Classifications

• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
  • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
  • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
  • G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
  • G01N33/577—Immunoassay; Biospecific binding assay; Materials therefor involving monoclonal antibodies binding reaction mechanisms characterised by the use of monoclonal antibodies
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
  • C07K16/18—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans
  • C07K16/28—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
  • C07K16/2866—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against receptors for cytokines, lymphokines, interferons
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
  • C07K16/42—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against immunoglobulins
• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
  • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
  • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
  • G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
  • G01N33/5306—Improving reaction conditions, e.g. reduction of non-specific binding, promotion of specific binding
• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
  • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
  • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
  • G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
  • G01N33/543—Immunoassay; Biospecific binding assay; Materials therefor with an insoluble carrier for immobilising immunochemicals
  • G01N33/54393—Improving reaction conditions or stability, e.g. by coating or irradiation of surface, by reduction of non-specific binding, by promotion of specific binding
• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
  • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
  • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
  • G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
  • G01N33/6854—Immunoglobulins
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
  • C07K2317/51—Complete heavy chain or Fd fragment, i.e. VH + CH1
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
  • C07K2317/515—Complete light chain, i.e. VL + CL
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
  • C07K2317/52—Constant or Fc region; Isotype
  • C07K2317/526—CH3 domain
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
  • C07K2317/52—Constant or Fc region; Isotype
  • C07K2317/53—Hinge
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
  • C07K2317/56—Immunoglobulins specific features characterized by immunoglobulin fragments variable (Fv) region, i.e. VH and/or VL
  • C07K2317/565—Complementarity determining region [CDR]
• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N2800/00—Detection or diagnosis of diseases
  • G01N2800/24—Immunology or allergic disorders
• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N2800/00—Detection or diagnosis of diseases
  • G01N2800/52—Predicting or monitoring the response to treatment, e.g. for selection of therapy based on assay results in personalised medicine; Prognosis

Definitions

• the present disclosure is directed towards modifying binding molecules in order to minimize pre-existing binding interactions, including binding molecules engineered to minimize or mitigate background reactivity in a sample matrix caused by drug non-specific binding interactions.
• Biologic therapy is a valuable tool for eliminating, supplementing, or replacing elements of a subject’s immune system to treat disease.
• Foreign biological material has a potential to induce an immune response from the subject being treated. This immune response can be triggered by the administration of a biologic therapeutic.
• a subject may have elements of their serum proteins that produce a signal prior to introduction of a biologic thus creating a high background or noise level when tested in an anti-drug antibody (ADA) assay.
• ADA anti-drug antibody
• a standard assay employed during the development and surveillance of a biologic therapeutic is the anti-drug antibody (ADA) assay.
• ADA anti-drug antibody
• This assay is used to detect whether a subject’s immune system has produced antibodies against an administered biologic.
• the signal to noise ratio has to be such that meaningful data can be obtained and analyzed.
• there already exists a high background (noise) even without the administration of any biologic such that detection of true treatment- emergent ADA is obfuscated due to the background signal and an effective ADA assay is attenuated.
• compositions and methods of the present invention provide a path towards reducing or eliminating the drug non-specific, pre-existing background reactivity present in some human serum or plasma samples that is observed in some ADA assays. It should also be understood that this drug non-specific binding may or may not interfere with the ability of a therapeutic to be active or remain in circulation.
• the present disclosure is directed to binding molecules engineered to mitigate drug non-specific pre-existing background reactivity in a subject sample either prior to or following the administration of the same.
• the instant invention is directed towards modifying binding molecules in order to minimize pre-existing binding interactions, including binding molecules engineered to minimize or mitigate background reactivity in a sample matrix caused by drug non-specific binding interactions.
• the present disclosure further provides binding molecules specific for one or more particular targets.
• the disclosure is directed to binding molecules specific for IL4Ra (Interleukin 4 alpha) or IL13R (Interleukin 13).
• the disclosure provides binding molecules directed to IgG4 antibodies, or fragments thereof.
• a binding molecule as understood herein is a molecule that specifically interacts with a particular target. Examples of such binding molecules include, but are not limited to, antibodies (including monoclonal antibodies) and fragments thereof, engineered antibodies, fusion proteins, and other like antigen-binding molecules well-known to those skilled in the art.
• the target is IL4Ra.
• a non-natural binding molecule comprising a C-terminal heavy chain sequence LSPG (SEQ ID NO: 21) or an antigen-binding portion thereof is disclosed which is engineered to minimize or mitigate background reactivity in a sample matrix caused by drug non-specific binding interactions.
• the instant disclosure provides a non-naturally occurring binding molecule, comprising a C-terminal heavy chain sequence SEQ ID NO: 21, or antigen-binding portion thereof, wherein said binding molecule mitigates interaction with pre-existing serum proteins and as such reduces high background signal during ADA analysis.
• the binding molecule comprises a CH domain sequence selected from the group consisting of SEQ ID NO: 5, SEQ ID NO: 6, SEQ ID NO: 7, and SEQ ID NO: 8, or an antigen-binding portion thereof.
• the binding molecule comprises a CH domain sequence selected from the group consisting of SEQ ID NO: 7 and SEQ ID NO: 8, or an antigen-binding portion thereof.
• the binding molecule comprises a CH domain comprising the amino acid sequence of SEQ ID NO: 7.
• the binding molecule comprises a truncated CH domain (REGN-E), wherein the sequence is SEQ ID NO: 22.
• the binding molecule comprises a VH CDR1 region comprising the amino acid sequence SEQ ID NO: 9; a VH CDR2 region comprising the amino acid sequence of SEQ ID NO: 10; a VH CDR3 region comprising the amino acid sequence of SEQ ID NO: 11 ; a VL CDR1 region comprising the amino acid sequence of SEQ ID NO: 12; a VL CDR2 region comprising the amino acid sequence of LGS; a VL CDR3 region comprising the amino acid sequence of SEQ ID NO: 14, and a CH3 domain selected from the group consisting of: SEQ ID NO: 5, SEQ ID NO: 6, and SEQ ID NO: 7.
• the binding molecule comprises a VH CDR1 region comprising the amino acid sequence SEQ ID NO: 9; a VH CDR2 region comprising the amino acid sequence of SEQ ID NO: 10; a VH CDR3 region comprising the amino acid sequence of SEQ ID NO: 11; a VL CDR1 region comprising the amino acid sequence of SEQ ID NO: 12; a VL CDR2 region comprising the amino acid sequence of LGS; a VL CDR3 region comprising the amino acid sequence of SEQ ID NO: 14, and a CH3 domain comprising the amino acid sequence of SEQ ID NO: 21.
• the disclosure provides a non-naturally occurring binding molecule, wherein the binding molecule comprises a VH CDR1 region comprising the amino acid sequence SEQ ID NO: 9; a VH CDR2 region comprising the amino acid sequence of SEQ ID NO: 10; a VH CDR3 region comprising the amino acid sequence of SEQ ID NO: 11 ; a VL CDR1 region comprising the amino acid sequence of SEQ ID NO: 12; a VL CDR2 region comprising the amino acid sequence of LGS; a VL CDR3 region comprising the amino acid sequence of SEQ ID NO: 14, and a CH3 domain comprising the amino acid sequence of SEQ ID NO: 5, or SEQ ID NO: 6, or SEQ ID NO: 7, or SEQ ID NO: 21, or SEQ ID NO: 22.
• the binding molecule comprises a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 15, and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 16.
• the binding molecule comprises an IgG4 C 111 region comprising the amino acid sequence of SEQ ID NO: 1.
• the binding molecule comprises an IgG4 CH2 region comprising the amino acid sequence of SEQ ID NO: 2.
• the binding molecule comprises a hinge region.
• the hinge region comprises the sequence of APEFLG (SEQ ID NO: 17).
• the binding molecule comprises an IgG4 constant region comprising the amino acid sequence of SEQ ID NO: 8.
• the disclosure provides an assay comprising (a) a solid support, wherein a first component is operably-linked to the solid support; (b) at least one capture agent, wherein a second component is operably-linked to the at least one capture agent, wherein the capture agent comprises a first non-naturally occurring binding molecule such as a monoclonal antibody, wherein the first non-naturally occurring binding molecule such as a monoclonal antibody comprises a sequence encoding a VH CDR1 region, a sequence encoding a VH CDR2 region, a sequence encoding a VH CDR3 region, a sequence encoding a VL CDR1 region, a sequence encoding a VL CDR2 region, a sequence encoding a VL CDR3 region, and a sequence encoding a heavy chain constant region, wherein the heavy chain constant region comprises the sequence SEQ ID NO: 21, and (c) at least one detection agent, wherein a detectable label is operably-linked
• the first non-naturally occurring binding molecule comprises a sequence encoding a heavy chain variable region and a sequence encoding a light chain variable region and wherein the second non-naturally occurring binding molecule comprises the sequence encoding a heavy chain variable region and the sequence encoding a light chain variable region of the first non-naturally occurring binding molecule.
• the first non-naturally occurring binding molecule comprises a sequence encoding a heavy chain constant region comprising SEQ ID NO: 7.
• the first non-naturally occurring binding molecule comprises a VH CDR1 region comprising the amino acid sequence SEQ ID NO: 9; a VH CDR2 region comprising the amino acid sequence of SEQ ID NO: 10; a VH CDR3 region comprising the amino acid sequence of SEQ ID NO: 11 ; a VL CDR1 region comprising the amino acid sequence of SEQ ID NO: 12; a VL CDR2 region comprising the amino acid sequence of LGS; a VL CDR3 region comprising the amino acid sequence of SEQ ID NO: 14.
• the first non-naturally occurring binding molecule comprises a heavy chain variable region comprising the amino acid sequence SEQ ID NO: 15, and a light chain variable region comprising the amino acid sequence SEQ ID NO: 16.
• the CH3 domain of an IgG4 antibody such as dupilumab is switched for an IgGl CH3 domain.
• the CH3 domain of an IgG4 antibody like dupilumab is truncated. In one aspect, the truncation occurs at Serine 444.
• the detection agent comprises dupilumab.
• the second non-naturally occurring binding molecule comprises dupilumab.
• the first component comprises streptavidin.
• the second component comprises biotin.
• the disclosure provides an assay comprising (a) a solid support, wherein a first component is operably-linked to the solid support; (b) at least one capture agent, wherein a second component is operably-linked to the at least one capture agent and wherein the capture agent comprises the non-naturally occurring binding molecule of the disclosure or a composition of the disclosure; and (c) at least one detection agent, wherein a detectable label is operably-linked to the detection agent and wherein the detection agent comprises dupilumab; wherein the first component and the second component selectively bind to one another.
• the first component comprises streptavidin.
• the second component comprises biotin.
• a binding molecule that does not specifically bind to a sequence of a variable region of dupilumab does not bind the at least one capture agent.
• a binding molecule that specifically binds to a sequence of a variable region of dupilumab binds to the at least one capture agent and to the at least one detection agent.
• the disclosure provides a method of determining a level of immunogenicity of a biologic therapy in a subject, comprising (a) contacting a biological sample from the subject with the assay of the disclosure under conditions suitable to allow binding of at least one binding molecule in the biological sample with the at least one capture agent and to the at least one detection agent, wherein the subject has been administered the binding molecule therapy prior to the contacting step, (b) detecting a signal from the at least one detection agent, and (c) identifying the level of immunogenicity of the subject as high when the signal from (b) is above a threshold value or (d) identifying the level of immunogenicity of the subject as low when the signal from (b) is below the threshold value.
• Certain embodiments of the present invention are directed toward methods for determining a level of immunogenicity of a biologic therapy, wherein the biologic therapy comprises a binding molecule described herein.
• the biologic comprises dupilumab.
• the threshold is a predetermined value.
• the threshold is a safety threshold.
• the amount of the biologic therapy is a therapeutically-effective dose, wherein a therapeutically-effective dose is an amount of therapeutic agent, e.g. a binding molecule of the present invention, that when administered to a subject is of sufficient quantity to achieve an intended purpose.
• a therapeutically-effective dose is an amount of therapeutic agent, e.g. a binding molecule of the present invention, that when administered to a subject is of sufficient quantity to achieve an intended purpose.
• the level of immunogenicity is a baseline level. In certain aspects, the level of immunogenicity is a subsequent or post treatment level.
• the subject is a participant in a clinical trial.
• the subject is a patient undergoing a medical treatment.
• the medical treatment is beginning and the level of immunogenicity is a baseline level.
• the medical treatment is ongoing and the level of immunogenicity is a subsequent level.
• the medical treatment is ending and the level of immunogenicity is a final level.
• the subject is a healthy individual.
• the subject has an inflammatory disease or disorder, an autoimmune disease or disorder, an allergic disease or disorder, an immune disease or disorder, or a benign proliferative disease or disorder.
• the subject has atopic dermatitis, asthma, allergic rhinitis, allergic conjunctivitis, eosinophilic esophagitis, nasal polyps, ABPA (Allergic bronchopulmonary aspergillosis), Bullous Pemphigoid, Chronic Obstructive pulmonary disease (COPD), HFE (Hand and foot eczema), Prurigo Nodularis, or any Type 2 inflammatory response or a combination thereof.
• the subject can have any disease or medical condition.
• the present disclosure provides a non-naturally occurring monoclonal antibody comprising a C-terminal heavy chain sequence comprising a sequence selected from the group consisting of SEQ ID NO: 7 and SEQ ID NO: 13, or an antigen-binding portion thereof.
• a C-terminal heavy chain sequence can be a CH3 domain sequence.
• a C-terminal heavy chain sequence can comprise SEQ ID NO: 7.
• a C-terminal heavy chain sequence can comprise SEQ ID NO: 13.
• a C-terminal heavy chain sequence can comprise a CH domain sequence comprising SEQ ID NO: 8.
• a C-terminal heavy chain sequence can comprise a CH domain sequence comprising SEQ ID NO: 22.
• a non-naturally occurring monoclonal antibody comprising a CH3 domain consisting of a sequence selected from the group consisting of SEQ ID NO: 7 and SEQ ID NO: 13, or an antigen-binding portion thereof.
• a non-naturally occurring monoclonal antibody comprising C-terminal heavy chain sequence consisting of a sequence selected from the group consisting of SEQ ID NO: 8 and SEQ ID NO: 22, or an antigen-binding portion thereof.
• a non-naturally occurring monoclonal antibody wherein the antibody comprises a VH CDR1 region comprising the amino acid sequence SEQ ID NO: 9; a VH CDR2 region comprising the amino acid sequence of SEQ ID NO: 10; a VH CDR3 region comprising the amino acid sequence of SEQ ID NO: 11; a VL CDR1 region comprising the amino acid sequence of SEQ ID NO: 12; a VL CDR2 region comprising the amino acid sequence of LGS; a VL CDR3 region comprising the amino acid sequence of SEQ ID NO: 14, and a CH3 domain consisting of an amino acid sequence selected from the group consisting of SEQ ID NO: 5, SEQ ID NO: 6, SEQ ID NO: 7 and SEQ ID NO: 13, or an antigen-binding portion thereof.
• the preceding antibodies can further comprises a VH CDR1 region comprising the amino acid sequence SEQ ID NO: 9; a VH CDR2 region comprising the amino acid sequence of SEQ ID NO: 10; a VH CDR3 region comprising the amino acid sequence of SEQ ID NO: 11; a VL CDR1 region comprising the amino acid sequence of SEQ ID NO: 12; a VL CDR2 region comprising the amino acid sequence of LGS; a VL CDR3 region comprising the amino acid sequence of SEQ ID NO: 14.
• the present disclosure provides a non-naturally occurring monoclonal antibody, wherein the antibody comprises a VH CDR1 region comprising the amino acid sequence SEQ ID NO: 9; a VH CDR2 region comprising the amino acid sequence of SEQ ID NO: 10; a VH CDR3 region comprising the amino acid sequence of SEQ ID NO: 11 ; a VL CDR1 region comprising the amino acid sequence of SEQ ID NO: 12; a VL CDR2 region comprising the amino acid sequence of LGS; a VL CDR3 region comprising the amino acid sequence of SEQ ID NO: 14, and a CH3 domain comprising the amino acid sequence selected from the group consisting of SEQ ID NO: 5, SEQ ID NO: 6, SEQ ID NO: 7 and SEQ ID NO: 13, or an antigen-binding portion thereof.
• the preceding antibodies can comprise a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 15, and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 16, or an antigen-binding portion thereof.
• the preceding antibodies can comprise an IgG4 Cn 1 region comprising the amino acid sequence of SEQ ID NO: 1.
• the preceding antibodies can comprise an IgG4 CH2 region comprising the amino acid sequence of SEQ ID NO: 2.
• An IgG4 CH2 region can comprise a hinge region.
• a hinge region can comprise the sequence of APEFLG (SEQ ID NO: 17).
• the antibodies of the present disclosure can mitigate high background signal during an immunogenicity analysis.
• the present disclosure provides an assay comprising: (a) a solid support, wherein a first component is operably -linked to the solid support; (b) at least one capture agent, wherein a second component is operably-linked to the at least one capture agent, wherein the capture agent comprises a first non-naturally occurring monoclonal antibody of the present disclosure, and (c) at least one detection agent, wherein a detectable label is operably-linked to the detection agent, wherein the detection agent comprises a second non-naturally occurring monoclonal antibody of the present disclosure, and wherein the first component and the second component selectively bind to one another.
• a detection agent can comprise dupilumab.
• a second non-naturally occurring monoclonal antibody can comprise dupilumab.
• a first component can comprise streptavidin.
• a second component can comprise biotin.
• the present disclosure provides an assay comprising: (a) a solid support, wherein a first component is operably -linked to the solid support; (b) at least one capture agent, wherein a second component is operably-linked to the at least one capture agent and wherein the capture agent comprises the non-naturally occurring monoclonal antibody of the present disclosure; and (c) at least one detection agent, wherein a detectable label is operably-linked to the detection agent and wherein the detection agent comprises dupilumab; wherein the first component and the second component selectively bind to one another.
• a first component can comprise streptavidin.
• a second component can comprise biotin.
• an at least one capture agent does not bind an antibody that does not specifically bind to a sequence of a variable region of dupilumab. In some aspects, an at least one capture agent and the at least one detection agent binds to an antibody that specifically binds to a sequence of a variable region of dupilumab.
• the present disclosure provides a method of determining a level of immunogenicity of a monoclonal antibody therapy in a subject, comprising: (a) contacting a biological sample from the subject with any assay of the present disclosure under conditions suitable to allow binding of at least one antibody in the biological sample with the at least one capture agent and to the at least one detection agent, wherein the subject has been administered the monoclonal antibody therapy prior to the contacting step; (b) detecting a signal from the at least one detection agent; and (c) identifying the level of immunogenicity of the subject as high when the signal from (b) is above a threshold value; or (d) identifying the level of immunogenicity of the subject as low when the signal from(b) is below the threshold value.
• a monoclonal antibody therapy can comprise an antibody of the present disclosure.
• a monoclonal antibody therapy can comprise dupilumab.
• a threshold can be a predetermined value.
• a threshold can be a safety threshold.
• An amount of the monoclonal antibody therapy can be a therapeutically-effective dose.
• a level of immunogenicity can be a baseline level.
• a level of immunogenicity can be a subsequent level.
• a subject can be a participant in a clinical trial.
• a subject can be a patient undergoing a medical treatment.
• a medical treatment can be beginning and a level of immunogenicity can be a baseline level.
• a medical treatment can be ongoing and a level of immunogenicity can be a subsequent level.
• a medical treatment can be ending and a level of immunogenicity can be a final level.
• a subject can be a healthy individual.
• a subject can have an inflammatory disease or disorder, an autoimmune disease or disorder, an allergic disease or disorder, an immune disease or disorder, or a benign proliferative disease or disorder.
• a subject can have atopic dermatitis, asthma, allergic rhinitis, allergic conjunctivitis, eosinophilic esophagitis, nasal polyps or a combination thereof.
• Figure 1 is a plot characterizing the specificity of pre-existing reactivity in baseline patient samples using competitive antibody constructs in an anti-drug antibody (ADA) assay.
• ADA anti-drug antibody
• the specific competitive antibody construct used in the bridging assay listed from left to right: dupilumab, REGN-A, wt IgG4, wt IgGl, wt IgG2, wt IgG3, REGN-B and REGN-C.
• the six patient samples (S1-S6) are represented, in order, as a circle, a square, a triangle point up, an asterisk, a diamond, and a triangle point down.
• Antibody reagents mentioned in the graph were used at 200 pg/mL as competitive inhibitors in the ADA confirmation assay format.
• Figure 2 is a drawing showing a diagrammatic representation of the three key constructs and their structural differences in comparison to dupilumab.
• REGN-B, REGN-C and REGN-E are molecular analogues of dupilumab. All three constructs are IgG4k constructs that have the same specificity and similar affinity for anti-IL4R as dupilumab and also possess the same CPPC hinge region mutation sequence present in dupilumab.
• Figure 3 is a drawing showing a diagrammatic representation of the amino acid sequence alignment and comparison of the CH3 domain of the wild type IgG4, IgGl and IgG2 subtypes.
• the Leucine at position 445 is the third from the C terminal end of the CH3 domain sequence, as indicated by the arrow.
• Figure 4 is one embodiment illustrating a diagrammatic representation of a drug specific bridging (panel A, ADA assay #1), non-drug specific bridging due to pre-existing reactivity in the current ADA assay (panel B) and no non-drug specific bridging due to use of REGN-C as the capture agent (panel C, ADA assay #2).
• Streptavidin on the plate is shown as a gray cross, the biotin moiety as a small black square and the Ruthenium label as a star.
• biotinylated REGN-D (dupilumab) capture agent black forked structure
• panel C biotinylated REGN-C is shown (black and white checkered forked structure).
• Pre-existing reactivity is represented in panels B and C as a smaller dashed outlined forked structure.
• Figure 5A is a plot showing assay signals from a subset of patient baseline samples using the original ADA assay (assay #1) which is diagrammed in panel A of Figure 4 and uses biotinylated REGN-D as the capture agent.
• Assay #1 On the y-axis, Signal/Noise ratio in log scale from 0 to 100.
• Figure 5B is a plot showing assay signals of the same patient baseline samples using a revised ADA assay (assay #2), which is diagrammed in panel C of Figure 4 and uses biotinylated REGN-C as the capture agent.
• Assay #2 a revised ADA assay
• Signal/Noise ratio in log scale from 0 to 100.
• Figure 6A is a plot showing assay signal from a subset of patient baseline samples using a drug specific bridging anti-drug antibody (ADA) assay, similar to that described in FIG. 4, with intact dupliumab employed as the capture and detection reagents.
• ADA drug specific bridging anti-drug antibody
• Figure 6B is a plot showing assay signal from the same subset of patient baseline samples tested in Figure 6A, using a revised bridging ADA assay with REGN-B ( Figure 2, a human IgG4 mAh where the entire CH3 of IgG4 was switched to an IgGl CH3 domain) as the capture and detection reagents.
• Figure 6C is a plot showing assay signal from the same subset of patient baseline samples tested in Figure 6A, using a revised bridging ADA assay with REGN-E ( Figure 2, a human IgG4 mAh where the CH3 domain is truncated with a stop codon after Serine 444) as the capture and detection reagents.
• Figure 7 is a series of plots characterizing the specificity of pre-existing reactivity in baseline patient samples using competitive antibody constructs in an anti-drug antibody (ADA) assay. On the y-axis, percent inhibition from 0 to 100 in increments of 25.
• ADA anti-drug antibody
• the specific competitive antibody construct used in the bridging assay listed from left to right: dupilumab, REGN-F and REGN-F (L445P) in the top plot or dupilumab, REGN-G and REGN-G (L445P) in the bottom plot.
• the six patient samples (S1-S6) are represented, in order, as a circle, a square, a triangle point up, an asterisk, a diamond, and a triangle point down.
• Antibody reagents mentioned in the graph were used at 200 pg/mL as competitive inhibitors in the ADA confirmation assay format.
• Figure 8 is a series of plots showing assay signal from a subset of patient baseline samples using a drug specific bridging anti-drug antibody (ADA) assay, similar to that described in FIG. 4, with either REGN-F used both as the capture and detection reagents (top) or with REGN-F (L445P) used as the capture reagent in combination with REGN-F as the detection reagent.
• ADA drug specific bridging anti-drug antibody
• Figure 9 is a series of plots showing assay signal from a subset of patient baseline samples using a drug specific bridging anti-drug antibody (ADA) assay, similar to that described in FIG. 4, with either REGN-G used both as the capture and detection reagents (top) or with REGN-G used as the capture reagent in combination with REGN-G (L445P) as the detection reagent.
• ADA drug specific bridging anti-drug antibody
• hIL-4R human IL4R
• IL-4Ra interleukin-4
• hIL-l3 human interleukin- 13
• hIL-l3/hIL-l3Rl complex refers to the complex formed by hIL-l3 binding to hIL-l3Rl complex, which complex binds hIL-4 receptor to initiate biological activity.
• binding molecule is intended to refer to molecules that specifically interact with and bind to a particular target.
• the target can comprise a biologic or small (chemical) molecule.
• the target molecule may define an antigen or antigenic moiety.
• Examples of a binding molecule include, but are not limited to, antibodies (including monoclonal antibodies, bispecific antibodies, as well as antibody fragments), fusion proteins, and other antigen-binding molecule known to those skilled in the art.
• the term“antibody,” as used herein, is an example of a binding molecule and refers to as an immunoglobulin that typically comprises four polypeptide chains, two heavy (H) chains and two light (L) chains inter-connected by disulfide bonds.
• Each heavy chain comprises a heavy chain variable region (HCVR or VH) and a heavy chain constant region.
• the heavy chain constant region comprises three domains, Oil, CH2 and CH3.
• Each light chain comprises a light chain variable region (LCVR or VL) and a light chain constant region.
• the light chain constant region comprises one domain (CL1).
• VH and VL regions can be further subdivided into regions of hypervariability, termed complementarity determining regions (CDR), interspersed with regions that are more conserved, termed framework regions (FR).
• CDR complementarity determining regions
• FR framework regions
• Each VH and VL is composed of three CDRs and four FRs, arranged from amino- terminus to carboxy-terminus in the following order: FR1, CDR1, FR2, CDR2, FR3, CDR3, FR4.
• Antibodies can include antibodies in the IgGl, IgG2, IgG3 or IgG4 subclasses.
• Antibodies can also comprise a combination of regions from different subclasses.
• IgG4 antibodies can include, but are not limited to, dupilumab and cemiplimab.
• binding molecules include, but are not limited to, bi-specific antibodies, tri-specific antibodies, tetra-specific antibodies and penta-specific antibodies.
• the bi-specific antibodies, tri-specific antibodies, tetra-specific antibodies and penta-specific antibodies can comprise an Fc portion of an antibody.
• the bi-specific antibodies, tri-specific antibodies, tetra-specific antibodies, penta-specific antibodies can comprise an IgG4 backbone.
• Another example of a“binding molecule” is an antibody- drug conjugate (ADC).
• ADC antibody- drug conjugate
• an ADC can comprise an IgG4 backbone.
• Another example of a“binding molecule” is a Bi-specific T-cell engager (BiTE).
• the BiTE can comprise an IgG4 backbone.
• a“binding molecule” is a TRAP fusion protein.
• the TRAP fusion protein has an IgG4 backbone.
• a“binding molecule” is a fynomer.
• antigen-binding portion of an antibody (or simply“antibody portion” or “antibody fragment”), as used herein, refers to one or more fragments of an antibody that retain the ability to specifically bind to an antigen (e.g., hIL-4Ra). It has been shown that the antigen-binding function of an antibody can be performed by fragments of a full-length antibody.
• binding fragments encompassed within the term“antigen-binding portion” of an antibody include (i) a Fab fragment, a monovalent fragment comprising the VL, VH, CIT and Cn 1 domains; (ii) a F(ab')2 fragment, a bivalent fragment comprising two F(ab)' fragments linked by a disulfide bridge at the hinge region; (iii) a Fc fragment comprising the VH and OHI domains; (iv) a Fv fragment comprising the VL and VH domains of a single arm of an antibody, (v) a dAb fragment (Ward el al.
• VL and VH are coded for by separate genes, they can be joined, using recombinant methods, by a synthetic linker that enables them to be made as a single contiguous chain in which the VL and VH regions pair to form monovalent molecules (known as single chain Fv (scFv); see e.g., Bird et al. (1988) Science 242:423-426; and Huston et al. (1988) Proc. Natl. Acad. Sci. USA 85:5879-5883.
• scFv single chain Fv
• single chain antibodies are also intended to be encompassed within the term“antigen-binding portion” of an antibody.
• Other forms of single chain antibodies, such as diabodies, are also encompassed (see e.g., Holliger et al. (1993) Proc. Natl. Acad Sci. USA 90:6444-6448).
• A“neutralizing” or“blocking” antibody is intended to refer to an antibody whose binding to hIL-4Ra results in inhibition of the biological activity of hIL-4 and/or hIL-l3.
• This inhibition of the biological activity of hIL-4 and/or IL-13 can be assessed by measuring one or more indicators of hIL-4 and/or hIL-l3 biological activity known to the art, such as hIL-4- and/or IL-l3-induced cellular activation and hIL-4 binding to hIL-4Ra (see examples below).
• A“CDR” or complementarity determining region is a region of hypervariability interspersed within regions that are more conserved, termed“framework regions” (FR).
• the FRs may be identical to the human germline sequences or may be naturally or artificially modified.
• the term“epitope” is an antigenic determinant that interacts with a specific antigen binding site in the variable region of an antibody molecule known as a paratope.
• a single antigen may have more than one epitope.
• Epitopes may be either conformational or linear.
• a conformational epitope is produced by spatially juxtaposed amino acids from different segments of the linear polypeptide chain.
• a linear epitope is one produced by adjacent amino acid residues in a polypeptide chain.
• an epitope may include moieties of saccharides, phosphoryl groups, or sufonyl groups on the antigen.
• immunogenicity refers to the ability of an antigen or immunogen to induce an immune response in the body of a human or an animal. Protein therapeutics have the ability to provoke adverse immune responses that can interfere with drug
• This immune response can take the form of the production of anti-drug antibodies (AD As).
• nucleic acid or fragment thereof indicates that, when optimally aligned with appropriate nucleotide insertions or deletions with another nucleic acid (or its complementary strand), there is nucleotide sequence identity in at least about 95%, and more preferably at least about 96%, 97%, 98% or 99% of the nucleotide bases, as measured by any well-known algorithm of sequence identity, such as FASTA, BLAST or Gap, as discussed below.
• the term“substantial similarity” or“substantially similar” means that two peptide sequences, when optimally aligned, such as by the programs GAP or BESTFIT using default gap weights, share at least 95% sequence identity, even more preferably at least 98% or 99% sequence identity.
• residue positions which are not identical differ by conservative amino acid substitutions.
• A“conservative amino acid substitution” is one in which an amino acid residue is substituted by another amino acid residue having a side chain (R group) with similar chemical properties (e.g., charge or hydrophobicity).
• R group side chain
• a conservative amino acid substitution will not substantially change the functional properties of a protein.
• the percent sequence identity or degree of similarity may be adjusted upwards to correct for the conservative nature of the substitution. Means for making this adjustment are well-known to those of skill in the art.
• Examples of groups of amino acids that have side chains with similar chemical properties include (1) aliphatic side chains: glycine, alanine, valine, leucine and isoleucine; (2) aliphatic-hydroxyl side chains: serine and threonine; (3) amide-containing side chains: asparagine and glutamine; (4) aromatic side chains: phenylalanine, tyrosine, and tryptophan; (5) basic side chains: lysine, arginine, and histidine; (6) acidic side chains: aspartate and glutamate, and (7) sulfur-containing side chains are cysteine and methionine.
• conservative amino acids substitution groups are: valine-leucine-isoleucine, phenylalanine-tyrosine, lysine-arginine, alanine-valine, glutamate-aspartate, and asparagine- glutamine.
• a conservative replacement is any change having a positive value in the PAM250 log-likelihood matrix disclosed in Gonnet et al. (1992) Science 256: 1443 45, herein incorporated by reference.
• A“moderately conservative” replacement is any change having a nonnegative value in the PAM250 log-likelihood matrix.
• Sequence similarity for polypeptides is typically measured using sequence analysis software. Protein analysis software matches similar sequences using measures of similarity assigned to various substitutions, deletions and other modifications, including conservative amino acid substitutions.
• GCG software contains programs such as Gap and Bestfit which can be used with default parameters to determine sequence homology or sequence identity between closely related polypeptides, such as homologous polypeptides from different species of organisms or between a wild type protein and a mutant thereof. See, e.g., GCG Version 6.1. Polypeptide sequences also can be compared using FASTA using default or recommended parameters, a program in GCG Version 6.1.
• FASTA e.g., FASTA2 and FASTA3
• FASTA2 and FASTA3 provides alignments and percent sequence identity of the regions of the best overlap between the query and search sequences (Pearson (2000) supra).
• Another algorithm when comparing a sequence of the disclosure to a database containing a large number of sequences from different organisms is the computer program BLAST, especially BLASTP or TBLASTN, using default parameters. See, e.g., Altschul et al. (1990) J. Mol. Biol. 215:403-410 and Altschul et al. (1997) Nucleic Acids Res. 25:3389-402, each of which is herein incorporated by reference.
• Methods for generating human antibodies include those described in, for example, U.S. Pat. No. 6,596,541, Green et al. (1994) Nature Genetics 7: 13-21), U.S. Pat. Nos.
• Rodents can be immunized by any method known in the art (see, for example, Harlow and Lane (1988 ) Antibodies: A Laboratory Manual 1988 Cold Spring Harbor Laboratory; Malik and Lillehoj (1994) Antibody Techniques, Academic Press, CA).
• Antibodies of the disclosure are typically prepared with the use of VELOCIMMUNE® technology (U.S. Pat. No. 6,596,541).
• a transgenic mouse in which the endogenous immunoglobulin heavy and light chain variable regions are replaced with the corresponding human variable regions is challenged with the antigen of interest, and lymphatic cells (such as B-cells) are recovered from the mice that express antibodies.
• lymphatic cells such as B-cells
• the lymphatic cells may be fused with a myeloma cell line to prepare immortal hybridoma cell lines, and such hybridoma cell lines are screened and selected to identify hybridoma cell lines that produce antibodies specific to the antigen of interest.
• DNA encoding the variable regions of the heavy chain and light chain may be isolated and linked to desirable isotypic constant regions of the heavy chain and light chain.
• Such an antibody protein may be produced in a cell, such as a CHO cell.
• DNA encoding the antigen-specific chimeric antibodies or the variable regions of the light and heavy chains
• the DNA encoding the variable regions of the heavy and light chains of the antibody may be isolated and operably linked to DNA encoding the human heavy and light chain constant regions.
• the DNA may be then expressed in a cell capable of expressing the fully human antibody.
• the cell is a CHO cell.
• Antibodies may be therapeutically useful in blocking a ligand-receptor interaction or inhibiting receptor component interaction, rather than by killing cells through fixation of complement (complement-dependent cytotoxicity) (CDC) and participation antibody- dependent cell-mediated cytotoxicity (ADCC).
• CDC complement-dependent cytotoxicity
• ADCC participation antibody- dependent cell-mediated cytotoxicity
• the constant region of an antibody is important in the ability of an antibody to fix complement and mediate cell -dependent cytotoxicity.
• the isotype of an antibody may be selected on the basis of whether it is desirable for the antibody to mediate cytotoxicity.
• Human immunoglobulins can exist in two forms that are associated with hinge heterogeneity.
• an immunoglobulin molecule comprises a stable four-chain construct of approximately 150-160 kDa in which the dimers are held together by an interchain heavy chain disulfide bond.
• the dimers are not linked via interchain disulfide bonds and a molecule of about 75-80 kDa is formed composed of a covalently coupled light and heavy chain (half-antibody). These forms have been extremely difficult to separate, even after affinity purification.
• the frequency of appearance of the second form in various intact IgG isotypes is due to, but not limited to, structural differences associated with the hinge region isotype of the antibody.
• a single amino acid substitution in the hinge region of the human IgG4 hinge can significantly reduce the appearance of the second form (Angal et al. (1993) Molecular Immunology 30: 105) to levels typically observed using a human IgGl hinge.
• the instant disclosure encompasses antibodies having one or more mutations in the hinge, CH2 or CH3 region that may be desirable, for example, in production, to improve the yield of the desired antibody form.
• high affinity chimeric antibodies are isolated having a human variable region and a mouse constant region.
• the antibodies are characterized and selected for desirable characteristics, including binding affinity to hIL-4Ra, ability to block hIL-4 binding to hIL-4Ra, and/or selectivity for the human protein.
• the mouse constant regions are replaced with desired human constant regions to generate the fully human antibodies of the disclosure, for example wild-type or modified IgG4 or IgGl (for example, SEQ ID NO: 4, 19, 20 and 23). While the constant region selected may vary according to specific use, high affinity antigen-binding and target specificity characteristics reside in the variable region.
• the present disclosure provides a non-naturally occurring binding molecule such as a monoclonal antibody, or antigen-binding portion thereof, comprising a C-terminal heavy chain sequence LSPG (SEQ ID NO: 21).
• the C-terminal heavy chain is a human CH3 domain.
• the human antibody is of the IgG4 class.
• the heavy chain sequence comprises SEQ ID NO: 7.
• the heavy chain sequence comprises SEQ ID NO: 8.
• the disclosure provides immunogenicity assays comprising an anti-IL-4Ra binding molecule such as an antibody or antigen-binding fragments thereof of the present disclosure.
• Immunogenicity assays of the disclosure can take the form of anti-drug antibody (ADA) assays.
• ADA assays of the disclosure may be ADA bridging assays or direct enzyme-linked immunosorbent (ELISA) assays.
• ELISA enzyme-linked immunosorbent
• Binding molecules like antibodies present in the sample then bind to both the biotinylated binding molecule and a labeled form of the same binding molecule, forming a bridging interaction with a detectable signal from the label.
• Suitable labels will be known to one ordinarily skilled in the art.
• Exemplary labels comprise Ruthenium, horseradish peroxidase, alkaline phosphatase and fluorophores.
• the ADA bridging assay may include titration of the sample performing the bridging reaction to generate a standard curve, and the use of a cold, unlabeled competitor antibody to inhibit the reaction.
• Figure 4 illustrates a drug specific bridging ADA assay in Panel A; in Panel B, a non- drug specific bridging assay due to pre-existing reactivity in the current ADA assay; and no non-drug specific bridging ADA assay due to use of REGN-C as the capture agent seen in Panel C.
• Pre-existing reactivity is represented in panels B and C as a smaller dashed outlined forked structure.
• assay reagent molecular analogs REGN-A, B, C, D and E are interchangeable thus permitting a skilled artisan to design various permutations of the assay as described.
• REGN-D in order to reduce background a skilled artisan could combine REGN-D with any of the following reagents to form novel combinations: REGN-B, REGN-C or REGN-E (D+B, D+C, D+E or flipped such that B+D, C+D or E+D) such that the order of alignment is“capture agent” + “detection agent.”
• REGN-B, REGN-C or REGN-E D+B, D+C, D+E or flipped such that B+D, C+D or E+D
• B+B, C+C or E+E such that the order of alignment is“capture agent” + “detection agent.”
• a skilled artisan could make the following pairs in order to reduce background signal: B+B, C+C or E+E.
• levels of immunogenicity are determined using binding molecules such antibodies (or antigen-binding portions thereof).
• the levels of immunogenicity are evaluated for dupilumab using an IgG4 antibody.
• IgG4 antibodies comprising a heavy chain sequence of either SEQ ID NO: 21, SEQ ID NO: 22, SEQ ID NO: 7 or SEQ ID NO: 8 resulting in a lower background signal.
• a binding molecule such as an antibody, or antigen-binding portion thereof, comprises (1) one or more VL chain sequences selected from the group consisting of SEQ ID NO: 12, LGS, SEQ ID NO: 14 and
• the binding molecule exhibits reduced background reactivity in an immunogenicity (ADA) assay compared to a binding molecule comprising (1) one or more VL chain sequences selected from the group consisting of SEQ ID NO: 12, LGS, SEQ ID NO: 14 and combinations thereof, (2) one or more VH chain sequences selected from the group consisting of SEQ ID NO: 9, SEQ ID NO: 10, SEQ ID NO: 11 and combinations thereof, and (3) a CH3 or CH sequence not selected from the group consisting of SEQ ID NO: 21, SEQ ID NO: 22, SEQ ID NO: 7 and SEQ ID NO: 8.
• the CH domain sequence of (3) can include SEQ ID NO: 5 and SEQ ID NO:
• the CH3 domain of an IgG4 antibody such as dupliumab is switched for an IgGl CH3 domain resulting in a lower background signal (FIG. 6B).
• the CH3 domain of an IgG4 antibody like dupliumab is truncated. In one aspect, the truncation occurs at Serine 444 resulting in a lower background signal (FIG. 6C).
• the present disclosure provides a binding molecule comprising (1) one or more VL chain sequences selected from the group consisting of SEQ ID NO: 12, LGS, SEQ ID NO: 14 and combinations thereof, (2) one or more VH chain sequences selected from the group consisting of SEQ ID NO: 9, SEQ ID NO: 10, SEQ ID NO: 11 and combinations thereof, and (3) a CH3 or CH sequence selected from the group consisting of SEQ ID NO: 21, SEQ ID NO: 22, SEQ ID NO: 13, SEQ ID NO: 7 and SEQ ID NO: 8.
• the present disclosure provides a binding molecule comprising (1) one or more VL chain sequences selected from the group consisting of SEQ ID NO: 12, LGS, SEQ ID NO: 14 and combinations thereof, (2) one or more VH chain sequences selected from the group consisting of SEQ ID NO: 9, SEQ ID NO: 10, SEQ ID NO: 11 and combinations thereof, and (3) a CH3 or CH sequence, wherein the CH3 or CH sequence comprises a one or more sequences selected from the group consisting of SEQ ID NO: 21, SEQ ID NO: 22, SEQ ID NO: 13, SEQ ID NO: 7 and SEQ ID NO: 8.
• the present disclosure provides a binding molecule comprising (1) one or more VL chain sequences selected from the group consisting of SEQ ID NO: 12, LGS, SEQ ID NO: 14 and combinations thereof, (2) one or more VH chain sequences selected from the group consisting of SEQ ID NO: 9, SEQ ID NO: 10, SEQ ID NO: 11 and combinations thereof, and (3) a CH3 sequence, wherein the CH3 sequence comprises one or more sequences selected from the group consisting of SEQ ID NO: 7, SEQ ID NO: 13, or SEQ ID NO: 21.
• the present disclosure provides a binding molecule comprising (1) one or more VL chain sequences selected from the group consisting of SEQ ID NO: 12, LGS, SEQ ID NO: 14 and combinations thereof, (2) one or more VH chain sequences selected from the group consisting of SEQ ID NO: 9, SEQ ID NO: 10, SEQ ID NO: 11 and combinations thereof, and (3) a CH sequence, wherein the CH sequence comprises one or more sequences selected from the group consisting of SEQ ID NO: 8, SEQ ID NO: 21 and SEQ ID NO: 22.
• the present disclosure provides a binding molecule comprising a CH sequence, wherein the CH sequence comprises one or more sequences selected from the group consisting of SEQ ID NO: 8, SEQ ID NO: 21 and SEQ ID NO: 22.
• the present disclosure provides a binding molecule comprising a CH3 sequence, wherein the CH3 sequence comprises one or more sequences selected from the group consisting of SEQ ID NO: 7, SEQ ID NO: 13, or SEQ ID NO: 21.
• the present disclosure provides a binding molecule comprising an IgG4 CH domain comprising a Proline to Leucine amino acid substitution at position 445.
• the present disclosure provides a binding molecule comprising SEQ ID NO: 1, SEQ ID NO: 2 and SEQ ID NO: 5.
• the present disclosure provides a binding molecule comprising SEQ ID NO: 1, SEQ ID NO: 2 and SEQ ID NO: 6.
• the present disclosure provides a binding molecule comprising (1) one or more VL chain sequences selected from the group consisting of SEQ ID NO: 12, LGS, SEQ ID NO: 14 and combinations thereof, (2) one or more VH chain sequences selected from the group consisting of SEQ ID NO: 9, SEQ ID NO: 10, SEQ ID NO: 11 and combinations thereof, and (3) a CH sequence comprising SEQ ID NO: 1, SEQ ID NO: 2 and SEQ ID NO: 5.
• the present disclosure provides a binding molecule comprising (1) one or more VL chain sequences selected from the group consisting of SEQ ID NO: 12, LGS, SEQ ID NO: 14 and combinations thereof, (2) one or more VH chain sequences selected from the group consisting of SEQ ID NO: 9, SEQ ID NO: 10, SEQ ID NO: 11 and combinations thereof, and (3) a CH sequence comprising SEQ ID NO: 1, SEQ ID NO: 2 and SEQ ID NO: 6.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 99% sequence identity to SEQ ID NO: 7. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 98% sequence identity to SEQ ID NO: 7. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 97% sequence identity to SEQ ID NO: 7. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 96% sequence identity to SEQ ID NO: 7. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 95% sequence identity to SEQ ID NO: 7.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 94% sequence identity to SEQ ID NO: 7. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 93% sequence identity to SEQ ID NO: 7. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 92% sequence identity to SEQ ID NO: 7. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 91% sequence identity to SEQ ID NO: 7. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 90% sequence identity to SEQ ID NO: 7.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 99% sequence identity to SEQ ID NO: 8. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 98% sequence identity to SEQ ID NO: 8. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 97% sequence identity to SEQ ID NO: 8. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 96% sequence identity to SEQ ID NO: 8. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 95% sequence identity to SEQ ID NO: 8.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 94% sequence identity to SEQ ID NO: 8. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 93% sequence identity to SEQ ID NO: 8. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 92% sequence identity to SEQ ID NO: 8. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 91% sequence identity to SEQ ID NO: 8. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 90% sequence identity to SEQ ID NO: 8.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 99% sequence identity to SEQ ID NO: 13. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 98% sequence identity to SEQ ID NO: 13. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 913% sequence identity to SEQ ID NO: 13. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 96% sequence identity to SEQ ID NO: 13. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 95% sequence identity to SEQ ID NO: 13.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 94% sequence identity to SEQ ID NO: 13. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 93% sequence identity to SEQ ID NO: 13. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 92% sequence identity to SEQ ID NO: 13. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 91% sequence identity to SEQ ID NO: 13. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 90% sequence identity to SEQ ID NO: 13.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 99% sequence identity to SEQ ID NO: 7, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 98% sequence identity to SEQ ID NO: 7, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 97% sequence identity to SEQ ID NO: 7, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 96% sequence identity to SEQ ID NO: 7, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 95% sequence identity to SEQ ID NO: 7, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 94% sequence identity to SEQ ID NO: 7, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 93% sequence identity to SEQ ID NO: 7, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 92% sequence identity to SEQ ID NO: 7, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 91% sequence identity to SEQ ID NO: 7, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 90% sequence identity to SEQ ID NO: 7, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 99% sequence identity to SEQ ID NO: 8, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 98% sequence identity to SEQ ID NO: 8, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 97% sequence identity to SEQ ID NO: 8, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 96% sequence identity to SEQ ID NO: 8, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 95% sequence identity to SEQ ID NO: 8, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 94% sequence identity to SEQ ID NO: 8, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 93% sequence identity to SEQ ID NO: 8, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 92% sequence identity to SEQ ID NO: 8, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21. In some aspects, the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 91% sequence identity to SEQ ID NO: 8, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21.
• the present disclosure provides a binding molecule comprising at least one polypeptide sequence with at least about 90% sequence identity to SEQ ID NO: 8, wherein the at least one polypeptide sequence comprises SEQ ID NO: 21.
• any binding molecule of the present disclosure can exhibit reduced background reactivity in an immunogenicity (ADA) assay compared to a binding molecule comprising a CH sequence comprising SEQ ID NO: 3.
• any binding molecule of the present disclosure can exhibit reduced background reactivity in an immunogenicity (ADA) assay compared to a binding molecule comprising a CH sequence comprising SEQ ID NO: 4.
• the disclosure provides therapeutic compositions comprising the anti-IL-4Ra binding molecules of the present disclosure.
• the administration of therapeutic compositions in accordance with the disclosure will be administered with suitable carriers, excipients, and other agents that are incorporated into formulations to provide improved transfer, delivery, tolerance, and the like.
• suitable carriers, excipients, and other agents that are incorporated into formulations to provide improved transfer, delivery, tolerance, and the like.
• a multitude of appropriate formulations can be found in the formulary known to all pharmaceutical chemists: Remington's Pharmaceutical Sciences, Mack
• formulations include, for example, powders, pastes, ointments, jellies, waxes, oils, lipids, lipid (cationic or anionic) containing vesicles (such as LIPOFECTINTM), DNA conjugates, anhydrous absorption pastes, oil-in-water and water-in- oil emulsions, emulsions carbowax (polyethylene glycols of various molecular weights), semi-solid gels, and semi-solid mixtures containing carbowax. See also Powell et al.
• the dose may vary depending upon the age and the size of a subject to be administered, target disease, conditions, route of administration, and the like.
• the binding molecule of the present disclosure is used for treating various conditions and diseases associated with IL-4Ra, in an adult patient, it is advantageous to intravenously administer the binding molecule of the present disclosure normally at a single dose of about 0.01 to about 20 mg/kg body weight, more typically about 0.02 to about 7, about 0.03 to about 5, or about 0.05 to about 3 mg/kg body weight.
• the dosing regimen can be 300 mg once every two weeks (Q2W) and can be extended up to every four weeks (Q4W). Depending on the severity of the condition, the frequency and the duration of the treatment can be adjusted.
• compositions of the disclosure e.g., encapsulation in liposomes, microparticles, microcapsules, recombinant cells capable of expressing the mutant viruses, receptor mediated endocytosis (see, e.g., Wu et al. (1987) J. Biol. Chem. 262:4429-4432).
• Methods of introduction include, but are not limited to, intradermal, intramuscular, intraperitoneal, intravenous, subcutaneous, intranasal, epidural, and oral routes.
• composition may be administered by any convenient route, for example by infusion or bolus injection, by absorption through epithelial or mucocutaneous linings (e.g., oral mucosa, rectal and intestinal mucosa, etc.) and may be administered together with other biologically active agents. Administration can be systemic or local.
• epithelial or mucocutaneous linings e.g., oral mucosa, rectal and intestinal mucosa, etc.
• Administration can be systemic or local.
• the pharmaceutical composition can be also delivered in a vesicle, for example a liposome (see Langer (1990) Science 249: 1527-1533; Treat et al. (1989) in Liposomes in the Therapy of Infectious Disease and Cancer, Lopez Berestein and Fidler (eds.), Liss, New York, pp. 353-365; Lopez-Berestein, ibid., pp. 317-327.
• a liposome see Langer (1990) Science 249: 1527-1533; Treat et al. (1989) in Liposomes in the Therapy of Infectious Disease and Cancer, Lopez Berestein and Fidler (eds.), Liss, New York, pp. 353-365; Lopez-Berestein, ibid., pp. 317-327.
• the pharmaceutical composition can be delivered in a controlled release system.
• a pump may be used (see Langer, supra, ⁇ Sefton (1987) CRC Crit. Ref. Biomed. Eng. 14:201).
• polymeric materials can be used (see Medical Applications of Controlled Release, Langer and Wise (eds.), CRC Pres., Boca Raton, Fla. (1974).
• a controlled release system can be placed in proximity of the composition's target, thus requiring only a fraction of the systemic dose (see, e.g., Goodson, in Medical Applications of Controlled Release, supra, vol. 2, pp. 115-138, 1984). Other controlled release systems are discussed in the review by Langer (1990) Science 249: 1527-1533.
• the injectable preparations may include dosage forms for intravenous, subcutaneous, intracutaneous and intramuscular injections, drip infusions, etc. These injectable preparations may be prepared by methods publicly known.
• the injectable preparations may be prepared, e.g., by dissolving, suspending or emulsifying the antibody or its salt described above in a sterile aqueous medium or an oily medium conventionally used for injections.
• aqueous medium for injections there are, for example, physiological saline, an isotonic solution containing glucose and other auxiliary agents, etc., which may be used in
• an appropriate solubilizing agent such as an alcohol (e.g., ethanol), a polyalcohol (e.g., propylene glycol, polyethylene glycol), a nonionic surfactant [e.g., polysorbate 80, HCO-50 (polyoxyethylene (50 mol) adduct of hydrogenated castor oil)], etc.
• an oily medium there are employed, e.g., sesame oil, soybean oil, etc., which may be used in combination with a solubilizing agent such as benzyl benzoate, benzyl alcohol, etc.
• the injection thus prepared is preferably filled in an appropriate ampoule.
• the pharmaceutical compositions for oral or parenteral use described above are prepared into dosage forms in a unit dose suited to fit a dose of the active ingredients.
• dosage forms in a unit dose include, for example, tablets, pills, capsules, injections (ampoules), suppositories, etc.
• the amount of the aforesaid binding molecule contained is generally about 5 to 500 mg per dosage form in a unit dose; especially in the form of injection, in certain embodiments the aforesaid binding molecule is contained in about 5 to 100 mg and in about 10 to 250 mg for the other dosage forms.
• binding molecules of the disclosure are useful for treating diseases and disorders which are improved, inhibited or ameliorated by reducing IL-4 activity. These disorders include those characterized by abnormal or excess expression of IL-4, or by an abnormal host response to IL-4 production.
• the disclosure encompasses combination therapies in which the anti- IL-4Ra binding molecule (e.g., antibody or antibody fragment) is administered in combination with a second therapeutic agent.
• Co-administration and combination therapy are not limited to simultaneous administration, but include treatment regimens in which an anti- IL-4Ra binding molecule is administered at least once during a course of treatment that involves administering at least one other therapeutic agent to the patient.
• a second therapeutic agent may be another IL-4 antagonist, such as another binding molecule, or a soluble cytokine receptor, an IgE antagonist, an anti-asthma medication (corticosteroids, non-steroidal agents, b-agonists, leukotriene antagonists, xanthines, fluticasone, salmeterol, albuterol) which may be delivered by inhalation or other appropriate means.
• the anti- IL- 4Ra binding molecule such as a binding molecule of the disclosure may be administered with an IL-l antagonist, such as rilonacept, or an IL-13 antagonist.
• an anti-IL- 4Ra binding molecule such as a binding molecule of the present disclosure may be administered in combination with a binding molecule that target cytokines and/or receptors in the Type 1 or Type 2 inflammatory response.
• the second agent may include one or more leukotriene receptor antagonists to treat disorders such as allergic inflammatory diseases, e.g., asthma and allergies. Examples of leukotriene receptor antagonists include but are not limited to montelukast, pranlukast, and zafirlukast.
• the second agent may include a cytokine inhibitor such as one or more of a TNF (etanercept, ENBRELTM), IL-9, IL-5 or IL- 17 antagonist.
• compositions and methods for treating a disease or disorder in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a binding molecule of the present disclosure.
• compositions and methods for treating a disease or disorder in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a composition of the disclosure.
• the disease or disorder is an Type 1 or Type 2 inflammatory disease or disorder.
• the disease or disorder is an autoimmune disease or disorder.
• the disease or disorder is an allergic disease or disorder.
• the disease or disorder is an immune disease or disorder.
• the disease or disorder is a benign proliferative disease or disorder. In certain embodiments of the instant disclosure, the disease or disorder is a malignant proliferative disease or disorder.
• the disease or disorder is atopic dermatitis, asthma, allergic rhinitis, allergic conjunctivitis, eosinophilic esophagitis, nasal polyps or a combination thereof.
• a binding molecule of the present invention is administered systemically.
• the binding molecule is administered intravenously or subcutaneously.
• the binding molecule is administered by an injection or an infusion.
• the binding molecule is administered by a subcutaneous injection.
• the binding molecule is administered systemically.
• the binding molecule is administered by a subcutaneous injection.
• a therapeutically effective dose comprises a subcutaneous injection of about 75 mg, 150 mg, 300 mg or 600 mg.
• the therapeutically effective dose comprises at least one subcutaneous injection, at least two subcutaneous injections, at least three subcutaneous injections, or at least four subcutaneous injections of about 75 mg, 150 mg, 300 mg or 600 mg.
• the binding molecule is administered systemically.
• the binding molecule is administered by a subcutaneous injection.
• a therapeutically effective dose comprises a subcutaneous injection of about 75 mg, 150 mg, 300 mg or 600 mg.
• the therapeutically effective dose comprises at least one subcutaneous injection, at least two subcutaneous injections, at least three subcutaneous injections, or at least four subcutaneous injections of about 75 mg, 150 mg, 300 mg or 600 mg.
• therapeutically effective dose comprises a subcutaneous injection of about 75 mg, 150 mg, 300 mg or 600 mg once every week, once every two weeks, once every four weeks or chronically administered as a maintenance dose to control disease symptoms.
• the binding molecule is administered systemically.
• the binding molecule is administered by a subcutaneous injection.
• the therapeutically effective dose comprises an initial dose of about 600 mg.
• the initial dose comprises a pair of injections of 300 mg each, administered at two distinct injection sites.
• the therapeutically effective dose further comprises a maintenance dose of about 300 mg.
• maintenance dose is administered every other week.
• the binding molecule is administered systemically.
• the binding molecule is administered intravenously at a dose of about 1.0 mg/kg, 3.0 mg/kg, 8.0 mg/kg, or 12.0 mg/kg.
• the binding molecule is administered in combination with a second therapeutic agent.
• the second therapeutic agent comprises an immunosuppressant.
• the second therapeutic agent comprises an agonistic antibody.
• the second therapeutic agent comprises an immunosuppressant.
• the second therapeutic agent comprises an IL-l b- inhibitor, an IL-5 inhibitor, an IL-9 inhibitor, an IL-3 inhibitor, an IL-l 3 inhibitor, an IL-l 7 inhibitor, an IL-25 inhibitor, a TNFa inhibitor, an eotixin-3 inhibitor, an IgE inhibitor, a prostaglandin D2 inhibitor, an immunosuppressant, a corticosteroid, a glucocorticoid, a proton pump inhibitor, a non-steroidal anti-inflammatory drug (NSAID), or a combination thereof.
• NSAID non-steroidal anti-inflammatory drug
• the binding molecule is administered in combination with a second therapeutic agent.
• the second therapeutic agent comprises a corticosteroid.
• the corticosteroid is a topical corticosteroid.
• compositions, formulations, kits, methods of the present disclosure is not limited to any one disease and/or medical condition.
• the compositions, formulations, kits and methods of the present disclosure can be applied to any disease and/or medical condition in which a patient exhibits pre-existing reactivity to therapeutic antibodies.
• Table 1 Exemplary sequences of the disclosure.
• Example 1 Replacement of the IgG4 C H 3 constant regions reduces pre-existing immunoreactivity in some patient samples.
• the reagents listed in Table 1 above can be broadly grouped into three categories, IgG4 backbone/Fc Hinge region constructs, commercially available isotype antibodies and dupilumab bioengineered constructs. Initial experiments examined whether this high assay reactivity was directed towards the CDR or the IgG4 backbone of dupilumab.
• REGN-A is a human monoclonal antibody that has the same IgG4 backbone as dupilumab, but a different CDR sequence and it does not bind to IL-4Ra.
• dupilumab and REGN-A demonstrate significant inhibition of the high assay signals in the six baseline samples from the patients examined.
• this inhibition result suggests that the high signal reactivity is not targeted to the CDR portion of dupilumab but rather to some common antibody backbone sequences.
• Both dupilumab and REGN-A contain an IgGl“CPPC” hinge region sequence that stabilizes the antibody hinge region in these IgG4 molecules.
• a commercial IgG4K antibody which has the wild type (wt) CPSC sequence at the hinge region was examined in the competitive inhibition experiment.
• the wild type IgG4 antibody also showed significant inhibition similar to dupilumab and REGN-A. This result suggests that the high baseline assay signal is not directed to the CPPC hinge region mutation in dupilumab but is most likely directed against the wild type constant regions of the IgG4 molecule. These results indicate that the high signals observed at baseline are not specific to dupilumab.
• a human monoclonal antibody (REGN-B) was constructed which was similar to dupilumab except that the IgG4 CH3 domain was replaced by an IgGl CH3 domain (See Figure 2). This antibody was examined in the competition studies to determine if the pre existing reactivity was targeted to the CH3 domain of dupilumab. REGN-B did not significantly inhibit the high signals in the samples (see Figure 1), suggesting that the pre existing reactivity is most likely targeting some region within the CH3 domain of the IgG4 molecule.
• n IgG4 construct with a leucine (L) to proline (P) substitution at position 445 was available and was examined in the competitive inhibition assay. This construct did not show significant inhibition of these high assay signals. This indicated that the pre- existing reactivity was probably specific to the L445 region of dupilumab. Additional samples with high assay signal were examined in the competitive inhibition assay using this construct with L to P substitution at position 445 and similar low levels of inhibition were observed. This appeared to confirm that the pre-existing reactivity is specifically targeting the region around L445.
• a second dupilumab based human monoclonal antibody construct (REGN-C), was generated.
• This construct is identical to dupilumab except for the insertion of a point mutation at the 445 residue in the antibody sequence, where a Leucine is changed to Proline (abbreviated as L>P).
• L>P Proline
• REGN-C could not significantly inhibit the high signals in the baseline samples that were tested (see Figure 1 and Figure 2). This confirmed that the pre-existing reactivity is specifically targeting the region around L445 in dupilumab and suggested that using this bioengineered dupilumab in the ADA assay eliminates most if not all of the high level background signal observed in the current ADA assay.
• REGN- F L445P
• REGN-G L445P
• REGN-F and REGN-G L445P
• a region in the dupilumab sequence to which at least most of the pre-existing reactivity is targeted has been identified.
• the high signals in the ADA assay appear to have been generated due to some matrix constituent in these serum samples that can bridge between the labeled dupilumab molecules in the assay by binding at or near L445 in the CH3 domain. This indicates that this pre-existing reactivity is not dupilumab drug specific but can bind to any IgG4 molecule.
• the results suggest that using this modified version of dupilumab with the L445P mutation in the ADA assay eliminates most if not all of the high level background signal.
• Example 2 Development of a modified anti-drug antihodv (ADA! assay that reduces background immunoreactivitv in patient samples
• a modified ADA assay was developed which uses of a biotinylated REGN-C (with the L445P mutation) as the capture agent.
• Figure 4 illustrates the difference in the assay design between the current ADA assay and the modified ADA assay using REGN-C.
• the current ADA assay will be considered as“ADA assay #1” and the modified ADA assay will be referred to as“ADA assay #2.”
• Figure 5 shows a comparative analysis of the ADA screen signals obtained using the current ADA assay #1 versus ADA Assay # 2, from all the patient baseline samples.
• Panel 5A shows a plot of the signal to noise ratio generated by these high ADA signal baseline samples in the current ADA screen assay (Assay #1), whereas Panel 5B shows a plot of the signal to noise ratio generated by the exact same samples in the ADA Assay # 2.
• the assay format of ADA assay #2 significantly reduces the high signals observed in the current ADA screen assay. Some samples still demonstrate reactivity in ADA assay #2, but the number of screen positives falls more in line with the expected false positive rate for a screen assay and the signal response level for those positive samples is generally much lower than that observed using the current ADA assay.
• the observed drop of these high assay signals to near baseline values in most cases in ADA assay #2, should allow for the improved detection of treatment emergent and drug specific AD As in a patient population.

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