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Immunogenetics. 2019 Nov;71(10):605-615. doi: 10.1007/s00251-019-01136-7. Epub 2019 Nov 27.

Correlation between antidrug antibodies, pre-existing antidrug reactivity, and immunogenetics (MHC class II alleles) in cynomolgus macaque.

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Department of Drug Disposition, Lilly Research Laboratories; Eli Lilly and Company; Lilly Corporate Center, Indianapolis, IN, USA.
Indiana Biosciences Research Institute, Indiana University - Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
Department of Drug Disposition, Lilly Research Laboratories; Eli Lilly and Company; Lilly Corporate Center, Indianapolis, IN, USA.


Immunogenicity of biomolecules is one of the largest concerns in biological therapeutic drug development. Adverse immune responses as a result of immunogenicity to biotherapeutics range from mild hypersensitivity reactions to potentially life-threatening anaphylactic reactions and can negatively impact human health and drug efficacy. Numerous confounding patient-, product- or treatment-related factors can influence the development of an immune reaction against therapeutic proteins. The goal of this study was to investigate the relationship between pre-existing drug reactivity (PE-ADA), individual immunogenetics (MHC class II haplotypes), and development of treatment-induced antidrug antibodies (TE-ADA) in cynomolgus macaque. PE-ADA refers to the presence of antibodies immunoreactive against the biotherapeutic in treatment-naïve individuals. We observed that PE-ADA frequency against four different bispecific antibodies in naïve cynomolgus macaque is similar to that reported in humans. Additionally, we report a trend towards an increased incidence of TE-ADA development in macaques with high PE-ADA levels. In order to explore the relationship between MHC class II alleles and risk of ADA development, we obtained full-length MHC class II sequences from 60 cynomolgus macaques in our colony. We identified a total of 248 DR, DP, and DQ alleles and 236 unique haplotypes in our cohort indicating a genetically complex set of animals potentially reflective of the human population. Based on our observations, we propose the evaluation of the magnitude/frequency of pre-existing reactivity and consideration of MHC class II genetics as additional useful tools to understand the immunogenic potential of biotherapeutics.


Antidrug antibodies; Immunogenicity; MHC class II; Pharmacokinetics; Pre-existing reactivity

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