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Bispecific Antibodies: Design, Development, and Therapeutic Potential

Biointron 2024-03-29 Read time: 7 mins
Mechanism and structure of different types of BsAbs. DOI: 10.3390/ph16101461

In the evolving landscape of biomedical research, bispecific antibodies (bsAbs) stand out as a remarkable innovation, heralding a new era in targeted therapy. Unlike traditional monoclonal antibodies that bind to a single specific antigen, bsAbs are engineered to engage with two distinct antigens simultaneously. This unique ability positions bAbs as a powerful tool in modern medicine, particularly in the treatment of complex diseases like cancer, autoimmune disorders, and infectious diseases.   

Understanding Bispecific Antibodies

Bispecific antibodies are artificially created antibodies that possess the unique capability to bind two different antigens or epitopes at the same time. This dual-targeting feature is achieved through various genetic and protein engineering techniques, enabling bsAbs to perform functions beyond the reach of conventional monoclonal antibodies. The mechanism of action for bsAbs can vary significantly depending on their structure and target antigens. For instance, in cancer therapy, some are designed to recruit immune cells to tumor cells, bridging an effective attack directly to the cancerous cells. 

BsAbs can be broadly categorized into two main types: IgG-like and non-IgG-like antibodies. IgG-like bsAbs maintain a structure similar to natural antibodies, with modifications to allow for dual antigen binding. This category benefits from the natural stability and long half-life of IgG antibodies, making them highly suitable for therapeutic applications. Non-IgG-like bsAbs, on the other hand, are more varied in structure, often designed for specific applications where size, flexibility, or binding characteristics are prioritized over structural similarity to natural antibodies. Examples include tandem single-chain variable fragments (scFvs) and diabodies, each tailored to optimize therapeutic efficacy and manufacturability.1


Designing Bispecific Antibodies

Designing a bispecific antibody (bsAb) is a multi-step process requiring careful planning and advanced techniques. The first step involves defining the target and desired outcome. Scientists need to identify the two specific molecules (antigens) the bsAb should bind to and determine the intended effect. This could involve blocking an interaction between the antigens, triggering an immune response against one, or delivering a therapeutic payload. 

Next comes choosing a format for the bsAb. Different configurations exist, each with its strengths and weaknesses. Bivalent bsAbs and TandAbs are common choices, featuring two distinct binding sites or linked single-chain fragments for targeting separate antigens. With the target and format defined, computational modeling comes into play. Scientists can use software to analyze the structures of the target antigens and predict how different bsAb configurations might interact. This helps identify optimal binding sites on each antigen for effective bsAb function.2

Designing a bsAb also involves considerations like linker design, which connects the two antigen-binding regions and is crucial for proper folding and function. Additionally, factors like stability during production and potential modifications for improved manufacturability need to be addressed. 

Following successful engineering, the bsAb is expressed in host cells, purified, and rigorously tested. Scientists evaluate its binding specificity and affinity for the target antigens, ensuring it interacts as designed. Additionally, they assess the bsAb's ability to achieve the desired biological effect, such as blocking an interaction or triggering an immune response.  

Therapeutic Applications

In the realm of cancer treatment, bsAbs have made significant strides, especially in immunotherapy. By bridging tumor cells and immune cells, bsAbs can directly recruit and activate the patient's immune system to target and destroy cancer cells. This is achieved through mechanisms like T-cell redirection, where bsAbs bind to a tumor antigen with one arm and a T-cell receptor with the other, effectively directing T-cells to cancer cells. 

BsAbs are also being investigated for their potential in treating autoimmune diseases. By targeting specific immune cell receptors and blocking the interaction with their ligands, bsAbs can modulate the immune response. This precise targeting helps to reduce the systemic immunosuppression associated with traditional therapies, leading to fewer side effects and improved patient outcomes. 

In infectious diseases, bsAbs offer a novel approach by simultaneously neutralizing pathogens and modulating the immune response. For inflammatory disorders, their dual-targeting ability allows for the blockade of multiple inflammatory pathways, potentially offering more effective control of disease activity than single-targeted agents. 

One of the first bispecific antibodies to gain approval was Blinatumomab, designed for the treatment of acute lymphoblastic leukemia (ALL). It targets CD19 on B cells and CD3 on T cells, redirecting T cells to attack leukemic cells.3 Its success in clinical trials and subsequent market approval highlighted the therapeutic potential of bsAbs, especially in diseases where conventional treatments have failed. 


Emerging Trends 

One of the most exciting trends in bsAbs research is the development of tri-specific antibodies, capable of binding three distinct antigens, which could further enhance specificity and therapeutic effect. Additionally, there is a growing interest in improving the manufacturability and scalability of bsAbs to ensure they can be produced efficiently and cost-effectively. 

Advancements in understanding the molecular mechanisms of diseases are guiding the design of next-generation bsAbs with even greater precision and efficacy. The integration of artificial intelligence and machine learning in the design process holds the promise of accelerating the discovery and optimization of novel bsAbs.  

As the scientific community continues to explore the vast potential of bispecific antibodies, their role in advancing personalized medicine and transforming patient care becomes increasingly evident. With each breakthrough, BsAbs are not only expanding the frontiers of therapeutic possibilities but also offering new hope for patients facing life-threatening conditions. Biointron offers bispecific antibody production with our high-throughput expression and optimization services. Contact us to learn more at



  1. Liguori, L., Polcaro, G., Nigro, A., Conti, V., Sellitto, C., Perri, F., Ottaiano, A., Cascella, M., Zeppa, P., Caputo, A., Pepe, S., & Sabbatino, F. (2022). Bispecific Antibodies: A Novel Approach for the Treatment of Solid Tumors. Pharmaceutics, 14(11).

  2. Wang, Q., Chen, Y., Park, J., Liu, X., Hu, Y., Wang, T., McFarland, K., & Betenbaugh, M. J. (2019). Design and Production of Bispecific Antibodies. Antibodies, 8(3), 43.

  3. Richard Burt, Dana Warcel & Adele K. Fielding (2019) Blinatumomab, a bispecific B-cell and T-cell engaging antibody, in the treatment of B-cell malignancies, Human Vaccines & Immunotherapeutics, 15:3, 594-602, DOI: 10.1080/21645515.2018.1540828

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