Presenter of 1 Presentation
TDP-43 IMMUNOTHERAPY DECREASES NEUROPATHOLOGY AND CONFERS NEUROPROTECTION THROUGH MICROGLIAL ENGAGEMENT IN MOUSE MODELS OF ALS/FTD
Abstract
Aims
Accumulation of pathological transactive response DNA binding protein 43 (TDP-43) into intracellular inclusions underlies frontotemporal lobar degeneration with TDP-43 pathology (FTLD-TDP), amyotrophic lateral sclerosis (ALS) as well as the newly defined limbic-predominant age-related TDP-43 encephalopathy (LATE). TDP-43 inclusions are also present as co-pathology in other neurodegenerative diseases including Alzheimer’s disease. However, no therapeutic interventions targeting TDP-43 pathology are in clinical development. Antibody-mediated clearance of misfolded TDP-43 by microglia and inhibition of cell-to-cell protein spreading represents an attractive strategy for therapeutic intervention.
Methods
Monoclonal antibodies (mAbs) were generated against various regions of TDP-43 using AC Immune’s proprietary SupraAntigenTM platform and selected for evaluation in cell-based and mouse models of TDP-43 proteinopathies.
Results
From a panel of mAbs, ACI-5891 binding to the C-terminal domain of TDP-43 was identified to substantially reduce de novo and templated TDP-43 aggregation induced by FTLD-TDP brain extracts. In rNLS8 transgenic mouse model of ALS and FTLD-TDP, ACI-5891 significantly reduced the levels of phosphorylated TDP-43 (pTDP-43) and insoluble TDP-43 in the brain with a concomitant increase in hypertrophic microglia without induction of inflammation. These outcomes translated into a significant neuroprotective effect in a second mouse model induced by inoculation of FTLD-TDP brain extracts and correlated with significant increase of mAb-mediated TDP-43 aggregate uptake by microglia in vitro.
Conclusions
Our findings demonstrate for the first time that a mAb specific for the C-terminal region of TDP-43 enables clearance of misfolded TDP-43 in vivo through microglia engagement thus limiting pathology progression and conferring neuroprotection. These results support the clinical assessment of TDP-43 immunotherapy.