Anti-drug antibodies as drug carriers. I. For small molecules.

PURPOSE: To better understand the pharmacokinetics of drugs compounds that bind endogenous antibodies METHODS: Three groups of mice with differing anti-fluorescein (FL) titers were established by empirically developed immunization protocols. These with two control groups were given intravenously [3H]-ethanolamine conjugate of FL (FL-EA). The latter was synthesized using isothiocyanate chemistry. Radioactivity in the circulation, and occasionally in peritoneal ascites, was monitored for 7 days. A group of mice was immunized with eosin Y and given FL-EA. Conversely, eosin Y conjugate of radiolabeled EA (EY-EA) was given to mice immunized with FL. These two groups represented animals of low affinity to probe haptens. The affinity was assessed by a precipitation procedure, while titer was determined by a standard ELISA. Dose of FL-EA varied over a 100-fold. RESULTS: On average, the three immunized groups showed a 1:13:85 ratio of anti-FL titer, with remarkably consistent levels within each group. Elimination rates of FL-EA from the serum of very high-titer mice and high-titer mice were similar, however, were substantially lower than that found in low-titer mice. The latter was in turn lower than that found in non- or mock-immunized mice. Serum of mice immunized with FL showed approximately 200-fold lower affinity towards EY-EA than FL-EA. In these mice and in mice immunized with eosin Y and given FL-EA, the elimination of the probe haptens was again fast, reminiscent of low-titer mice. Mice of either low titer or low affinity showed more rapid redistribution of the conjugate between serum and peritoneal fluid. In a group of mice with comparable anti-FL titer, elimination from serum was independent of dose over a 100-fold difference. The bi-phasic concentration-time profile observed was accommodated by a physiologically meaningful pharmacokinetic model incorporating two compartments in which antibody binding can occur. CONCLUSIONS: Monovalent antigenic substance cannot trigger immune clearance. As such, endogenous antibodies that recognize the molecule can serve as a carrier to result in a substantial decrease in clearance.

Antibodies as drug carriers. II. For proteins.

PURPOSE: To evaluate the potential use of antibodies as a carrier for monovalent protein haptens. METHODS: A single -SH functionality present in the human IgG light chain was fluoresceinated. This conjugate, FL-LC, was treated with pepsin to obtain FL conjugate of half light chain, FL-(LC)1/2, of MW 11 kDa. These two were radiolabeled using [3H]-propionic acid N-hydroxysuccinimide ester, and administered via tail vein to FL-immunized or mock-immunized mice. The blood radioactivity was measured over a 72-h period. Attempts were made to measure the affinity constant for the interaction between the conjugates and anti-FL antibodies by fluorescence quenching, surface plasmon resonance spectroscopy, and competitive ELISA. RESULTS: All of the three methods used produced supportive, if not conclusive, evidence of decreased binding affinity with increased conjugate size. Subsequent to tail-vein injection to FL-immunized mice, FL-LC showed approximately 4-fold smaller volume of distribution than mock-immunized mice: 0.041 +/- 0.005 vs. 0.16 +/- 0.02 mL/g. Corresponding values for FL-(LC)1/2, were significantly larger: 0.070 +/-0.013 and 0.30 +/- 0.02 mL/g, respectively. Compared with a small FL conjugate of ethanolamine, FL-EA, we studied earlier, the dose-normalized concentrations of the protein conjugates started at a higher level but declined more rapidly with time. In mock-immunized mice, the radioactivity disappeared very rapidly after administration, followed by an extremely slow decline with half-life close to 60 h. Evidence is provided to support that the radiolabel dissociated in the kidney, however, binding to anti-FL antibodies greatly stabilized the conjugate. CONCLUSIONS: Based on an entropic principle alone the affinity of monovalent hapten-antibody interaction is expected to diminish with increase in hapten size. As such, the size of a hapten should be an important determinant of its pharmacokinetics in animals harboring antibodies that recognize the hapten. Relative to what was observed with small MW FL-EA, the protein conjugates showed substantially sustained circulation as a result of antibody binding, but this effect was diminished at later time points. Both affinity and pharmacokinetic data are consistent with the hypothesis of reduced affinity with increasing MW for monovalent hapten conjugates, but neither offered overwhelming proof.

Antibodies as carrier proteins.

Pre-existing antibodies against a drug substance can significantly alter the pharmacokinetic profile of the drug in the circulation. Rapid clearance, mediated by complement or Fc receptors, occurs for crosslinked immune complexes, but not for complexes containing only one or two antibodies. With antibodies functioning as carrier proteins, monovalent antigens may enjoy a prolonged circulatory half-life, as observed in the case of digoxin, insulin, and various interleukins. While such an effect should be highly sensitive to fluctuations in antibody affinity and titer, it may present a means of extending the circulation of potent but rapidly cleared therapeutic agents. This mini-review attempts to delineate the causal relation between the factors influencing antibody binding and the circulatory life of a therapeutic agent, be it a small drug or a macromolecule.