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XOMA 3AB is a novel therapeutic antibody mixture developed to combat botulinum neurotoxin serotype A (BoNT/A), classified as a category A bioterrorism agent. It is an equimolar mixture of three distinct IgG1 monoclonal antibodies (MAbs), referred to as Aa, Ab, and Ac. Each antibody has been engineered with distinct human or humanized variable regions that bind to different regions/epitopes of BoNT/A, including subtypes A1, A2, A3, and A4. The antibodies share a common human light and heavy chain constant region. The antibodies work synergistically through multiple mechanisms including increasing functional binding affinity, blocking multiple epitopes on the toxin-binding domain surface, and facilitating first-pass hepatic clearance of immune complexes. This results in highly potent neutralization of the toxin. Clinical trials have shown XOMA 3AB to be well-tolerated and non-immunogenic, unlike some current antitoxin therapies.
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