WO/2018/107082 | METHODS OF TREATING INFLAMMATORY DISORDERS WITH MULTIVALENT FC COMPOUNDS |
WO/2021/057991 | BINDING MOLECULE SPECIFIC FOR LIF AND USE THEREOF |
WO/2002/070690 | ABCA5 TRANSPORTER AND USES THEREOF |
YONG HAEYOUNG (KR)
JUNG MIJIN (KR)
YOON MINHO (KR)
SHIM HYEEUN (KR)
KIM EUNSUN (KR)
PARK SEUNGKOOK (KR)
MACIAS WILLIAM LOUIS (US)
LIANG SU (US)
IMMUNOVANT SCIENCES GMBH (CH)
WO2015107026A1 | 2015-07-23 | |||
WO2015167293A1 | 2015-11-05 | |||
WO2014177460A1 | 2014-11-06 | |||
WO2015167293A1 | 2015-11-05 |
KR101815265B1 | 2018-01-04 | |||
KR101954906B1 | 2019-03-08 |
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STEVENSON ET AL., NTICANCER DRUG DESIGN, vol. 3, 1989, pages 219 - 230
SAUNDERS ET AL., FRONT. IMMUNOL., vol. 10, 2019, pages 1296
WANG ET AL., PROTEIN CELL, vol. 9, no. 1, 2018, pages 63 - 73
ENGELSUHLMANN, ANGEW CHEM INTED ENGL., vol. 37, 1988, pages 73 - 127
SAMBROOK ET AL.: "Molecular Cloning: A laboratory Manual", 1989, COLD SPRING Σ-IARBOR LABORATORY PRESS
DEUSCHER, M.: "Guide to Protein Purification Methods Enzymology", vol. 182, 1990, ACADEMIC PRESS. INC.
"Remington's Pharmaceutical Sciences", 1995
LLEDO-GARCIA ET AL., UCB PHARMA, 2022
Claims What is claimed is: [Claim 1] An anti-FcRn antibody or an antigen binding fragment thereof comprising: a light chain variable region comprising LCDR1 comprising the amino acid sequence of SEQ ID NO: 1, LCDR2 comprising the amino acid sequence of SEQ ID NO: 2, and LCDR3 comprising the amino acid sequence of SEQ ID NO: 3; and a heavy chain variable region comprising HCDR1 comprising the amino acid sequence of SEQ ID NO: 5, HCDR2 comprising the amino acid sequence of SEQ ID NO: 6, and HCDR3 comprising the amino acid sequence of SEQ ID NO: 7, wherein the amino acid of N3 in the amino acid sequence of SEQ ID NO: 1 is substituted with another amino acid, and/or the amino acid of C2 in the amino acid sequence of SEQ ID NO: 5 is substituted with another amino acid. [Claim 2] The anti-FcRn antibody or antigen binding fragment thereof according to claim 1, wherein the amino acid of N3 in the amino acid sequence of SEQ ID NO: 1 is substituted with Ser (S) or Gln (Q). [Claim 3] The anti-FcRn antibody or antigen binding fragment thereof according to claim 1 or 2, wherein the amino acid of C2 in the amino acid sequence of SEQ ID NO: 5 is substituted with Ser (S) or Tyr (Y). [Claim 4] The anti-FcRn antibody or antigen binding fragment thereof according to any one of claims 1-3, wherein the heavy chain variable region comprises a framework composed of FR1 of the amino acid sequence of SEQ ID NO: 15, FR2 of the amino acid sequence of SEQ ID NO: 16, FR3 of the amino acid sequence of SEQ ID NO: 17, and FR4 of the amino acid sequence of SEQ ID NO: 18. The anti-FcRn antibody or antigen binding fragment thereof according to claim 4, wherein the amino acid of Q16 in the amino acid sequence of SEQ ID NO: 17 is substituted with another amino acid. [Claim 6] The anti-FcRn antibody or antigen binding fragment thereof according to claim 5, wherein the amino acid of Q16 in the amino acid sequence of SEQ ID NO: 17 is substituted with Glu (E). [Claim 7] An anti-FcRn antibody or an antigen binding fragment thereof comprising a light chain variable region comprising the amino acid sequence of SEQ ID NO: 4 and a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 8, wherein the amino acid of N25 in the amino acid sequence of SEQ ID NO: 4 is substituted with another amino acid, and the amino acid of C32 or Q82 in the amino acid sequence of SEQ ID NO: 8 is substituted with another amino acid. [Claim 8] The anti-FcRn antibody or antigen binding fragment thereof according to claim 7, wherein the amino acid of N25 in the amino acid sequence of SEQ ID NO: 4 is substituted with Ser (S) or Gln (Q). [Claim 9] The anti-FcRn antibody or antigen binding fragment thereof according to claim 7 or 8, wherein the amino acid of C32 in the amino acid sequence of SEQ ID NO: 8 is substituted with Ser (S) or Tyr (Y). [Claim 10] The anti-FcRn antibody or antigen binding fragment thereof according to any one of claims 7-9, wherein the amino acid of Q82 in the amino acid sequence of SEQ ID NO: 8 is substituted with Glu (E). An anti-FcRn antibody or an antigen binding fragment thereof comprising a light chain variable region comprising LCDR1 comprising the amino acid sequence of SEQ ID NO: 9, LCDR2 comprising the amino acid sequence of SEQ ID NO: 2, and LCDR3 comprising the amino acid sequence of SEQ ID NO: 3; and a heavy chain variable region comprising HCDR1 comprising the amino acid sequence of SEQ ID NO: 11, HCDR2 comprising the amino acid sequence of SEQ ID NO: 6, and HCDR3 comprising the amino acid sequence of SEQ ID NO: 7. [Claim 12] The anti-FcRn antibody according to any one of claims 1 to 11, wherein the anti-FcRn antibody comprises an Fc region, wherein the Fc region is an IgG1 Fc region or an IgG4 Fc region. [Claim 13] The anti-FcRn antibody according to claim 12, wherein the Fc region is an IgG1 Fc region comprising Leu234Ala and Leu235Ala amino acid substitutions. [Claim 14] A polynucleotide encoding the anti-FcRn antibody or antigen binding fragment thereof according to any one of claims 1 to 13. [Claim 15] A recombinant expression vector comprising the polynucleotide according to claim 14. [Claim 16] A host cell transformed with the recombinant expression vector according to claim 15. [Claim 17] A method for producing an anti-FcRn antibody or an antigen binding fragment thereof, comprising: culturing the host cell according to claim 16 to produce an antibody; and isolating and purifying the produced antibody to recover an antibody that specifically binds to FcRn. [Claim 18] A pharmaceutical composition comprising the anti-FcRn antibody or antigen binding fragment thereof according to any one of claims 1 to 13, and a pharmaceutically acceptable carrier. [Claim 19] A pharmaceutical composition for treating an autoimmune disease, comprising the anti-FcRn antibody or antigen binding fragment thereof according to any one of claims 1 to 13. [Claim 20] The pharmaceutical composition according to claim 19, wherein the autoimmune disease is one selected from the group consisting of: autoimmune neutropenia, Guillain-Barré syndrome, epilepsy, autoimmune encephalitis, Isaacs' syndrome, nevus syndrome, pemphigus vulgaris, deciduous pemphigus, bullous pemphigoid, acquired epidermolysis bullosa, gestational pemphigoid, mucous membrane pemphigoid, antiphospholipid syndrome, autoimmune anemia, autoimmune Graves' disease, thyroid eye disease (TED), Goodpasture syndrome, myasthenia gravis, multiple sclerosis, rheumatoid arthritis, lupus, idiopathic thrombocytopenic purpura (ITP), warm autoimmune hemolytic anemia (WAIHA), chronic inflammatory demyelinating polyneuropathy (CIDP), lupus nephritis, and membranous nephropathy. [Claim 21] A method of treating an autoimmune disease in a subject in need thereof, comprising administering to the subject the anti-FcRn antibody or antigen-binding fragment thereof according to any one of claims 1 to 13 or the pharmaceutical composition according to any one of claims 18 to 20, optionally wherein the subject is human. [Claim 22] The method according to claim 21, wherein the autoimmune disease is selected from the group consisting of: autoimmune neutropenia, Guillain-Barré syndrome, epilepsy, autoimmune encephalitis, Isaacs' syndrome, nevus syndrome, pemphigus vulgaris, deciduous pemphigus, bullous pemphigoid, acquired epidermolysis bullosa, gestational pemphigoid, mucous membrane pemphigoid, antiphospholipid syndrome, autoimmune anemia, myasthenia gravis, autoimmune Graves' disease, thyroid eye disease (TED), Goodpasture syndrome, multiple sclerosis, rheumatoid arthritis, lupus, idiopathic thrombocytopenic purpura (ITP), warm autoimmune hemolytic anemia (WAIHA), chronic inflammatory demyelinating polyneuropathy (CIDP), lupus nephritis, and membranous nephropathy. [Claim 23] The method according to claim 21 or 22, wherein the administering is parenteral. [Claim 24] The method according to claim 23, wherein the administering is subcutaneous or intravenous. [Claim 25] The method according to any one of claims 21 to 24, wherein the administering is at a dose from 300 mg to 2400 mg. [Claim 26] The method according to any one of claims 21 to 24, wherein the administering is once weekly, once in two weeks, once in three weeks or once monthly. [Claim 27] The method according to any one of claims 21 to 26, wherein the administering is subcutaneous once weekly at a dose from 300 mg to 900 mg. [Claim 28] The method according to any one of claims 21 to 26, wherein the administering is subcutaneous once in two weeks at a dose from 300 mg to 1800 mg. [Claim 29] The method according to any one of claims 21 to 28, wherein the administering does not result in more than 5% or more than 10% decrease in blood albumin levels in the subject compared to the blood albumin levels prior to the administration of the anti-FcRn antibody or antigen-binding fragment. [Claim 30] The method according to any one of claims 21 to 29, wherein the administering does not result in more than 5% or more than 10% increase in blood total cholesterol or low-density lipoprotein (LDL) levels in the subject compared to the blood total cholesterol or LDL levels prior to the administration of the anti-FcRn antibody or antigen-binding fragment. |
[00130] A vector provided herein may comprise a polynucleotide encoding the light chain of an anti-FcRn antibody or antigen-binding fragment thereof and/or the heavy chain an anti- FcRn antibody or antigen-binding fragment thereof.
[00131] In some embodiments, the vector comprises a polynucleotide comprising the sequence of SEQ ID NO: 30. In some embodiments, the vector comprises a polynucleotide comprising the sequence of SEQ ID NO: 31. In some embodiments, the vector comprises a polynucleotide comprising the sequence of SEQ ID NO: 30 (encoding the light chain) and the sequence of SEQ ID NO: 31 (encoding the heavy chain).
[00132] In some embodiments, the vector comprises a polynucleotide comprising the sequence of SEQ ID NO: 32. In some embodiments, the vector comprises a polynucleotide comprising the sequence of SEQ ID NO: 33. In some embodiments, the vector comprises a polynucleotide comprising the sequence of SEQ ID NO: 32 (encoding the light chain) and the sequence of SEQ ID NO: 33 (encoding the heavy chain).
[00133] The vector may be introduced into a host cell and recombined and inserted into a host cell genome. Alternatively, the vector is understood to be a nucleic acid means comprising a polynucleotide sequence capable of spontaneous replication as an episome. The vector includes linear nucleic acids, plasmids, phagemids, cosmids, RNA vectors, viral vectors and analogs thereof. Examples of viral vectors include retrovirus, adenovirus, and adeno-associated virus, but are not limited thereto.
[00134] Specifically, the vector may be plasmid DNA, phage DNA, and the like. In addition, it may be commercially developed plasmids (pUC18, pBAD, pIDTSAMRT-AMP, etc.), E. coli derived plasmids (pYG601BR322, pBR325, pUC118, pUC119, etc.), Bacillus subtilis-derived plasmids (pUBl 10, pTP5, etc ), yeast-derived plasmids (YEpl3, YEp24, YCp50, etc.), phage DNA (Charon4A, Charon21 A, EMBL3, EMBL4, λgt10, λgt11, XZAP, etc.), animal viral vectors (retrovirus, adenovirus, vaccinia virus, etc.), insect viral vectors (baculovirus, etc.). Since the vector shows different protein expression levels and modifications depending on the host cell, it is preferable to select and use the most suitable host cell for the purpose.
[00135] The vector of the present disclosure may be fused with other sequences in order to facilitate purification of the antibody expressed therefrom. The sequence to be fused includes, for example, glutathione S-transferase (Pharmacia, USA), maltose binding protein (NEB, USA), FLAG (IBI, USA), 6× His (hexahistidine; Quiagen, USA), and the like. [00136] In addition, since the protein expressed by the vector of the present disclosure is an antibody, the expressed antibody may be easily purified through a Protein A column or the like without an additional sequence for purification. Transformed cell expressing anti-FcRn antibody variant [00137] In another aspect of the present disclosure, there is provided a host cell transformed with the recombinant expression vector. [00138] A host cell of the transformed cell may include a prokaryotic cell, a eukaryotic cell, a cell of mammal, plant, insect, fungal or cellular origin, but is not limited thereto. E. coli may be used as an example of the prokaryotic cell. In addition, yeast may be used as an example of the eukaryotic cell. In addition, as the mammal cell, CHO cells, F2N cells, CSO cells, BHK cells, Bowes melanoma cells, HeLa cells, 911 cells, AT1080 cells, A549 cells, HEK 293 cells, HEK293T cells, or the like may be used, but is not limited thereto, and any cell that may be used as a mammalian host cell known to one of ordinary skill in the art is available. [00139] In the present disclosure, "transformation" or "transfection" into a host cell includes any method of introducing a nucleic acid into an organism, cell, tissue or organ, and as is known in the art, suitable standard techniques may be selected and performed depending on the host cell. For example, CaCl 2 precipitation method, Hanahan method with increased efficiency by using DMSO (dimethyl sulfoxide) as a reducing agent in CaCl 2 precipitation method, electroporation, calcium phosphate precipitation method, protoplast fusion method, stirring method using silicon carbide fiber, agrobacterium-mediated transformation method, transformation method using PEG, dextran sulfate, lipofectamine and drying/inhibition mediated transformation method, and the like may be used. Method for producing anti-FcRn antibody variant or antigen binding fragment thereof [00140] In another aspect of the present disclosure, there is provided a method for producing an anti-FcRn antibody or an antigen binding fragment thereof, comprising culturing the host cell to produce an antibody; and isolating and purifying the produced [00141] The FcRn specific antibody according to the present disclosure may be produced in a large quantity by culturing the transformant expressing the recombinant vector in a nutrient medium, and the medium and culture conditions that are tolerated depending on the host cell may be appropriately selected and used. In culture, conditions such as temperature, pH of the medium, and culture duration may be appropriately regulated to be suitable for cell growth and mass production of proteins. The antibody or antibody fragment that are recombinantly produced as described above may be recovered from the medium or cell lysate, and may be isolated and purified by conventional biochemical separation techniques (Sambrook et al., Molecular Cloning: A laboratory Manual, 2nd Ed., Cold Spring Harbor Laboratory Press (1989); Deuscher, M., Guide to Protein Purification Methods Enzymology, Vol. 182. Academic Press. Inc., San Diego, CA (1990)). As an example, electrophoresis, centrifugation, gel filtration, precipitation, dialysis, chromatography (ion exchange chromatography, affinity chromatography, immunosorbent chromatography, size exclusion chromatography, etc.), isoelectric focusing, and methods with various modifications and combinations thereof, and the like may be used, but are not limited thereto. In particular, isolation and purification using Protein A is preferable. [00142] In particular, the anti-FcRn antibody or antigen binding fragment thereof is preferably prepared by expression and purification using a genetic recombination method. Specifically, it is preferable to prepare the variable region encoding the antibody that specifically binds to FcRn according to the present disclosure by simultaneous expression in one host cell. Use of anti-FcRn antibody variant or antigen binding fragment thereof [00143] In another aspect of the present disclosure, there is provided a pharmaceutical composition for treating an autoimmune disease, comprising the anti-FcRn antibody or antigen binding fragment thereof. Also provided herein is a method of treating an autoimmune disorder comprising administering to a subject in need thereof an effective amount of an anti-FcRn antibody or antigen-binding fragment thereof, or a pharmaceutical composition described herein. [00144] The "anti-FcRn antibody" and "antigen binding fragment" are as described above. [00145] As used herein, the term "autoimmune disease" is a generic term for diseases that occur when the immune system attacks its normal tissues, organs, or other body components may occur in almost any part of the body, including the nervous system, gastrointestinal system, endocrine system, skin, skeletal system, vascular tissue, and the like. [00146] The pharmaceutical composition may be applied to all autoimmune diseases mediated by IgG and FcRn. Representative autoimmune diseases may be one selected from the group consisting of autoimmune neutropenia, Guillain-Barré syndrome, epilepsy, autoimmune encephalitis, Isaacs' syndrome, nevus syndrome, pemphigus vulgaris, deciduous pemphigus, bullous pemphigoid, acquired epidermolysis bullosa, gestational pemphigoid, mucous membrane pemphigoid, antiphospholipid syndrome, autoimmune anemia, autoimmune Graves' disease, Goodpasture syndrome, myasthenia gravis, multiple sclerosis, rheumatoid arthritis, lupus, idiopathic thrombocytopenic purpura (ITP), lupus nephritis, membranous nephropathy, allogenic islet graft rejection, alopecia areata, ankylosing spondylitis, autoimmune Addison’s disease, Alzheimer’s disease, antineutrophil cytoplasmic autoantibodies (ANCA), autoimmune disorders of the adrenal gland, warm autoimmune hemolytic anemia (WAIHA), autoimmune hepatitis, autoimmune myocarditis, autoimmune oophoritis and orchitis, autoimmune thrombocytopenia, autoimmune urticaria, Behcet’s disease, cardiomyopathy, Castleman’s syndrome, celiac spruce-dermatitis, chronic fatigue immune dysfunction syndrome, chronic inflammatory demyelinating polyneuropathy (CIDP), Churg-Strauss syndrome, cicatrical pemphigoid, CREST syndrome, cold agglutinin disease, Crohn’s disease, dermatomyositis, dilated cardiomyopathy, discoid lupus, essential mixed cryoglobulinemia, factor VIII deficiency, fibromyalgia-fibromyositis, glomerulonephritis, thyroid eye disease (TED, also known as Graves’ Ophthalmopathy); graft-versus-host disease (GVHD), Hashimoto’s thyroiditis, hemophilia A, idiopathic membranous neuropathy, idiopathic pulmonary fibrosis, IgA neuropathy, IgM polyneuropathies, immune mediated thrombocytopenia, juvenile arthritis, Kawasaki’s disease, lichen plantus, lichen sclerosus, lupus erthematosis, Meniere’s disease, mixed connective tissue disease, type 1 diabetes mellitus, Multifocal motor neuropathy (MMN), paraneoplastic bullous pemphigoid, pemphigus foliaceus, pernicious anemia, polyarteritis nodosa, polychrondritis, polyglandular syndromes, polymyalgia rheumatica, polymyositis and dermatomyositis, primary agammaglobinulinemia, primary biliary cirrhosis, psoriasis, psoriatic arthritis, relapsing polychondritis, Reynauld’s phenomenon, Reiter’s syndrome, sarcoidosis, scleroderma, Sjogren’s syndrome, solid organ transplant rejection, stiff-man syndrome, systemic lupus erythematosus, takayasu arteritis, toxic epidermal necrolysis thrombocytopenia purpura, ulcerative colitis, uveitis, dermatitis herpetiformis vasculitis, anti- neutrophil cytoplasmic antibody-associated vasculitides, vitiligo, and Wegner’s granulomatosis. In some embodiments, the autoimmune disorder is an autoimmune channelopathy, optionally wherein the channelopathy is selected from the group consisting of autoimmune limbic encephalitis, neuromyelitis optica, Lambert-Eaton myasthenic syndrome, myasthenia gravis, anti-N-Methyl-D-aspartate (NMDA) receptor encephalitis, anti-Į-Amino- 3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor encephalitis, Morvan syndrome, neuromyotonia, pediatric autoimmune neuropychiatric disorders associated with streptococcal infection (PANDAS), Glycine receptor antibody-associated disorder, myositis, myelin oligodendrocyte glycoprotein antibody disorders (MOG-antibody disorder), Hemolytic disease of the foetus and new-born, cutaneous lupus erythematosus, refractory rheumatoid arthritis, immune thrombocytopenia, anti-GBM disease, Primary Membranous Nephropathy, Necrotizing Autoimmune Myopathy, Antisynthetase Syndrome, ANCA vasculitis, Hidradenitis Suppurativa, pulmonary alveolar proteinosis (PAP) and systemic lupus erythematosus (SLE), but are not limited thereto. [00147] In some embodiments, the disease treated in accordance with a method described herein is a disease that is characterized by or exhibits increased blood total IgG levels in a subject to be treated. In some embodiments, the disease treated in accordance with a method described herein is any one of the autoimmune diseases referenced herein. In some embodiments, the disease is an autoimmune Graves’ Disease. In some embodiments, the disease is thyroid eye disease (TED, also known as Graves’ Ophthalmopathy). In some embodiments, the disease is warm autoimmune hemolytic anemia (WAIHA). In some embodiments, the disease is myasthenia gravis. In some embodiments, the disease is chronic inflammatory demyelinating polyneuropathy (CIDP). In some embodiments, the disease is pemphigus vulgaris, pemphigus foliaceus, deciduous pemphigus, bullous pemphigoid, gestational pemphigoid, or mucous membrane pemphigoid. [00148] In some embodiments, the disease treated in accordance with a method described herein is a disease that responds to plasma exchange therapy. The subject treated in accordance with a method described herein may have previously undergone plasma exchange. In some embodiments, the disease treated in accordance with a method described herein is a disease that responds to a therapy that decreases total IgG levels. The subject treated in accordance with a method described herein may have previously undergone a accordance with a method described herein is a disease that responds to rituximab. The subject treated in accordance with a method described herein may have previously undergone treatment with rituximab. [00149] In some embodiments, the anti-FcRn antibody or antigen-specific fragment thereof described herein decreases the level of an antigen-specific immunoglobulin or an autoantibody, such as any of the autoantibodies described herein or known in the art. In some embodiments, the anti-FcRn antibody or antigen-specific fragment thereof described herein decreases the level of an autoimmune disease-specific autoantibody or an autoantibody associated, or known to be associated, with an autoimmune disease, such as any of the autoantibodies described herein or known in the art. In some embodiments, the autoimmune disease is any of the autoimmune diseases disclosed herein. [00150] In some embodiments, administration (e.g., subcutaneous) to a subject (e.g., a human) of an effective amount of the anti-FcRn antibody described herein decreases antigen- specific immunoglobulin levels or an autoantibody level (e.g., the level of any one or more of the autoantibodies described herein) in the blood by at least about 40%, 50%, 65% or 80%. In some embodiments, such administration has no or minimal effect on blood albumin levels (e.g., decreases blood albumin by less than 10%, less than 5%, less than 2%, or less than 1%) and/or has no or minimal effect on blood LDL levels (e.g., increases LDL by less than 10%, less than 5%, less than 2%, or less than 1%) compared to the levels prior to administration. In some embodiments, the antigen-specific immunoglobulin or the autoantibody is associated with a disease, such as an autoimmune disease. [00151] In some embodiments, chronic subcutaneous administration to a human for 12 weeks or more of an effective amount of the anti-FcRn antibody described herein decreases antigen-specific immunoglobulin levels or an autoantibody level (e.g., the level of any one or more of the autoantibodies described herein) in the blood by at least about 40%, 50%, 65% or 80%, but has no or minimal effect on blood albumin levels (e.g., decreases blood albumin by less than 10%, less than 5%, less than 2%, or less than 1%) and has no or minimal effect on blood LDL and/or cholesterol levels (e.g., increases LDL and/or cholesterol by less than 10%, less than 5%, less than 2%, or less than 1%) compared to the levels prior to administration. In some embodiments, the antigen-specific immunoglobulin or the autoantibody is associated with a disease, such as an autoimmune disease. [00152] Illustrative examples of autoantibodies associated with specific autoimmune • anti-Desmoglein 3 (anti-Dsg3) antibody (associated with pemphigus vulgaris),
• anti-Desmoglein 1 (anti-Dsgl) antibody (associated with pemphigus vulgaris and pemphigus foliaceus),
• anti -Bull ous Pemphigoid 180 (anti-BP180 or anti-collagen XVII) antibody and anti-Bullous Pemphigoid 230 (anti-BP230) antibody (both associated with bullous pemphigoid),
• antibodies against the noncollagenous domain 1 of the 3 chain of type IV collagen (anti-α3 NCI antibody) and against the noncollagenous domain 1 of the 5 chain of type IV collagen (anti-α5 NCI antibody) (both associated with anti-GBM disease),
• anti-phospholipase A2 receptor (anti-PLA2R) antibody (associated with idiopathic membranous nephropathy),
• anti-proteinase 3 (anti-PR3) antibody and anti- Myeloperoxidase (anti-MPO) antibody (both associated with ANCA-associated vasculitis),
• anti-double stranded(ds)-DNA antibody, antibody against anti-Sjogren's- syndrome-related antigen A (anti-SSA/Ro antibody) and anti-Sjogren's- syndrome-related antigen B (anti-SSB/La antibody), anti-Smith antibody, anti-ribonucleoprotein (anti-RNP) antibody, anti-complement Clq antibody, anti-proliferating cell nuclear antigen (PCNA) antibody, anti-cardiolipin antibody, anti-beta2 glycoprotein antibody, anti-granzyme B antibody, and anti-nucleosome antibody (all associated with systemic lupus erythematosus),
• anti-nuclear antibody (associated with systemic lupus erythematosus, systemic sclerosis and autoimmune hepatitis),
• rheumatoid factor, anti-citrullinated peptide antibody (ACPA), anti-CarP antibody, and anti-acetylated peptide antibody (AAPA) (all associated with rheumatoid arthritis),
• anti -centromere antibody (ACA), anti-Scl-70 antibody, anti-endothelial cell antibody (AECA), angiotensin II type- 1 -receptor (anti -AT 1R) antibody, and anti-endothelin-1 type A receptor (anti-ETAR) antibody (all associated with systemic sclerosis), • anti-signal recognition particle (anti-SRP) antibody (associated with immune- mediated necrotizing myopathy and polymyositis),
• anti-HMG-CoA reductase (anti-HMGCR) antibody (associated with immune- mediated necrotizing myopathy),
• anti-Jo- 1 antibody, anti-PL-7 antibody, anti-PL-12 antibody, anti-EJ antibody, anti-OJ antibody, anti-Mi-2- antibody, anti-U3 ribonucleoprotein (anti-U3 RNP or anti-fibrillarin) antibody, anti-U2 ribonucleoprotein and (anti-U2 RNP) antibody (all associated with polymyositis),
• anti-Ku antibody (associated with systemic lupus erythematosus and polymyositis),
• anti-nuclear matrix protein 2 (anti-NXP-2) antibody, anti-Mi2 antibody, antimelanoma differentiation-associated protein 5 (anti-MDA5) antibody, and anti-transcription intermediary factor 1 -gamma (anti-TIFly) antibody (all associated with dermatomyositis),
• anti -acetyl choline receptor (anti-AChR) antibody, anti-muscle-specific kinase (anti-MuSK) antibody, and anti-lipoprotein-related protein 4 (anti-LRP4) antibody (all associated with myasthenia gravis),
• anti-neurofascin-155 (anti-Nfascl 55) antibody, anti-neurofascin-140/186 (anti-Nfascl40/186) antibody, anti -contactin- 1 (anti-CNTNl) antibody, and anti contactin-associated protein-like 1 (anti-Casprl) antibody (all associated with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)),
• anti-ganglioside GM1 (anti-GMl) antibody, anti-ganglioside GTla (anti- GTla) antibody, and anti-ganglioside GDla (anti-GDla) antibody (all associated with Guillain-Barre syndrome),
• anti-ganglioside GQlb (anti-GQlb) antibody (associated with Guillain-Barre syndrome and Miller Fisher syndrome),
• anti-aquaporin-4 (anti-AQP4) antibody (associated with neuromyelitis optica spectrum disorders),
• anti -NMD AR antibodies (associated with systemic lupus erythematosus and autoantibody-positive autoimmune encephalitis),
• anti -contactin-associated protein-like 2 (anti-Caspr2) antibody, anti-gamma- amino butyric acid receptor type B (anti-GABAbR) antibody, anti-leucine- rich glioma-inactivated 1 (anti-LGIl) antibody, and anti-Kelch-Like Protein 11 (anti-Klhl 1) antibody (all associated with autoantibody-positive autoimmune encephalitis),
• anti-β32 glycoprotein I (anti-β2GPI) antibody, and anti-phospholipid antibody (both associated with primary antiphospholipid syndrome),
• anti-FcyRIIIb antibody and anti-CD177 antibody (both associated with Primary Autoimmune Neutropenia),
• anti-smooth muscle actin (anti-SMA) antibody and anti-liver-kidney microsomal (anti-LKM) antibody (both associated with autoimmune hepatitis),
• anti-ADAMTS13 antibody (associated with idiopathic thrombotic thrombocytopenic purpura),
• anti-platelet GP Ilb/IIIa antibody and anti-platelet GP Ib/IX antibody (both associated with idiopathic immune thrombocytopenic purpura),
• thyroid stimulating hormone (TSH)-binding inhibitor immunoglobulin (TBH), thyroid-stimulating immunoglobulins (TSI), thyrotropin-binding inhibitory (TBI) antibody, and anti-insulin-like growth factor 1 receptor (anti- IFG1R) antibody (all associated with Graves’ disease and thyroid eye disease),
• anti-thyroid peroxidase (anti-TPO) antibody (associated with Autoimmune Thyroiditis/Hashimoto’s Thyroiditis),
• anti-thyroglobulin antibody (associated with Graves’ Disease),
• islet cell cytoplasmic autoantibody (ICA), glutamic acid decarboxylase autoantibody (GADA), insulinoma-associated-2 autoantibody (IA-2A), and insulin autoantibody (IAA) (all associated with Type 1 diabetes),
• neutralizing anti-adenovirus antibody, neutralizing anti-lentivirus antibody, neutralizing anti-AAVl, AAV2, AAV3 AAV4, AAV5, AAV6, AAV7, AAV8, and/or AAV9 antibody (associated with prior gene therapy), and
• anti -granulocyte-macrophage colony stimulating factor (anti-GM-CSF) antibody (associated with acquired pulmonary alveolar proteinosis (PAP).
[00153] In some embodiments, administration to a human subject (e.g., subcutaneous or chronic subcutaneous administration to a human) of an effective amount of the anti-FcRn antibody described herein decreases proteinuria in a subject having lupus nephritis by at least about 40%, 50%, 65% or 80%, as measured by the levels of protein in the urine of the subject. [00154] The preferred dosage of the pharmaceutical composition may vary depending on the condition and body weight of the patient, the severity of the disease, the form of the drug, the route and duration of administration, but may be appropriately selected by one of ordinary skill in the art. In the pharmaceutical composition for the treatment or prevention of an autoimmune disease of the present disclosure, the active ingredient may be included in any amount (effective amount) depending on the use, formulation, purpose of combining, and the like, as long as it may exhibit therapeutic activity for an autoimmune disease, or in particular, a therapeutic effect on an autoimmune disease. A typical effective amount will be determined within the range of 0.001 % by weight to 20.0 % by weight based on the total weight of the composition. As used herein, the term "effective amount" refers to an amount of an active ingredient having an effect of treating or improving the state of an autoimmune disease, in particular, an amount of an active ingredient capable of inducing an effect of treating or improving the state of an autoimmune disease. Such an effective amount may be determined empirically within the ordinary ability of one of ordinary skill in the art. [00155] In one embodiment, the term "treatment" includes any form of administration or application for treating a disease in a mammal, including a human. In addition, the above term includes inhibiting or slowing the disease or its progression; restoring or repairing damaged or missing function, thereby partially or completely alleviating the disease; stimulating inefficient processes; or alleviating serious diseases. [00156] In another aspect, provided herein is a method of preventing an autoimmune disorder comprising administering to a subject in need thereof an effective amount of an anti- FcRn antibody or antigen-binding fragment thereof, or a pharmaceutical composition described herein. [00157] Any embodiment herein that refers to methods of treating an autoimmune disorder comprising administering an anti-FcRn antibody, an antigen-binding fragment thereof, or a pharmaceutical composition also encompasses use of the anti-FcRn antibody, an antigen- binding fragment thereof, or the pharmaceutical composition for preparation of a medicament for treating an autoimmune disorder. Likewise, any embodiment herein that refers to methods of preventing an autoimmune disorder comprising administering an anti-FcRn antibody, an the anti-FcRn antibody, an antigen-binding fragment thereof, or the pharmaceutical composition for preparation of a medicament for preventing an autoimmune disorder. [00158] Pharmacokinetic parameters such as bioavailability and underlying parameters such as clearance rate may also affect efficacy. Therefore, "improved efficacy" (for example, improvement in efficacy) may be attributed to improved pharmacokinetic parameters and improved efficacy, and may be measured by comparing parameters such as clearance rate and treatment or improvement of an autoimmune disease in a laboratory animal or human subject. [00159] As used herein, the term "therapeutically effective amount" or "pharmaceutically effective amount" refers to an amount of a compound or composition effective for preventing or treating a target disease, and means an amount that is sufficient to treat a disease with a reasonable benefit/risk ratio applicable to medical treatment and does not cause side effects. The level of the effective amount may be determined according to the patient's health condition, the type and severity of the disease, the activity of the drug, the sensitivity to the drug, administration method, administration time, the route of administration and excretion rate, treatment duration, factors including the combined or concurrently used drugs, and other factors well known in the medical field. In one embodiment, a therapeutically effective amount refers to an amount of a drug effective to treat an autoimmune disease. [00160] In this regard, the pharmaceutical composition may further comprise a pharmaceutically acceptable carrier. The pharmaceutically acceptable carrier may be any non-toxic material suitable for delivery to a patient. Distilled water, alcohol, fats, waxes and inert solids may be included as a carrier. In addition, a pharmaceutically acceptable adjuvant (buffer, dispersing agent) may be included in the pharmaceutical composition. [00161] Specifically, the pharmaceutical composition may include a pharmaceutically acceptable carrier in addition to an active ingredient and may be prepared as a parenteral formulation according to the route of administration by a conventional method known in the art. Here, "pharmaceutically acceptable" means that it does not inhibit the activity of an active ingredient and does not have toxicity beyond what a subject to be applied (prescribed) may tolerate. [00162] When the pharmaceutical composition is prepared as a parenteral formulation, it may be formulated in the form of injections, transdermal preparations, nasal inhalants and suppositories together with a suitable carrier according to methods known in the art. Formulation of a pharmaceutical composition is known in the art, and specifically, reference may be made to the literature [Remington's Pharmaceutical Sciences (19th ed., 1995)] and the like. The literature is considered a part of the present specification. [00163] The preferred dosage of the pharmaceutical composition may vary depending on the condition, body weight, sex, and age of the patient, the severity of the disease, the route of administration, and the like, and may be appropriately selected by one of ordinary skill in the art. [00164] A subject to which the pharmaceutical composition may be applied (prescribed) is a mammal and a human, particularly preferably a human. [00165] In another aspect of the present disclosure, there is provided a method for treating an autoimmune disease, comprising administering an effective amount of an antibody or an antigen binding fragment thereof that specifically binds to FcRn to a patient in need of treatment for an autoimmune disease. [00166] In another aspect of the present disclosure, there is provided a method for alleviating an autoimmune or alloimmune condition, comprising administering the anti-FcRn antibody or antigen binding fragment thereof to a subject in need thereof. In addition, there is provided a specific anti-FcRn therapy at the same time. [00167] The method or anti-FcRn therapy for alleviating an autoimmune or alloimmune condition according to the present disclosure may be achieved by administering the pharmaceutical composition according to the present disclosure to a subject. The pharmaceutical composition according to the present disclosure may be administered orally or parenterally. For example, it may be administered via a route of administration such as intravenous injection, subcutaneous injection, intramuscular injection, intraperitoneal injection, topical administration, intranasal administration, intrapulmonary administration, and intrarectal administration. In some embodiments, the pharmaceutical composition disclosed herein is administered subcutaneously. [00168] The preferred dosage of the pharmaceutical composition may vary depending on the condition and body weight of the patient, the severity of the disease, the form of the drug, the route and duration of administration, but may be appropriately selected by one of ordinary skill in the art, and may be administered once or repeatedly. [00169] In various embodiments of the therapeutic methods and uses disclosed herein, the antibody or antigen-binding fragment is administered to a patient as a fixed dose. In various embodiments of the therapeutic methods and uses disclosed herein, the antibody or antigen- on the patient’s bodyweight. In various embodiments of the therapeutic methods and uses disclosed herein, the antibody or antigen-binding fragment is administered to a patient as a body surface area-based dose, i.e., a dose dependent on the patient’s body surface area (BSA). In various embodiments, the dose administered to the patient comprises a therapeutically effective amount of the antibody or antigen-binding fragment. [00170] In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 300 mg to about 500 mg. In some embodiments, the antibody or antigen-binding fragment is administered to the patient subcutaneously at a dose of about 300 mg to about 500 mg, e.g., once weekly, once monthly, or once every 2 weeks, or once every 3 weeks. In some embodiments, the antibody or antigen-binding fragment is administered (e.g., subcutaneously) to the patient at a dose of about 300 mg, about 310 mg, about 320 mg, about 330 mg, about 340 mg, about 350 mg, about 360 mg, about 370 mg, about 380 mg, about 390 mg, about 400 mg, about 410 mg, about 420 mg, about 430 mg, about 440 mg, about 450 mg, about 460 mg, about 470 mg, about 480 mg, about 490 mg, or about 500 mg (e.g., once weekly, once monthly, once every two weeks, or once every three weeks). In some embodiments, the antibody or antigen-binding fragment is administered (e.g., subcutaneously) to the patient at a dose of at least or more than about 300 mg (e.g., once weekly, once monthly, or once every two weeks). In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 340 mg. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 340 mg once weekly, once monthly, or once every 2 weeks. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 340 mg once weekly. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 340 mg once weekly as a single subcutaneous injection. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 340 mg once weekly for at least 2 weeks (e.g., 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 10 weeks, 12 weeks, or longer). In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 340 mg once weekly for at least 4 weeks. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 340 mg once weekly for at least 7 weeks. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 340 mg once weekly for at least 12 [00171] In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 500 mg to about 700 mg. In some embodiments, the antibody or antigen-binding fragment is administered to the patient subcutaneously at a dose of about 500 mg to about 700 mg, e.g., once weekly, once monthly, once every two weeks, or once every three weeks. In some embodiments, the antibody or antigen-binding fragment is administered (e.g., subcutaneously) to the patient at a dose of about 500 mg, about 510 mg, about 520 mg, about 530 mg, about 540 mg, about 550 mg, about 560 mg, about 570 mg, about 580 mg, about 590 mg, about 600 mg, about 610 mg, about 620 mg, about 630 mg, about 640 mg, about 650 mg, about 660 mg, about 670 mg, about 680 mg, about 690 mg, or about 700 mg (e.g., once weekly, once monthly, once every two weeks, or once every three weeks). In some embodiments, the antibody or antigen-binding fragment is administered (e.g., subcutaneously) to the patient at a dose of at most or less than about 750 mg or 700 mg (e.g., once weekly, once monthly, or once every two weeks). In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 680 mg. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 680 mg once weekly, once monthly, or once every 2 weeks. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 680 mg once weekly. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 680 mg once weekly as two or more (e.g., two) consecutive subcutaneous injections. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 680 mg once weekly for at least 2 weeks (e.g., 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 10 weeks, 12 weeks, or longer). In some embodiments, the antibody or antigen- binding fragment is administered to the patient at a dose of about 680 mg once weekly for at least 4 weeks. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 680 mg once weekly for at least 7 weeks. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 680 mg once weekly for at least 12 weeks. In some embodiments, the administration is subcutaneous. [00172] In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 100 mg, about 150 mg, about 200 mg, about 300 mg, about 400 mg, about 450 mg, about 500 mg, about 600 mg, about 700 mg, about 800 mg, about 900 1500 mg, about 1600 mg, about 1700 mg, about 1800 mg, about 1900 mg, about 2000 mg, about 2100 mg, about 2200 mg, about 2300 mg, about 2400 mg, or about 2500 mg. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 100 mg, about 150 mg, about 200 mg, about 300 mg, about 400 mg, about 450 mg, about 500 mg, about 600 mg, about 700 mg, about 800 mg, about 900 mg, about 1000 mg, about 1100 mg, about 1,200 mg, about 1300 mg, about 1400 mg, about 1500 mg, about 1600 mg, about 1700 mg, about 1800 mg, about 1900 mg, about 2000 mg, about 2100 mg, about 2200 mg, about 2300 mg, about 2400 mg, or about 2500 mg intravenously. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 100 mg, about 150 mg, about 200 mg, about 300 mg, about 400 mg, about 450 mg, about 500 mg, about 600 mg, about 700 mg, about 800 mg, about 900 mg, about 1000 mg, about 1100 mg, about 1,200 mg, about 1300 mg, about 1400 mg, about 1500 mg, about 1600 mg, about 1700 mg, about 1800 mg, about 1900 mg, about 2000 mg, about 2100 mg, about 2200 mg, about 2300 mg, about 2400 mg, or about 2500 mg subcutaneously. [00173] In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose range between any of the dose values referenced herein. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose which is less than any of the dose values referenced herein. [00174] In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 100 mg, about 150 mg, about 200 mg, about 300 mg, about 400 mg, about 450 mg, about 500 mg, about 600 mg, about 700 mg, about 800 mg, about 900 mg, about 1000 mg, about 1100 mg, about 1,200 mg, about 1300 mg, about 1400 mg, about 1500 mg, about 1600 mg, about 1700 mg, about 1800 mg, about 1900 mg, about 2000 mg, about 2100 mg, about 2200 mg, about 2300 mg, about 2400 mg, or about 2500 mg once weekly (e.g., subcutaneously). [00175] In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 100 mg, about 150 mg, about 200 mg, about 300 mg, about 400 mg, about 450 mg, about 500 mg, about 600 mg, about 700 mg, about 800 mg, about 900 mg, about 1000 mg, about 1100 mg, about 1,200 mg, about 1300 mg, about 1400 mg, about 1500 mg, about 1600 mg, about 1700 mg, about 1800 mg, about 1900 mg, about 2000 mg, about 2100 mg, about 2200 mg, about 2300 mg, about 2400 mg, or about 2500 mg once every two weeks (e.g., subcutaneously). [00176] In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 100 mg, about 150 mg, about 200 mg, about 300 mg, about 400 mg, about 450 mg, about 500 mg, about 600 mg, about 700 mg, about 800 mg, about 900 mg, about 1000 mg, about 1100 mg, about 1,200 mg, about 1300 mg, about 1400 mg, about 1500 mg, about 1600 mg, about 1700 mg, about 1800 mg, about 1900 mg, about 2000 mg, about 2100 mg, about 2200 mg, about 2300 mg, about 2400 mg, or about 2500 mg once every three weeks (e.g., subcutaneously). [00177] In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 100 mg, about 150 mg, about 200 mg, about 300 mg, about 400 mg, about 450 mg, about 500 mg, about 600 mg, about 700 mg, about 800 mg, about 900 mg, about 1000 mg, about 1100 mg, about 1,200 mg, about 1300 mg, about 1400 mg, about 1500 mg, about 1600 mg, about 1700 mg, about 1800 mg, about 1900 mg, about 2000 mg, about 2100 mg, about 2200 mg, about 2300 mg, about 2400 mg, or about 2500 mg once monthly (e.g., subcutaneously). [00178] In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 300 mg, about 600 mg, about 900 mg, about 1200 mg, about 1500 mg, about 1800 mg, about 2100 mg or about 2400 mg. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 300 mg, about 600 mg, about 900 mg, about 1200 mg, about 1500 mg, about 1800 mg, about 2100 mg or about 2400 mg intravenously. In some embodiments, the antibody or antigen- binding fragment is administered to the patient at a dose of about 300 mg, about 600 mg, about 900 mg, about 1200 mg, about 1500 mg, about 1800 mg, about 2100 mg or about 2400 mg subcutaneously. In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 300 mg, about 600 mg, about 900 mg, about 1200 mg, about 1500 mg, about 1800 mg or about 2100 mg once weekly (e.g., subcutaneously). In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 300 mg, about 600 mg, about 900 mg, about 1200 mg, about 1500 mg, about 1800 mg, about 2100 mg or about 2400 mg once every two weeks (e.g., subcutaneously). In some embodiments, the antibody or antigen-binding fragment is administered to the patient at a dose of about 300 mg, about 600 mg, about 900 mg, about 1200 mg, about 1500 mg, about 1800 mg, about 2100 mg or about 2400 mg once every three weeks (e.g., subcutaneously). In some embodiments, the antibody or antigen- about 900 mg, about 1200 mg, about 1500 mg, about 1800 mg, about 2100 mg or about 2400 mg once monthly (e.g., subcutaneously). [00179] In some embodiments, the antibody is administered (e.g., subcutaneously) to the patient at a dose of about 150 mg, about 300 mg, about 450 mg, about 600 mg, about 900 mg, about 1200 mg, about 1500 mg, about 1800 mg, about 2100 mg, or about 2400 mg, or at any dose in between any two of these doses (e.g., administered at this dose once weekly subcutaneously, once in two weeks subcutaneously, once in three weeks subcutaneously, or once monthly subcutaneously). In some embodiments, the doses provided herein are suitable doses for administration to a human. [00180] In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once weekly or once monthly. In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once weekly for at least 1 week, at least 2 weeks, at least 3 weeks, at least 4 weeks, at least 5 weeks, at least 6 weeks, at least 7 weeks, at least 8 weeks, at least 9 weeks, at least 10 weeks, at least 12 weeks, at least 20 weeks, at least 24 weeks, at least 30 weeks, at least 40 weeks, at least 50 weeks, at least 60 weeks, at least 70 weeks, at least 76 weeks, at least 80 weeks, or longer. [00181] In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once in about two or three weeks. In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once every other week (i.e., once in two weeks) for at least 2 weeks, at least 4 weeks, at least 6 weeks, at least 8 weeks, at least 10 weeks, at least 12 weeks, at least 20 weeks, at least 24 weeks, at least 30 weeks, at least 40 weeks, at least 50 weeks, at least 60 weeks, at least 70 weeks, at least 76 weeks, at least 80 weeks, or longer. [00182] In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once in 3 weeks for at least 3 weeks, at least 6 weeks, at least 9 weeks, at least 12 weeks, at least 18 weeks, at least 21 weeks, at least 24 weeks, at least 30 weeks, at least 42 weeks, at least 48 weeks, at least 60 weeks, at least 72 weeks, at least 78 weeks, at least 81 weeks, or longer. [00183] In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once monthly for at least 1 month, at least 2 months, at least 3 months, at least 4 months, at least 5 months, at least 6 months, at least 7 months, at least 24 months, at least 30 months, at least 40 months, at least 50 months, at least 60 months, at least 70 months, at least 76 months, at least 80 months, or longer. [00184] In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once weekly for 6 to 76 weeks, or any time period in between. In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once weekly for at least 2 weeks, at least 3 weeks, at least 4 weeks, or at least 6 weeks. In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once weekly for at least 4 weeks. In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once weekly for at least 7 weeks. In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once weekly for at least 12 weeks. In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once weekly for at least 24 weeks. In some embodiments, the antibody, antigen-binding fragment, or pharmaceutical composition is administered to the patient once weekly for at least 52 weeks. [00185] In some embodiments, the antibody or antigen-binding fragment is administered to the patient at one or more doses (e.g., two or more different doses). For example, in some embodiments, the antibody or antigen-binding fragment is administered to the patient at two different doses, e.g., at least one higher dose, followed by at least one lower dose. A higher dose ( e.g., a higher dose of two different doses) may be referred to herein as an "induction" dose, i.e., a dose capable of reducing the level of at least one autoantibody and/or pathogenic antibody ( e.g., at least one IgG) in a patient and/or a sample from a patient. A lower dose (e.g., a lower dose of two different doses) may be referred to herein as a "maintenance" dose, i.e., a dose capable of maintaining the reduced level of at least one autoantibody and/or pathogenic antibody ( e.g., at least one IgG) in the patient and/or a sample from the patient following at least one induction dose of an antibody or antigen-binding fragment ( e.g., about 20-80% of pretreatment (pre-induction dose) values). In some embodiments, a maintenance dose maintains the level of at least one autoantibody and/or pathogenic antibody (e.g., at least one IgG) in the patient and/or a sample from the patient at about or less than 20%, about 25%, about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, or about 80% of pretreatment (pre-induction dose) [00186] In some embodiments, the induction dose and the maintenance dose are alternated, e.g., the patient may receive the induction dose for a first period of time followed by the maintenance dose for a first period of time, followed by the induction dose for a second period of time, optionally followed by the maintenance dose for a second period of time. In some embodiments, the cycle of induction and maintenance dose (administration of the induction dose for a period of time followed by administration of the maintenance dose for a period of time being one cycle) is repeated one twice, three times, four times, five times, six times seven times, or ten times. In some embodiments, the cycle of induction and maintenance dose is repeated for about 3 months, about 6 months, about 12 months, about 15 moths, about 18 months, about 24 months, or longer. [00187] In some embodiments, at least one higher dose and/or induction dose is about 680 mg per dose or more (e.g., about 680 mg, about 700 mg per dose, about 720 mg per dose, about 750 mg per dose, or more). In some embodiments, the at least one higher dose and/or induction dose is about one dose, about 2 doses, about 3 doses, about 4 doses, or about 5 doses at about 680 mg per dose or more (e.g., about 680 mg, about 700 mg per dose, about 720 mg per dose, about 750 mg per dose, or more). In some embodiments, the at least one higher dose and/or induction dose is about 3 doses at about 680 mg per dose or more (e.g., about 680 mg, about 700 mg per dose, about 720 mg per dose, about 750 mg per dose, or more). [00188] In some embodiments, the at least one higher dose and/or induction dose is administered to the patient once, once weekly, once every 2 weeks, or once monthly. In some embodiments, the at least one higher dose and/or induction dose is administered to the patient intravenously. In some embodiments, the at least one higher dose and/or induction dose is administered to the patient subcutaneously. In some embodiments, each higher dose is administered to the patient as one or more subcutaneous injections. In some embodiments, each higher dose is administered to the patient as two consecutive subcutaneous injections. [00189] In some embodiments, at least one lower dose and/or maintenance dose is about 340 mg per dose or more (e.g., about 340 mg, about 360 mg, about 380 mg, about 400 mg per dose or more). In some embodiments, the at least one lower dose and/or maintenance dose is about one dose, about 2 doses, about 3 doses, about 4 doses, or about 5 doses at about 340 mg per dose or more (e.g., about 340 mg, about 360 mg, about 380 mg, about 400 mg per dose or more). In some embodiments, the at least one lower dose and/or maintenance dose is about 3 about 400 mg per dose or more). In some embodiments, the at least one lower dose and/or maintenance dose is administered to the patient once, once weekly, once every 2 weeks, or once monthly. In some embodiments, the at least one lower dose and/or maintenance dose is administered to the patient subcutaneously. In some embodiments, each lower dose is administered to the patient as one or more subcutaneous injections. In some embodiments, each lower dose is administered to the patient as one subcutaneous injection. Examples [00190] Hereinafter, the present disclosure will be described in more detail by way of the following examples. However, the following examples are only for illustrating the present disclosure, and the scope of the present disclosure is not limited thereto. I. Design of variants to improve physical properties of HL161AN antibody [00191] For the purpose of improving stability through molecular engineering of HL161AN, Lonza's in silico tool and LC-MS/MS analysis were used to identify amino acid sites that could affect stability and to design variants. A schematic of the in silico design of the HL161AN variants is shown in FIG. 1. [00192] Therapeutic proteins, including antibodies, are present in a heterogeneous form due to post-translational modification (PTM) and chemical modification. Modification includes glycosylation, deamidation, oxidation, and the like, and is known to occur depending on the host cell system, production process, storage conditions, and the like. This modification is considered to be a major challenge during the production process of therapeutic proteins as it causes side effects such as decreased efficacy, limited shelf life, and immune response due to aggregation (De Groot 2006). [00193] HL161AN is an anti-hFcRn antibody in the form of modified human IgG 1 that has a high affinity for human FcRn (2×10 -10 M) and has a high PD effect in an in vivo study on cynomolgus monkeys. However, it has disadvantages that it has low thermal stability (about 58.4^), aggregation occurs at a concentration of 30 mg/mL or more, and many charge variants are identified in CEX-HPLC and cIEF analysis. Therefore, we found the PTM site and the major site for aggregation using an in silico tool based on the amino acid sequence and X-ray crystal structure analysis results, and we identified the modified site through LC- MS/MS analysis of the HL161AN sample. Thereafter, by combining the two results, we tried Example 1. In silico evaluation of aggregation risk and PTM risk [00194] The risk of aggregation and post-translational modification were predicted through in silico analysis. [00195] The aggregation of proteins is affected by environmental factors such as pH, concentration, buffer, excipient, shear-force, and the like, and intrinsic properties. In order to predict the risk of aggregation according to the amino acid sequence, Lonza's Sentinel APART™ database was used. This is a program validated based on the experimental results on the aggregation of more than 500 antibodies. When the sequence of the tested antibody is input, the risk of aggregation is predicted. The Sentinel APART algorithm predicted that HL161AN would have an increased aggregation risk. [00196] In addition, using the in silico tool developed by Lonza, the post-translational modification (PTM) as described below was predicted (FIGs 2 and 3). Specifically, the risk of the post-translational modification was performed in consideration of i) asparagine deamidation, ii) aspartic acid isomerization and fragmentation, iii) C-terminal lysine clipping, iv) Fc ADCC/CDC response, half-life and Protein A purification, v) free cysteine thiol group, vi) N-glycosylation, O-glycosylation, vii) oxidation, and viii) pyroglutamate formation, and the like. [00197] As a result of the HL161AN amino acid sequence analysis, the possibility of asparagine deamidation was predicted at 4 sites of the light chain (L) and 12 sites of the heavy chain (H). Most of them were conserved asparagines and were predicted to be low- risk, and 4 sites had the possibility of deamidation, but did not correspond to the CDR regions, so it was confirmed that protein engineering was not required. Accordingly, it was analyzed that only L:Asn25 of the light chain CDR region required protein engineering. [00198] In addition, a free cysteine thiol group results in protein misfolding, aggregation, non-specific tissue binding, immunogenicity, and potentially low productivity. As a result of confirming whether HL161AN has a free cysteine thiol group, a free thiol group was found in H:Cys32, and it was determined that protein engineering of this amino acid was necessary. Example 2. Analysis of PTM site through LC-MS/MS analysis [00199] The modification of deamidation and oxidation for 2 lots of HL161AN were analyzed by LC-MS/MS. As a result of peptide mapping using two enzymes, i.e., trypsin+Lys C mix and chymotrypsin, 100% sequence coverage was confirmed (FIG. 4). [00200] As a result of modification analysis, deamidation and oxidation were confirmed at 7 and 6 sites in the HL161AN in-house standard sample, respectively, and at 10 and 8 sites in the HL161AN B012 sample, respectively. [00201] The deamidation and oxidation sites of the HL161AN sample by LC-MS/MS are summarized and shown in Tables 2 and 3, respectively, below. [Table 2] Example 3. Selection of sites to be engineered [00202] Based on the in silico analysis results and LC-MS/MS results, the substitution amino acids for the three amino acid sites (L:Asn25, H:Cys32, H:Gln82) that are determined to require engineering were selected. From the X-ray crystallography structure analysis data, these three amino acid sites are far from the CDR region binding to the target antigen, so it was determined that the substitution would not affect the affinity (FIG. 5). In the selection of substitution of amino acids, it was determined that substitution with serine (Ser) or glutamine (Gln) for L:Asn25; serine (Ser) or tyrosine (Tyr) for H:Cys32; and serine (Ser), threonine (Thr), or glutamic acid (Glu) for H:Gln82 could reduce the risk of PTM. For each amino acid selection method, a chemically similar side chain substitution method was used, such as replacing asparagine with glutamine (Table 4). Based on these results, 2 light chains and 11 heavy chains were designed (Table 5). [00203] The suggested substitutions of the selected PTM sites are summarized and shown in Table 4 below, and the designed variants of HL161AN are summarized and shown in Table 5 below. [Table 4]
[00204] Combining the above series of results, it is as described below. [00205] For the purpose of improving stability through molecular engineering of HL161AN, Lonza's in silico tool and LC-MS/MS analysis were used to identify amino acid sites that could affect stability and to design variants through mutations. [00206] As a result, it was determined that the three amino acid sites (L:Asn25, H:Cys32, H:Gln82) of the HL161AN antibody required engineering. It was determined that substitution with serine or glutamine for L:Asn25; serine or tyrosine for H:Cys32; and serine, threonine, or glutamic acid for H:Gln82 could reduce the risk of PTM. A total of 22 HL161AN variants (2 light chains and 11 heavy chains of HL161AN variants) were designed by amino acid substitution.
[00207] Hereinafter, 22 variants were prepared by a site-directed mutagenesis method, and then antibodies with improved stability were screened through in vitro and in vivo evaluations.
IL In vitro screening of HL161AN antibody variants
[00208] HL 161 AN has excellent in vitrolin vivo pharmacological efficacy, but has disadvantages that it has poor physicochemical properties, so storage stability is poor, and high concentration SC (subcutaneous) formulation is difficult. In order to improve this, sites that could affect the stability of the antibody were determined as described above through the amino acid sequence and molecular structure analysis of HL161AN, and a total of 22 HL161 AN variants were prepared by engineering the derived amino acid sites (Table 6). Hereinafter, in vitro evaluation was performed by producing 22 obtained HL161AN variants.
Preparation Example 1. Preparation of test materials
Preparation Example 1.1. HL161AN reference standard sample (Reference
Standard, RS): control 1
- Lot No: HL161AN/16E11/ST01
- Concentration: 13 mg/mL
- Formulation buffer: 100 mM histidine, 100 mM arginine-HCl, pH 6.0
- Storage condition: < -60°C
Preparation Example 1.2. HL161AN variant plasmid
- 2 light chain mutations and 11 heavy chain mutations
- Storage condition: < -60°C
[00209] In the amino acid sequence of HL161 AN, two or more amino acids were substituted as shown in Table 6 below.
[Table 6]
Example 4. First in vitro evaluation of 22 HL161 AN variants
[00210] 22 HL161AN variants were evaluated in comparison with the control antibody HL161AN.
Example 4.1. Production of samples
[00211] One day before transfection, Expi293F cells were seeded in a 500 mL Erienmeyer flask at 1 x 10 6 cells/mL (100 mL volume) and then incubated in an incubator of 8% CO2, 125 rpm, 37°C conditions for 24 hours while shaking. On the day of transfection, the cell concentration was adjusted to 2 x 10 6 cells/mL, and then the cells were transfected with the plasmid DNA of each variant. The antibody plasmid was diluted to 1 pg/pL in LAL water (Lonza Bioscience). 0.12 mL of the heavy chain plasmid and 0.12 mL of the light chain plasmid were added to 5 mL of Opti-MEM SFM, respectively, and suspended. 0.24 mL of FectoPro was added to 5 mL of Opti-MEM SFM and suspended.
[00212] The plasmid DNA and FectoPro were mixed 1 : 1 and incubated at room temperature for 10 minutes, and then added to the flask containing the cells. It was incubated in an incubator of 8% CO2, 37°C conditions at 125 rpm for 3 hours while shaking, and then 100 μL of Booster was added to continue the culture. On the 6th day of culture, the culture solution was placed in a 250 mL centrifuge bottle and centrifuged at 3,000 rpm, for 15 minutes, and then only the supernatant was collected and filtered through a 0.2 pm bottle top filter. The expression level of the antibody in the recovered culture medium was quantified using a Cedex bioanalyzer. [00213] As a result, a total of 22 HL161AN antibody variants were transiently expressed using Expi293F cells. Transfection was carried out on a 100 mL culture scale to obtain an expression medium in an amount of 0.5 mg or more for each antibody, and the culture medium was harvested on the 6th day. The expression level in the obtained medium was 65- 181 mg/L (Table 7). The production results for 22 HL161AN variants are summarized and shown in Table 7 below. [Table 7] Example 4.2. Purification of antibodies
[00214] The purification of the sample was carried out by packing 1.5 mL of MabSelect SuRe™ LX resin into a Poly-prep® chromatography column. IX PBS (pH 7.4) was used as the binding buffer and the washing buffer, and the elution was carried out by fractionation by 1.5 mL using a 0.1 M glycine (pH 3.0) buffer. All fraction tubes were neutralized to pH 7.0 by adding 1 M Tris-HCl (pH 9.0) and then pooled. The pooled eluent was purified by buffer exchange with a citrate phosphate buffer (pH 8.0) and concentration to 1.0 mg/mL using a Millipore centricon (cutoff of 30 kDa). HL 161 AN RS was also used for in vitro evaluation by buffer exchange with a citrate phosphate buffer (pH 8.0) in the same manner as the HL161 AN variant. For each sample, the A280 value was measured using a Nanodrop, and the concentration was calculated. Based on the quantitative value, for each antibody, the status of the sample was confirmed by SDS-PAGE analysis.
[00215] As a result, the culture solution obtained by transiently expressing a total of 22 HL161AN antibody variants using Expi293F cells was purified by a Protein A column and concentrated to a concentration of 1.0 mg/mL. It was confirmed that the produced sample had a purity of 97% or more by SDS-PAGE and SEC-HPLC analysis (FIG. 6 and Table 7).
Example 4.3. SPR analysis
[00216] SPR (Surface plasmon resonance) analysis was performed under two conditions of pH 6.0 and pH 7.4 using Proteon XPR36 equipment. shFcRn (soluble human FcRn) was immobilized on a GLC chip, and the antibody samples were reacted at 5 concentrations, and then the sensogram results were obtained. Kinetic analysis was performed using a 1 : 1 Langmuir binding model, and the average KD value was obtained by repeating the analysis 6 times in each condition of pH 6.0 and pH 7.4.
[00217] Chip activation was performed under EDAC/NHS 0.5X, 30 μL/min, and 300 sec conditions. Thereafter, shFcRn was prepared at 2 pg/mL, 250 μL using an acetate buffer (pH 5.5), and immobilization was performed while flowing at 30 μL/min. The reaction was stopped when the immobilization level corresponded to 200 RU to 300 RU. Thereafter, deactivation was performed using ethanolamine at 30 μL/min, 300 sec. The antibody samples were prepared by serial dilution by 1/2 to 5 nM, 2.5 nM, 1.25 nM, 0.625 nM, and 0.312 nM based on a concentration of 10 nM. Sample dilution was performed using IX PBST (pH 7.4) or IX PBST (pH 6.0) buffer depending on the analysis pH In the sample analysis conditions, association was carried out by reaction at 50 μL /min, 200 sec, and dissociation was carried out by reaction at 50 μL/min, 600 sec. Thereafter, reaction was carried out using a glycine buffer (pH 2.0) at 100 μL /min, 18 sec to perform regeneration. For kinetic analysis, samples were prepared and reacted once in three cells to which shFcRn was immobilized. Then three kinetic values were obtained, and then an average KD value was measured. When analyzing reaction signals, interspot-referencing and signals in which only buffer was analyzed were used for a double-referencing.
[00218] As described above, SPR analysis was performed on 22 HL161AN antibody variants at pH 6.0 and pH 7.4. As a result, the HL161 AN variants exhibited a similar binding affinity compared to a binding affinity of HL161AN to shFcRn (1.16E-10 M (at pH 6.0) and
2.94E-10 M (at pH 7.4)) (FIG. 7 and Table 8).
[00219] The kinetic results of the HL161AN variants are summarized and shown in Table
8 below.
[Table 8]
Example 4.4. Analysis of hFcRn binding of antibody variants using FACS [00220] The analysis of hFcRn binding using FACS was carried out under two conditions of pH 6.0 and pH 7.4. hFcRn-expressing HEK293 (hFcRn HEK293) cells were diluted with the reaction buffer (0.05% BSA in PBS, pH 6.0 or pH 7.4) and prepared in duplicate in a 96 well plate at 1 x 10 5 cells for each sample. In addition, each antibody sample was diluted with the reaction buffer to 10 nM, and then put into a 96 well plate, and incubated at 4°C for 90 minutes. Thereafter, the plate was centrifuged to remove the supernatant, and then Alexa488- goat anti-hlgG Ab (1:200) was added thereto, and again incubated at 4°C for 90 minutes. After the reaction was completed, it was centrifuged to remove the supernatant, and 200 μL of the reaction buffer was added to resuspend the cell pellet, and then the MFI value was measured in a FACS instrument.
[00221] As described above, binding evaluation using FACS was carried out for 22 HL161AN antibody variants at pH 6.0 and pH 7.4. As a result, 22 HL161AN variants exhibited MFI values similar to those of HL161 AN (FIG. 8). Example 4.5. Analysis of hFcRn blocking ability of antibodies using FACS [00222] 1 X 10 7 hFcRn HEK293 cells were seeded into a T75 flask and cultured for 24 hours. After culturing, the cells were removed and placed in a 96 well plate at 1 x 10 5 cells for each sample in duplicate. Thereafter, each antibody sample (0.2, 2, 20, and 200 nM) and 100 nM Alexa488-hIgGl were added in a 1 : 1 ratio and incubated at 4°C for 90 minutes. After the reaction was completed, it was centrifuged to remove the supernatant. 200 μL of the reaction buffer was added to resuspend the cell pellet, and then the MFI value was measured in a FACS instrument. Each MFI value was converted into % blocking, and the EC 50 value was obtained by fitting with 4-PL.
[00223] As a result, blocking evaluation using FACS was carried out at 0.1 nM, 1 nM, 10 nM, and 100 nM. Each antibody blocked in a concentration-dependent manner, and it was confirmed that the EC 50 values were similar. Similar to the results of hFcRn binding analysis using FACS, it was confirmed that the EC 50 values of 22 HL161AN variants were similar to those of the control antibody HL161 AN. Accordingly, it was determined that the amino acid substitution did not affect the function of the HL161 AN variants (FIG. 9).
Example 4.6. Evaluation of stability
[00224] 200 μL of the purified sample was each aliquoted into a 1.5 mL tube, and then the samples were stored under accelerated conditions at 40°C for up to 4 weeks, and the samples at weeks 0, 1, 2, and 4 were analyzed by SEC-HPLC. Analysis of each sample was performed under the SEC-HPLC analysis conditions shown in Table 9 below, and the degree of stability under accelerated conditions was analyzed.
[Table 9]
55 [00225] The samples were stored under accelerated conditions at 40 ºC for up to 4 weeks and the stability of the samples was analyzed by SEC-HPLC. As a result, in the case of HL161 AN, aggregates were increased by 47.5% and fragments were increased by 4.8% in the sample at week 4 compared to the sample at week 0. On the other hand, the production rate of aggregates of 22 variants was 5.6% to 39.6%, which was reduced compared to HL161 AN, and the production rate of fragments was 3.2% to 12.3%, which was increased or similar to that of HL161AN (FIG. 10, FIG. 11, and Table 10).
[Table 10] Example 4.7. DSC analysis [00226] Differential scanning calorimetry (DSC) analysis was carried out using NANO DSC instrument (TA Instrument, PN:602000, SN: K10126), and the Tm values were analyzed with a two-state scaled model using NanoAnalyze software. DSC analysis was carried out by K Bio Health (Osong Medical Innovation Foundation, New Drug Development Support Center). [00227] The thermal stability of the HL161AN variants was analyzed. As a result, as shown in Table 11 below, the Tm value of HL161AN was 58.4^ and the Tm values of the HL161AN variants were 60^ to 61.5^. Therefore, it was confirmed that the Tm values of the HL161AN variants were increased by up to 2^ compared to HL161AN. [00228] The thermal stability of the HL161AN variants is summarized and shown in Table 11 below. [Table 11] [00229] The results of the first in vitro evaluation of 22 HL161AN variants described above are summarized and shown in Table 12 below. [00230] Evaluation of FcRn binding affinity/blocking and stability was carried out for a total of 22 HL161AN variants. As a result, it was confirmed that the binding affinity and blocking effect were similar to those of HL161AN, and all HL161AN variants had improved stability in terms of the production of aggregates compared to HL161AN. Accordingly, the top eight variants that had the reduced production rate of aggregates of less than 10% when lead molecule after preparing a high concentration sample and performing the second in vitro screening. [Table 12] 1) Transient expression level of Expi293F, >150 mg/L (+++), 100-150 mg/L (++), <100 mg/L (+) 2) hFcRn was immobilized on a chip and reacted with an antibody. 3) Increase rate (%) of aggregates at pH 8.0 and 40º by SEC-HPLC Example 5. Second in vitro evaluation of high concentration samples of eight HL161AN variants [00231] The eight high concentration HL161AN variants and the control antibody HL161AN were evaluated. Example 5.1. Production of samples [00232] The culture method for producing a high concentration sample is the same as the method of Example 4.1, and in order to obtain 120 mg or more of the antibody, 1 L or more for each antibody variant was cultured. Example 5.2. Purification of antibodies [00233] The purification method of the sample is the same as in Example 4.2, and the eluent was buffer exchanged with a 50 mM histidine buffer (pH 5.0) and concentrated to a concentration of about 150 mg/mL to complete purification. In the case of HL161AN RS, in the same manner as in the HL161AN variants the eluent was buffer exchanged with a 50 mM histidine (pH 5.0) and concentrated to a concentration of about 150 mg/mL to obtain the sample. For each antibody sample, the concentration was calculated using a Nanodrop, and SDS-PAGE analysis was performed based on this to confirm the sample status. Example 5.3. Production of high concentration samples of HL161AN variants [00234] The eight HL161AN variants selected in the first in vitro evaluation were transiently expressed in Expi293F cells in the same manner as in Example 5.1 and Example 5.2 above and purified to prepare to a concentration of 150 mg/mL or more. HL161AN was used by concentrating the standard product to a high concentration. All samples were analyzed by A280 and SEC-HPLC after production (Table 13), and it was confirmed that all samples except for variant No. 2 and variant No. 13 had high purity of 98% or more. In the case of variant No.2 and variant No. 13, precipitate was observed during the concentration process, and the SEC-HPLC purity was confirmed to be as low as about 93% (Table 13). [Table 13] Example 5.4. Analysis of hFcRn binding of antibodies using FACS [00235] It was performed in the same manner as in Example 4.4. For the eight high performed at pH 6.0 and pH 7.4 using FACS. As a result, the eight HL161 AN variants showed the MFI values similar to those of HL161AN (pH 6.0: 2952, pH 7.4: 7155) (FIG. 12).
Example 5.5. Analysis of hFcRn blocking of antibodies using FACS
[00236] It was performed in the same manner as in Example 4.5. The evaluation of hFcRn blocking was performed at 0.1 nM, 1 nM, 10 nM, and 100 nM using FACS. Each antibody blocked in a concentration-dependent manner, and the EC 50 value was similar to that of the control antibody HL161 AN (FIG. 13).
Example 5.6. Evaluation of stability
[00237] It was performed in the same manner as in Example 4.6. In order to evaluate the stability of the eight high concentration HL161AN variants, the change in purity of the samples stored at 40°C for 4 weeks was confirmed by SDS-PAGE and SEC-HPLC. In the case of HL161 AN, the production rate of aggregates was 50% or more when stored for 4 weeks, which was also confirmed by SDS-PAGE (FIG. 14). In the case of the eight HL161AN variants, it was confirmed that the production rate of aggregates was 8.4% to 25.7%, which was improved compared to HL 161 AN, and the production rate of fragments was 3.5% to 4.4%, which was similar to that of HL161 AN (4.1%) (FIG. 15).
Example 5.7. Analysis of viscosity
[00238] The VROC chip was mounted on the main body of the viscometer (m-VROC system), and then about 300 μL of each of the high concentration HL161AN RS control sample and the HL161 AN variant samples was loaded into a syringe. The VROC chip was connected to a syringe, and when it was stabilized at the set temperature of 25°C, the viscosity was measured by repeating three times.
[00239] The viscosity of HL161 AN, a control substance, and the four high concentration
HL161 AN variants, which had sufficient sample volume, was analyzed. The viscosity of the buffer (50 mM histidine) was measured to be 0.93 cP. The average viscosity of the four HL161AN variants was measured to be 5.57 cP to 7.65 cP, which was less than a viscosity capable of subcutaneous (sc) administration (< 20cP) (Table 14). The viscosities of the four high concentration HL 16 IAN variants are summarized and shown in Table 14 below. [Table 14] [00240] The results of the second in vitro evaluation of the high concentration (150 to 170 mg/mL) samples of the eight HL161AN variants described above are summarized and shown in Table 15 below. [00241] For the eight HL161AN variants selected in the first in vitro evaluation, 150 mg/mL to 163 mg/mL high concentration samples were prepared, and FcRn binding/blocking and stability were measured to select lead molecules. As a result, HL161AN variant No. 1 and variant No. 12, which had FcRn binding/blocking similar to that of HL161AN and improved stability, were selected as lead molecules (Table 15). [Table 15] Example 6. Conclusion of in vitro screening of HL161AN antibody variants [00242] For in vitro evaluation of 22 HL161AN variants designed to improve the physical properties of HL161AN, a total of 22 HL161AN variants were produced and FcRn binding affinity/blocking and stability were measured. As a result, all 22 variants showed bioactivity similar to that of HL161AN, and the top eight variants with improved stability were first selected. The high concentration samples (150 mg/mL to 163 mg/mL) of the selected eight variants were prepared and the evaluation of stability was performed. As a result, all eight HL161AN variants showed bioactivity similar to that of HL161AN and had improved stability compared to HL161AN. [00243] The light chain N25S mutation was added in the HL161AN variants No. 1, 2, 8, and 11, and the N25Q mutation was added in the variants No. 12, 13, 19, and 22. However, there was no difference in stability between the two groups. In the case of the heavy chain, C32 was further mutated to S or Y, and Q82 was further mutated to S, T, or E. However, in all variants, the production rate of aggregates was reduced by at least 2-fold compared to the control group HL161AN. In particular, when C32 was mutated to S, the production rate of aggregates (10% or less) was reduced by more than 5 times compared to HL161AN, and the stability was the most improved compared to other variants (FIG. 16). Accordingly, HL161AN variant No. 1 (LC:N25S, HC:C32S; HL161ANS) and variant No. 12 (LC:N25Q, HC:C32S; HL161ANQ), which had the production rate of aggregates of 10% or less, were finally selected as lead molecules.
HL Evaluation of hlgG catabolism of HL161AN antibody variants using hFcRn transgenic mice
[00244] The in vivo hlgG catabolism efficacy of three HL161 AN variants engineered to improve stability was evaluated using hFcRn transgenic (Tg) 32 mice.
[00245] The test material for the hlgG catabolism test of anti-FcRn antibody (HL161 AN) variants using hFcRn transgenic mice was prepared as follows. The test substance information is shown in Table 16. The three HL161 AN variants, HL161 ANS-IgGILALA , HL161ANQ-IgGlLALA and HL161ANQ-IgG4S228P, were diluted with the buffer shown in Table 16 below to prepare 2 mg/mL. 10 mL to be administered to 5 animals was prepared, divided into 4 doses of 2.5 mL/day, and stored at <-60°C until administration.
[Table 16]
[00246] In addition, HL161 AN, a comparative substance, was prepared as shown in Tab e
17. HL161AN was diluted with a 50 mM histidine (pH 5.9) dilution buffer to prepare 2 mg/mL. 10 mL to be administered to 5 animals was prepared, divided into 4 doses of 2.5 mL/day, and stored at <-60°C until administration. [Table 17]
00247] As a control substance, IV-Globulin SN Inj. (IVIG), a product commercially available from GC Biopharma, was used. Product information is shown in Table 18. Specifically, 0.4 mL of 50 mg/mL of IV-Globulin Inj. was diluted to a concentration of 2 mg/mL by adding 9.6 mL of PBS (pH 7.4), and divided into 4 doses of 2.5 mL/day, and stored at 4°C for up to 4 days until administration.
[Table 18]
00248] In addition, the tracer was prepared by mixing 495 mg/kg of total hlgG and 5 mg/kg of biotin-hlgG. Specifically, total hlgG was prepared at a concentration of 49.5 mg/mL in order to administer 495 mg/kg of IV-Globulin Inj. by adding 0.2 mL of PBS (pH 7.4) to 19.8 mL of 50 mg/mL of IV-Globulin Inj. In addition, biotin-hlgG was prepared by adding 267 μL of 10 mM biotin to 20 mg of IV-Globulin Inj., followed by incubation at room temperature for 30 minutes. Thereafter, in order to remove free biotin, the sample was transferred to a dialysis bag, and dialysis was performed with IX PBS (pH 7.4). The biotin- labeled hlgG was quantified by measuring absorbance at UV280 nm (IgG El%=14.0 at 280 nm).
Example 7. Animal experimental method
[00249] The stocked mFcRn' / 'hFcRn transgenic (Tg) 32 mice (Jackson Laboratory, USA) (male, 5-10 weeks old) were identified by marking the number on the tail and putting 5 mice in each cage. After enrollment, they were acclimatized for 1 to 2 weeks. In addition, the sample substances were administered by dividing the groups as shown in Table 19 below. [Table 19] * Five animals per group were administered, including one animal in each group as a spare. 1) Vehicle: 50 mM histidine, pH 5.9 2) i.p.: intraperitoneal injection [00250] Specifically, as a tracer, 495 mg/kg of total hIgG and 5 mg/kg of biotin-hIgG were intraperitoneally administered (i.p.) at a dose of 10 mL/kg, and the administration time was set to 0 hours. In addition, the test substances HL161ANS (IgG1-LALA), HL161ANQ (IgG1-LALA), and HL161ANQ (IgG4 S228P), the comparative substance HL161AN, and the control substance vehicle and IVIG were intraperitoneally administered 4 times at a dose of 20 mg/kg on 24, 48, 72, and 96 hours after tracer administration. [00251] Thereafter, the administration time of the tracer was set to 0 hours, and then blood was collected after 24, 48, 72, 96, 120, and 168 hours. The test substance, comparative substance, and control substance were administered at 24, 48, 72, and 96 hours. In this case, blood was first collected, and then administration was performed. The mice were anesthetized using an respiratory anesthesia device, and then blood was collected from the orbital venous plexus using a micro-hematocrit capillary tube. [00252] About 0.2 mL of whole blood was centrifuged at 3000 rpm for 15 minutes. Thereafter, the obtained serum was transferred to a 1.5 mL microcentrifuge tube and stored at ≤ ~60º until analysis. Example 8. Confirmation of degree of catabolism of biotin-hIgG tracer through ELISA analysis [00253] The degree of catabolism of the biotin-hIgG tracer in the body was confirmed [00254] Specifically, dilution solution/blocking buffer (assay diluent (AD), 1% BSA in 1XPBS, pH 7.4): 10 g of Probumin® was dissolved in 900 mL of IX PBS (pH 7.4), adjusted to a final volume of IL, filtered through a 0.2 pm filter, and then stored at 4°C. In addition, the standard stock (500 ng/mL biotin-hlgG) was prepared by mixing 10 μL of biotin-hlgG (4 mg/mL) with 990 μL of PBS to obtain 40 pg/mL. Thereafter, 750 μL of the dilution solution was mixed with 250 μL of 40 pg/mL of biotin-hlgG to prepare 10 pg/mL. 500 ng/mL of the standard stock was prepared by mixing 50 μL of 10 pg/mL of biotin-hlgG with 950 μL of the dilution solution, and then aliquoted by 50 μL . The aliquoted standard stock was stored at - 80°C. In addition, the neutral avidin was used by diluting 10 μL of 2 mg/mL of neutral avidin with 10 mL of IX PBS to 2 pg/mL.
[00255] Thereafter, the samples of the vehicle and IVIG groups were all diluted 1 : 10,000 using a dilution solution to prepare analysis samples. Except for the HL 161 ANS (IgGl- LALA) group, samples of 24, 48, and 72 hr were diluted l;10,000, and samples of 96, 120, and 168 hr were diluted 1:1,000. In the case of the HL161 ANS (IgGl-LALA) group, only the sample of 168 hr was diluted 1 : 1,000, and all samples at the other time points were diluted 1 : 10,000. The diluted samples were loaded in duplicate at 100 μL per well and incubated at room temperature for 2 hours.
[00256] The concentration of biotin-hlgG in the blood administered at 0 hours was measured at 24, 48, 72, 96, 120, and 168 hours after administration of HL161 ANS (IgGl- LALA), HL161ANQ (IgGl-LALA), HL161 ANQ (IgG4S228P), HL161AN, and IVIG at 20 mg/kg by ELISA. As a result, the other test groups showed a significant decrease in biotin- hlgG over time compared to the vehicle and IVIG administration group. On the other hand, there was no significant difference between the three HL161 AN variants and HL161AN. Among the three variants, HL161ANQ (LC:N25Q, HC:C32S)-IgGl-LALA showed a relatively high effect on biotin-hlgG catabolism. However, there was no statistical significance and thus it was determined to be a similar effect (Table 20, Table 21, and FIG. 17).
[00257] The concentrations of biotin-hlgG after administration of the HL161AN variants at 20 mg/kg are summarized and shown in Table 20 below.
[Table 20]
[00258] The biotin-hIgG catabolism results (% of 24 hours after tracer administration) of the HL161AN variants in Tg32 mice are summarized and shown in Table 21 below. [Table 21] Example 9. Calculation of half-life of biotin-IgG tracer through pharmacokinetic (PK) analysis [00259] The biotin-hIgG ELISA quantitative analysis results were used to calculate the half-life of tracer after administration of each test substance with BA calc (2007, Korea). Specifically, using the ELISA analysis results, the half-lives from 24 hours to 120 hours after tracer administration were calculated for the three HL161AN variants (Table 16), the comparative substance, and the control substance. [00260] As a result, as shown in Table 22, the half-lives were 22.7±9.0 hours for HL161ANS (IgG1-LALA), 15.9±0.9 hours for HL161ANQ (IgG1-LALA), and 17.8±2.6 hours for HL161ANQ (IgG4S228P). The half-life of the comparative substance HL161AN was 20.6±3.6 hours, which was confirmed to be equivalent to those of the three HL161AN variants. In addition, the half-lives of vehicle and IVIG were 108.2±29.0 hours and 98.0±16.8 hours, respectively, which were confirmed to be similar. The results of the half-life analysis of biotin-hIgG after administration of the HL161AN variants in Tg mice are summarized and shown in Table 22 below. [Table 22] Group name T 1/2 ( hr) Vehicle 108.3±29.0 HL161ANS (IgG1-LALA) 22.7±9.0 HL161ANQ (IgG1-LALA) 15.9±0.9 HL161ANQ (IgG4D228P) 17.8±2.6 HL161AN 20.6±3.6 IVIG 98.0±16.8 Example 10. hIgG catabolism of HL161AN antibody variants in hFcRn transgenic mice [00261] The effect of hIgG catabolism was confirmed after administration to Tg32 mice at 20 mg/kg for the three HL161AN variants engineered to increase the stability of HL161AN. As a result, it was confirmed that HL161ANS (IgG1-LALA), HL161ANQ (IgG1-LALA), and HL161ANQ (IgG4S228P) had the effect of hIgG catabolism equivalent to that of the comparative substance HL161AN. [00262] In conclusion, it was confirmed that HL161ANS (light chain: N32S, heavy chain: C32S) and HL161ANQ (light chain: N32Q, heavy chain: C32S), which are substances in which two amino acids are substituted in order to increase stability among the variable domains of HL161AN, had the in vivo IgG catabolism effect similar to that of the original molecule HL161AN. That is, it was confirmed that the three HL161AN variants engineered to increase stability did not affect the in vivo efficacy compared to the existing HL161AN. Example 11. Conclusion of hIgG catabolism by administration of anti-FcRn antibody (HL161AN) variants in hFcRn transgenic mice [00263] In order to evaluate the effect of HL161AN and HL161AN variants (HL161ANS administration to Tg32 mice at 20 mg/kg, and the concentration of biotin-hIgG in the blood was confirmed. [00264] As a result, in the case of biotin-hIgG, a similar biotin-hIgG catabolism effect was confirmed for all three administered substances. All test substances (HL161AN, HL161ANS, and HL161ANQ) reduced the concentration of biotin-hIgG by 90% or more within 120 hours after administration compared to the IVIG control group. [00265] In conclusion, it was confirmed that the hIgG catabolism effect of HL161ANS and HL161ANQ was not significantly different from that of HL161AN through the hIgG catabolism test. Example 12: Comparison of Antibodies HL161ANS and Batoclimab [00266] In this head-to-head study in monkeys, the HL161ANS variant (also referred to as IMVT-1402) was compared to another anti-FcRn antibody, Batoclimab (HL161BKN, see, e.g., International Patent Application Publication No. WO/2015/167293). [00267] 20 monkeys in four groups were dosed intravenously with 50 mg/kg batoclimab, 5 mg/kg HL161ANS, 50 mg/kg HL161ANS, or placebo. IgG, albumin and low-density lipoprotein (LDL) and cholesterol) were measured at the indicated time points. Cynomolgus monkeys are known to be reliable pharmacodynamic proxy for anti-FcRn mediated impacts on IgG (see, e.g., Lledo-Garcia, et al., UCB Pharma, 2022). [00268] At comparable doses, IgG lowering was nearly identical for batoclimab and HL161ANS (FIG. 18). The IgG lowering effect was dose-dependent. HL161ANS and placebo demonstrated similar impacts on albumin, LDL, and cholesterol (FIGs. 19A-19C, respectively). Thus, there was no substantial effect of HL161ANS on albumin, LDL or cholesterol levels. Example 13: A 4-Week Intravenous Exploratory Pharmacology Study Followed by a 4-Week Recovery Period in Cynomolgus Monkeys [00269] The objective of the study was to determine the pharmacology, toxicity and toxicokinetic (TK) profile of the test item, HL161ANS, following the once weekly intravenous injection administration to the cynomolgus monkey for 4 weeks (on Days 1, 8, 15 and 22) and to assess the persistence, delayed onset or reversibility of any changes following a 4-Week recovery period. [00270] The test, positive control and control/vehicle items were administered to groups of monkeys once weekly by intravenous injection administration (over approximately 60 seconds) on Days 1, 8, 15 and 22 as described in Table 23 below: [Table 23] a: Control/Vehicle animals were administered the control/vehicle item (20 mM Histidine, 200 mM Arginine, pH 6.0, 2% w/v PS-20). b: Group 2 animals were administered the positive control item only. [00271] Following completion of the last weekly dosing cycle, all animals were observed for 4 weeks and then animals of Groups 1, 3 and 4 were euthanized and subjected to a necropsy examination on Day 57. [00272] Parameters monitored during this study included mortality, clinical observations and body weights. In addition, clinical pathology parameters (hematology, coagulation, clinical chemistry and urinalysis) were evaluated. Blood sampling was performed for toxicokinetic, ApoB, IgG and ADA evaluation. A necropsy was performed and tissues were collected for possible histopathological examination. [00273] No mortality or HL161ANS related clinical signs were noted. [00274] No test item related effects were noted on body weights, hematology, coagulation, clinical chemistry and urinalysis. [00275] Splenic mottling at 5 and 50 mg/kg of HL161ANS and a higher incidence of small thymus at 50 mg/kg was noted. As no microscopic examination was performed the toxicological significance of these findings could not be determined. [00276] In conclusion, the once weekly intravenous administration for four weeks (Days 1, 8, 15 and 22) of HL161ANS to the cynomolgus monkey at 5 and 50 mg/kg was well tolerated. Example 14: A 6-Week Subcutaneous and/or Intravenous Injection Toxicity and Toxicokinetic Study with HL161ANS in Cynomolgus Monkeys with a 9-Week Recovery Phase [00277] The purpose of this study was to evaluate the toxicity and determine the toxicokinetics of HL161ANS when administered twice weekly via subcutaneous and/or intravenous (slow bolus) injection to cynomolgus monkeys for at least 6 weeks (total of 13 dose intervals) and to assess the reversibility or persistence of any effects after a 9-week recovery phase. [00278] Male and female cynomolgus monkeys were assigned to six groups, and doses were administered as indicated in Table 24. Animals were dosed via subcutaneous (SC) injection (Groups 1 through 4) and/or intravenous (IV) - (slow bolus) injection (Groups 1, 5, and 6) on Days 1, 4, 8, 11, 15, 18, 22, 25, 29, 32, 36, 39, and 43 of the dosing phase at a volume of 1.3 mL/kg/dose. The vehicle control article/diluent was HL161ANS Formulation Buffer. Additionally, KLH was administered to each animal once on Day 14 of the dosing phase and once on Day 28 of the recovery phase via subcutaneous injection at a volume of 1 mL/dose. [Table 24] a Group 1 was administered vehicle control article only. b Animals were dosed at a volume of 1.3 mL/kg/dose. c Three animals/sex/group were designated as terminal animals, and 2 animals/sex/group in Groups 1, 4, and 6 were designated as recovery animals. [00279] Assessment of toxicity was based on mortality, clinical observations, body weights, qualitative food consumption, ophthalmic observations, electrocardiographic (ECG) measurements, dermal observations, neurobehavioral observations, respiration rate assessment, and clinical and anatomic pathology. Blood samples were collected for toxicokinetic, ADA, and immunotoxicology evaluations. [00280] Toxicokinetic parameters were generally similar in male and female monkeys (within 2-fold). With SC dosing, HL161ANS systemic exposures, as indicated by Cmaxand AUCo-72 values, increased with dose level. AUCo-72 assessments are limited insofar as this parameter could not be determined on Day 43 in any but the recovery animals in the 198.4 mg/kg/dose group, as terminal sacrifice occurred on Day 44. The increases were generally greater than proportional between doses of 50.0 and 198.4 mg/kg/dose. After repeated twice- weekly SC dosing, there was no observed serum accumulation in the 50.0 mg/kg/dose group from Day 1 to Day 22 based on combined-sex mean ARs, reflecting values in two individual female animals in the group that were considerably less than 1.0. Accumulation did occur at higher doses, with the extent of accumulation increasing with dose. Accumulation ratios for Cmaxand AUCo-72 values were 1.65 to 1.86 in the 100.0 mg/kg/dose group (Day 1 to Day 22) and 1.83 to 2.88 in the 198.4 mg/kg/dose group (Day 1 to Day 22 and Day 43). With IV dosing, HL161ANS Cmax and AUCo-72 values increased with dose level. The increases in AUCo-72 values were greater than proportional between doses of 50.0 and 198.4 mg/kg/dose. Dose proportionality assessments for Cmax after IV bolus administration indicated an approximately proportional increase with dose on Day 1 but were difficult to interpret on Days 22 and 43 due to the contributing effects of accumulation. After repeated twice-weekly IV dosing, serum accumulation, based on Cmax, was slight (50.0 mg/kg/dose) to modest (198.4 mg/kg/dose), with ARs of 1.11 to 1.23 and 1.40 to 1.63, respectively. For AUCo-72, combined-sex mean exposures in the 50.0 mg/kg/dose group decreased by one-half from Day 1 to Day 22 and remained the same through Day 43, with ARs of approximately 0.460; this reflects very low ARs in five of the six animals in this group. Modest increases in AUCo-72 were observed in the 198.4 mg/kg/dose IV group, with ARs of approximately 1.5. Positive anti-drug antibody (ADA) titers were observed in 35 of 38 (92.1%) HL161ANS -treated animals (1 animal at 100 mg/kg/dose SC and 2 animals at 198.4 mg/kg/dose IV were negative for ADA titers). HL161 ANS induced ADA may have impacted accumulation ratios on Days 22 and 43 as ARs tended to decline with increased ADA titers; the 50 mg/kg/dose group was more impacted than other groups.
[00281] On Day 30 of the dosing phase, one female administered 100 mg/kg/dose SC was sacrificed due to a thin body condition (body weight loss of 0.3 kg), a low body condition score, sunken eyes, decreased skin turgor, liquid feces, and a low body temperature (36.4°C). The animal was previously examined and treated for swelling and a laceration on the left foot on Day 23 of the dosing phase; however, the condition of this animal worsened. HL161ANS- related clinical pathology changes consisted of mildly to moderately decreased total protein and albumin concentrations. These changes were similar to those observed in animals that survived to the scheduled sacrifice and were likely exacerbated by the inflammatory response and clinical observations of liquid feces. [00282] Macroscopic observations included abnormal shape and compression of the cerebrum, which correlated microscopically with minimal dilatation of the brain stem, which was considered incidental. Minimally increased cellularity of myeloid precursors in the sternal bone marrow might have correlated with the inflammatory response related to the laceration on the digit. The cause of the moribund condition was undetermined based on microscopic observations, but the continuous liquid feces and digit wound that led to the decreased mobility and food consumption would have contributed to the moribund condition of this animal. Based on the available clinical observations and clinical and anatomic pathology results, this mortality was not associated with HL161ANS. No HL161ANS - related clinical observations; ophthalmic observations; body weight or food consumption alterations; respiration rate effects; dermal observations; ECG effects; effects on coagulation, urinalysis, or IgM and IgA titers; effects on CH50 levels; effects on immunity and lymphocyte subsets; organ weight differences; or macroscopic findings were noted. [00283] An increase in IgM titers was noted predose of Day 22 of the dosing phase, compared with predose of Day 1 of the dosing phase, in most controls and males and females administered ೈ50 mg/kg/dose HL161ANS. A subsequent decline in IgM titers was noted at predose and 1344 hours postdose of Day 43 of the dosing phase in females administered ೈ50 mg/kg/dose HL161ANS with values remaining comparable to controls. In HL161ANS- treated males, IgM titers predose on Day 43 of the dosing phase remained comparable to predose of Day 22 of the dosing phase, with a subsequent decline noted at 1344 hours postdose of Day 43 of the dosing phase. A decrease in IgG concentrations was noted predose of Day 4 of the dosing phase, compared with predose of Day 1 of the dosing phase, in all animals administered ೈ50 mg/kg/dose HL161ANS. Percent change of mean IgG concentrations for groups administered ೈ50 mg/kg/dose were approximately 48 to 76% below baseline values at Day 43 of the dosing phase, consistent with expected pharmacology. Mean IgG concentrations for each group increased starting on Day 15 of the recovery phase and returned to baseline levels by the end of the recovery phase. Increased IgG concentrations compared with predose Day 1 of the dosing phase were noted in two females administered 198.4 mg/kg/dose SC starting on Days 15 of the dosing phase following the decrease seen on Day 4 of the dosing phase. IgG concentrations remained high through Day 43 of the dosing phase for both animals followed by a decrease on Day 1 of the recovery phase. Increased IgG concentrations, compared with predose Day 1 of the dosing phase, was noted in one male administered 198.4 mg/kg/dose SC starting on Day 15 of the dosing phase following the decrease seen on Day 4 of the dosing phase. IgG concentrations remained high through Day 32 of the dosing phase followed by a decrease on Day 36 of the dosing phase. IgG concentrations decreased below baseline until Day 50 of the recovery phase. The increase in IgG concentration in one animal may be related to the vascular inflammation seen in various tissues at the microscopic examination. These variations from the group mean IgG concentrations are of unknown relationship with HL161ANS and/or ADA titers. [00284] Marginally increased C3a levels were observed on Day 43 of the dosing phase in animals administered 198.4 mg/kg/dose SC or IV, compared with control and baseline values, and were considered potentially related to HL161ANS due to the consistency between sexes and the small magnitude of change. C3a is an effector in the complement system and has various stimulatory functions on the immune system. HL161ANS-related effects in clinical chemistry test results consisted of minimally to mildly decreased total protein concentration on Day 43 of the dosing phase in animals administered up to 198.4 mg/kg/dose SC or IV. Minimally to moderately decreased albumin concentration was observed on Days 16 and/or 43 of the dosing phase in animals administered >50 mg/kg/dose SC, males administered >50 mg/kg/dose IV, and females administered 198.4 mg/kg/dose IV. Minimally decreased globulin concentration was observed on Day 43 of the dosing phase in males administered 50 or 100 mg/kg/dose SC or >50 mg/kg/dose IV and females administered 50 mg/kg/dose SC or IV. Males administered 50 mg/kg/dose IV exhibited evidence of reversibility of the albumin effect by Day 43 of the dosing phase, and all other effects in clinical chemistry test results for animals administered 198.4 mg/kg/dose SC or IV exhibited evidence of reversibility by Day 22 or 50 of the recovery phase. [00285] An HL161ANS-related effect in hematology test results was small in magnitude and consisted of minimally decreased absolute neutrophil count on Day 43 of the dosing phase in animals administered 198.4 mg/kg/dose IV. These effects exhibited evidence of reversibility by Day 22 or 50 of the recovery phase, except for in one male administered 198.4 mg/kg/dose IV. One female administered 198.4 mg/kg/dose SC was noted with correlated with microscopic findings of vascular inflammation and infiltrates of mononuclear cells. At the terminal sacrifice, the HL161ANS-related microscopic finding of vascular inflammation likely associated with immune complex-mediated damage was noted in the lung, liver, gall bladder, kidney, stomach, small and large intestines, tongue, heart, uterus, and Subcutaneous Injection Site E of one female administered 198.4 mg/kg/dose SC. The additional findings in this animal included minimal extramedullary hematopoiesis and slight hypertrophy of Kupffer cells of the liver and minimal hypertrophy of the tunica media in the lung vessels. No HL161ANS-related findings were noted at the recovery sacrifice. [00286] In conclusion, male and female cynomolgus monkeys were administered vehicle control article/diluent or 50, 100, 198.4 mg/kg/dose HL161ANS via SC and/or IV injection twice weekly for 6 weeks. Increased C3A levels were observed on Day 43 of the dosing phase in animals administered 198.4 mg/kg/dose SC or IV. This finding was reversible during the recovery phase. Clinical pathology changes included mildly decreased total protein concentration in both sexes administered up to 198.4 mg/kg/dose SC or IV; minimally to moderately decreased albumin concentration both sexes administered up to 198.4 mg/kg/dose SC, males administered ೈ50 mg/kg/dose IV, and females administered 198.4 mg/kg/dose IV; minimally decreased globulin concentration in males administered 50 or 100 mg/kg/dose SC or ೈ50 mg/kg/dose IV and females administered 50 mg/kg/dose SC or IV; and minimally decreased absolute neutrophil count in both sexes administered 198.4 mg/kg/dose IV. These findings were reversible during the recovery phase. [00287] HL161ANS-related microscopic findings included vascular inflammation in the lung, liver, gall bladder, kidney, stomach, small and large intestines, tongue, heart, uterus, and Subcutaneous Injection Site E of one female administered 198.4 mg/kg/dose SC. No HL161ANS-related findings were noted at the recovery sacrifice. Due to the systemic nature of the microscopic findings of animals administered 198.4 mg/kg/dose SC, effects for this dose were considered adverse. Due to the mild severity of the findings and the lack of an impact on the health and wellbeing of animals administered 100 mg/kg/dose SC or 198.4 mg/kg/dose IV, effects for these doses were considered nonadverse. Thus, the no observed adverse effect level (NOAEL) is 100 mg/kg/dose via SC injection and 198.4 mg/kg/dose via IV injection. The SC dose level corresponded to a mean maximum observed concentration (Cmax) value of 964 mg/L on Day 43 of the dosing phase and area under the concentration- time curve over a dosing interval (AUCtau or AUC0-72) value of 2290 mg/L on Day 22 of the dosing phase (it should be noted that the AUC0-72 on Day 43 was note able to be calculated since the terminal sacrifice was one day following the Day 43 dose). The IV dose level corresponded to a mean maximum observed concentration (Cmax) and area under the concentration-time curve over a dosing interval (AUC tau or AUC 0-72 ) values of 7100 mg/L and 10800 mg x day/L on Day 43 of the dosing phase. Example 15: Subcutaneous and/or Intravenous Injection Dose Range Finding Toxicity, Toxicokinetic, and Pharmacodynamic Study with HL161ANS in Cynomolgus Monkeys [00288] The purpose of this study was to evaluate the toxicity and determine the toxicokinetics (TK) and pharmacodynamics (PD) of HL161ANS when administered twice weekly via subcutaneous (SC) injection or once weekly via intravenous (IV, slow bolus) injection to cynomolgus monkeys for at least 6 weeks. [00289] Male and female cynomolgus monkeys were assigned to six groups, and doses were administered as indicated in the following table. Animals were dosed via intravenous and/or subcutaneous injection once or twice weekly at a volume of 1 mL/kg/dose. The vehicle control article/diluent was HL161ANS Formulation Buffer. IV = Intravenous; SC = Subcutaneous a Group 1 was administered vehicle control article only. On Days 1, 8, 15, 22, 29, and 36, subcutaneous administration was followed by intravenous administration. On Days 4, 11, 18, 25, 32, and 39, subcutaneous administration only. b Animals were dosed at a volume of 1 mL/kg/dose. [00290] Assessment of toxicity was based on mortality, clinical observations, body weights, food consumption, dermal observations, immunotoxicology, and clinical and anatomic pathology. Blood samples were collected for toxicokinetic evaluation and anti-drug antibody analysis. [00291] No HL161ANS-related deaths occurred and no HL161ANS-related clinical or dermal observations, alterations to body weight, body weight gain, or food consumption, organ weight differences, macroscopic observations, or microscopic findings were noted. [00292] HL161ANS-related clinical chemistry effects noted for animals administered 100 mg/kg/dose IV or SC were limited to minimally to mildly decreased albumin concentration noted for individual animals. The decreased albumin was more consistently noted on Day 15 or 22 through 50 for animals administered 100 mg/kg/dose SC whereas it was mostly noted on Days 36 and 43 of the dosing phase for animals administered 100 mg/kg/dose IV. A mechanism was not known for decreased albumin. [00293] In conclusion, male and female cynomolgus monkeys were administered HL161ANS formulation buffer (vehicle control) via subcutaneous injection twice weekly and intravenous injection once weekly or 3, 10, or 100 mg/kg/dose HL161ANS via once weekly intravenous injection or 100 mg/kg/dose HL161ANS via twice weekly subcutaneous injection. HL161ANS was well tolerated at all dose levels and all dose routes. No HL161ANS-related deaths occurred and no HL161ANS-related clinical observations, alterations to body weight, body weight gain, or food consumption, organ weight differences, macroscopic observations, or microscopic findings were noted. No HL161ANS-related clinical pathology effects were observed in animals administered up to 100 mg/kg/dose IV. HL161ANS-related clinical pathology effects noted for animals administered 100 mg/kg/dose SC were limited to minimally to mildly decreased albumin concentration on Days 15 or 22 through Day 50. Based on these findings, 100 mg/kg/dose HL161ANS, the highest dose level administered, via intravenous or subcutaneous injection is considered the maximum tolerated dose (MTD). Example 16: A Phase 1 Study to Assess the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of HL161ANS in Healthy Participants [00294] This Example describes a Phase 1, randomized, placebo-controlled, double-blind, sequential parallel-group study to investigate the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of single and multiple ascending doses of HL161ANS in healthy adult male participants and adult female participants of non-childbearing potential (NCBP). Participants participate in 1 dosing cohort. [00295] There are 6 single ascending dose (SAD) cohorts (100, 300, 600, and 1,200 mg intravenous [IV]; and 300 and 600 mg subcutaneous [SC]). There are 2 multiple ascending dose (MAD) cohorts (300 and 600 mg SC once weekly [QW]) and 2 optional MAD cohorts (150 and 450 mg SC QW). Each MAD cohort is to receive 4 weekly administrations of HL161ANS or placebo. Each cohort is to dose 2 sentinel subjects (one active and one placebo). [00296] The SAD cohorts each consist of 6 and 2 participants in HL161ANS and placebo, respectively, and the 4 MAD cohorts each consist of 10 and 2 participants in HL161ANS and placebo, respectively. Therefore, the study is to have a total of up to 96 participants (76 in HL161ANS and 20 in placebo). [00297] Selected doses are not to exceed the fixed doses of 1,530 mg IV for SAD and 800 mg SC for MAD. [00298] Participants are to be screened to assess eligibility for randomization into the study. For SAD cohorts, participants are to be randomized into 6 sequential dose cohorts, with 8 participants per cohort. For each SAD cohort, 2 participants are to be randomized 1:1 to receive HL161ANS or placebo for sentinel dosing, then the remaining 6 participants are to be randomized 5:1 to receive HL161ANS or placebo, if HL161ANS is well tolerated in the respective sentinel participants. [00299] For MAD cohorts, participants are to be randomized into up to 4 sequential cohorts (2 planned and 2 optional), with 12 participants per cohort. For each MAD cohort, 2 participants are to be randomized 1:1 to receive HL161ANS or placebo for sentinel dosing, then the remaining 10 participants are to be randomized 9:1 to receive HL161ANS or placebo, if HL161ANS is well tolerated in the respective sentinel participants. [00300] Objectives and endpoints are shown in Table 25 [Table 25]