In-depth characterization and semi-quantification of anti-drug antibodies in clinical samples using specific hybrid IC-LC-MS/MS methods

Anti-drug antibodies (ADAs) generated by biotherapeutics can impair the drug clearance, prevent the binding to its target or lead to hypersensitivity reactions, thereby affecting efficacy and safety. It is therefore essential to assess the immunogenicity of potential biotherapeutics, particularly in clinical development. Ligand binding assays (LBA) are the gold standard for ADA detection because of their high sensitivity and throughput. However, LBA assays don't provide details on the isotypes produced and their relative abundance. As certain isotypes are known to be associated with ADA mediated adverse events, this information could be helpful to anticipate or better characterize the immunogenicity risk of biotherapeutics. A hybrid IC-LC-MS/MS strategy was developed for the detection of specific isotypes/subclasses of ADAs in a phase I clinical study. A first approach using the biotinylated drug to capture ADAs in human serum allowed the simultaneous semi-quantification of all IgG subclasses and the detection of ADAs of the IgM isotype in clinical samples. These results enabled a detailed characterization of the immune response against the biotherapeutic. A second assay was developed using a sequential immunocapture to measure drug specific IgEs known to be potentially associated with hypersensitivity reactions. The overall results were consistent with the clinical adverse events observed in some healthy volunteers.

Pharmacokinetic analysis using single dilution assays: enhancing precision, reducing errors and increasing throughput

BACKGROUND

Technologies such as ELISA, MSD, and Gyrolab have been employed for quantifying protein therapeutics in clinical trials. However, these technologies have limitations with dynamic range often requiring multiple dilution steps, introducing potential errors and variability.

RESULTS/METHODOLOGY

A pharmacokinetics assay was successfully developed on the NUcleic acid Linked Immuno-Sandwich Assay (NULISA) platform with a concentration dynamic range exceeding 6 logs. This enabled assessment of all clinical samples across different concentrations with a single dilution, yielding results with good correlation to ELISA and Gyrolab.

CONCLUSIONS

NULISA technology offers high sensitivity, full automation, and a wide dynamic range, streamlining assay development and optimization, simplifying sample analysis, minimizing errors, and increasing throughput.

Integrating machine learning and biosensors in microfluidic devices: A review

Microfluidic devices are increasingly widespread in the literature, being applied to numerous exciting applications, from chemical research to Point-of-Care devices, passing through drug development and clinical scenarios. Setting up these microenvironments, however, introduces the necessity of locally controlling the variables involved in the phenomena under investigation. For this reason, the literature has deeply explored the possibility of introducing sensing elements to investigate the physical quantities and the biochemical concentration inside microfluidic devices. Biosensors, particularly, are well known for their high accuracy, selectivity, and responsiveness. However, their signals could be challenging to interpret and must be carefully analysed to carry out the correct information. In addition, proper data analysis has been demonstrated even to increase biosensors' mentioned qualities. To this regard, machine learning algorithms are undoubtedly among the most suitable approaches to undertake this job, automatically learning from data and highlighting biosensor signals' characteristics at best. Interestingly, it was also demonstrated to benefit microfluidic devices themselves, in a new paradigm that the literature is starting to name "intelligent microfluidics", ideally closing this benefic interaction among these disciplines. This review aims to demonstrate the advantages of the triad paradigm microfluidics-biosensors-machine learning, which is still little used but has a great perspective. After briefly describing the single entities, the different sections will demonstrate the benefits of the dual interactions, highlighting the applications where the reviewed triad paradigm was employed.

Automated System for Attomolar-Level Detection of MiRNA as a Biomarker for Influenza A Virus

We have developed an automated sensing system for the repeated detection of a specific microRNA (miRNA) of the influenza A (H1N1) virus. In this work, magnetic particles functionalized with DNAs, target miRNAs, and alkaline phosphate (ALP) enzymes formed sandwich structures. These particles were trapped on nickel (Ni) patterns of our sensor chip by an external magnetic field. Then, additional electrical signals from electrochemical markers generated by ALP enzymes were measured using the sensor, enabling the highly sensitive detection of target miRNA. The magnetic particles used on the sensor were easily removed by applying the opposite direction of external magnetic fields, which allowed us to repeat sensing measurements. As a proof of concept, we demonstrated the detection of miRNA-1254, one of the biomarkers for the H1N1 virus, with a high sensitivity down to 1 aM in real time. Moreover, our sensor could selectively detect the target from other miRNA samples. Importantly, our sensor chip showed reliable electrical signals even after six repeated miRNA sensing measurements. Furthermore, we achieved technical advances to utilize our sensor platform as part of an automated sensing system. In this regard, our reusable sensing platform could be utilized for versatile applications in the field of miRNA detection and basic research.

Plasma extracellular vesicle tau and TDP-43 as diagnostic biomarkers in FTD and ALS

Minimally invasive biomarkers are urgently needed to detect molecular pathology in frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS). Here, we show that plasma extracellular vesicles (EVs) contain quantifiable amounts of TDP-43 and full-length tau, which allow the quantification of 3-repeat (3R) and 4-repeat (4R) tau isoforms. Plasma EV TDP-43 levels and EV 3R/4R tau ratios were determined in a cohort of 704 patients, including 37 genetically and 31 neuropathologically proven cases. Diagnostic groups comprised patients with TDP-43 proteinopathy ALS, 4R tauopathy progressive supranuclear palsy, behavior variant FTD (bvFTD) as a group with either tau or TDP-43 pathology, and healthy controls. EV tau ratios were low in progressive supranuclear palsy and high in bvFTD with tau pathology. EV TDP-43 levels were high in ALS and in bvFTD with TDP-43 pathology. Both markers discriminated between the diagnostic groups with area under the curve values >0.9, and between TDP-43 and tau pathology in bvFTD. Both markers strongly correlated with neurodegeneration, and clinical and neuropsychological markers of disease severity. Findings were replicated in an independent validation cohort of 292 patients including 34 genetically confirmed cases. Taken together, the combination of EV TDP-43 levels and EV 3R/4R tau ratios may aid the molecular diagnosis of FTD, FTD spectrum disorders and ALS, providing a potential biomarker to monitor disease progression and target engagement in clinical trials.

Automated Bioanalytical Workflow for Ligand Binding-Based Pharmacokinetic Assay Development

The growth of therapeutic monoclonal antibodies (mAbs) continues to accelerate due to their success as treatments for many diseases. As new therapeutics are developed, it is increasingly important to have robust bioanalytical methods to measure the pharmacokinetics (PK) of circulating therapeutic mAbs in serum. Ligand-binding assays such as enzyme-linked immunosorbent assays (ELISAs) with anti-idiotypic antibodies (anti-IDs) targeting the variable regions of the therapeutic antibody are sensitive and specific bioanalytical methods to measure levels of therapeutic antibodies in a biological matrix. However, soluble circulating drug mAb targets can interfere with the anti-IDs binding to the therapeutic mAb, thereby resulting in an underestimation of total drug concentration. Therefore, in addition to a high binding affinity for the mAb, the selection of anti-IDs and the assay format that are not impacted by soluble antigens and have low matrix interference is essential for developing a robust PK assay. Standardized automated approaches to screen and select optimal reagents and assay formats are critical to increase efficiency, quality, and PK assay robustness. However, there does not exist an integrated screening and analysis platform to develop robust PK assays across multiple formats. We have developed an automated workflow and scoring platform with multiple bioanalytical assay parameters that allow for ranking of candidate anti-IDs. A primary automated indirect electrochemiluminescence (ECL) was utilized to shortlist the anti-IDs that were selected for labeling and screening in pairs. A secondary screen using an ECL sandwich assay with labeled-anti-ID pairings was used to test multiple PK assay formats to identify the best anti-ID pairing/PK assay format. We developed an automated assay using fixed plate maps combined with a human-guided graphical user interface-based scoring system and compared it to a data-dependent scoring system using Gaussian mixture models for automated scoring and selection. Our approach allowed for screening of anti-IDs and identification of the most robust PK assay format with significantly reduced time and resources compared with traditional approaches. We believe that such standardized, automated, and integrated platforms that accelerate the development of PK assays will become increasingly important for supporting future human clinical trials.

Affinity-based electrochemical sensors for biomolecular detection in whole blood

The detection and/or quantification of biomarkers in blood is important for the early detection, diagnosis, and treatment of a variety of diseases and medical conditions. Among the different types of sensors for detecting molecular biomarkers, such as proteins, nucleic acids, and small-molecule drugs, affinity-based electrochemical sensors offer the advantages of high analytical sensitivity and specificity, fast detection times, simple operation, and portability. However, biomolecular detection in whole blood is challenging due to its highly complex matrix, necessitating sample purification (i.e., centrifugation), which involves the use of bulky, expensive equipment and tedious sample-handling procedures. To address these challenges, various strategies have been employed, such as purifying the blood sample directly on the sensor, employing micro-/nanoparticles to enhance the detection signal, and coating the electrode surface with blocking agents to reduce nonspecific binding, to improve the analytical performance of affinity-based electrochemical sensors without requiring sample pre-processing steps or laboratory equipment. In this article, we present an overview of affinity-based electrochemical sensor technologies that employ these strategies for biomolecular detection in whole blood.

Fluorescent paper strip immunoassay with carbon nanodots@silica for determination of human serum amyloid A1

A fluorescent paper strip immunoassay in conjunction with carbon nanodots@silica (CND@SiO₂) as a label was developed for the quantitative measurements of human serum amyloid A1 (hSAA1) in serum at clinically significant concentrations for lung cancer diagnosis. Monodispersed CND@SiO₂ was prepared by cohydrolysis between silane-crosslinked carbon nanodots and silica precursors via the Ströber method and further attached covalently to anti-hSAA1 (14F8) monoclonal antibody [anti-hSAA1(14F8)] specific to the hSAA1 target. The hSAA1 concentrations were then determined by quantifying the blue fluorescence intensity upon 365 nm excitation of the captured hSAA1 with anti-hSAA1(14F8)-CND@SiO₂ conjugates in the test line on a paper strip where anti-hSAA1 (10G1) monoclonal antibody was physisorbed. The developed fluorescent paper strip with CND@SiO₂ can detect hSAA1 at concentrations ranging from 0.1 to 5 nM (R² = 0.995), with a limit of detection of  0.258 nM in 10 mM phosphate buffer pH 7.4 containing human serum albumin. The performance of  recovery (90.98-109.17%) and repeatability (coefficients of variation < 8.46%) obtained was also acceptable for quantitative determinations. The platform was employed for direct determination of hSAA1 concentrations in undiluted serum samples from lung cancer patients (relative standard deviation (RSD) < 7.46%) and healthy humans (RSD < 3.96%). The results were compared with those obtained using a commercially available enzyme-linked immunosorbent assay alongside liquid chromatography with tandem mass spectrometry measurements.

Nanocellulose aerogel inserts for quantitative lateral flow immunoassays

The Lateral Flow Immuno Assay (LFIA) is a well-established technique that provides immediate results without high-cost laboratory equipment and technical skills from the users. However, conventional colorimetric LFIA strips suffer from high limits of detection, mainly due to the analysis of a limited sample volume, short reaction time between the target analyte and the conjugation molecules, and a weak optical signal. Thus, LFIAs are mainly employed as a medical diagnostic tool for qualitative and semi/quantitative detection, respectively. We applied a novel cellulose nanofiber (CNF) aerogel material incorporated into LFIA strips to increase the sample flow time, which in turn extends the binding interactions between the analyte of interest and the detection antibody, thus improving the limit of detection (LOD). Compared to a conventional LFIA strip, the longer sample flow time in the aerogel modified LFIA strips improved the LOD for the detection of mouse IgG in a buffer solution by a 1000-fold. The accomplished LOD (0.01 ng/mL) even outperformed specifications of a commercial ELISA kit by a factor of 10, and the CNF aerogel assisted LFIA was successfully applied to detect IgG in human serum with a LOD of 0.72 ng/mL. Next to the improved LOD, the aerogel assisted LFIA could quantify IgG samples in buffer and human serum in the concentration ranges of 0.17 ng/mL - 100 ng/mL (in buffer) and 4.6 ng/mL - 100 ng/mL (in human serum). The presented solution thus poses a unique potential to transform lateral flow assays into highly sensitive, fully quantitative point-of-care diagnostics.

Formation and Glomerular Deposition of Immune Complexes in Mice Administered Human Antibodies: Evaluation of Dose, Frequency, and Biomarkers

Administration of human protein-based drugs to animals often leads to formation of antidrug antibodies (ADAs) that may form circulating immune complexes (CICs) with the dosed protein. Circulating immune complexes can activate and bind complement (cCICs), and if large amount of CICs or cCICs is formed, the clearance mechanism potentially becomes saturated, which can lead to immune complex (IC) deposition and inflammation. To obtain a better understanding of the underlying factors, including the relationship between different dose regimes on IC formation and deposition and identification of possible biomarkers of IC deposition and IC-related pathological changes in kidneys, BALB/c and C57BL/6J mice were administered with human anti-tumor necrosis factor α (aTNFα, adalimumab) or a humanized anti-TNP (aTNP) antibody for 13 weeks. Particularly, ADA, CIC, cCIC formation, IC deposition, and glomerulonephritis were observed in C57BL/6J administered with aTNFα, whereas the immunologic response was minor in BALB/c mice administered with aTNFα and in BALB/c and C57BL/6J mice administered aTNP. Changing dose levels or increasing dosing frequency of aTNFα on top of an already-established CIC and cCIC response did not lead to substantial changes in CIC, cCIC formation, or IC deposition. Finally, no association between the presence of CICs or cCIC in plasma and glomerular IC deposition and/or glomerulonephritis was observed.

Bottlenose dolphin calves have multi-year elevations of plasma oxytocin compared to all other age classes

Providing for infants nutritionally via lactation is one of the hallmarks of mammalian reproduction, and infants without motivated mothers providing for them are unlikely to survive. Mothers must maintain regular contact with infants both spatially and temporally while utilising their environment to forage, avoid threats and find shelter. However, mothers can only do this and maximise their reproductive success with some degree of co-operation from infants, despite their developing physical and cognitive capabilities. The neuropeptide hormone oxytocin (OT) triggers proximity-seeking behaviour and acts in a positive feedback loop across mother-infant bonds, stimulating appropriate pro-social behaviour across the pair. However, data on infant OT levels is lacking, and it is unclear how important infants are in maintaining mother-infant associations. The bottlenose dolphin (Tursiops truncatus) is a mammalian species that is fully physically mobile at birth and has multi-year, but individually variable, lactation periods. We investigated OT concentrations in mother-infant pairs of wild individuals compared to other age and reproductive classes. An ELISA to detect OT in dolphin plasma was successfully validated with extracted plasma. We highlight a statistical method for testing for parallelism that could be applied to other ELISA validation studies. OT concentrations were consistently elevated in calves up to at least 4 years of age with lactating mothers (12.1 ± 0.9 pg/ml), while all mothers (4.5 ± 0.4 pg/ml) had OT concentrations comparable to non-lactating individuals (5.9 ± 0.5 pg/ml). Concentrations within infants were individually variable, and may reflect the strength of the bond with their mother. The OT system likely provides a physiological mechanism for motivating infants to perform behaviours that prevent long-term separation from their mothers during this crucial time in their life history. Elevated infant OT has also been linked to energetic and developmental advantages which may lead to greater survival rates. Environmental or anthropogenic disturbances to OT release can occur during bond formation or can disrupt the communication methods used to reinforce these bonds via OT elevation. Variation in OT expression in infants, and its behavioural and physiological consequences, may explain differences in reproductive success despite appropriate maternal behaviour expression.

Immunostick Test for Detecting ζ-Globin Chains and Screening of the Southeast Asian α-Thalassemia 1 Deletion

Background

Couples who carry α-thalassemia-1 deletion are at 25% risk of having a fetus with hemoglobin Bart’s hydrops fetalis. Southeast Asian deletion (−-(SEA)) is the most common type of α-thalassemia 1 among Southeast Asian populations. Thus, identification of the (−-(SEA)) α-thalassemia 1 carrier is necessary for controlling severe α-thalassemia in Southeast Asian countries.

Results

Using our generated anti ζ-globin chain monoclonal antibodies (mAbs) clones PL2 and PL3, a simple immunostick test for detecting ζ-globin chain presence in whole blood lysates was developed. The procedure of the developed immunostick test was as follows. The immunostick paddles were coated with 50 μg/mL of mAb PL2 as capture mAb, or other control antibodies. The coated immunostick was dipped into cocktail containing tested hemolysate at dilution of 1:500, 0.25 μg/mL biotin-labeled mAb PL3 and horseradish peroxidase-conjugated streptavidin at dilution of 1:1000. The immunostick was then dipped in precipitating substrate and the presence of ζ-globin chain in the tested sample was observed by the naked eye. Upon validation of the developed immunostick test with various types of thalassemia and normal subjects, 100% sensitivity and 82% specificity for detection of the (−-(SEA)) α-thalassemia-1 carriers were achieved. The mAb pre-coated immunostick can be stored at room temperature for at least 20 weeks.

Conclusion

In this study, a novel simple immunostick test for the screening of (−-(SEA)) α-thalassemia 1 carriers was presented. The developed immunostick test, within a single test, contains both positive and negative internal procedural controls.

Ultra-sensitive electrochemical detection of bacteremia enabled by redox-active gold nanoparticles (raGNPs) in a nano-sieving microfluidic system (NS-MFS)

Early diagnosis of bacterial infections is crucial to improving survival rates by enabling treatment with appropriate antibiotics within the first few hours of infection. This paper presents a highly sensitive amperometric biosensor for the detection of several pathogenic bacterial cells in blood plasma around 30 min. The proposed device is based on an electropolymerized self-assembled layer on gold nanoparticles operated in a portable nano-sieving microfluidic system (NS-MFS). The redox-active gold nanoparticles (raGNPs) enhanced the electrical conductivity and provided a greater number of electrochemically active molecules for sensing, while improving resistance to the fouling of sensors by oxidation products in blood plasma. The detection limit of the device has been shown to reach 10 CFU/mL for Pseudomonas aeruginosa and Staphylococcus aureus spiked in plasma. The dynamic range of the sensing system falls between 10 and 10⁵ CFU/mL in a buffer solution by cyclic voltammetry (CV) measurements. The results demonstrated that the raGNPs/NS-MFS can successful detect P. aeruginosa and S. aureus in human plasma, and is very useful for the diagnosis of bacteremia from clinical samples.

Femtomolar Detection of Lipopolysaccharide in Injectables and Serum Samples Using Aptamer-Coupled Reduced Graphene Oxide in a Continuous Injection-Electrostacking Biochip

A method for microfluidic sample preconcentration to detect femtomolar level of lipopolysaccharide (LPS) is introduced, enabled by 6-carboxyfluorescein (6-FAM) labeled aptamer-LPS binding along with reduced graphene oxide (rGO). The free FAM-aptamers can be adsorbed onto the surface of rGO, resulting in fluorescence quenching of background signals. Conversely, the aptamer-LPS complex cannot be adsorbed by rGO, so the fluorescence is maintained and detected. When an electric field is applied across the microchannel with Nafion membrane in the chip, only the fluorescence of aptamer-LPS complex can be detected and stacked by continuous injection-electrostacking (CI-ES). The method shows a high selectivity (in the presence of pyrophosphate, FAD⁺, NAD⁺, AMP, ADP, ATP, phosphatidylcholine, LTA, and β-d-glucans which respond positively to LAL) to LPS and an extreme sensitivity with the limit of detection (LOD) at 7.9 fM (7.9 × 10^-4 EU/mL) and 8.3 fM (8.3 × 10^-4 EU/mL) for water sample and serum sample, respectively. As a practical application, this method can detect LPS in injections and serum samples of human and sepsis model mouse and quickly distinguish Gram-negative bacteria Escherichia coli ( E. coli) from Gram-positive bacteria Staphylococcus aureus ( S. aureus) and fungus Candida albicans ( C. albicans). More importantly, by changing the aptamers based on different targets, we can detect different analytes. Therefore, aptamer-coupled rGO in a CI-ES biochip is a universal, sensitive, and specific method. For TOC only.

Parallelism experiments to evaluate matrix effects, selectivity and sensitivity in ligand-binding assay method development: pros and cons

Parallelism is an essential experiment characterizing relative accuracy for a ligand-binding assay (LBA). By assessing the effects of dilution on the quantitation of endogenous analyte(s) in matrix, selectivity, matrix effects, minimum required dilution, endogenous levels of healthy and diseased populations and the LLOQ are assessed in a single experiment. This review compares and discusses all available approaches that can be used to assess key assay parameters for pharmacokinetic and biomarker LBAs, as well as the advantages and disadvantages of each approach. This review also summarizes a systematic approach that can apply to guide endogenous LBA method development and optimization with a suggested way to interpret parallelism data.

Bypassing nonparallelism of a monoclonal antibody ligand-binding assay by employment of alternative assay formats

Determination of concentration-time profiles in cynomolgus monkeys of a therapeutic monoclonal antibody against a soluble target revealed a substantial discrepancy between a generic anti-human IgG capture/detection and target bridging assay with the target bridging assay leading to dose- and time-dependent underquantification of drug concentrations, lack of parallelism and subsequently different pharmacokinetic parameters. In contrast, plasma levels derived from a target capture and an anti-idiotypic antibody bridging assay were in close concordance with the generic assay and demonstrated parallelism with high precision across several dilutions. The results provide a practical attempt to overcome nonparallelism by employing alternative assay formats utilizing tailored assay reagent combinations in order to obtain unbiased pharmacokinetic data.

Inhibition of interleukin-5 induced false positive anti-drug antibody responses against mepolizumab through the use of a competitive blocking antibody

Mepolizumab, a humanized IgG1 monoclonal antibody that blocks native homodimeric interleukin-5 (IL-5) from binding to the IL-5 receptor, has recently been approved for treatment of severe eosinophilic asthma. Our initial immunogenicity assay method for phase I and II studies utilized a bridging electrochemiluminescence format with biotin and ruthenium-labelled mepolizumab linked by anti-drug antibodies (ADA). We discovered that IL-5 significantly increased in dosed subjects from a phase II study and that the increased IL-5 was in the form of a drug-bound complex. We demonstrated that the elevated drug-bound IL-5 produced false-positive response in the in vitro ADA assay, in which drug-bound IL-5 dissociated and then bridged mepolizumab conjugates to yield positive signal. To eliminate the IL-5 interference, we compared two strategies: a solid-phase immunodepletion of IL-5 and an in-solution IL-5 immunocompetition. We identified the best competitive antibody for each purpose. We found both methods demonstrated similar effectiveness in reducing the false positive signal in IL-5 spiked samples; however, the in-solution immunocompetition for IL-5 had fewer false positives in study samples. Additionally, the in-solution immunocompetition method was experimentally simpler to execute. We modified the ADA assay by adding a pre-treatment step with a mepolizumab competitive anti- IL-5 antibody. Using this new method, we retested clinical samples from two phase II studies (MEA112997 and MEA114092). The confirmed ADA positive incidence was reduced from 29% and 61% to 1% and 8% with the modified in-solution immune inhibition method. Target interference is a fairly common problem facing immunogenicity testing, and target-induced false positive cannot be distinguished from true ADA response by the commonly used drug competitive confirmation assay. The approach and method used here for resolving target interference in ADA detection will be useful for differentiating between a true ADA response and target induced false positive as well as similar challenges in other programs.