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Pepinemab is a humanized IgG4 monoclonal antibody that targets and blocks the activity of semaphorin 4D (SEMA4D, also known as CD100). SEMA4D is involved in multiple cellular processes contributing to neuroinflammatory and neurodegenerative diseases as well as cancer. By inhibiting SEMA4D, pepinemab modulates the activity of astrocytes and microglia (innate inflammatory brain cells), promotes differentiation of oligodendrocyte precursor cells for remyelination, and helps maintain blood-brain barrier integrity. It has potential immunomodulating and antineoplastic activities. Pepinemab is being developed primarily for neurodegenerative disorders such as Huntington’s disease and Alzheimer’s disease, with additional investigation in various cancers including non-small cell lung cancer, melanoma, head and neck cancer, adenocarcinoma, osteosarcoma, squamous cell carcinoma among others. Clinical trials have shown signals of cognitive improvement in Huntington’s disease patients and early-stage Alzheimer’s disease patients. The drug is investigational with no current regulatory approval.
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