title: A role for protein misfolding in immunogenicity of biopharmaceuticals.
abstract: For largely unknown reasons, biopharmaceuticals evoke potentially harmful antibody formation. Such antibodies can inhibit drug efficacy and, when directed against endogenous proteins, cause life-threatening complications. Insight into the mechanisms by which biopharmaceuticals break tolerance and induce an immune response will contribute to finding solutions to prevent this adverse effect. Using a transgenic mouse model, we here demonstrate that protein misfolding, detected with the use of tissue-type plasminogen activator and thioflavin T, markers of amyloid-like properties, results in breaking of tolerance. In wild-type mice, misfolding enhances protein immunogenicity. Several commercially available biopharmaceutical products were found to contain misfolded proteins. In some cases, the level of misfolded protein was found to increase upon storage under conditions prescribed by the manufacturer. Our results indicate that misfolding of therapeutic proteins is an immunogenic signal and a risk factor for immunogenicity. These findings offer novel possibilities to detect immunogenic protein entities with tPA and reduce immunogenicity of biopharmaceuticals.
authors.affiliation: Laboratory for Thrombosis and Haemostasis, Department of Clinical Chemistry and Haematology, University Medical Center Utrecht and the Institute for Biomembranes, Padualaan 8, 3584 CH Utrecht, The Netherlands.
authors.forename: Coen
authors.initials: C
authors.lastname: Maas
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hermeling
authors.forename: Barend
authors.initials: B
authors.lastname: Bouma
authors.forename: Wim
authors.initials: W
authors.lastname: Jiskoot
authors.forename: Martijn F B G
authors.initials: MF
authors.lastname: Gebbink
mesh_terms: D000818:Animals; D000906:Antibodies / Q000276:immunology; D000917:Antibody Formation; D001702:Biopharmaceutics; D005260:Female; D006801:Humans; D007114:Immunization; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000737:chemistry / Q000276:immunology; D051379:Mice; D008807:Mice, Inbred BALB C; D010047:Ovalbumin / Q000737:chemistry / Q000276:immunology; D017510:Protein Folding; D011506:Proteins / Q000737:chemistry / Q000276:immunology; D011994:Recombinant Proteins / Q000737:chemistry / Q000276:immunology
chemical_list: D000906:Antibodies; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011506:Proteins; D011994:Recombinant Proteins; D010047:Ovalbumin