Antibodies

12 pages, 1055 KiB

Open AccessArticle

Antibodies to Laminin β4 in Pemphigoid Diseases: Clinical–Laboratory Experience of a Single Central European Reference Centre

by Maciej Marek Spałek, Magdalena Jałowska, Natalia Welc, Monika Bowszyc-Dmochowska, Takashi Hashimoto, Justyna Gornowicz-Porowska and Marian Dmochowski

Antibodies 2025, 14(3), 66; https://doi.org/10.3390/antib14030066 (registering DOI) - 1 Aug 2025

Abstract

Background/Objectives: Anti-p200 pemphigoid is a rare and likely underdiagnosed autoimmune blistering disorder. Laminin γ1 and laminin β4 have been implicated as potential target antigens in its pathogenesis. Recently, a novel indirect immunofluorescence assay targeting anti-laminin β4 antibodies has been developed, demonstrating high sensitivity [...] Read more.

Background/Objectives: Anti-p200 pemphigoid is a rare and likely underdiagnosed autoimmune blistering disorder. Laminin γ1 and laminin β4 have been implicated as potential target antigens in its pathogenesis. Recently, a novel indirect immunofluorescence assay targeting anti-laminin β4 antibodies has been developed, demonstrating high sensitivity and specificity, and offering a valuable tool for improved diagnosis. Methods: Of the 451 patients, 21 were selected for further laboratory analysis based on medical records. Sera from 10 patients, which showed a positive direct immunofluorescence (DIF) result and negative results in multiplex enzyme-linked immunosorbent assays (ELISAs) and/or mosaic six-parameter indirect immunofluorescence (IIF) for various autoimmune bullous diseases, were tested for the presence of anti-laminin β4 antibodies. Additionally, sera from 11 patients with positive DIF and positive ELISA for antibodies against BP180 and/or BP230 were analyzed. Results: Among the 10 patients with positive DIF and negative ELISA and/or mosaic six-parameter IIF, 6 sera were positive for anti-laminin β4 antibodies. These patients presented with atypical clinical features. In contrast, all 11 sera from patients with both positive DIF and positive ELISA for BP180 and/or BP230 were negative for anti-laminin β4 antibodies. Conclusions: In patients with a positive DIF result but negative ELISA and/or mosaic six-parameter IIF findings, testing for anti-laminin β4 antibodies should be considered. Furthermore, in cases presenting with atypical clinical features—such as acral distribution of lesions, intense pruritus, or erythematous–edematous plaques—the possibility of anti-p200 pemphigoid should be included in the differential diagnosis. Full article

(This article belongs to the Section Antibody-Based Diagnostics)

► Show Figures

Figure 1

18 pages, 590 KiB

Open AccessReview

FcRn Blockade as a Targeted Therapeutic Strategy in Antibody-Mediated Autoimmune Diseases: A Focus on Warm Autoimmune Hemolytic Anemia

by Michael Sandhu and Irina Murakhovskaya

Antibodies 2025, 14(3), 65; https://doi.org/10.3390/antib14030065 (registering DOI) - 1 Aug 2025

Abstract

Antibody-mediated autoimmune diseases are common, can involve any organ system, and pose a large burden for patients and healthcare systems. Most antibody-mediated diseases are mediated by IgG antibodies. Selective targeting of pathogenic antibodies is an attractive treatment option which has already proven to [...] Read more.

Antibody-mediated autoimmune diseases are common, can involve any organ system, and pose a large burden for patients and healthcare systems. Most antibody-mediated diseases are mediated by IgG antibodies. Selective targeting of pathogenic antibodies is an attractive treatment option which has already proven to be effective in antibody-positive generalized myasthenia gravis, maternal-fetal alloimmune cytopenias, and immune thrombocytopenic purpura. Warm autoimmune hemolytic anemia (wAIHA) is an autoimmune disorder mediated by pathogenic antibodies mainly of the IgG class with no approved therapy. Current treatment includes non-specific immunosuppression with corticosteroids, rituximab, and other immunosuppressive agents. With most therapies, time to response can be delayed and transfusions may be needed. Neonatal Fc receptor (FcRN) therapies provide rapid and sustained reduction of pathogenic IgG levels providing potential for fast, effective therapy in antibody-mediated autoimmune diseases including warm autoimmune hemolytic anemia. This review focuses on the emerging role of FcRn inhibition in autoimmune hematologic diseases, and their therapeutic potential in wAIHA. Full article

(This article belongs to the Special Issue Antibody and Autoantibody Specificities in Autoimmunity)

► Show Figures

Figure 1

8 pages, 1392 KiB

Open AccessBrief Report

Determination of the Epitopes of Alpha-Glucosidase Anti-Drug Antibodies in Pompe Disease Patient Plasma Samples

by Evgeniy V. Petrotchenko, Andreas Hahn and Christoph H. Borchers

Antibodies 2025, 14(3), 64; https://doi.org/10.3390/antib14030064 - 28 Jul 2025

Viewed by 126

Abstract

Pompe disease is a rare autosomal-recessive neuromuscular disorder caused by a deficiency of the lysosomal enzyme acid alpha-glucosidase (GAA), leading to the pathological accumulation of glycogen and impaired autophagy. Enzyme replacement therapy (ERT) with recombinant human alpha-glucosidase (rhGAA) has been available since 2006, [...] Read more.

Pompe disease is a rare autosomal-recessive neuromuscular disorder caused by a deficiency of the lysosomal enzyme acid alpha-glucosidase (GAA), leading to the pathological accumulation of glycogen and impaired autophagy. Enzyme replacement therapy (ERT) with recombinant human alpha-glucosidase (rhGAA) has been available since 2006, but may lead to the formation of anti-drug antibodies (ADAs) against the recombinant human enzyme, which, in turn, may adversely affect the response to ERT. Knowledge of the antigenic determinants of rhGAA involved in interaction with ADAs may facilitate the development of strategies to attenuate the anti-drug immune response in patients. Here, we determined the rhGAA ADA epitopes in the plasma of Pompe disease patients using a series of affinity purifications combined with epitope extraction and label free quantitation LC-MS. Full article

(This article belongs to the Section Humoral Immunity)

► Show Figures

Graphical abstract

12 pages, 255 KiB

Open AccessArticle

Anti-HMGCR-Antibody-Positive Statin-Induced Myositis: A Pilot Case Series on Treatment with Bempedoic Acid and Immunosuppressive Therapy

by Maurizio Benucci, Riccardo Terenzi, Francesca Li Gobbi, Emanuele Antonio Maria Cassarà, Tommaso Picchioni, Edda Russo, Barbara Lari, Mariangela Manfredi and Maria Infantino

Antibodies 2025, 14(3), 63; https://doi.org/10.3390/antib14030063 - 23 Jul 2025

Viewed by 254

Abstract

Background/Objectives: Immune-mediated necrotizing myopathy (IMNM) is a severe inflammatory myopathy marked by proximal muscle weakness, elevated creatine kinase (CK), and the presence of anti-HMGCR antibodies. Statin exposure is a recognized trigger for anti-HMGCR-positive IMNM, which may persist despite statin withdrawal. This pilot case [...] Read more.

Background/Objectives: Immune-mediated necrotizing myopathy (IMNM) is a severe inflammatory myopathy marked by proximal muscle weakness, elevated creatine kinase (CK), and the presence of anti-HMGCR antibodies. Statin exposure is a recognized trigger for anti-HMGCR-positive IMNM, which may persist despite statin withdrawal. This pilot case series explores, for the first time, the use of bempedoic acid—a liver-specific lipid-lowering agent with minimal muscle toxicity—as an alternative to statins in these patients. Methods: We report 10 anti-HMGCR-antibody-positive IMNM patients (6 females, 4 males) previously on statins for primary prevention (8 on atorvastatin, 2 on simvastatin) without prior cardiovascular events. Statins were discontinued at myositis onset. All patients received prednisone and immunosuppressants (methotrexate in 7, mycophenolate in 3), plus bempedoic acid. Anti-HMGCR antibodies were measured using a chemiluminescence method. Results: Their mean anti-HMGCR antibody levels decreased significantly from 390.93 ± 275.22 to 220.89 ± 113.37 CU/L (p = 0.027) after 6 months of treatment. Their CK levels dropped from 1278.9 ± 769.39 to 315.1 ± 157.72 IU/L (p = 0.001), and aldolase dropped from 11.63 ± 2.18 to 6.61 ± 1.22 U/L (p = 0.0001). The mean LDL-C value was 96.1 ± 8.16 mg/dL. No disease recurrence was observed. Autoimmune panels were negative for other myositis-associated and/or -specific antibodies. Conclusions: Bempedoic acid appears to be a safe, effective, and cost-efficient lipid-lowering alternative in statin-intolerant IMNM patients. Larger studies are warranted to confirm its efficacy across different subgroups and to optimize dyslipidemia management in this setting. Full article

(This article belongs to the Section Antibody-Based Diagnostics)

22 pages, 5945 KiB

Open AccessArticle

Immunogenicity Risk Assessment of Biotherapeutics Using an Ex Vivo B Cell Assay

by Kevin M. Budge, Ross Blankenship, Patricia Brown-Augsburger and Lukasz K. Chlewicki

Antibodies 2025, 14(3), 62; https://doi.org/10.3390/antib14030062 - 22 Jul 2025

Viewed by 316

Abstract

Background/Objectives: Anti-drug antibody (ADA) formation can impact the safety, pharmacokinetics, and/or efficacy of biotherapeutics, including monoclonal antibodies (mAbs). Current strategies for ADA/immunogenicity risk prediction of mAbs include in silico algorithms, T cell proliferation assays, MHC-associated peptide proteomics assays (MAPPs), and dendritic cell internalization [...] Read more.

Background/Objectives: Anti-drug antibody (ADA) formation can impact the safety, pharmacokinetics, and/or efficacy of biotherapeutics, including monoclonal antibodies (mAbs). Current strategies for ADA/immunogenicity risk prediction of mAbs include in silico algorithms, T cell proliferation assays, MHC-associated peptide proteomics assays (MAPPs), and dendritic cell internalization assays. However, B cell-mediated responses are not assessed in these assays. B cells are professional antigen-presenting cells (APCs) and secrete antibodies toward immunogenic mAbs. Therefore, methods to determine B cell responses would be beneficial for immunogenicity risk prediction and may provide a more comprehensive assessment of risk. Methods: We used a PBMC culture method with the addition of IL-4, IL-21, B cell activating factor (BAFF), and an anti-CD40 agonist mAb to support B cell survival and activation. Results: B cells in this assay format become activated, proliferate, and secrete IgG. A panel of 51 antibodies with varying clinical immunogenicity rates were screened in this assay with IgG secretion used as a readout for immunogenicity risk. IgG secretion differed among test articles but did not correlate with the clinical immunogenicity rating. Conclusions: This dataset highlights the challenges of developing a B cell assay for immunogenicity risk prediction and provides a framework for further refinement of a B cell-based assay for immunogenicity risk prediction of mAbs. Full article

(This article belongs to the Special Issue Unravelling Effector Functions of B cells in Infectious Diseases and Cancer)

► Show Figures

Graphical abstract

9 pages, 553 KiB

Open AccessBrief Report

by Matteo Bonato, Francesca Savoia, Enrico Orzes, Elisabetta Favero, Gianenrico Senna and Micaela Romagnoli

Antibodies 2025, 14(3), 61; https://doi.org/10.3390/antib14030061 - 22 Jul 2025

Viewed by 212

Abstract

Background: Mepolizumab is an effective treatment for severe eosinophilic asthma, leading to a depletion of blood eosinophil levels, the clinical relevance of which remains unclear. Objective: The aim of this study was to assess the relationship between mepolizumab-induced blood eosinophil reduction [...] Read more.

Background: Mepolizumab is an effective treatment for severe eosinophilic asthma, leading to a depletion of blood eosinophil levels, the clinical relevance of which remains unclear. Objective: The aim of this study was to assess the relationship between mepolizumab-induced blood eosinophil reduction and clinical outcome in patients with severe eosinophilic asthma, in particular, whether the magnitude of blood eosinophil reduction was associated with clinical remission. Methods: We conducted a real-world retrospective analysis of 58 adult patients with severe eosinophilic asthma treated with mepolizumab. Clinical and respiratory functional parameters were evaluated at the start of mepolizumab treatment (T0) and after two years of treatment (T2; mean follow-up: 22.8 ± 7.5 months). Blood eosinophil counts were recorded at T0 and during the first year of treatment (T1; mean follow-up: 7.7 ± 4.1 months). Results: After two years of mepolizumab treatment, 58 severe asthmatic patients showed significant improvements in ACT score, FVC, and FEV₁ and a reduction in acute exacerbations and the use of maintenance therapies. Clinical remission was achieved in 55.1% of patients. Lower blood eosinophil counts during the first year (T1) were associated with greater improvements in lung function and fewer exacerbations. A greater relative decrease in eosinophils from baseline to T1 (ΔEOS%) was significantly associated with remission, reductions in exacerbations, and no maintenance OCS use. ΔEOS% was the only independent predictor of remission in the multivariate analysis. A ≥90% reduction predicted remission with 80% specificity (AUC = 0.726). Conclusions: Monitoring blood eosinophils after mepolizumab initiation could be a useful tool for predicting long-term response to treatment. In particular, a reduction by over 90% of peripheral blood eosinophils during the first year of mepolizumab treatment predicts clinical remission with a specificity of 80%. Considering the accessibility and the low cost of this biomarker, it may help to optimize long-term asthma management. Full article

(This article belongs to the Section Antibody-Based Therapeutics)

► Show Figures

Figure 1

14 pages, 1031 KiB

Open AccessArticle

Seroprevalence of IgG and IgE Antibodies Against Anisakis in the Presumably Healthy Population of the Canary Islands

by Eligia González-Rodríguez, Marta Rodero, J. Alberto Montoya-Alonso, Kevin M. Santana-Hernández, Myriam R. Ventura, Carmen Cuéllar and Eligia Rodríguez-Ponce

Antibodies 2025, 14(3), 60; https://doi.org/10.3390/antib14030060 - 17 Jul 2025

Viewed by 198

Abstract

Food-borne zoonoses, particularly anisakiosis caused by Anisakis spp., are an increasing public health concern due to the rising consumption of raw fish. Anisakiosis results from the ingestion of third-stage larvae of Anisakidae nematodes, with the genus Anisakis re-sponsible for approximately 97% of human [...] Read more.

Food-borne zoonoses, particularly anisakiosis caused by Anisakis spp., are an increasing public health concern due to the rising consumption of raw fish. Anisakiosis results from the ingestion of third-stage larvae of Anisakidae nematodes, with the genus Anisakis re-sponsible for approximately 97% of human cases. While regulatory protocols exist to minimize infection risk in commercial settings, domestic food preparation often lacks such safeguards, creating a gap in public health protection. In the Canary Islands, a major Spanish aquaculture region, farmed fish exhibit a low Anisakis prevalence, suggesting minimal risk from aquaculture products. In contrast, wild-caught fish demonstrate varia-ble parasitism, with recent studies reporting a 25% prevalence among commercial species. Methods: This study assessed Anisakis exposure in the Canary Islands by measuring specific IgG and IgE antibodies in 1043 serum samples collected from all seven islands between March 2014 and October 2015. ELISA assays detected anti-Anisakis antibodies, and the results were analyzed by age, sex, island, and isoclimatic zone. Results: Overall, 16.9% of samples were IgG-positive and 6.8% were IgE-positive. Seroprevalence was significantly higher in indi-viduals aged 60 years and above. Geographic heterogeneity was notable: La Palma had the highest IgG seroprevalence (35.3%), while El Hierro showed the highest IgE prevalence (16.3%). Temperate isoclimatic zones exhibited higher antibody prevalence than dry zones. These findings indicate variable Anisakis exposure across the Canary Islands, likely influenced by environmental and behavioral factors. Conclusions: The results highlight the need for targeted public health interventions to reduce the anisakiosis risk, particularly in regions and populations with elevated exposure. Full article

(This article belongs to the Section Antibody-Based Diagnostics)

► Show Figures

Graphical abstract

24 pages, 3435 KiB

Open AccessArticle

Loss of IgA and IgM Compromises Broad Neutralization of Structurally Divergent SARS-CoV-2 Variants

by Yalcin Pisil, Tomoyuki Miura, Kiyoki Ito and Yoshihiro Watanabe

Antibodies 2025, 14(3), 59; https://doi.org/10.3390/antib14030059 - 12 Jul 2025

Viewed by 810

Abstract

Objectives: The durability and breadth of neutralizing antibodies following SARS-CoV-2 mRNA vaccination remain incompletely understood. This study aimed to investigate how longitudinal changes in antibody isotype composition impact neutralization against structurally diverse SARS-CoV-2 variants. Methods: After screening a broader cohort of mRNA-vaccinated sera, [...] Read more.

Objectives: The durability and breadth of neutralizing antibodies following SARS-CoV-2 mRNA vaccination remain incompletely understood. This study aimed to investigate how longitudinal changes in antibody isotype composition impact neutralization against structurally diverse SARS-CoV-2 variants. Methods: After screening a broader cohort of mRNA-vaccinated sera, time-matched samples collected one month (1 mpv) and three months post-vaccination (3 mpv) were selected for detailed analysis. Neutralization assays against live virus variants, enzyme-linked immunosorbent assays (ELISA), and immunogold electron microscopy were performed to assess antibody titers, isotype levels, and virion morphology. Results: Neutralization titers declined markedly at 3 mpv, particularly against immune-evasive variants. Notably, the Lambda variant showed disproportionately high sensitivity to early-phase sera despite its divergence from the vaccine strain. Antibody isotyping showed that IgA and IgM decreased over time, while IgG levels were relatively more sustained. Electron microscopy revealed broader virion size heterogeneity in Lambda (50–200 nm) compared to Wuhan (80–120 nm), potentially enhancing multivalent antibody engagement. Consistently, ELISA under reduced spike density conditions showed that IgA and IgM retained stronger binding than IgG. Conclusions: These findings indicate that the decline of IgA and IgM compromises neutralization breadth, especially against structurally divergent variants such as Lambda. Sustaining dynamic multivalent isotype responses that adapt to diverse spike morphologies may be critical for broad cross-variant immunity. Full article

(This article belongs to the Special Issue Antiviral Antibody Immune Responses in the Context of Vaccination and Infection)

► Show Figures

Graphical abstract

21 pages, 940 KiB

Open AccessReview

Immunotherapy in GI Cancers: Lessons from Key Trials and Future Clinical Applications

by Supriya Peshin, Faizan Bashir, Naga Anvesh Kodali, Adit Dharia, Sajida Zaiter, Sakshi Singal and Nagaishwarya Moka

Antibodies 2025, 14(3), 58; https://doi.org/10.3390/antib14030058 - 11 Jul 2025

Cited by 1 | Viewed by 660

Abstract

Immunotherapy has emerged as a transformative approach in gastrointestinal (GI) cancers, addressing historically poor survival rates in advanced-stage disease. Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis demonstrate remarkable efficacy in colorectal cancer with deficient mismatch repair (dMMR) or high microsatellite instability (MSI-H), [...] Read more.

Immunotherapy has emerged as a transformative approach in gastrointestinal (GI) cancers, addressing historically poor survival rates in advanced-stage disease. Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis demonstrate remarkable efficacy in colorectal cancer with deficient mismatch repair (dMMR) or high microsatellite instability (MSI-H), exemplified by trials like NICHE-2 achieving exceptional pathological response rates. However, significant limitations persist, including resistance in some dMMR/MSI-H tumors, minimal efficacy in proficient mismatch repair (pMMR) tumors, and low overall response rates across most GI malignancies due to tumor heterogeneity and immune evasion mechanisms. Predictive biomarkers such as tumor mutational burden (TMB) and PD-L1 expression are crucial for optimizing patient selection, while hypermutated pMMR tumors with POLE mutations represent emerging therapeutic opportunities. In pancreatic adenocarcinoma, where survival remains dismal, combination strategies with chemotherapy and novel approaches like cancer vaccines show promise but lack transformative breakthroughs. Esophagogastric cancers benefit from ICIs combined with chemotherapy, particularly in MSI-H and HER2-positive tumors, while hepatocellular carcinoma has achieved significant progress with combinations like atezolizumab–bevacizumab and durvalumab–tremelimumab surpassing traditional therapies. Biliary tract cancers show modest improvements with durvalumab–chemotherapy combinations. Despite these advances, immunotherapy faces substantial challenges including immune-related adverse events, acquired resistance through cancer immunoediting, and the need for biomarker-driven approaches to overcome tumor microenvironment barriers. This review discusses key clinical trials, therapeutic progress, and emerging modalities including CAR T-cell therapies and combination strategies, emphasizing the critical need to address resistance mechanisms and refine precision medicine approaches to fully realize immunotherapy’s potential in GI malignancies. Full article

(This article belongs to the Section Antibody-Based Therapeutics)

► Show Figures

Figure 1

13 pages, 1650 KiB

Open AccessArticle

Isolation of a Monoclonal Human scFv Against Cytomegalovirus pp71 Antigen Using Yeast Display

by Kazuhisa Aoki, Rikio Yabe, Sayaka Ono, Mayumi Saeki, Yuri Tanno and Hidetaka Tanno

Antibodies 2025, 14(3), 57; https://doi.org/10.3390/antib14030057 - 10 Jul 2025

Viewed by 328

Abstract

Background: Human cytomegalovirus (CMV) is a major pathogen that poses significant risks to immunocompromised individuals and neonates. The tegument protein pp71, encoded by the UL82 gene, plays a pivotal role in initiating viral lytic replication and evading host immune responses. Despite its clinical [...] Read more.

Background: Human cytomegalovirus (CMV) is a major pathogen that poses significant risks to immunocompromised individuals and neonates. The tegument protein pp71, encoded by the UL82 gene, plays a pivotal role in initiating viral lytic replication and evading host immune responses. Despite its clinical relevance, standardized monoclonal antibodies (mAbs) for pp71 remain limited, prompting the need to expand the available repertoire of antibodies targeting this critical protein. Methods: In this study, we constructed a diverse human single-chain variable fragment (scFv) library using RNA derived from the B cells of four healthy donors. The library was expressed in Saccharomyces cerevisiae, and iterative rounds of magnetic-activated cell sorting (MACS) were performed against recombinant pp71. Clonal enrichment was monitored using flow cytometry. Results: Among the isolated clones, one designated ID2 exhibited high sensitivity and specificity for pp71, as demonstrated by flow cytometry, immunofluorescence, an enzyme-linked immunosorbent assay (ELISA), and biolayer interferometry (BLI). Conclusions: Collectively, these findings establish a novel pp71-specific mAb and underscore the utility of yeast surface display combined with MACS for expanding the antibody toolkit available for CMV research and diagnostics. Full article

(This article belongs to the Section Antibody Discovery and Engineering)

► Show Figures

Graphical abstract

15 pages, 1797 KiB

Open AccessSystematic Review

Diagnosis of Systemic Rheumatic Disease Using the Connective Tissue Disease Screen

by Abeline Kapuczinski, Dorian Parisis, Nour Kassab, Julie Smet and Muhammad Soyfoo

Antibodies 2025, 14(3), 56; https://doi.org/10.3390/antib14030056 - 2 Jul 2025

Viewed by 354

Abstract

Connective tissue diseases (CTDs) comprise a heterogeneous group of autoimmune conditions characterized by diverse clinical manifestations and autoantibody profiles, posing significant diagnostic challenges. This systematic review and meta-analysis evaluated the diagnostic performance of automated connective tissue disease screening assays, commonly known as CTD [...] Read more.

Connective tissue diseases (CTDs) comprise a heterogeneous group of autoimmune conditions characterized by diverse clinical manifestations and autoantibody profiles, posing significant diagnostic challenges. This systematic review and meta-analysis evaluated the diagnostic performance of automated connective tissue disease screening assays, commonly known as CTD screens, in diagnosing systemic rheumatic diseases. Eleven studies, including cohort and case–control designs, involving a total of 2384 CTD-positive patients, 8972 controls without CTD, and 679 healthy blood donors, were analyzed. The results demonstrated a pooled sensitivity of 79.36% and specificity of 90.79% for Elia^® CTD-screen, and a sensitivity of 87.23% and specificity of 83.56% for QuantaFlash^® CTD-screen. These tests exhibited varied sensitivity across individual CTDs, with excellent specificity for distinguishing CTD patients from healthy controls. Despite their utility, CTD screens should not be solely relied upon for diagnosis due to limitations in positive predictive value, particularly in low-prevalence populations. Clinical context and expert rheumatological evaluation remain indispensable. Optimizing the use of CTD screens can enhance diagnostic efficiency, reduce unnecessary testing, and mitigate patient anxiety and healthcare costs. Further research focusing on integrating these assays with clinical evaluation is recommended. Full article

(This article belongs to the Section Antibody-Based Diagnostics)

► Show Figures

Figure 1

21 pages, 1316 KiB

Open AccessReview

Teprotumumab for Thyroid Eye Disease: Mechanism, Clinical Efficacy, and Current Challenges

by Yuan Zong, Shuang Qiu, Mingming Yang, Jing Zhang, Yaru Zou, Yuxin Jing, Kyoko Ohno-Matsui and Koju Kamoi

Antibodies 2025, 14(3), 55; https://doi.org/10.3390/antib14030055 - 30 Jun 2025

Viewed by 1028

Abstract

Thyroid eye disease (TED) is a complex autoimmune disorder characterized by orbital inflammation and tissue remodeling. Teprotumumab, a fully human monoclonal antibody targeting insulin-like growth factor-1 receptor (IGF-1R), represents a significant breakthrough in TED treatment. This review comprehensively analyzes the therapeutic role of [...] Read more.

Thyroid eye disease (TED) is a complex autoimmune disorder characterized by orbital inflammation and tissue remodeling. Teprotumumab, a fully human monoclonal antibody targeting insulin-like growth factor-1 receptor (IGF-1R), represents a significant breakthrough in TED treatment. This review comprehensively analyzes the therapeutic role of teprotumumab in TED management. Mechanistically, teprotumumab inhibits the IGF-1R/TSHR signaling complex, thereby reducing orbital fibroblast differentiation and inflammatory responses. Phase II and III clinical trials have demonstrated its remarkable efficacy in reducing proptosis and improving clinical activity scores, with the benefits extending to both active and chronic TED cases. Real-world studies have validated these findings further and expanded its potential applications to various clinical scenarios, including dysthyroid optic neuropathy and steroid-resistant cases. However, several challenges remain. These include treatment-related adverse effects such as hyperglycemia and hearing impairment, with emerging evidence suggesting ethnic variations in susceptibility. The high cost of treatment poses significant accessibility barriers, while limited long-term follow-up data and potential disease recurrence necessitate further investigation. This review synthesizes the current evidence to inform clinical decision-making and highlights areas requiring additional research to optimize teprotumumab’s therapeutic application in TED management. Full article

(This article belongs to the Section Antibody-Based Therapeutics)

► Show Figures

Figure 1

21 pages, 885 KiB

Open AccessArticle

Survival Outcomes and Prognostic Factors in Rheumatoid Arthritis Patients Receiving Biologic or Targeted Synthetic Therapy: Real-World Data

by Zhaklin Apostolova, Tanya Shivacheva and Tsvetoslav Georgiev

Antibodies 2025, 14(3), 54; https://doi.org/10.3390/antib14030054 - 30 Jun 2025

Viewed by 522

Abstract

Objectives: The present study aimed to evaluate the long-term survival of patients with rheumatoid arthritis (RA) receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in a real-world setting, and to identify key prognostic factors influencing mortality within this cohort. Methods: This retrospective, [...] Read more.

Objectives: The present study aimed to evaluate the long-term survival of patients with rheumatoid arthritis (RA) receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in a real-world setting, and to identify key prognostic factors influencing mortality within this cohort. Methods: This retrospective, observational cohort study analyzed 165 patients with confirmed RA who were on b/tsDMARD treatment for at least six months as of June 2017. Patient data, including demographics, disease duration, prior therapeutic regimens, and global functional status were extracted from medical records to collect data covering a seven-year follow-up period, extending from June 2017 to December 2024. Corticosteroid use was defined as continuous systemic intake during the RA activity analysis period. Survival outcomes were analyzed using Kaplan-Meier methods and multivariate Cox proportional hazards models to identify independent predictors of mortality. Results: Over a mean follow-up of 9.4 years, the mortality rate was 13.5 deaths per 1000 treatment-years, with an overall survival rate of 87.3%. Advanced functional disability and prolonged corticosteroid use were independently associated with higher mortality risk. In subgroup analyses, chronic kidney disease significantly increased mortality among patients on TNF inhibitors. In contrast, patients who remained on their initial anti-IL6 therapy had lower mortality, though this may reflect survivor bias. Conclusions: This study highlights the importance of long-term b/tsDMARD intervention in RA patients, with observed low mortality and high survival rates. Subgroup findings suggest the importance of comorbidity management in TNFi users and therapeutic stability in anti-IL6 users. Full article

(This article belongs to the Section Antibody-Based Therapeutics)

► Show Figures

Figure 1

14 pages, 1544 KiB

Open AccessBrief Report

Impact of Light-Chain Variants on the Expression of Therapeutic Monoclonal Antibodies in HEK293 and CHO Cells

by Alexander Veber, Dennis Lenau, Polyniki Gkragkopoulou, David Kornblüh Bauer, Ingo Focken, Wulf Dirk Leuschner, Christian Beil, Sandra Weil, Ercole Rao and Thomas Langer

Antibodies 2025, 14(3), 53; https://doi.org/10.3390/antib14030053 - 24 Jun 2025

Viewed by 468

Abstract

Recombinantly produced monoclonal antibodies (mabs) belong to the fastest growing class of biotherapeutics. In humans, antibodies are classified into five different classes: IgA, IgD, IgE, IgG and IgM. Most of the therapeutic mabs used in the clinic belong to the IgG class, albeit [...] Read more.

Recombinantly produced monoclonal antibodies (mabs) belong to the fastest growing class of biotherapeutics. In humans, antibodies are classified into five different classes: IgA, IgD, IgE, IgG and IgM. Most of the therapeutic mabs used in the clinic belong to the IgG class, albeit other antibody classes, e.g., IgM, have been evaluated in clinical stages. Antibodies are composed of heavy chains paired with a light chain. In IgM and IgA, an additional chain, the J-chain, is present. Two types of light chains exist in humans: the κ-light chain and the λ-light chain. The κ-light chain predominates in humans and is used in the vast majority of therapeutic IgG. The reason for the preference of the κ-light chain in humans is not known. Our study investigates whether light-chain selection influences the productivity of the clinically validated mabs adalimumab and trastuzumab. Both mabs were expressed as IgG and IgM with a κ- or a λ-light chain in HEK293 cells. Besides comparing the expression levels of the different mabs, we also evaluated whether the passage number of the cell line has an impact on product yield. In addition, the expressions of adalimumab, trastuzumab, an anti-CD38 and an anti-PD-L1-antibody were analyzed in HEK293 and CHO cells when both the κ- and λ-light chains are present. In summary, IgG outperformed IgM variants in expression efficacy, while light-chain selection had minimal impact on the overall expression levels. The yields of all mab variants were higher in fresh cells, despite cell cultures with a high cell passage number having higher cell densities and cell numbers at the time of harvest. The incorporation of a particular light chain occurred at similar rates in HEK293 and CHO cells. Full article

(This article belongs to the Section Antibody Discovery and Engineering)

► Show Figures

Figure 1

53 pages, 1486 KiB

Open AccessReview

Fragment-Based Immune Cell Engager Antibodies in Treatment of Cancer, Infectious and Autoimmune Diseases: Lessons and Insights from Clinical and Translational Studies

by Ge Yang and Mohammad Massumi

Antibodies 2025, 14(3), 52; https://doi.org/10.3390/antib14030052 - 24 Jun 2025

Viewed by 1556

Abstract

Since the advent of recombinant DNA technologies and leading up to the clinical approval of T cell engager blinatumomab, the modular design of therapeutic antibodies has enabled the fusion of antibody fragments with proteins of various functionalities. This has resulted in an expansive [...] Read more.

Since the advent of recombinant DNA technologies and leading up to the clinical approval of T cell engager blinatumomab, the modular design of therapeutic antibodies has enabled the fusion of antibody fragments with proteins of various functionalities. This has resulted in an expansive array of possible mechanisms of action and has given birth to fragment-based antibodies (fbAbs) with immune cell engager modalities. In searchable databases, the preclinical development of these antibodies has shown promise; however, clinical outcomes and restructuring efforts involving these agents have produced mixed results and uncertainties. Amid budgetary cuts in both academia and industry, critical planning and evaluation of drug R&D would be more essential than ever before. While many reviews have provided outstanding summaries of preclinical phase fbAbs and cataloged relevant clinical trials, to date, very few of the articles in searchable databases have comprehensively reviewed the details of clinical outcomes along with the underlying reasons or potential explanations for the success and failures of these fbAb drug products. To fill the gap, in this review, we seek to provide the readers with clinically driven insights, accompanied by translational and mechanistic studies, on the current landscape of fragment-based immune cell engager antibodies in treating cancer, infectious, and autoimmune diseases. Full article

(This article belongs to the Special Issue A Festschrift Celebrating Dr. Dimiter Stanchev Dimitrov: Antibodies, Innovation, and Impact on Infectious Disease and Cancer Research)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Antibodies, Volume 14, Issue 3 (September 2025) – 15 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI