Brain delivery of therapeutic proteins using an Fc fragment blood-brain barrier transport vehicle in mice and monkeys

MS Kariolis, RC Wells, JA Getz, W Kwan… - Science translational …, 2020 - science.org
MS Kariolis, RC Wells, JA Getz, W Kwan, CS Mahon, R Tong, DJ Kim, A Srivastava…
Science translational medicine, 2020science.org
Effective delivery of protein therapeutics to the central nervous system (CNS) has been
greatly restricted by the blood-brain barrier (BBB). We describe the development of a BBB
transport vehicle (TV) comprising an engineered Fc fragment that exploits receptor-mediated
transcytosis for CNS delivery of biotherapeutics by binding a highly expressed brain
endothelial cell target. TVs were engineered using directed evolution to bind the apical
domain of the human transferrin receptor (hTfR) without the use of amino acid insertions …
Effective delivery of protein therapeutics to the central nervous system (CNS) has been greatly restricted by the blood-brain barrier (BBB). We describe the development of a BBB transport vehicle (TV) comprising an engineered Fc fragment that exploits receptor-mediated transcytosis for CNS delivery of biotherapeutics by binding a highly expressed brain endothelial cell target. TVs were engineered using directed evolution to bind the apical domain of the human transferrin receptor (hTfR) without the use of amino acid insertions, deletions, or unnatural appendages. A crystal structure of the TV-TfR complex revealed the TV binding site to be away from transferrin and FcRn binding sites, which was further confirmed experimentally in vitro and in vivo. Recombinant expression of TVs fused to anti–β-secretase (BACE1) Fabs yielded antibody transport vehicle (ATV) molecules with native immunoglobulin G (IgG) structure and stability. Peripheral administration of anti-BACE1 ATVs to hTfR-engineered mice and cynomolgus monkeys resulted in substantially improved CNS uptake and sustained pharmacodynamic responses. The TV platform readily accommodates numerous additional configurations, including bispecific antibodies and protein fusions, yielding a highly modular CNS delivery platform.
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