Clarification of Nomenclature and Potential Misidentifications
The term "REM23" may derive from:
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Gene/Protein Context: REM1 (RRAD and GEM-like GTPase 1), a small GTPase involved in cellular signaling .
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Antibody Targets: IL-23 (interleukin-23), a cytokine implicated in autoimmune diseases. For example, ABT-874 targets IL-12/23 .
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Typographical Errors: Possible confusion with "REGEN-COV" (REGN10933 + REGN10987), a SARS-CoV-2-targeting antibody cocktail .
No antibody explicitly named "REM23" is listed in:
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Clinical trials (e.g., NCT06396065, NCT05899608) .
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Approved therapeutics (e.g., epcoritamab, regdanvimab) .
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Antibody databases (e.g., PubMed, PMC, Antibody Society) .
IL-12/23-Targeting Antibodies
ABT-874 (anti-IL-12/23) was investigated for multiple sclerosis (MS):
| Parameter | Details |
|---|
| Target | IL-12/23, pro-inflammatory cytokines involved in T-cell differentiation . |
| Mechanism | Blocks IL-12/23 signaling, reducing immune cell activation and inflammation. |
| Clinical Findings | In a 24-week trial, reduced gadolinium-enhanced lesions in MS patients . |
| Status | Discontinued due to limited efficacy in later-stage trials. |
SARS-CoV-2 Neutralizing Antibodies
REGEN-COV (casirivimab + imdevimab) demonstrated resistance to viral escape:
| Study Design | Key Results |
|---|
| In Vitro Escape | Seven passages required to achieve resistance, vs. 1–2 for monotherapies . |
| In Vivo (Hamsters) | No resistance variants detected in REGEN-COV-treated animals . |
| Human Trials | Reduced viral load (SMD = -3.39) in COVID-19 outpatients . |
Bispecific Antibodies in Oncology
Ivonescimab (SMT112), a PD-1/VEGF bispecific antibody, is in Phase 3 trials for NSCLC:
| Feature | Ivonescimab | Epcoritamab (CD20/CD3) |
|---|
| Target | PD-1 (immune checkpoint) + VEGF (angiogenesis) | CD20 (B-cell marker) + CD3 (T-cell activator) |
| Format | Tetravalent (dual binding sites) | Full-length, heterodimeric (lambda/kappa chains) |
| Applications | Combats tumor immune evasion and angiogenesis | Redirects T-cells to B-cell malignancies |
| Clinical Status | NCT05899608 (metastatic NSCLC vs. pembrolizumab + chemo) | Approved for DLBCL (2023) |
Antibody-Based Diagnostics
Monoclonal antibodies enable precise detection of biomarkers:
| Use Case | Example Antibody | Application |
|---|
| Pregnancy Testing | Anti-hCG | Detects hCG in urine/serum . |
| Cancer Imaging | Radio-labeled anti-tumor antibodies | Identifies cancerous cells via radioisotopes . |
Preclinical Remyelination Studies
Mouse natural IgMs (e.g., rHIgM22) promote remyelination in CNS demyelinating diseases:
| Mechanism | Outcome | Source |
|---|
| Myelin Lipid Binding | Oligodendrocyte proliferation, reduced lesion severity | TMEV-infected mice . |
| Human IgM Screening | 6/52 IgMs bound CNS myelin, 2 showed therapeutic potential | Mayo Clinic serum bank . |
Emerging Trends in Antibody Engineering
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Non-Competing Combinations: REGEN-COV’s dual antibodies bind distinct RBD epitopes, preventing viral escape .
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Fc Engineering: Modifications (e.g., L234A, L235A) reduce effector functions, enhancing safety .
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Bispecific Formats: Tetravalent designs (e.g., ivonescimab) enable simultaneous targeting of two pathways .