6R8X image
Entry Detail
PDB ID:
6R8X
Keywords:
Title:
COAGULATION FACTOR XI CATALYTIC DOMAIN IN COMPLEX WITH FAB-PORTION OF MAA868
Biological Source:
Source Organism:
PDB Version:
Deposition Date:
2019-04-02
Release Date:
2019-04-10
Method Details:
Experimental Method:
Resolution:
2.04 Å
R-Value Free:
0.28
R-Value Work:
0.22
Space Group:
C 1 2 1
Macromolecular Entities
Polymer Type:polypeptide(L)
Description:Coagulation factor XI
Chain IDs:A
Chain Length:238
Number of Molecules:1
Biological Source:Homo sapiens
Polymer Type:polypeptide(L)
Description:anti-Factor-XI Fab fragment light chain MAA868
Chain IDs:B
Chain Length:216
Number of Molecules:1
Biological Source:unidentified
Polymer Type:polypeptide(L)
Description:anti-Factor-XI Fab fragment heavy chain MAA868
Chain IDs:C
Chain Length:236
Number of Molecules:1
Biological Source:unidentified
Primary Citation
MAA868, a novel FXI antibody with a unique binding mode, shows durable effects on markers of anticoagulation in humans.
Blood 133 1507 1516 (2019)
PMID: 30692123 DOI: 10.1182/blood-2018-10-880849

Abstact

A large unmet medical need exists for safer antithrombotic drugs because all currently approved anticoagulant agents interfere with hemostasis, leading to an increased risk of bleeding. Genetic and pharmacologic evidence in humans and animals suggests that reducing factor XI (FXI) levels has the potential to effectively prevent and treat thrombosis with a minimal risk of bleeding. We generated a fully human antibody (MAA868) that binds the catalytic domain of both FXI (zymogen) and activated FXI. Our structural studies show that MAA868 traps FXI and activated FXI in an inactive, zymogen-like conformation, explaining its equally high binding affinity for both forms of the enzyme. This binding mode allows the enzyme to be neutralized before entering the coagulation process, revealing a particularly attractive anticoagulant profile of the antibody. MAA868 exhibited favorable anticoagulant activity in mice with a dose-dependent protection from carotid occlusion in a ferric chloride-induced thrombosis model. MAA868 also caused robust and sustained anticoagulant activity in cynomolgus monkeys as assessed by activated partial thromboplastin time without any evidence of bleeding. Based on these preclinical findings, we conducted a first-in-human study in healthy subjects and showed that single subcutaneous doses of MAA868 were safe and well tolerated. MAA868 resulted in dose- and time-dependent robust and sustained prolongation of activated partial thromboplastin time and FXI suppression for up to 4 weeks or longer, supporting further clinical investigation as a potential once-monthly subcutaneous anticoagulant therapy.

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