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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5366_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Foreword
- •Preface
- •Acknowledgements
- •Contents
- •Contributors
- •About the Editors
- •1.2.2.3 Progeria
- •1. Bioprocessing, Bioengineering and Process Chemistry in the Biopharmaceutical Industry: Using Chemistry and Bioengineering to Improve the Performance of Biologics
- •1.1 Introduction
- •1.2.2.2 Cystic Fibrosis
- •1.3.2.1 ADC Drugs
- •1.4 Top 25 Best-Selling Drugs
- •1.5.1 An Overview
- •1.5.2 Synthetic Biology
- •1.5.8 Biopharmaceutical Regulatory CMC
- •1.5.9 Technology Transfer
- •References
- •2.1 What Is Synthetic Biology?
- •2.6 CAR-T Cell Therapies
- •2.7 Conclusion
- •References
- •3.1 Introduction
- •3.2.1 Oligonucleotide Synthesis
- •3.2.1.1 Early Synthetic Chemistries
- •3.2.2 Solid Supports
- •3.2.3 Modern Oligo Synthesis Platforms
- •3.3 Gene Synthesis
- •3.3.1 Early DNA Assembly Methods
- •3.3.2 Array-Based Gene Synthesis
- •3.4 New Discovery Bottleneck
- •3.4.1.1 Hybridoma Technology
- •3.4.1.2 Phage Display Technology
- •3.4.1.3 Synthetic Antibody Library Construction
- •Semi-Synthetic Libraries
- •Fully Synthetic Libraries
- •3.5 Perspectives
- •References
- •4.1 Introduction
- •4.2.1 Batch
- •4.2.2 Fed-Batch
- •4.2.4 Hybrid Processes
- •4.2.7 Dynamic Perfusion Processes
- •4.3.2 Glucose Limitation
- •4.4.1 N-1 Perfusion
- •4.4.3 Linked Bioreactors
- •4.5 Process Analytical Technology
- •4.6 Single-Use Bioreactors (SUBs)
- •4.7 Conclusions
- •References
- •5.1 Introduction
- •5.2.1 Molecular Format Considerations
- •5.2.1.1 The Charge-Based Electrostatic Approach
- •5.2.1.2 The Knob into Hole Approach
- •5.2.2.1 Stable CHO Host Cell Integration System—Random or Targeted?
- •5.2.2.2 Expression Vector Considerations
- •5.2.2.3 Cell Line Screening Strategy Considerations
- •5.3.1 Upstream Process Development
- •5.3.2 Downstream Process Development Considerations
- •5.3.2.1 Unique Impurity Challenges
- •5.3.2.2 Stability Concerns
- •5.5.2.1 H/H Removal
- •5.5.2.2 HMMS Removal
- •References
- •6.1 Introduction
- •6.2.1 N-Linked Glycosylation
- •6.2.2 O-Linked Glycosylation
- •6.2.3 Glycosaminoglycan Synthesis
- •6.3.1 Mannosylation
- •6.3.2 Fucosylation
- •6.3.3 Galactosylation
- •6.3.4 Sialylation
- •6.5 Glycoengineering
- •6.5.1 Manipulating Heterogeneity
- •6.5.2 Manipulating Sialylation
- •6.5.2.1 Increasing α-2,6 Sialylation
- •6.5.3 Manipulating Fucosylation
- •6.5.4 Manipulating Branching
- •6.6.1 Temperature
- •6.6.2 pH
- •6.6.3.2 Amino Acids
- •6.6.3.3 Glycosaminoglycan Production
- •6.6.4 Culture Additives
- •References
- •7.1 Introduction
- •7.1.1 AAV Gene Therapy
- •7.3.1 Humoral Immunity
- •7.3.2 Cell-Mediated Immunity
- •7.4 Conclusion
- •References
- •8.1 Introduction
- •8.2 mRNA Vaccines
- •8.2.1 Background
- •8.2.2 Production Process
- •8.2.2.2 Production
- •8.4.1 Background
- •8.4.2 Production Process
- •8.4.2.2 Production
- •8.4.2.3 Viral Inactivation
- •8.5 Protein-Based Vaccines
- •8.5.1 Background
- •8.5.2 Production Processes
- •8.5.2.1 NVX-CoV2373 (Novavax)
- •8.3 Viral Vectors
- •8.3.1 Background
- •8.3.2 Production Process
- •8.3.2.2 Production
- •8.4 Whole Inactivated Virus Vaccines
- •8.5.2.2 CoVLP (Medicago)
- •8.5.2.3 EpiVacCorona (Vector Institute)
- •8.7 Conclusions
- •References
- •9. CAR-T Bioprocessing
- •9.1 Introduction
- •9.2.1 Introduction
- •9.2.2 Lentiviral Vector Design
- •9.2.5 Upstream Bioprocessing
- •9.2.6 Downstream Bioprocessing
- •9.3 Cell Product Bioprocessing
- •9.3.1 End-to-End Systems
- •9.3.4 Activation
- •9.3.6 Cell Expansion
- •9.3.8 T-Cell Cryopreservation
- •References
- •10.1.1 What Is CRISPR?
- •10.1.4 Mechanism Behind CRISPR Gene Editing
- •10.2.1 Creating Gene Knockouts
- •10.2.2 Creating Gene Knock-Ins
- •10.2.4 CRISPR Screens
- •10.3.1 Derivative Technologies
- •10.4.2 Delivery Methods
- •10.6.2 TCR Engineered T Cell Therapy
- •10.6.3 Chimeric Antigen Receptor T Cell Therapy
- •10.9.2 Safety Considerations
- •References
- •11.1 Introduction
- •11.1.2 Categories
- •11.2 Current Status
- •11.2.1 Approved Products
- •11.2.2 Market
- •11.3 Design
- •11.3.1 Building Blocks
- •11.3.2 Linkers
- •11.3.3 Oligomerization
- •11.3.3.1 Monomer
- •11.3.3.2 Dimer
- •11.3.3.3 Trimer
- •11.3.3.4 Tetramer
- •11.3.3.5 Pentamer
- •11.3.3.6 Hexamer
- •11.3.3.7 Octamer
- •11.3.4 Orientation
- •11.3.5 Protein Engineering
- •11.3.6 Immunogenicity
- •11.4 Manufacturing
- •11.4.1 Upstream
- •11.4.2 Downstream
- •11.4.3 Glycosylation
- •11.4.4 Aggregation
- •11.4.5 Analytics
- •11.5 Therapeutic Concepts
- •11.5.1 Half-Life Extension
- •Albumin Fusions
- •Fc Fusions
- •Transferrin Fusions
- •Repetitive Peptide Fusions
- •Glycosylated Peptides
- •11.5.1.3 Aggregate Forming Peptides
- •11.5.2 Targeting Functions
- •11.5.3.1 Fc Domain Receptor-Mediated Toxicity
- •11.5.3.2 Toxins
- •11.5.3.3 Immunocytokines
- •11.5.3.4 Human Enzymes
- •11.5.3.5 Apoptosis Induction
- •11.6 Summary
- •11.7 Future Perspectives
- •References
- •12.1 Introduction
- •12.2 ADC History
- •12.3 Target Selection
- •12.4 Antibody Selection
- •12.6 ADC Technology
- •12.7 ADC Clinical Development
- •12.8.1 Mylotarg
- •12.8.2 Adcetris
- •12.8.3 Kadcyla
- •12.8.4 Besponsa
- •12.8.5 Polivy
- •12.8.6 Padcev
- •12.8.7 Enhertu
- •12.8.8 Trodelvy
- •12.8.9 Blenrep
- •12.8.10 Zynlonta
- •12.8.11 Tivdak
- •12.9 Concluding Remarks
- •References
- •13.1 Introduction
- •13.2 Gemtuzumab Ozogamicin
- •13.3 Gemtuzumab Antibody
- •13.4 Calicheamicin
- •13.7.3 Isolation of N-Acetyl Calicheamicin
- •13.10 Conclusions
- •References
- •14.1 Introduction
- •14.2.1 Antibody Generation
- •14.3.1 Structure Prediction
- •14.3.2 Biophysical Properties
- •14.3.3 Hydrophobicity
- •14.3.5 Isoelectric Point (pI)
- •References
- •15.1 Introduction
- •15.2 ADA Program Development
- •15.2.3 Project Approach
- •15.2.4 Model Library
- •15.3 Case Study
- •15.3.3 Hypothesis Generation
- •15.3.5 Feature Engineering Example
- •15.3.7 Model Insights
- •References
- •16.1 Introduction
- •16.1.1.1 United States
- •16.1.1.2 European Union
- •16.1.2 Global Markets
- •16.4.1 United States FDA
- •16.4.2 European Medicines Agency (EMA)
- •16.4.3 The World Health Organization
- •References
- •17.1 Introduction
- •17.3.1.2 Clone Selection

280
frequency, and location of all off-target editing events, and assessment of genomic
integrity including chromosomal rearrangements, large insertions or deletions, integration of exogenous DNA, and potential oncogenicity or insertional mutagenesis.
For gene-edited cell therapies, advances in single-cell DNA sequencing enabled
more accurate and reliable characterization of these therapies. In-depth analysis of
off-target editing and the assessment of large-scale chromosomal rearrangements
that can result from inducing DSBs in DNA are also critical for safe CRISPR therapies [93].
The coming years are likely to see an increase in the use of CRISPR derivatives
to treat a wider variety of diseases. This includes RNA editing systems for the treatment of RNA-mediated diseases and removal of RNA viruses, and CRISPR systems
that can modify DNA without inducing DSBs, such as base, prime, PASTE, and
epigenetic editing. The potentially increased safety proles of these systems may
generate more public support for these advanced biologics they are used to create.
R. Kishton et al.
10.9.3 Regulatory Issues andDeveloping New Clinical
Frameworks forCRISPR Therapies
As the eld of CRISPR gene editing continues to grow, an increasing number of
therapies are approaching clinical trials. Despite this progress, a key stumbling
block remains in the form of the outdated clinical development pipeline; the current
framework for developing a therapeutic product was simply not designed to accommodate the novelty and complexity of next-generation CRISPR cell and gene therapies. Many CRISPR scientists have stated that an entirely new clinical framework
should be developed by the FDA with these therapies in mind.
The FDA has recently voiced its support for CRISPR-based therapies, announcing several new draft guidance and initiatives for their improved development. This
includes the bespoke Gene Therapy Consortium, which aims to provide clearer
information on basic and clinical research, manufacturing, and regulatory requirements in order to streamline the development of small-batch therapies [94]. As part
of this initiative, the FDA also suggested that nancial incentives may be provided
to encourage companies to generate gene therapies that may not otherwise be nancially viable, such as diseases with very small patient populations. Other FDA initiatives include a gene therapy pilot program, which would provide real-time
feedback to sponsors throughout development, and the INitial Targeted Engagement
for Regulatory Advice on CBER producTs (INTERACT) program, which allows for
informal meetings between the FDA’s Center for Biologics Evaluation and Research
(CBER) and trial sponsors in the early stages of development [95]. The FDA’s
increased commitment to ensuring the streamlined development and success of
CRISPR-based therapies suggests that this eld will only continue to grow in the
coming years, likely with more positive outcomes for patients.

10 CRISPR Technology andIts Application inTherapeutics
281
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R. Kishton et al.

Part VI
Fusion Proteins, Antibody Drug
Conjugates and Process Chemistry


Chapter 11
Fusion Proteins: Current Status
andFuture Perspectives
StefanR.Schmidt
Abstract Fusion proteins, consisting of the joined peptide chains of two or more
proteins that are naturally not connected, are popular and highly successful recombinant protein drugs with a wide range of different functionalities and therapeutic
applications. This chapter summarizes the main features of this protein class and
explains the general design principles. Typical building blocks comprise the constant domain of immunoglobulins, linkers with specic properties, and a second
protein module that carries some extra functionality such as an enzyme for instance.
In some cases, the inherent ability to form higher order complexes is utilized to
generate oligomers with novel characteristics. As the articially combined protein
subunits not necessarily share the same physicochemical characteristics, manufacturing becomes challenging. Often even the orientation of the fusion partners has an
effect on activity and yield. Therefore, some efforts were undertaken to optimize the
constructs through protein engineering. These unnatural proteins are unknown to
the human body and immune system, although their components are derived from
existing proteins. This can lead to immunogenic reactions particularly through
novel epitopes at the junction positions between linkers and fusion partners. The
different therapeutic concepts rely on some specic features such as half-life extension by either enlarging the diameter of the proteins to protect them from rapid
kidney clearance or through recycling by Fc gamma receptor (FcRn). Both
approaches have successfully been used to generate so-called biobetters with
enhanced functions. The other important category of fusion proteins contains targeting abilities often conferred trough antibody derivatives. Some proteins from that
subtype are immunocytokines that deliver cytokines to specic cell types or organs
to exert the corresponding pharmaceutical effect. Overall fusion proteins represent
a highly successful but heterogeneous class of recombinant therapeutic.
S. R. Schmidt (*)
evitria AG, Zurich, Switzerland
e-mail: ssc@evitria.com
K. Gadamasetti, S. A. Kolodziej (eds.), Bioprocessing, Bioengineering
and Process Chemistry in the Biopharmaceutical Industry,
https://doi.org/10.1007/978-3-031-62007-2_11
287© The Author(s), under exclusive license to Springer Nature Switzerland AG 2024

288
Keywords Fusion protein · Half-life extension · Glycosylation · Fc-fusion ·
Aggregation · Albumin · Stability · Cytokine · Protein engineering · Orientation ·
Biobetters
S. R. Schmidt
11.1 Introduction
11.1.1 Denition
This chapter focuses on fusion proteins engineered from two or more genes that
code for separate proteins joined by genetic techniques. The result is a single polypeptide sharing functional properties of both parent proteins. These recombinant
proteins are combinations of unrelated domains that do not occur in nature.
Therapeutic fusion proteins belong to the class of next generation biologicals as
they are designed exclusively through human creativity and are not evolved from a
natural process. Very often they represent so-called biobetters, molecules with
improved functionalities such as, for instance, extended half-life.
Although this denition would also cover multi-epitope recombinant vaccines,
they are excluded from the content of this chapter as well as naturally occurring
fusion proteins resulting from chromosomal rearrangements that can be observed in
many cancer cells or fusion tags utilized for protein afnity purication. Bispecic
functionalities in antibodies have also become very popular in the last decade but
are out of scope for this chapter as they typically are not forming a continuous polypeptide, but rather come together via disulde bridges.
11.1.2 Categories
The simplest classication of these new proteins might be based on the function of
their integrated domains. Typically, one fragment plays a role in molecular recognition or binding, while the other fragment adds a specic function, such as half-life
extension or stability, cytotoxicity, or new targeting or delivery pathways [1]. Most
fusion proteins fulll three main goals, extend the half-life, and introduce a targeting function or a specic bioactivity. At least two of these three elements coexist in
the fusion protein. Interestingly, a natural molecule, the immunoglobulin G also
known as antibody, incorporates all three elements in one molecule. Antibody derivatives, fragments, or domains are widely used as building blocks of fusion proteins,
constituting a huge share of the protein portfolio discussed here. High afnity and
selectivity for specic epitopes, which are key functions of antibodies, have been
generated from many nonantibody constructs that can be used as a single module or
by combining two units with different specicities [2]. Fusion proteins are very

11 Fusion Proteins: Current Status andFuture Perspectives
289
attractive due to several advantages. The combination of the two functions in a single molecule facilitates the production and delivery of drugs. Two molecules linked
together automatically have the same biodistribution prole instead of two separate
molecules with completely different proles. Interestingly new functions not found
in natural or free proteins can be generated. This includes changes in half-life or
targeting specicity [3]. There are also economic opportunities by creating new
intellectual properties for novel and unnatural protein combinations. Therapeutic
benets due to reduced side effects or longer dosing intervals together with enhanced
activity are strong motifs for fusion protein production. However, in addition to
these important benets, there are also many issues. In some cases, the combination
of unrelated proteins can be difcult because the fusion partners have incompatible
properties. For instance, misfolding or aggregation can occur for one domain while
the same conditions might be perfect for the other domain. Although some fusion
protein modules are elements of other well-established molecules such as antibodies, platform processes may not apply because other elements mightreplace the
necessary domain. This can prohibit a successful formulation because of conicting
features. In addition, it could be complicated to control and ne-tune the relative
amounts of each component, making it difcult to administer in the optimal efcacy
and safety window. Perhaps the most important issue is the high potential for immunogenicity due to the formation of new epitopes at the junctions between the fusion
partners, even when using only human protein domains. A summary can be seen in
Table11.1.
Table 11.1 Advantages and challenges of fusion proteins
Advantages Challenges
Two functionalities in one molecule simplify
manufacture and drug delivery
Truly identical bio-distribution prole for both
entities
Designing of novel „unnatural “functionalities with
clear therapeutic benets (e.g., half-life and
targeting)
Potential of life cycle extension of products with
expiring patents
Combination of two different proteins →
different properties (not always
compatible)
pH preferences, hydrophobicity,
glycosylation-isoforms, cellular
localization
Sensitivity to virus inactivation method at
low pH
Typically lower expression level than
antibodies
No platform process (neither USP nor
DSP)
Rarely afnity chromatography applicable
(exception: Fc and HSA-Fusions)
Tendency to aggregate → avoiding and
removing aggregates
Difcult ne tuning of functions (e.g.,
afnity)
Immunogenicity risk
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