Blockade of Autoantibody-Initiated Tissue Damage by Using Recombinant Fab Antibody Fragments against Pathogenic Autoantigen

• Published in: The American journal of pathology Vol. 176; no. 2; pp. 914 - 925
• Main Authors: Wang, Gang, Ujiie, Hideyuki, Shibaki, Akihiko, Nishie, Wataru, Tateishi, Yasuki, Kikuchi, Kazuhiro, Li, Qiang, McMillan, James R, Morioka, Hiroshi, Sawamura, Daisuke, Nakamura, Hideki, Shimizu, Hiroshi
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Elsevier Inc 01-02-2010; ASIP; American Society for Investigative Pathology
• Subjects: Animals; Animals, Newborn; Autoantibodies - adverse effects; Autoantibodies - immunology; Autoantibodies - isolation & purification; Autoantibodies - metabolism; Autoantigens - drug effects; Autoantigens - immunology; Autoimmune Diseases - etiology; Autoimmune Diseases - immunology; Autoimmune Diseases - pathology; Autoimmune Diseases - therapy; Biological and medical sciences; Disease Models, Animal; Dose-Response Relationship, Drug; Humans; Immunoglobulin Fab Fragments - immunology; Immunoglobulin Fab Fragments - pharmacology; Immunoglobulin Fab Fragments - therapeutic use; Immunotherapy - methods; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Mice; Mice, Nude; Pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Pemphigoid, Bullous - blood; Pemphigoid, Bullous - immunology; Pemphigoid, Bullous - pathology; Pemphigoid, Bullous - therapy; Peptide Library; Recombinant Fusion Proteins - immunology; Recombinant Fusion Proteins - pharmacology; Recombinant Fusion Proteins - therapeutic use; Regular; Autoimmunity; Tissue; Anatomic pathology; Autoantigen; Antibody; Pathogenesis; Pathogenic; Autoantibody; Fab'-Fragment; Fab-Fragment; Lesion; Recombinant protein
• ISSN: 0002-9440; 1525-2191
• DOI: 10.2353/ajpath.2010.090744

Activation of the complement cascade via the classical pathway is required for the development of tissue injury in many autoantibody-mediated diseases. It therefore makes sense to block the pathological action of autoantibodies by preventing complement activation through inhibition of autoantibody binding to the corresponding pathogenic autoantigen using targeted Fab antibody fragments. To achieve this, we use bullous pemphigoid (BP) as an example of a typical autoimmune disease. Recombinant Fabs against the non-collagenous 16th-A domain of type XVII collagen, the main pathogenic epitope for autoantibodies in BP, were generated from antibody repertoires of BP patients by phage display. Two Fabs, Fab-B4 and Fab-19, showed marked ability to inhibit the binding of BP autoantibodies and subsequent complement activation in vitro . In the in vivo experiments using type XVII collagen humanized BP model mice, these Fabs protected mice against BP autoantibody-induced blistering disease. Thus, the blocking of pathogenic epitopes using engineered Fabs appears to demonstrate efficacy and may lead to disease-specific treatments for antibody-mediated autoimmune diseases.