Improved tumor imaging and therapy via i.v. IgG-mediated time-sequential modulation of neonatal Fc receptor.

The long plasma half-life of IgG, while allowing for enhanced tumor uptake of tumor-targeted IgG conjugates, also results in increased background activity and normal-tissue toxicity. Therefore, successful therapeutic uses of conjugated antibodies have been limited to the highly sensitive and readily accessible hematopoietic tumors. We report a therapeutic strategy to beneficially alter the pharmacokinetics of IgG antibodies via pharmacological inhibition of the neonatal Fc receptor (FcRn) using high-dose IgG therapy. IgG-treated mice displayed enhanced blood and whole-body clearance of radioactivity, resulting in better tumor-to-blood image contrast and protection of normal tissue from radiation. Tumor uptake and the resultant therapeutic response was unaltered. Furthermore, we demonstrated the use of this approach for imaging of tumors in humans and discuss its potential applications in cancer imaging and therapy. The ability to reduce the serum persistence of conjugated IgG antibodies after their infusion can enhance their therapeutic index, resulting in improved therapeutic and diagnostic efficacy.

[1]  D. Schoenfeld,et al.  Increased clearance of IgG in mice that lack β2‐microglobulin: possible protective role of FcRn , 1996, Immunology.

[2]  Sanjiv S Gambhir,et al.  Tailoring the pharmacokinetics and positron emission tomography imaging properties of anti-carcinoembryonic antigen single-chain Fv-Fc antibody fragments. , 2005, Cancer research.

[3]  R. Hansen,et al.  Antibody pharmacokinetics and pharmacodynamics. , 2004, Journal of pharmaceutical sciences.

[4]  H. Vriesendorp,et al.  A review of the intravenous administration of radiolabeled immunoglobulin G to cancer patients. High or low protein dose? , 2003, Cancer biotherapy & radiopharmaceuticals.

[5]  M. Brechbiel,et al.  Antibody-targeted radiation cancer therapy , 2004, Nature Reviews Drug Discovery.

[6]  R. Hansen,et al.  Mechanisms of IVIG action in immune thrombocytopenic purpura. , 2004, Clinical laboratory.

[7]  H. Spiegelberg,et al.  The catabolism of human G immunoglobulins of different heavy chain subclasses. 3. The catabolism of heavy chain disease proteins and of Fc fragments of myeloma proteins. , 1972, Clinical and experimental immunology.

[8]  C. Fong,et al.  Turnover of labeled normal gamma globulin in multiple myeloma. , 1960, The Journal of clinical investigation.

[9]  J. M. Osborne,et al.  Isolation from human placenta of the IgG transporter, FcRn, and localization to the syncytiotrophoblast: implications for maternal-fetal antibody transport. , 1996, Journal of immunology.

[10]  Raimund J Ober,et al.  Generation of mutated variants of the human form of the MHC class I-related receptor, FcRn, with increased affinity for mouse immunoglobulin G. , 2003, Journal of molecular biology.

[11]  S. Akilesh,et al.  The MHC class I-like Fc receptor promotes humorally mediated autoimmune disease. , 2004, The Journal of clinical investigation.

[12]  Jin‐Kyoo Kim,et al.  Abnormally short serum half‐lives of IgG in β2‐microglobulin‐deficient mice , 1996, European journal of immunology.

[13]  V. Lennon,et al.  Mechanism of intravenous immune globulin therapy in antibody-mediated autoimmune diseases. , 1999, The New England journal of medicine.

[14]  G. V. van Dongen,et al.  The promise of immuno-PET in radioimmunotherapy. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[15]  Jonghan Kim,et al.  Perspective-- FcRn transports albumin: relevance to immunology and medicine. , 2006, Trends in immunology.

[16]  Raimund J. Ober,et al.  Increasing the serum persistence of an IgG fragment by random mutagenesis , 1997, Nature Biotechnology.

[17]  D. Scheinberg,et al.  Targeted actinium-225 in vivo generators for therapy of ovarian cancer. , 2003, Cancer research.

[18]  R. Ober,et al.  Differences in promiscuity for antibody-FcRn interactions across species: implications for therapeutic antibodies. , 2001, International immunology.

[19]  D. Scheinberg,et al.  Pharmacokinetics, dosimetry, and toxicity of the targetable atomic generator, 225Ac-HuM195, in nonhuman primates. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[20]  P. Telleman,et al.  The role of the Brambell receptor (FcRB) in liver: protection of endocytosed immunoglobulin G (IgG) from catabolism in hepatocytes rather than transport of IgG to bile , 2000, Immunology.

[21]  P. Bjorkman,et al.  Expression and crystallization of a soluble and functional form of an Fc receptor related to class I histocompatibility molecules. , 1992, Proceedings of the National Academy of Sciences of the United States of America.

[22]  K. Mostov,et al.  An Fc receptor structurally related to MHC class I antigens , 1989, Nature.

[23]  R. Hansen,et al.  IVIG effects on autoantibody elimination , 2004, Allergy.

[24]  R. Wahl Tositumomab and (131)I therapy in non-Hodgkin's lymphoma. , 2005, Journal of Nuclear Medicine.

[25]  T. Waldmann,et al.  Familial hypercatabolic hypoproteinemia caused by deficiency of the neonatal Fc receptor, FcRn, due to a mutant beta2-microglobulin gene. , 2006, Proceedings of the National Academy of Sciences of the United States of America.

[26]  Jin‐Kyoo Kim,et al.  Mapping the site on human IgG for binding of the MHC class I‐related receptor, FcRn , 1999, European journal of immunology.

[27]  E. Choi,et al.  The MHC Class I-Like IgG Receptor Controls Perinatal IgG Transport, IgG Homeostasis, and Fate of IgG-Fc-Coupled Drugs1 , 2003, The Journal of Immunology.

[28]  E. May,et al.  Tissue and cell-specific expression of the p53-target genes: bax, fas, mdm2 and waf1/p21, before and following ionising irradiation in mice , 2000, Oncogene.

[29]  E. Ward,et al.  Abnormally short serum half-lives of IgG in beta 2-microglobulin-deficient mice. , 1996, European journal of immunology.

[30]  M. Simionescu,et al.  Functional expression of the MHC class I-related receptor, FcRn, in endothelial cells of mice. , 1998, International immunology.

[31]  J. S. Hunt,et al.  An IgG‐transporting Fc receptor expressed in the syncytiotrophoblast of human placenta , 1996, European journal of immunology.

[32]  D. Scheinberg,et al.  Efforts to control the errant products of a targeted in vivo generator. , 2005, Cancer research.

[33]  S. Langermann,et al.  Increasing the Affinity of a Human IgG1 for the Neonatal Fc Receptor: Biological Consequences1 , 2002, The Journal of Immunology.

[34]  R. Junghans Finally! the Brambell receptor (FcRB) , 1997, Immunologic research.

[35]  D. Barisani,et al.  A major histocompatibility complex class I-related Fc receptor for IgG on rat hepatocytes. , 1995, The Journal of clinical investigation.

[36]  D. Scheinberg,et al.  Design and synthesis of 225Ac radioimmunopharmaceuticals. , 2002, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[37]  E. Ward,et al.  Delineation of the amino acid residues involved in transcytosis and catabolism of mouse IgG1. , 1997, Journal of immunology.

[38]  Leonard G Presta,et al.  Enhanced half-life of genetically engineered human IgG1 antibodies in a humanized FcRn mouse model: potential application in humorally mediated autoimmune disease. , 2006, International immunology.

[39]  Raimund J. Ober,et al.  Visualizing the Site and Dynamics of IgG Salvage by the MHC Class I-Related Receptor, FcRn1 , 2004, The Journal of Immunology.

[40]  D. Scheinberg,et al.  Renal tubulointerstitial changes after internal irradiation with alpha-particle-emitting actinium daughters. , 2005, Journal of the American Society of Nephrology : JASN.

[41]  C. Hack,et al.  Accelerated autoantibody clearance by intravenous immunoglobulin therapy: studies in experimental models to determine the magnitude and time course of the effect. , 2001, Blood.

[42]  R. Ober,et al.  Engineering the Fc region of immunoglobulin G to modulate in vivo antibody levels , 2005, Nature Biotechnology.