Martinez-Rivas, G. | bioRxiv Science

bioRxiv2025

Preclinical characterization of AT-03, a novel Serum Amyloid P fusion protein that demonstrates pan-amyloid binding and removal

The systemic amyloidoses are progressive disorders caused by extracellular deposition of insoluble amyloid fibrils leading to organ dysfunction that often proves fatal. New therapeutics aiming at removing deposited amyloid are urgently needed to improve patient outcomes. MethodsWe developped AT-03 (originally called SAP-scFc), a fusion protein consisting of serum amyloid P-component, which binds all types of amyloid, linked to a single chain human IgG1 Fc domain. AT-03 binding to diverse types of amyloid and phagocytic activity were assessed both in vitro and in vivo. Therapeutic efficacy was evaluated in an AA mouse model. ResultsAT-03 bound with high potency to AL and ATTR human amyloid extracts. In murine models, intravenously administered AT-03 bound to AA, AL and AApoA2 amyloid, including in the heart. Ex vivo AT-03 opsonization induced phagocytosis of human AL extract by activated human THP-1 macrophages and enhanced in vivo phagocytosis in mice. A single intravenous injection of SAP-scFc induced a significant reduction of splenic amyloid in a murine model of AA amyloidosis. ConclusionsAT-03 binds many amyloid types and can promote macrophage-mediated phagocytosis of the deposits. Thus, AT-03 is a promising novel therapeutic agent for the removal of systemic amyloid.

pathology↗

bioRxiv2024

A mouse model of cardiac AL amyloidosis unveils mechanisms of tissue accumulation and toxicity of amyloid fibrils

AL amyloidosis is one of the most common types of systemic amyloidosis, caused by the deposition in tissues of fibrillar aggregates of abnormal immunoglobulin (Ig) light chain (LC), leading to organ dysfunction. The most frequent and severe forms affect the kidneys and heart, the latter being associated with a poor prognosis. Despite extensive efforts to decipher the mechanisms of fibril formation and their toxicity, the lack of reliable in vivo models hinders the study of the disease in its physiological context. We developped a transgenic mouse model producing high amounts of a human AL light chain (LC). While mice exceptionnaly develop spontaneous AL amyloidosis and do not exhibit organ toxicity due to the circulating amyloidogenic free LC, a single injection of amyloid fibrils, made up of the variable domain (VL) of the human LC, or soluble VL led to amyloid deposits in the heart, vessels, spleen and, to a lesser extent, in the kidney and other visceral tissues. AL fibrils in mice contain both full length and fragmented LC with a fragmentation pattern highly superposable to that of human AL fibrils from the same LC subgroup (IGLV6-57). They also develop an early cardiac dysfunction closely resembling the human disease with increased NT-proBNP,and activation of pathways involved in the extracellular matrix remodeling and fibrosis. Overall, this transgenic AL model closely reproduces human cardiac AL amyloidosis and shares with humans the biochemical composition of the deposits, arguing for a conserved mechanism of amyloid fibrils formation. It also shows that a partial degradation of the LC is likely required to initiate amyloid fibril formations. This model offers a new avenue for research on AL amyloidosis and fills an important gap for the preclinical evaluation of new therapies.

pathology↗