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Differential Toxicity of Antibodies to the Prion Protein

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    Differential Toxicity of Antibodies to the Prion Protein

    Differential Toxicity of Antibodies to the Prion Protein

    Regina R. Reimann ,
    Contributed equally to this work with: Regina R. Reimann, Tiziana Sonati

    Affiliation: Institute of Neuropathology, University of Zurich, Zurich, Switzerland

    ⨯
    Tiziana Sonati ,
    Contributed equally to this work with: Regina R. Reimann, Tiziana Sonati

    Affiliation: Institute of Neuropathology, University of Zurich, Zurich, Switzerland

    ⨯
    Simone Hornemann,
    Affiliation: Institute of Neuropathology, University of Zurich, Zurich, Switzerland

    ⨯
    Uli S. Herrmann,
    Affiliation: Institute of Neuropathology, University of Zurich, Zurich, Switzerland

    ⨯
    Michael Arand,
    Affiliation: Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland

    ⨯
    Simon Hawke,
    Affiliation: Vascular Immunology Laboratory, Department of Pathology, University of Sydney, Camperdown, Australia

    ⨯
    Adriano Aguzzi
    * E-mail: adriano.aguzzi@usz.ch

    Affiliation: Institute of Neuropathology, University of Zurich, Zurich, Switzerland

    ⨯
    Differential Toxicity of Antibodies to the Prion Protein
    Regina R. Reimann,
    Tiziana Sonati,
    Simone Hornemann,
    Uli S. Herrmann,
    Michael Arand,
    Simon Hawke,
    Adriano Aguzzi
    PLOS
    x
    Published: January 28, 2016
    DOI: 10.1371/journal.ppat.1005401


    Abstract

    Antibodies against the prion protein PrPC can antagonize prion replication and neuroinvasion, and therefore hold promise as possible therapeutics against prion diseases. However, the safety profile of such antibodies is controversial. It was originally reported that the monoclonal antibody D13 exhibits strong target-related toxicity, yet a subsequent study contradicted these findings. We have reported that several antibodies against certain epitopes of PrPC, including antibody POM1, are profoundly neurotoxic, yet antibody ICSM18, with an epitope that overlaps with POM1, was reported to be innocuous when injected into mouse brains. In order to clarify this confusing situation, we assessed the neurotoxicity of antibodies D13 and ICSM18 with dose-escalation studies using diffusion-weighted magnetic resonance imaging and various histological techniques. We report that both D13 and ICSM18 induce rapid, dose-dependent, on-target neurotoxicity. We conclude that antibodies directed to this region may not be suitable as therapeutics. No such toxicity was found when antibodies against the flexible tail of PrPC were administered. Any attempt at immunotherapy or immunoprophylaxis of prion diseases should account for these potential untoward effects.


    Author Summary

    The human prion disease, Creutzfeldt-Jakob disease (CJD), is a progressive neurodegenerative syndrome. Although far less prevalent, CJD shows many molecular and clinical similarities to Alzheimer's disease, such as the buildup of protein aggregates in the brain and the absence of effective treatments. Many attempts at immunotherapy for Alzheimer’s disease are being reported in specialized journals and in the lay press, and have been linked to strong hopes for a cure. The same therapeutic strategy appears plausible for Creutzfeldt-Jakob disease, and indeed, there are some encouraging preclinical studies. However, there have also been reports that antibodies against the prion protein (PrPC) can also wreak damage on the brain. We have gathered evidence that various antiprion antibodies vary not only in their efficacy but also in their potential to induce serious untoward effects. In a dose-escalation study, we report that all antibodies against a set of epitopes in the globular domain of the prion protein display acute neurotoxicity. These issues need to be carefully assessed before considering any clinical studies involving human subjects.





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