Development of a novel humanized anti-TSLP monoclonal antibody, QX008N, and exploration of combination therapy of anti-TSLP antibody and anti-IL-4R antibody

Int Immunopharmacol. 2024 Dec 5;142(Pt A):113102. doi: 10.1016/j.intimp.2024.113102. Epub 2024 Sep 13.

Abstract

Background: Severe asthma is a complex and chronic respiratory disease, and current conventional treatments are not effective in controlling the patients' condition. Thymic stromal lymphopoietin (TSLP) is a key regulatory factor in the initiation and maintenance of asthma. Thus, blocking TSLP during allergic inflammation emerges as a promising therapeutic approach; however, novel anti-TSLP therapies remain to be developed. Furthermore, the importance of other signaling molecules, such as IL-4 and IL-13, should be considered. Moreover, to the best of our knowledge, the inhibitory effect of binding upstream and downstream signaling molecules has not been assessed.

Purpose: This study aimed to develop a novel, humanized anti-TSLP antibody and explore the enhancement in its efficacy when combined with anti-IL-4R antibodies to treat asthma.

Results: QX008N, derived from a rabbit antibody platform, exhibits a high affinity for TSLP and superior efficacy in blocking TSLP-induced signaling pathways and inflammation in vitro compared with Tezepelumab. In a cynomolgus monkey asthma model, QX008N ameliorated lung function and reduced the levels of eosinophils and IgE. Moreover, the coadministration of QX008N with anti-IL-4R antibodies enhanced the inhibition of inflammatory mediator production triggered via costimulation in vitro. In mouse asthma models, the simultaneous blockade of TSLP and IL-4R using anti-TL4R and anti-TSLP surrogates surpassed the efficacy of monotherapy. To the best of our knowledge, the therapeutic effect of a combination of anti-TSLP and IL-4R antibodies in an asthma model has not yet been reported.

Conclusion: These results furnish comprehensive preclinical evidence for QX008N as an innovative anti-TSLP therapeutic agent and provide a preliminary rationale for the development of combination therapies that simultaneously target the TSLP and IL-4R signaling pathways.

Keywords: Asthma; Combination therapy; Humanized TSLP monoclonal antibody; IL-4 receptor α; TSLP.

MeSH terms

  • Animals
  • Anti-Asthmatic Agents / pharmacology
  • Anti-Asthmatic Agents / therapeutic use
  • Antibodies, Monoclonal, Humanized* / pharmacology
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Asthma* / drug therapy
  • Asthma* / immunology
  • Cytokines* / immunology
  • Cytokines* / metabolism
  • Disease Models, Animal
  • Drug Therapy, Combination
  • Female
  • Humans
  • Lung / drug effects
  • Lung / immunology
  • Macaca fascicularis*
  • Mice
  • Rabbits
  • Receptors, Interleukin-4 / antagonists & inhibitors
  • Receptors, Interleukin-4 / immunology
  • Signal Transduction / drug effects
  • Thymic Stromal Lymphopoietin*

Substances

  • Cytokines
  • Antibodies, Monoclonal, Humanized
  • Thymic Stromal Lymphopoietin
  • Anti-Asthmatic Agents
  • Receptors, Interleukin-4
  • tezepelumab