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EcNΔlpp::A5-aTN is an engineered live biotherapeutic product (LBP) derived from the probiotic *Escherichia coli* Nissle 1917 (EcN), developed for the treatment of ulcerative colitis (UC). The strain is genetically modified to surface-display Annexin A5 (ANXA5), a protein that binds to phosphatidylserine (PS) exposed on the surface of apoptotic colonic epithelial cells, thereby improving the targeting and colonization of the bacteria at sites of intestinal inflammation. To enhance therapeutic delivery, the *lpp* gene (encoding Braun's lipoprotein) is deleted to increase the secretion of an anti-TNF-α nanobody (aTN) cargo. This dual-action approach combines localized anti-inflammatory activity with improved mucosal barrier restoration and immune-microbiota balance, offering a potential alternative to systemic anti-TNF biologics with reduced side effects and improved cost-effectiveness.
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