Antibody-based countermeasures against fentanyl and its analogues

抽象的。该项目将开发抗意外致死性和毒性的单抗(MAb)。 或故意接触芬太尼、卡芬太尼、乙酰芬太尼和阿芬太尼。美国经历了急剧的增长 由于芬太尼和芬太尼类似物的广泛使用，导致致命的阿片类药物中毒。因为 意外或故意大规模伤亡事件的风险，芬太尼化学家族被列入国土安全部 化学品威胁风险评估清单。作为当前抢救药物的补充辅助策略 对于阿片中毒(如阿片受体拮抗剂纳洛酮)，我们的团队正在开发针对芬太尼的mAb 以及其有效的类似物，以降低民用和国防应用中的毒性和致命性。我们队有 表明基于抗体的策略有效地减少了阿片类药物在大脑中的分布以及阿片类药物的诱导 小鼠和大鼠呼吸抑制和心动过缓。抗体选择性地针对预期的阿片类药物，但 不要干扰内源性阿片类药物，也不要干扰纳洛酮或其他经批准的药物。我们队有 用基于抗原的浓缩策略鉴定Lead第一代小鼠抗芬太尼单抗 免疫小鼠产生杂交瘤的阿片类特异性B细胞和人/鼠嵌合体 用于在合适的哺乳动物系统中表达的单抗。建议的U01项目将进一步优化这些线索 通过一个迭代的发展计划。AIM1致力于人源化抗芬太尼单抗的优化， 卡芬太尼、乙酰芬太尼和阿芬太尼 人源化或转基因小鼠。主导单抗将被用作下一代选择的基准 候选人。将在体外确定铅的亲和力和选择性，并在体内确定其降低 大鼠的抗伤害性、呼吸抑制和致死性。人性化进程将由 单抗与芬太尼及其类似物结合的X射线结晶学生物物理表征AIM2焦点 关于通过聚合物修饰来优化铅单抗(Fab或F(Ab)2片段作为替代选项) 改善半衰期和分布体积，并提高对芬太尼及其类似物的疗效。AIM3将测试 多组分单抗制剂与阿片类拮抗剂联合给药的疗效 加强对芬太尼和芬太尼激发的大鼠呼吸抑制和致死的保护 它的衍生产品。为了提供可伸缩性的证据，AIM4测试了先导人源化mAb在非人类体内的效果 阿片类药物所致呼吸抑制的灵长类动物模型。来自以前目标的线索将在更大的 承包商现场的规模。最后，AIM5侧重于起草一条通往后期开发和 商业化。

ABSTRACT. This project will develop monoclonal antibodies (mAb) against toxicity and lethality from accidental or deliberate exposure to fentanyl, carfentanil, acetylfentanil, and alfentanil. The US has seen dramatic increases in fatal opioid poisoning due to the widespread availability of fentanyl and fentanyl-like analogs. Because of the risk for accidental or deliberate mass casualty incidents, the fentanyl chemical family is listed in the DHS Chemical Threat Risk Assessment list. As a complementary adjuvant strategy to current medications for rescue of opioid poisoning (e.g., the opioid receptor antagonist naloxone), our team is developing mAb against fentanyl and its potent analogs to reduce toxicity and lethality in both civilian and defense applications. Our team has shown that antibody-based strategies effectively reduce opioid distribution to the brain as well as opioid-induced respiratory depression and bradycardia in mice and rats. Antibodies selectively target the intended opioid, but do not interfere with endogenous opioids nor with naloxone or other approved medications. Our team has identified lead first-generation mouse anti-fentanyl mAbs using an antigen-based enrichment strategy to isolate opioid-specific B cell lymphocytes from immunized mice to generate hybridomas, and mouse/human chimeric mAb for expression in a suitable mammalian system. The proposed U01 project will further optimize these leads through an iterative developmental plan. AIM1 focuses on optimization of humanized mAb against fentanyl, carfentanil, acetylfentanyl, and alfentanil by integrating humanization of lead mouse mAb and immunization of humanized or transgenic mice. The lead mAb will be used as a benchmark for selection of next-generation candidates. Leads will be identified for their affinity and selectivity in vitro, and for in vivo efficacy in reducing antinociception, respiratory depression and lethality in rats. The humanization process will be guided by biophysical characterization of mAb binding to fentanyl and its analogs by X-ray crystallography. AIM2 focuses on optimization of lead mAb (Fab or F(ab)2 fragments as alternative options) via polymer-based modifications to improve half-life and volume of distribution, and increase efficacy against fentanyl and its analogs. AIM3 will test efficacy of leads co-administered as a multicomponent mAb formulation in combination with opioid antagonists to provide enhanced protection against respiratory depression and lethality in rats challenged with fentanyl and its derivatives. To provide proof of scalability, AIM4 tests the efficacy of the lead humanized mAb in a non-human primate model of opioid-induced respiratory depression. Leads from previous aims will be synthesized at a larger scale at a contractor site. Finally, AIM5 focuses on drafting a regulatory path toward late-stage development and commercialization.