Example of chemically linked Fabs: two Fab' fragments linked with a thioether, resulting in a F(ab')2 . The molecule is bound to a tumour cell via the tumour antigen CD30 and to a macrophage via an Fc receptor .
Two chemically linked fragments antigen-binding form an artificial antibody that binds to two different antigens , making it a type of bispecific antibody . They are fragments antigen-binding (Fab or Fab') of two different monoclonal antibodies and are linked by chemical means like a thioether .[ 1] [ 2] Typically, one of the Fabs binds to a tumour antigen (such as CD30 ) and the other to a protein on the surface of an immune cell , for example an Fc receptor on a macrophage . In this way, tumour cells are attached to immune cells, which destroy them.[ 3]
In the late 1990s and early 2000s, clinical trials with chemically linked Fabs were conducted for the treatment of various types of cancer . Early results were promising,[ 3] [ 4] but the concept was dropped because of high production costs.[ 5]
Bi-specific T-cell engagers employ a similar mechanism of action while being cheaper.
^ Karpovsky, B.; Titus, J. A.; Stephany, D. A.; Segal, D. M. (1984). "Production of target-specific effector cells using hetero-cross-linked aggregates containing anti-target cell and anti-Fc gamma receptor antibodies" . The Journal of Experimental Medicine . 160 (6): 1686–1701. doi :10.1084/jem.160.6.1686 . PMC 2187539 . PMID 6239899 .
^ Glennie, M. J.; McBride, H. M.; Worth, A. T.; Stevenson, G. T. (1987). "Preparation and performance of bispecific F(ab' gamma)2 antibody containing thioether-linked Fab' gamma fragments". Journal of Immunology . 139 (7): 2367–2375. doi :10.4049/jimmunol.139.7.2367 . PMID 2958547 .
^ a b Borchmann, P.; Schnell, R.; Fuss, I.; Manzke, O.; Davis, T.; Lewis, L. D.; Behnke, D.; Wickenhauser, C.; Schiller, P.; Diehl, V.; Engert, A. (2002). "Phase 1 trial of the novel bispecific molecule H22xKi-4 in patients with refractory Hodgkin lymphoma" . Blood . 100 (9): 3101–3107. doi :10.1182/blood-2001-12-0295 . PMID 12384405 .
^ Link, B. K.; Kostelny, S. A.; Cole, M. S.; Fusselman, W. P.; Tso, J. Y.; Weiner, G. J. (1998). "Anti-CD3-based bispecific antibody designed for therapy of human B-cell malignancy can induce T-cell activation by antigen-dependent and antigen-independent mechanisms" . International Journal of Cancer . 77 (2): 251–256. doi :10.1002/(SICI)1097-0215(19980717)77:2<251::AID-IJC14>3.0.CO;2-E . PMID 9650561 .
^ Kellner, C (2008). Entwicklung und Charakterisierung bispezifischer Antikörper-Derivate zur Immuntherapie CD19-positiver Leukämien und Lymphome [Development and characterisation of bispecific antibody derivatives for the immunotherapy of CD19-positive leukaemia and lymphoma ] (Thesis) (in German and English). Erlangen-Nürnberg: Friedrich-Alexander-Universität.