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Cx43-M2 (also known as ALMB-0168 in its humanized form) is a first-in-class monoclonal antibody agonist that specifically targets and activates connexin 43 (Cx43) hemichannels in osteocytes. Developed by researchers at the University of Texas Health Science Center at San Antonio and licensed to AlaMab Therapeutics (a subsidiary of CSPC Pharmaceutical Group), Cx43-M2 binds to the second extracellular loop of Cx43, promoting hemichannel opening and the subsequent release of adenosine triphosphate (ATP) and prostaglandin E2 (PGE2) into the extracellular microenvironment. This action suppresses tumor growth and metastasis in bone-involved cancers, such as osteosarcoma and breast cancer bone metastasis, by transforming the bone microenvironment from tumor-supportive to tumor-suppressive and enhancing anti-tumor immunity (e.g., activating CD8+ cytotoxic T cells). Additionally, Cx43-M2-mediated hemichannel activation has shown therapeutic potential in preventing bone loss and osteocyte apoptosis associated with disuse (mechanical unloading) and aging.
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