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HMGB1 neutralizing antibody refers to a class of monoclonal or polyclonal antibodies designed to bind and neutralize high mobility group box 1 (HMGB1), a highly conserved non-histone nuclear protein. Under physiological conditions, HMGB1 stabilizes nucleosome structure and regulates gene transcription. However, upon cellular stress, injury, or necrosis, HMGB1 is actively secreted or passively released into the extracellular space, where it functions as a key damage-associated molecular pattern (DAMP) or alarmin. Extracellular HMGB1 triggers robust inflammatory responses by binding to pattern recognition receptors, primarily Toll-like receptor 4 (TLR4), Toll-like receptor 2 (TLR2), and the receptor for advanced glycation end products (RAGE). By neutralizing extracellular HMGB1, these antibodies block its interaction with these receptors, thereby mitigating downstream pro-inflammatory cytokine release and tissue damage. HMGB1 neutralizing antibodies are being widely investigated in preclinical models of sterile and infectious inflammation, including acute kidney injury-induced acute lung injury, ischemia-reperfusion injury, colitis, and sepsis. Clinical-stage candidates, such as Change Cure's CC001, are also entering clinical trials for neurodegenerative conditions like frontotemporal lobar degeneration (FTLD).
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