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VHHMHCII-MOG-DEX is a preclinical trimodal nanobody-peptide-drug conjugate designed to induce antigen-specific tolerance for the treatment of multiple sclerosis (MS). The therapeutic construct consists of an alpaca-derived single-domain antibody fragment (nanobody) targeting major histocompatibility complex class II (MHCII) antigens, which is site-specifically conjugated at its C-terminus to a myelin oligodendrocyte glycoprotein (MOG) peptide (specifically MOG35-55) and the anti-inflammatory corticosteroid dexamethasone (DEX). By targeting MHCII, the conjugate selectively delivers the autoantigen and dexamethasone to professional antigen-presenting cells (APCs) such as dendritic cells, macrophages, and B cells under non-inflammatory conditions. This targeted delivery promotes the deletion, anergy, and regulatory differentiation of MOG-specific T cells, effectively halting and reversing the severity of experimental autoimmune encephalomyelitis (EAE) in animal models without causing systemic immunosuppression.
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