The deglycosylated form of 1E12 inhibits platelet activation and prothrombotic effects induced by VITT antibodies

Haematologica. 2022 Oct 1;107(10):2445-2453. doi: 10.3324/haematol.2021.280251.

Abstract

In order to improve the safety of COVID-19 vaccines, there is an urgent need to unravel the pathogenesis of vaccineinduced immune thrombotic thrombocytopenia (VITT), a severe complication of recombinant adenoviral vector vaccines used to prevent COVID-19, and likely due to anti-platelet factor 4 (PF4) IgG antibodies. In this study, we demonstrated that 1E12, a chimeric anti-PF4 antibody with a human Fc fragment, fully mimics the effects of human VITT antibodies, as it activates platelets to a similar level in the presence of platelet factor 4 (PF4). Incubated with neutrophils, platelets and PF4, 1E12 also strongly induces NETosis, and in a microfluidic model of whole blood thrombosis, it triggers the formation of large platelet/leukocyte thrombi containing fibrin(ogen). In addition, a deglycosylated form of 1E12 (DG-1E12), which still binds PF4 but no longer interacts with Fcγ receptors, inhibits platelet, granulocyte and clotting activation induced by human anti-PF4 VITT antibodies. This strongly supports that 1E12 and VITT antibodies recognize overlapping epitopes on PF4. In conclusion, 1E12 is a potentially important tool to study the pathophysiology of VITT, and for establishing mouse models. On the other hand, DG-1E12 may help the development of a new drug that specifically neutralizes the pathogenic effect of autoimmune anti-PF4 antibodies, such as those associated with VITT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • COVID-19 Vaccines* / adverse effects
  • COVID-19*
  • Epitopes
  • Fibrin
  • Humans
  • Immunoglobulin Fc Fragments
  • Immunoglobulin G
  • Mice
  • Platelet Activation
  • Platelet Factor 4 / adverse effects
  • Platelet Factor 4 / metabolism
  • Purpura, Thrombocytopenic, Idiopathic* / chemically induced
  • Receptors, IgG / genetics
  • Receptors, IgG / metabolism
  • Thrombocytopenia* / chemically induced
  • Thrombosis / pathology

Substances

  • COVID-19 Vaccines
  • Epitopes
  • Immunoglobulin Fc Fragments
  • Immunoglobulin G
  • Receptors, IgG
  • Platelet Factor 4
  • Fibrin

Grants and funding

Funding: This study was supported by the Institut pour la Recherche sur la Thrombose et l’Hémostase, the program “Investissements d'Avenir” (grant agreement no. LabEx MAbImprove ANR-10-LABX-53-01), the Région Centre-Val de Loire (APR IR 2020_DOMINO) and Force Hémato. The study has been funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – project number 374031971 - TRR 240.