UB-311, a novel UBITh? amyloid β peptide vaccine for mild?Alzheimer's?disease
Journal
Alzheimer's and Dementia: Translational Research and Clinical Interventions
Journal Volume
3
Journal Issue
2
Pages
262-272
Date Issued
2017
Author(s)
Wang C.Y.
Abstract
Introduction A novel amyloid β (Aβ) synthetic peptide vaccine (UB-311) has been evaluated in a first-in-human trial with patients of mild-to-moderate Alzheimer's disease. We describe translational research covering vaccine design, preclinical characterization, and phase-I clinical trial with supportive outcome that advances UB-311 into an ongoing phase-II trial. Methods UB-311 is constructed with two synthetic Aβ1–14–targeting peptides (B-cell epitope), each linked to different helper T-cell peptide epitopes (UBITh?) and formulated in a Th2-biased delivery system. The hAPP751 transgenic mouse model was used to perform the proof-of-concept study. Baboons and macaques were used for preclinical safety, tolerability, and immunogenicity evaluation. Patients with mild-to-moderate Alzheimer's disease (AD) were immunized by intramuscular route with 3 doses of UB-311 at weeks 0, 4, and 12, and monitored until week 48. Safety and immunogenicity were assessed per protocol, and preliminary efficacy was analyzed by Alzheimer's Disease Assessment Scale–Cognitive Subscale (ADAS-Cog), Mini–Mental State Examination (MMSE), and Alzheimer's Disease Cooperative Study–Clinician's Global Impression of Change (ADCS-CGIC). Results UB-311 covers a diverse genetic background and facilitates strong immune response with high responder rate. UB-311 reduced the levels of Aβ1–42 oligomers, protofibrils, and plaque load in hAPP751 transgenic mice. Safe and well-tolerated UB-311 generated considerable site-specific (Aβ1–10) antibodies across all animal species examined. In AD patients, UB-311 induced a 100% responder rate; injection site swelling and agitation were the most common adverse events (4/19 each). A slower rate of increase in ADAS-Cog from baseline to week 48 was observed in the subgroup of mild AD patients (MMSE???20) compared with the moderate AD subgroup, suggesting that UB-311 may have a potential of cognition improvement in patients with early stage of Alzheimer's dementia. Discussion The UBITh? platform can generate a high-precision molecular vaccine with high responder rate, strong on-target immunogenicity, and a potential of cognition improvement, which support UB-311 for active immunotherapy in early-to-mild AD patients currently enrolled in a phase-II trial (NCT02551809). ? 2017 United Biomedical, Inc.
Subjects
Alzheimer's disease; Amyloid β vaccine; FIH clinical trial; UB-311; UBITh? platform
SDGs
Other Subjects
alanine aminotransferase; amyloid beta protein[1-42]; antibody; aspartate aminotransferase; autoantibody; oligomer; peptide vaccine; ub 311; unclassified drug; adult; aged; agitation; Alzheimer disease; animal experiment; animal model; Article; breast disease; burn; cellulitis; Clinical Global Impression scale; coughing; decreased appetite; disease severity; dizziness; drug efficacy; drug safety; drug tolerability; epididymitis; erythrocyte; female; gastrointestinal disease; genetic background; genital system disease; helper cell; herpes zoster; human; hyperglycemia; immune response; immunogenicity; infection; infestation; injection site bleeding; injection site pain; injection site swelling; injury; intoxication; kidney disease; leukocyte count; male; mediastinum disease; mental disease; metabolic disorder; Mini Mental State Examination; mouse; nephrolithiasis; neurologic disease; neurologic disease assessment; neutrophil; neutrophil count; nonhuman; nutritional disorder; obsessive compulsive disorder; outcome assessment; phase 1 clinical trial; priority journal; rating scale; respiratory tract disease; side effect; skin disease; sleep disorder; soft tissue disease; thorax disease; tinea cruris; tooth pain; translational research; upper respiratory tract infection; urinary tract infection; urogenital tract disease; vomiting; wound
Publisher
Elsevier Inc
Type
journal article