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Targeted Two-Drug Combo Therapy:

How it works

In patients with Systemic Lupus Erythematosus, CD4+ T cells are overactive, resulting in the overwhelming production of autoantibodies. These autoantibodies then attack healthy tissue and organs instead of foreign invaders. The intravenous targeted two-drug combo therapy will effectively normalize T cell metabolism to prevent the overproduction of autoantibodies. A combination of metformin and 2-deoxy-D-glucose are placed inside the aqueous solution core of a liposome, a nanoparticle that serves as a drug delivery vehicle. The surface of the liposome is surrounded by monoclonal antibodies, in which their targeting abilities allow the therapy to travel through the bloodstream until it finds and binds to CD4 and gp96 proteins on the surface of a T cell. By excluding a cytotoxic agent, the monoclonal antibodies will not destroy it. After binding to the cell, the lipid bilayer of the liposome fuses with the cell membrane, releasing the drugs into its interior. They will then work to slow down glucose and mitochondrial metabolism. This normalization will reduce autoantibody production, preventing attacks on healthy tissue. Instead of simply treating symptoms of lupus, the targeted two-drug combo therapy will target the potential cause of the disease, creating a more efficient and reliable treatment.

Why use CD4 and gp96 antibodies?

According to a study by scientists, Jung Min Han, Nam Hoon Kwon, Jin Young Lee, Seung Jae Jeong, Hee Jung Jung, Hyeong Raee Kim, Zihai Li, and Sunghoon Kim, â€‹â€‹mice that largely expressed gp96 proteins on cell surfaces showed lupus phenotypes through their correlation with inflammation. These proteins also act as activators for dendritic cells. Their significance in these processes suggests that they are only chronically present on defective T cells. This ensures that the Targeted Two-Drug Combo Therapy will most often target these defective cells.

Scientists Miceli MC and Parnes JR. discussed the roles of CD4 proteins in T cell activation. These proteins initiate the early phase of T cell activation by interacting with the T cell receptor and MHC ligands presented on antigen presenting cells. Their presence on CD4+ T cells aids in the targeting of these specific cells, critical to the success of the treatment. 

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