping regions of the spike protein. Importantly, escape mutants were not generated following treatment with a non-competing antibody cocktail.
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            Studies in humanized mice and convalescent humans yield a SARS-CoV-2 antibody cocktail

            Neutralizing antibodies have become an important tool in treating infectious diseases. Recently, two separate approaches yielded successful antibody treatments for Ebola – one from genetically-humanized mice, and the other from a human survivor. Here, we describe parallel efforts using both humanized mice and convalescent patients to generate antibodies against the SARS-CoV-2 spike protein, yielding a large collection of fully-human antibodies that were characterized for binding, neutralization and three dimensional structure. Based on these criteria, we selected pairs of highly-potent individual antibodies that simultaneously bind the receptor-binding domain of the spike protein, providing ideal partners for a therapeutic antibody cocktail that aims to decrease the potential for virus escape mutants that might arise in response to selective pressure from a single antibody treatment.
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              IgG Subclasses and Allotypes: From Structure to Effector Functions

              Of the five immunoglobulin isotypes, immunoglobulin G (IgG) is most abundant in human serum. The four subclasses, IgG1, IgG2, IgG3, and IgG4, which are highly conserved, differ in their constant region, particularly in their hinges and upper CH2 domains. These regions are involved in binding to both IgG-Fc receptors (FcγR) and C1q. As a result, the different subclasses have different effector functions, both in terms of triggering FcγR-expressing cells, resulting in phagocytosis or antibody-dependent cell-mediated cytotoxicity, and activating complement. The Fc-regions also contain a binding epitope for the neonatal Fc receptor (FcRn), responsible for the extended half-life, placental transport, and bidirectional transport of IgG to mucosal surfaces. However, FcRn is also expressed in myeloid cells, where it participates in both phagocytosis and antigen presentation together with classical FcγR and complement. How these properties, IgG-polymorphisms and post-translational modification of the antibodies in the form of glycosylation, affect IgG-function will be the focus of the current review.
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                Author and article information

                Contributors
                p.parren@lavatherapeutics.com
                Journal
                Nat Rev Drug Discov
                Nat Rev Drug Discov
                Nature Reviews. Drug Discovery
                Nature Publishing Group UK (London )
                1474-1776
                1474-1784
                5 July 2022
                : 1-21
                Affiliations
                [1 ]GRID grid.466767.2, ISNI 0000 0004 0620 3167, Genmab, ; Utrecht, Netherlands
                [2 ]GRID grid.10419.3d, ISNI 0000000089452978, Department of Immunology, , Leiden University Medical Center, ; Leiden, Netherlands
                [3 ]GRID grid.418158.1, ISNI 0000 0004 0534 4718, Department of Antibody Engineering, , Genentech, ; San Francisco, CA USA
                [4 ]Sparring Bioconsult, Odijk, Netherlands
                [5 ]GRID grid.512049.b, Lava Therapeutics, ; Utrecht, Netherlands
                Author information
                http://orcid.org/0000-0002-6088-9206
                http://orcid.org/0000-0002-9738-9926
                http://orcid.org/0000-0002-4365-3859
                Article
                501
                10.1038/s41573-022-00501-8
                9255845
                35790857
                5966fb54-47c6-4f4d-b769-984cd457ef88
                © Springer Nature Limited 2022

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 30 May 2022
                Categories
                Review Article

                antibody therapy,drug discovery
                antibody therapy, drug discovery

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