Abstract:
Treatment of oncological and autoimmune diseases still remains a considerable challenge
to modern medicine. Current therapy options such as chemotherapy and
radiotherapy in oncology and glucocorticoids or other conventional immunosuppressive
drugs for autoimmune diseases are often of limited efficacy. They suffer from
a lack of specificity, with respect to the eradication of tumour and immune cells,
respectively. The use of monoclonal antibodies in oncology allowed in some instances
specific targeting of tumour cells and thus, improved this situation in the
last decades. Some antibodies, such as anti-CD20 antibody Rituximab, targeting
normal and malignant B-cells, are meanwhile firmly established in oncological treatment
regimes. Interestingly, over the last years the anti B-cell activity of Rituximab
was used in addition in numerous studies for the treatment of autoimmune diseases.
Many strategies have been developed to further improve therapeutic activity of monoclonal
antibodies. One of them is the development of bispecific antibodies recognising
target cell antigens and effector cells or effector molecules at the same time.
The “bispecific concept” used in this work is the target cell restricted stimulation
of the death receptor CD95 (APO-1/Fas) with bispecific antibodies as described by
Jung et al. in 2000. Whereas initial experiments were performed using chemically
hybridised bispecific antibodies with CD20×CD95 specificity, the goal of this thesis
was the generation of recombinant antibodies within a suitable format.
To this end, a recombinant CD20×CD95 molecule in the so called FabSc format,
designated BS9520 was developed and characterised in various in vitro and in vivo
assays. It was found that the capability of this antibody to suppress the growth
of malignant B-cells in vitro and in vivo and to specifically deplete normal, activated
B-cells from PBMC cultures was superior to that achieved with monospecific
clinically established anti-CD20 antibodies including a newly developed third generation
Fc-optimized CD20 antibody. Moreover, the bispecific antibody was the only
reagent capable of significantly suppressing IgG production by activated B-cells in
vitro. These findings imply that the bispecific CD95×CD20 antibody might become
an attractive reagent for the treatment of B-cell malignancies as well as B-cell mediated
autoimmune diseases.
In the second part of this work a completely new approach for the stimulation of
the CD95 death receptor on antigen specific B-cells was evaluated. For proof of
principle, the CD20 part in the BS9520 antibody was replaced by antigen fragments
(tetanus or diphtheria toxoid derivatives). We named these fusion proteins BS95TT
and BS95DT, respectively. Such protein should bind to B-cell receptor via their
toxoid part and with the CD95 antibody part to CD95 receptor on activated TTspecific
B-cells. Thereby, apoptosis is induced only in an antigen-specific fashion.
This approach could be used for the treatment of autoimmune diseases if the antigen
inducing auto-antibody production is known (such as Myasthenia gravis, multiple
sclerosis and others).