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VHH MHCII-antigen-dexamethasone conjugate (VHH MHCII-antigen-DEX) is a preclinical-stage trimodal nanobody-drug conjugate platform developed by Boston Children's Hospital and its spinout company, Cerberus Therapeutics, for the induction of antigen-specific immune tolerance in autoimmune diseases and allergies. The platform utilizes an alpaca-derived single-domain antibody fragment (nanobody/VHH) that targets major histocompatibility complex class II (MHCII) molecules on antigen-presenting cells (APCs). This nanobody is covalently conjugated to a disease- or allergen-specific peptide antigen (such as myelin oligodendrocyte glycoprotein for multiple sclerosis, citrullinated collagen for rheumatoid arthritis, insulin for type 1 diabetes, or ovalbumin/house dust mite for allergic asthma) and the anti-inflammatory corticosteroid dexamethasone (DEX). By delivering both the specific antigen and dexamethasone directly to APCs, the conjugate promotes the deletion, anergy, and regulatory differentiation of pathogenic antigen-specific T cells, thereby restoring long-lasting immune tolerance without causing systemic immunosuppression.
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