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Originally published online as doi:10.2353/ajpath.2010.090744 on December 30, 2009

Published online before print December 30, 2009
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(American Journal of Pathology. 2010;176:914-925.)
© 2010 American Society for Investigative Pathology
DOI: 10.2353/ajpath.2010.090744

Blockade of Autoantibody-Initiated Tissue Damage by Using Recombinant Fab Antibody Fragments against Pathogenic Autoantigen

Gang Wang*{dagger}, Hideyuki Ujiie*, Akihiko Shibaki*, Wataru Nishie*, Yasuki Tateishi*, Kazuhiro Kikuchi*, Qiang Li*, James R. McMillan*{dagger}, Hiroshi Morioka{ddagger}, Daisuke Sawamura*, Hideki Nakamura* and Hiroshi Shimizu*

From the Department of Dermatology,* Hokkaido University Graduate School of Medicine, the Creative Research Initiative Sousei,{dagger} and the Faculty of Pharmaceutical Sciences,{ddagger} Hokkaido University, Sapporo, Japan

Activation of the complement cascade via the classical pathway is required for the development of tissue injury in many autoantibody-mediated diseases. It therefore makes sense to block the pathological action of autoantibodies by preventing complement activation through inhibition of autoantibody binding to the corresponding pathogenic autoantigen using targeted Fab antibody fragments. To achieve this, we use bullous pemphigoid (BP) as an example of a typical autoimmune disease. Recombinant Fabs against the non-collagenous 16th-A domain of type XVII collagen, the main pathogenic epitope for autoantibodies in BP, were generated from antibody repertoires of BP patients by phage display. Two Fabs, Fab-B4 and Fab-19, showed marked ability to inhibit the binding of BP autoantibodies and subsequent complement activation in vitro. In the in vivo experiments using type XVII collagen humanized BP model mice, these Fabs protected mice against BP autoantibody-induced blistering disease. Thus, the blocking of pathogenic epitopes using engineered Fabs appears to demonstrate efficacy and may lead to disease-specific treatments for antibody-mediated autoimmune diseases.






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