A novel inhalable nanobody targeting IL-4Rα for the treatment of asthma

J Allergy Clin Immunol. 2024 Oct;154(4):1008-1021. doi: 10.1016/j.jaci.2024.05.027. Epub 2024 Jun 11.

Abstract

Background: Inhalable biologics represent a promising approach to improve the efficacy and safety of asthma treatment. Although several mAbs targeting IL-4 receptor α chain (IL-4Rα) have been approved or are undergoing clinical trials, the development of inhalable mAbs targeting IL-4Rα presents significant challenges.

Objective: Capitalizing on the distinctive advantages of nanobodies (Nbs) in maintaining efficacy during storage and administration, we sought to develop a novel inhalable IL-4Rα Nb for effectively treating asthma.

Methods: Three IL-4Rα immunized Nb libraries were used to generate specific and functional IL-4Rα Nbs. LQ036, a bivalent Nb comprising 2 HuNb103 units, was constructed with a high affinity and specificity for human IL-4Rα. The efficacy, pharmacokinetics, and safety of inhaled LQ036 were evaluated in B-hIL4/hIL4RA humanized mice.

Results: LQ036 inhibited secreted embryonic alkaline phosphatase reporter activity, inhibited TF-1 cell proliferation, and suppressed phosphorylated signal transducer and activator of transduction 6 in T cells from patients with asthma. Crystal structure analysis revealed a binding region similar to dupilumab but with higher affinity, leading to better efficacy in blocking the signaling pathway. HuNb103 competed with IL-4 and IL-13 for IL-4Rα binding. Additionally, LQ036 significantly inhibited ovalbumin-specific IgE levels in serum, CCL17 levels in bronchoalveolar lavage fluid, bronchial mucous cell hyperplasia, and airway goblet cell hyperplasia in B-hIL4/hIL4RA humanized mice. Inhaled LQ036 exhibited favorable pharmacokinetics, safety, and tissue distribution, with higher concentrations observed in the lungs and bronchi.

Conclusions: These findings from preclinical studies establish the safety and efficacy of inhaled LQ036, underscoring its potential as a pioneering inhalable biologic therapy for asthma.

Keywords: IL-4Rα; asthma; inhalable; nanobody.

MeSH terms

  • Administration, Inhalation
  • Animals
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / pharmacokinetics
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma* / drug therapy
  • Asthma* / immunology
  • Asthma* / therapy
  • Female
  • Humans
  • Interleukin-4 Receptor alpha Subunit / antagonists & inhibitors
  • Interleukin-4 Receptor alpha Subunit / immunology
  • Mice
  • Single-Domain Antibodies* / administration & dosage
  • Single-Domain Antibodies* / immunology

Substances

  • Single-Domain Antibodies
  • Interleukin-4 Receptor alpha Subunit
  • IL4R protein, human
  • Anti-Asthmatic Agents