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Exceptionally potent human monoclonal antibodies are effective for prophylaxis and treatment of tetanus in mice
Marco Pirazzini, … , Antonio Lanzavecchia, Cesare Montecucco
Marco Pirazzini, … , Antonio Lanzavecchia, Cesare Montecucco
Published October 7, 2021
Citation Information: J Clin Invest. 2021;131(22):e151676. https://doi.org/10.1172/JCI151676.
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Research Article Neuroscience

Exceptionally potent human monoclonal antibodies are effective for prophylaxis and treatment of tetanus in mice

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Abstract

We used human monoclonal antibodies (humAbs) to study the mechanism of neuron intoxication by tetanus neurotoxin and to evaluate these antibodies as a safe preventive and therapeutic substitute for hyperimmune sera to treat tetanus in mice. By screening memory B cells from immune donors, we selected 2 tetanus neurotoxin–specific mAbs with exceptionally high neutralizing activities and extensively characterized them both structurally and functionally. We found that these antibodies interfered with the binding and translocation of the neurotoxin into neurons by interacting with 2 epitopes, whose identification pinpoints crucial events in the cellular pathogenesis of tetanus. Our observations explain the neutralization ability of these antibodies, which we found to be exceptionally potent in preventing experimental tetanus when injected into mice long before the toxin. Moreover, their Fab derivatives neutralized tetanus neurotoxin in post-exposure experiments, suggesting their potential for therapeutic use via intrathecal injection. As such, we believe these humAbs, as well as their Fab derivatives, meet the requirements to be considered for prophylactic and therapeutic use in human tetanus and are ready for clinical trials.

Authors

Marco Pirazzini, Alessandro Grinzato, Davide Corti, Sonia Barbieri, Oneda Leka, Francesca Vallese, Marika Tonellato, Chiara Silacci-Fregni, Luca Piccoli, Eaazhisai Kandiah, Giampietro Schiavo, Giuseppe Zanotti, Antonio Lanzavecchia, Cesare Montecucco

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Figure 6

TT110-Fab neutralizes TeNT toxicity by preventing the translocation of the L chain into the nerve terminal cytosol.

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TT110-Fab neutralizes TeNT toxicity by preventing the translocation of t...
(A) Western blotting of CGNs treated with 50 pM TeNT alone (PC) or preincubated with the indicated TT104-Fab/TeNT molar ratio. After 12 hours, CGNs were lysed and immunoblotted for VAMP-2 and SNAP-25 as in Figure 2. Blots are representative of 3 independent experiments. (B) Survival curve for mice injected i.p. with either TeNT alone (4 ng/kg) or premixed with 5 times the molar excess of TT104-Fab. The number of mice in each group is indicated in the panel. (C) Scheme illustrating entry of the TeNT L chain into the neuronal cytosol via either canonical receptor–mediated cell uptake and translocation across the membrane of SVs triggered by the acidification of their lumen induced by proton pump activity of the V-ATPase (light blue), or low-pH translocation across the plasma membrane in the presence of bafilomycin A1 (Baf-A1). (D) Western blot analysis showing the inhibition of TeNT L chain membrane translocation by TT110-Fab. CGNs were incubated at 4°C for 15 minutes with either TeNT (10 nM) or TeNT preincubated with TT110-Fab. The culture medium was then replaced with a 37°C buffer for 10 minutes at pH 7.4 or pH 5.0. Samples were then incubated for 12 hours with normal medium (PC) or normal medium supplemented with Baf-A1 (100 nM). Membrane translocation was assessed according to VAMP-2 cleavage. SNAP-25 served as a loading control. Results are representative of 3 independent experiments. (E) ANS fluorescence binding experiment showing the pH-induced conformational change of TeNT blocked by TT110-Fab. TeNT (0.35 μM) or TeNT preincubated with TT110-Fab was incubated at pH 7.0 in the presence of 50 μM ANS and liposomes. The conformational change was triggered by lowering the pH with sequential addition of specific volumes of HCl and evaluated following the ANS fluorescence intensity at 470 nm. Results are representative of 2 independent experiments.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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