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An anti-PD-1 immunotoxin (specifically PD-1 DIT) is a recombinant fusion protein designed to selectively deplete programmed cell death protein 1 (PD-1)-expressing cells, such as activated lymphocytes and macrophages. Developed at the University of Utah, the immunotoxin is composed of two single-chain variable fragments (scFv) derived from an anti-PD-1 antibody conjugated to the catalytic and translocation domains of diphtheria toxin. By targeting PD-1, the immunotoxin is internalized into PD-1+ cells, where the diphtheria toxin payload inhibits protein synthesis via ADP-ribosylation of elongation factor 2 (EF-2), leading to cell death. This targeted depletion of pathogenic PD-1+ immune cells has shown therapeutic potential in preclinical models of temporal lobe epilepsy (by crossing the blood-brain barrier to ameliorate neuroinflammation), type 1 diabetes, multiple sclerosis (experimental autoimmune encephalomyelitis), and cancer.
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