Current views on N-glycolylneuraminic acid in therapeutic recombinant proteins

The incorporation of the non-human N-glycolylneuraminic acid (Neu5Gc) in therapeutic recombinant proteins raises clinical concerns due to its immunogenic potential and the high prevalence of pre-existing anti-Neu5Gc antibodies in humans. The scientific literature is ambiguous regarding the actual impact of Neu5Gc-containing biotherapeutics as no severe adverse clinical manifestations were unequivocally attributed to Neu5Gc for currently marketed biotherapeutics. This review discusses structural and functional considerations of Neu5Gc-containing glycans regarding the potential impact on drug clearance, their recognition by pre-existing antibodies, and recent hypotheses regarding the tolerance to low Neu5Gc levels. Furthermore, it provides recommendations regarding the standardization of analysis and reporting, analytical aspects relevant for assessing risks associated with Neu5Gccontaining biotherapeutics, and approaches to minimize Neu5Gc incorporation in recombinant protein manufacturing.

Automated summary

The review discusses the structural and functional considerations of Neu5Gc-containing glycans in therapeutic recombinant proteins, including their potential impact on drug clearance, recognition by pre-existing antibodies, and recent hypotheses regarding tolerance to low Neu5Gc levels. Recommendations are provided for standardization of analysis and reporting, relevant analytical aspects for risk assessment associated with Neu5Gc-containing biotherapeutics, and approaches to minimize Neu5Gc incorporation in recombinant protein manufacturing.