Edited by Peter CresswellBispecific antibodies show great promise as intrinsic combination therapies, but often suffer from poor physiochemical properties, many times related to poor heterodimerization. De Nardis et al. identify specific electrostatic interactions that facilitate efficient heterodimerization, resulting in bispecific antibodies with physiochemical properties very similar to those of naturally occurring antibodies. This provides a new platform for the treatment of an array of diseases from cancer and autoimmune diseases to infectious diseases.
Bispecific antibodies (bsAbs)3 represent a fast-growing field of research, with seemingly endless opportunities. Whereas naturally occurring antibodies bind bivalently to one antigen by means of their two Fab arms, bsAbs are engineered to contain the arms of two different antibodies, allowing them to bind simultaneously to two distinct antigens (Fig. 1). Since the 1980s, many different bsAbs have been generated against a variety of targets and more than 20 bsAbs are currently in clinical development, whereas many more are in the pipeline for clinical testing (1, 2). The therapeutic application of bsAbs is very broad, ranging from immunotherapy against cancer and immune disorders to applications against infectious diseases. However, applying bsAbs requires maintaining the natural antibody structure and the ability for large-scale production of high-quality material, which has proven challenging with these engineered sequences. A study by De Nardis et al. (3) now demonstrates one solution to this problem, facilitated by pairing oppositely charged amino acids across the heterodimer interface.Engineered bsAbs have been designed to act by a variety of mechanisms. For example, bsAb MM-111 acts on solid tumors by targeting two different antigens, human epidermal growth factor receptors (HER) 2 and 3, simultaneously (4). bsAb DVD-Ig FVM09ϳMR72 protects against ebolavirus by using one arm to bind to the virus and enter the endosome and using the other arm to block viral entry in the host cell (5). An alternative use of bsAbs that has proven to be successful in cancer therapy involves recruiting specific immune cells with one arm and binding to target cells with the other arm. Blinatumomab, which is approved for acute lymphocytic leukemia (ALL) therapy, recognizes the CD19 receptor on leukemic B cells with one arm while recruiting killer T cells that mediate lysis of the tumor cells with the other arm (6).There are many methods used to produce bsAbs, including quadroma technology (fusing two hybridoma cell lines), chemical cross-linking, and genetic engineering. However, these modifications often result in lower production yields, lower stability, reduced antibody half-life in vivo, and higher immunogenicity compared with regular antibodies. Therefore, bsAbs that mimic intact IgG antibodies are favored, and extensive efforts have been aimed at optimizing their expression and production. Such bsAbs obviously also have the advantage of retaining antibody functions media...