{"id":4540,"date":"2025-06-21T09:53:18","date_gmt":"2025-06-21T15:53:18","guid":{"rendered":"https:\/\/allphasepharma.com\/dir\/?p=4540"},"modified":"2025-06-28T23:19:38","modified_gmt":"2025-06-29T05:19:38","slug":"nanobodies-for-autoimmune-diseases","status":"publish","type":"post","link":"https:\/\/allphasepharma.com\/dir\/2025\/06\/21\/4540\/nanobodies-for-autoimmune-diseases\/","title":{"rendered":"NANOBODIES FOR AUTOIMMUNE DISEASES"},"content":{"rendered":"\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/HR-BLOG-NANOS.jpg?ssl=1\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"530\" height=\"149\" src=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/HR-BLOG-NANOS.jpg?resize=530%2C149&#038;ssl=1\" alt=\"\" class=\"wp-image-4558\" srcset=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/HR-BLOG-NANOS.jpg?w=640&amp;ssl=1 640w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/HR-BLOG-NANOS.jpg?resize=300%2C84&amp;ssl=1 300w\" sizes=\"auto, (max-width: 530px) 100vw, 530px\" \/><\/a><\/figure>\n\n\n\n<p>Thrombotic thrombocytopenic purpura (TTP) is a devastating disease with a downhill course of neurologic, renal and cardiac complications leading to death at a young age if untreated.&nbsp; Thrombocytopenia and thrombosis are its hallmark, with fever, anemia and neurologic deficits.<\/p>\n\n\n\n<p>It is caused by large aggregates of vWF, a protein which is normally cleaved by ADAMTS13. In the presence of autoantibodies, activity of this protease is greatly diminished resulting in the formation of vWF multimers..&nbsp;Caplacizumab prevents this pathologic aggregation.&nbsp; Approved in 2019 as Caplivi, it was the first nanobody to make it to patients.<\/p>\n\n\n\n<p>Nanobodies have an interesting history dating back to the discovery of VHH antibodies in camelids in the mid-90s.&nbsp; Ablynx, a Belgian company, was the innovative biotech that recognized the potential of the small-size antibodies early on.&nbsp; They were aware that full-size mAbs have significant shortcomings related to size and target binding.&nbsp; For some diseases, conventional mAbs may not work as well as a nanobody.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><a href=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-1.jpeg?ssl=1\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"530\" height=\"540\" src=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-1.jpeg?resize=530%2C540&#038;ssl=1\" alt=\"\" class=\"wp-image-4543\" style=\"width:265px;height:auto\" srcset=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-1.jpeg?w=652&amp;ssl=1 652w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-1.jpeg?resize=295%2C300&amp;ssl=1 295w\" sizes=\"auto, (max-width: 530px) 100vw, 530px\" \/><\/a><\/figure>\n\n\n\n<p>Figure 1: Camelid antibody without L-chains and without CH1 domain; the VHH segment is the basic building block for single domain nanobodies<\/p>\n\n\n\n<p>Here is a list of reasons to consider nanobodies:<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-7.png?ssl=1\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"530\" height=\"298\" src=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-7.png?resize=530%2C298&#038;ssl=1\" alt=\"\" class=\"wp-image-4546\" srcset=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-7.png?resize=1024%2C575&amp;ssl=1 1024w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-7.png?resize=300%2C169&amp;ssl=1 300w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-7.png?resize=768%2C431&amp;ssl=1 768w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-7.png?resize=1536%2C863&amp;ssl=1 1536w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-7.png?w=1714&amp;ssl=1 1714w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-7.png?w=1590&amp;ssl=1 1590w\" sizes=\"auto, (max-width: 530px) 100vw, 530px\" \/><\/a><\/figure>\n\n\n\n<p>Since then we have another FDA-approved nanobody construct: Ciltacabtagene Autoleucel (Carvykti) is a bivalent nanobody construct for the treatment of relapsed or refractory multiple myeloma.&nbsp; Several nanobodies for tumor diagnostics are also approved.<\/p>\n\n\n\n<p>Given the list of differentiated features and properties, it would seem that nanos should find many uses in oncology and non-oncology indications.&nbsp; Despite this, biologicals such as ADCs, TCE and bispecific mAbs have stolen the show apparently.&nbsp; Most mAbs currently in development are standard IgG derivatives, with non-canonical formats as rare exceptions.<\/p>\n\n\n\n<p>Most mAbs listed in the yearly update of The Antibody Society\u2019s yearly review are for oncology indications.&nbsp; As nanos are among the smallest proteins capable of penetrating the tumor microenvironment, there is a now a significant uptick in numbers in development.&nbsp; A recent update and review of nanos in development for oncologic diseases is provided by DePauw et al.<a href=\"#_ftn1\" id=\"_ftnref1\">[1]<\/a><\/p>\n\n\n\n<p>When we look at autoimmune diseases, nanos entering clinical Phases 1 to 3 are also increasing in numbers, but less than expected.<\/p>\n\n\n\n<p>As of 2023, 8 nanos were in development for autoimmune diseases according to LeadGeneBio (psoriasis, Crohn\u2019s, ulcerative colitis, spondylitis and other non-specified autoimmune diseases).<a href=\"#_ftn2\" id=\"_ftnref2\">[2]<\/a>&nbsp; The list is certainly incomplete; nonetheless it makes the good point that companies develop nanos that are often derivatives of well-established therapeutics like TNFa inhibitors, IL-13 or IL-17 mAbs, or TSLP mAbs.&nbsp; In other words, these nanos are like repurposed mAbs: They represent derisked projects that have the benefit of established efficacy.&nbsp; As such, they are not really breaking new ground.&nbsp; One could therefore \u2013 perhaps cynically &#8211; say that these nanos are \u2018me-toos\u2019, offering minor improvements over existing mAbs, providing known mAb targeting in a nanobody format.&nbsp;<\/p>\n\n\n\n<p>This, however, would be an unfair characterization.&nbsp; Let\u2019s look more systematically at nanos in development that are breaking new ground, going where no mAbs have gone before.&nbsp; <\/p>\n\n\n\n<p>In order to find these novel nanos, we studied the complete lists of mAbs in late stage development published by The Antibody Society.<a href=\"#_ftn3\" id=\"_ftnref3\">[3]<\/a>&nbsp; Their latest tally includes 178 mAbs, with tables providing excellent target and format information.&nbsp;<\/p>\n\n\n\n<p>Surprisingly, with only 2 exceptions, we do not see any nanos in development for non-cancer \/ non-diagnostic indications.<\/p>\n\n\n\n<p>These exceptions are (1) sonelokimab, an IL-17 nano construct developed for PsA, psoriasis and HS, and (2) gefurulimab, a bi-specific nano with binding to complement C5 and albumin.&nbsp; Here the structures:<\/p>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><a href=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-5.png?ssl=1\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"530\" height=\"291\" src=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-5.png?resize=530%2C291&#038;ssl=1\" alt=\"\" class=\"wp-image-4544\" style=\"width:333px;height:auto\" srcset=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-5.png?w=564&amp;ssl=1 564w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-5.png?resize=300%2C165&amp;ssl=1 300w\" sizes=\"auto, (max-width: 530px) 100vw, 530px\" \/><\/a><\/figure>\n\n\n\n<p>Figure 2: M1095 \/ Sonekinumab, a bispecific VHH construct.&nbsp; Ref.<a href=\"#_ftn4\" id=\"_ftnref4\"><strong>[4]<\/strong><\/a><\/p>\n\n\n\n<figure class=\"wp-block-image size-large is-resized\"><a href=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-6.png?ssl=1\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"530\" height=\"143\" src=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-6.png?resize=530%2C143&#038;ssl=1\" alt=\"\" class=\"wp-image-4545\" style=\"width:362px;height:auto\" srcset=\"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-6.png?resize=1024%2C277&amp;ssl=1 1024w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-6.png?resize=300%2C81&amp;ssl=1 300w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-6.png?resize=768%2C208&amp;ssl=1 768w, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/image-6.png?w=1263&amp;ssl=1 1263w\" sizes=\"auto, (max-width: 530px) 100vw, 530px\" \/><\/a><\/figure>\n\n\n\n<p>Figure 3: Gefurulimab, a bi-specific VHH construct. Ref <a href=\"#_ftn5\" id=\"_ftnref5\"><strong>[5]<\/strong><\/a><\/p>\n\n\n\n<p>Why so few nanos for autoimmune disease indications?<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>A short word about sonelokimab. This is a great bi-specific nano developed by Merck KG and and MoonLake.&nbsp; It is an IL-17A plus IL-17F blocker, connected to albumin to improve its half-life.&nbsp; In late clinical trials, it has shown excellent efficacy even in patients with hidradenitis suppurativa (HS), a tough challenge for any IL-17 or TNFa antibody.&nbsp; Once approved it will become clearer whether it can truly provide superior efficacy.&nbsp; As a late arrival to the market, it will be hard to beat the competition which is heating up.&nbsp;HS is a fairly common condition in the US: 1 in 250 adults are affected by some estimates <a href=\"#_ftn6\" id=\"_ftnref6\">[6]<\/a>.&nbsp; Bimekizumab\/Bimzelx, a full-size mAb targeting IL-17A \/ IL-17F just like sonelokimab, is already approved for HS, but its efficacy comes with a higher rate of oral candidiasis. &nbsp;Secukinumab\/Cosentyx just garnered FDA approval for HS as well.&nbsp;<\/p>\n<\/blockquote>\n\n\n\n<p>Back to nanos in development for autoimmune diseases.&nbsp; The Antibody Society list is woefully incomplete.&nbsp; Alexander et al. published what we believe is a more up-to-date and more comprehensive review of nanobodies in development <a href=\"#_ftn7\" id=\"_ftnref7\">[7]<\/a>.&nbsp; For non-onc indications, the authors list nanos for infectious diseases like SARS\/Covid, HIV, HBV, RSV and other viruses; the MoA being block of surface receptors or neutralization of antitoxins.&nbsp; The stability of nanos is a favorable and desired feature, esp.with aerosolized use for the prophylaxis (and treatment?) of viral respiratory infections.&nbsp;&nbsp;<\/p>\n\n\n\n<p>More interesting is the use of nanos in neurologic diseases.&nbsp; Brain penetration cannot be achieved with full-size mAbs unless there is a leaky BBB.&nbsp; Otherwise it would be hard to explain the CNS findings in Alzheimer studies with aducanumab and lecanemab.&nbsp; There is also some evidence that secukinumab may be able to penetrate the CSF based on results in RRMS.&nbsp; Used with the transferrin shuttle, better CNS levels can possibly be achieved.&nbsp; These studies are still at very early stages but AD, PD, and ALS are neurodegenerative diseases with significant immune components; nanos could potentially revolutionize the field of neurology.&nbsp;<\/p>\n\n\n\n<p>For autoimmune diseases, most development work is still centered on the tried-and-true: mimicking the efficacy of TNF\u03b1, interleukin and lymphokine blockers, often as dual nanos for combined receptor interaction.&nbsp; This seems advantageous for scientific, PK, and other reasons \u2013 after all, combining standard mAbs would be prohibitively expensive.&nbsp;&nbsp;<\/p>\n\n\n\n<p><\/p>\n\n\n\n<figure class=\"wp-block-pullquote\"><blockquote><p>Looking for the rise of nanobodies in AI in the years ahead, esp. in neurology<\/p><cite>H REINHART MD<\/cite><\/blockquote><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>NOTE:&#8221;Nobody&#8221; is a trademarks of Ablynx, now a Sanofi company<\/p>\n\n\n\n<p><strong>ABBREVIATIONS<\/strong><br \/>ACE2\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 angiotensin\u00a0 converting enzyme 2<br \/>AD\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Alzheimer\u2019s disease<br \/>ADA\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0anti-drug antibody<br \/>ADAMTS13\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 von Willebrand factor-cleaving protease<br \/>ADC\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 antibody-drug conjugate<br \/>ADCC\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 antibody-dependent cellular cytotoxicity<br \/>AI                                          autoimmune (disease) &#8211; not artificial intelligence!<br \/>ALS\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 amyotrophic lateral sclerosis<br \/>BBB\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 blood-brain barrier<br \/>CDR\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 complementarity determining region<br \/>CNS\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 central nervous system<br \/>CSF\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 cerebrospinal fluid<br \/>GPCR\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G-protein coupled receptor<br \/>HS\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 hidradenitis suppurativa<br \/>PD\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Parkinson\u2019s disease<br \/>RBD\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 receptor-binding domain \/ Covid<br \/>RRMS\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 recurrent\/relapsing multiple sclerosis<br \/>RSV\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 respiratory syncytial virus<br \/>TCE\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T-cell engager<br \/>TSLP\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 thymic stromal lymphopoietin<br \/>TTP\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0thrombotic thrombocytopenic purpura<br \/>VHH\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 variable piece of heavy chain of camelid antibody<br \/>vWF\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 von Willebrand factor<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>REFERENCES<\/strong><br \/><a href=\"#_ftnref1\" id=\"_ftn1\">[1]<\/a> DePauw T. Current status and future expectations of nanobodies in oncology trials.&nbsp; Expert Opinion Investigational Drugs, 32:, 705, 2023<br \/><a href=\"#_ftnref2\" id=\"_ftn2\">[2]<\/a> https:\/\/www.leadgenebio.com\/scientific_knowledge\/detail\/nanobodies_2024_en<br \/><a href=\"#_ftnref3\" id=\"_ftn3\">[3]<\/a> Crescioli S. Antibodies to watch in 2025.&nbsp; MABS 2025, 17:&nbsp; 2443538. https:\/\/doi.org\/10.1080\/19420862.2024.2443538<br \/><a href=\"#_ftnref4\" id=\"_ftn4\">[4]<\/a> Svecova D.&nbsp; A randomized, double-blind, placebo-controlled phase 1 study of multiple ascending doses of subcutaneous M1095, an anti\u2013interleukin 17A\/F nanobody, in moderate-to-severe psoriasis.&nbsp; J Am Acad Dermatol 81, : 196, 2019<br \/><a href=\"#_ftnref5\" id=\"_ftn5\">[5]<\/a> Jindal S.&nbsp; Characterization of the bispecific VHH antibody gefurulimab (ALXN1720) targeting complement component 5, and designed for low volume subcutaneous administration.&nbsp; Mol Immunol 165: 29, 2024<br \/><a href=\"#_ftnref6\" id=\"_ftn6\">[6]<\/a> Jifri A.&nbsp; Prevalence of Hidradenitis Suppurativa.&nbsp; A Systematic Review and Meta-regression Analysis.&nbsp; JAMA Dermatol 2021;157:924<br \/><a href=\"#_ftnref7\" id=\"_ftn7\">[7]<\/a> Alexander E. Discovery of nanobodies: a comprehensive review of their applications and potential over the past five years.&nbsp; J Nanobiotechnol 2024; 22:661<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Thrombotic thrombocytopenic purpura (TTP) is a devastating disease with a downhill course of neurologic, renal and cardiac complications leading to death at a young age if untreated.&nbsp; Thrombocytopenia and thrombosis are its hallmark, with fever, anemia and neurologic deficits. It is caused by large aggregates of vWF, a protein which <a class=\"more-link\" href=\"https:\/\/allphasepharma.com\/dir\/2025\/06\/21\/4540\/nanobodies-for-autoimmune-diseases\/\">Continue reading <span class=\"screen-reader-text\">  NANOBODIES FOR AUTOIMMUNE DISEASES<\/span><span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":4558,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[227,3,18],"tags":[2278,2289,2265,2285,2292,1271,2279,2281,2288,2286,2263,2264,2274,2275,2273,2272,2261,2007,2287,1583,2269,237,2268,2262,2290,2291,2259,2258,2217,2277,2276,2266,2280,2282,801,2260,2257,2284,2283,2267,2271,2270],"class_list":["post-4540","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-recent_literature","category-the_news","category-the_viewpoint","tag-ablynx","tag-adacanumab","tag-adalimumab","tag-adc","tag-aduhelm","tag-allphase-pharma-consulting","tag-alzheimers-disease","tag-amyotrophic-lateral-sclerosis","tag-anti-c5-nanobody","tag-antibody-drug-conjugate","tag-bimekizumab","tag-bimzelx","tag-caplacizumab","tag-caplivi","tag-carvykti","tag-ciltacabtagene-autoleucel","tag-cosentyx","tag-crohns-disease","tag-gefurulimab","tag-harald-reinhart","tag-hidradenitis-suppurativa","tag-humira","tag-il-13-mab","tag-il-17-mab","tag-lecanemab","tag-leqembi","tag-merck-kg","tag-moonlake-immunotherapeutics","tag-multiple-sclerosis","tag-nanobodies-in-development","tag-nanobody","tag-oral-candidiasis","tag-parkinsons-disease","tag-rrms","tag-sanofi","tag-secukinumab","tag-sonelokimab","tag-t-cell-engager","tag-tce","tag-tnf-mab","tag-tslp","tag-ulcerative-colitis"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/06\/HR-BLOG-NANOS.jpg?fit=640%2C180&ssl=1","jetpack_shortlink":"https:\/\/wp.me\/p4KWFr-1be","jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":4416,"url":"https:\/\/allphasepharma.com\/dir\/2025\/05\/30\/4416\/baff-april-inhibitors-homing-in-on-igan\/","url_meta":{"origin":4540,"position":0},"title":"BAFF \/ APRIL Inhibitors Homing in on IgAN","author":"Harald","date":"May 30, 2025","format":false,"excerpt":"Today we discuss the group of BAFF\/APRIL inhibitors, specifically the three TACI mAb constructs that are currently in development. They were tested in a broad gamut of B-cell indications but failed to show efficacy in many. So far, consistent clinical success has been seen only in IgA nephropathy (IgAN), with\u2026","rel":"","context":"In &quot;Recent Literature&quot;","block_context":{"text":"Recent Literature","link":"https:\/\/allphasepharma.com\/dir\/category\/recent_literature\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/05\/HR-BLOG-BAFF-APRIL.jpg?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/05\/HR-BLOG-BAFF-APRIL.jpg?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/05\/HR-BLOG-BAFF-APRIL.jpg?resize=525%2C300&ssl=1 1.5x"},"classes":[]},{"id":3131,"url":"https:\/\/allphasepharma.com\/dir\/2017\/02\/02\/3131\/monoclonal-pursuit-cmv-therapeutic\/","url_meta":{"origin":4540,"position":1},"title":"The Monoclonal Pursuit of the Next CMV Therapeutic","author":"Harald","date":"February 2, 2017","format":false,"excerpt":"There is no doubt that immunity to human cytomegalovirus (CMV) is both cell-and antibody-mediated. Studies in transplant patients showed that absence of T-cell protection with\u00a0chemotherapy is a set-up for recurrent and severe CMV disease. It was also shown that patients with pre-existing CMV antibodies are less likely to develop CMV\u2026","rel":"","context":"In &quot;Recent Literature&quot;","block_context":{"text":"Recent Literature","link":"https:\/\/allphasepharma.com\/dir\/category\/recent_literature\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2017\/02\/CMV-blog-slider.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2017\/02\/CMV-blog-slider.jpg?resize=350%2C200 1x, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2017\/02\/CMV-blog-slider.jpg?resize=525%2C300 1.5x"},"classes":[]},{"id":2157,"url":"https:\/\/allphasepharma.com\/dir\/2015\/12\/03\/2157\/there-is-momentum-building-for-rsv-therapeutics\/","url_meta":{"origin":4540,"position":2},"title":"There is Momentum Building for RSV Therapeutics","author":"Harald","date":"December 3, 2015","format":false,"excerpt":"Sometimes \u2013 for no obvious reason \u2013 there is a flurry of publications from a particular area which has been quiet for a long time.\u00a0 RSV is such an area where new drug development had a hard time getting started.\u00a0 There was always the lure of big money: an infection\u2026","rel":"","context":"In &quot;Recent Literature&quot;","block_context":{"text":"Recent Literature","link":"https:\/\/allphasepharma.com\/dir\/category\/recent_literature\/"},"img":{"alt_text":"RSV - banner copy","src":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2015\/11\/RSV-banner-copy.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2015\/11\/RSV-banner-copy.jpg?resize=350%2C200 1x, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2015\/11\/RSV-banner-copy.jpg?resize=525%2C300 1.5x"},"classes":[]},{"id":3211,"url":"https:\/\/allphasepharma.com\/dir\/2017\/03\/05\/3211\/qidp-liberal-hand-out-fda\/","url_meta":{"origin":4540,"position":3},"title":"QIDP, a Liberal Hand-Out from FDA","author":"Harald","date":"March 5, 2017","format":false,"excerpt":"On our blog site, \u2018QIDP\u2019 stands for \u201cQualified Infectious Diseases Product\u201d but when you look up \u2018QIDP\u2019 on the internet, you will find that it also stands for \u201cQualified Intellectual Disabilities Professional\u201d. 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