Transferrin receptor-targeted anti-amyloid antibody enhances brain delivery and mitigates ARIA

Science. 2025 Aug 7;389(6760):eads3204. doi: 10.1126/science.ads3204. Epub 2025 Aug 7.

Abstract

Amyloid-related imaging abnormalities (ARIA), side effects of anti-amyloid drugs seen in magnetic resonance imaging of the brain, are a major safety concern in patients with Alzheimer's disease. We developed an antibody transport vehicle (ATV) targeting transferrin receptor (TfR) for brain delivery of anti-amyloid-β protein (anti-Aβ) using asymmetrical Fc mutations (ATVcisLALA) that mitigates TfR-related liabilities and retains effector function when bound to Aβ. Administration of ATVcisLALA:Aβ in mice exhibited broad brain distribution and enhanced parenchymal plaque target engagement. This biodistribution reduced ARIA-like lesions and vascular inflammation. Taken together, ATVcisLALA has the potential to improve the next generation of Aβ immunotherapy through enhanced biodistribution mediated by transport across the blood-brain barrier.

MeSH terms

  • Alzheimer Disease* / diagnostic imaging
  • Alzheimer Disease* / drug therapy
  • Alzheimer Disease* / metabolism
  • Amyloid beta-Peptides* / immunology
  • Amyloid beta-Peptides* / metabolism
  • Animals
  • Antibodies, Monoclonal* / administration & dosage
  • Antibodies, Monoclonal* / pharmacokinetics
  • Blood-Brain Barrier / metabolism
  • Brain* / diagnostic imaging
  • Brain* / metabolism
  • Humans
  • Immunoglobulin Fc Fragments / genetics
  • Magnetic Resonance Imaging
  • Mice
  • Mutation
  • Plaque, Amyloid
  • Receptors, Transferrin* / immunology
  • Receptors, Transferrin* / metabolism
  • Tissue Distribution

Substances

  • Receptors, Transferrin
  • Amyloid beta-Peptides
  • Immunoglobulin Fc Fragments
  • Antibodies, Monoclonal