Researchers at The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center have developed a promising new antibody-based therapy that could revolutionize treatment for mucormycosis, a deadly fungal infection that primarily affects immunocompromised individuals.
The research team, led by Dr. Ashraf Ibrahim and Dr. Yiyou Gu, recently published their findings in Science Translational Medicine, detailing how their humanized monoclonal antibody VX-01 targets a key fungal protein to prevent tissue invasion and enhance treatment efficacy.
Rising Global Health Threat
Mucormycosis, caused by fungi of the Mucorales order, has seen a steady increase in cases over the past four decades. The infection carries mortality rates approaching 60% in vulnerable populations, including patients with poorly controlled diabetes, those undergoing cancer chemotherapy, and organ transplant recipients. The disease gained significant attention during the COVID-19 pandemic when numerous patients treated with high-dose corticosteroids developed the infection.
Currently, the United States reports approximately 4,000 cases annually, while Southeast Asia—particularly India, where the disease is endemic—sees around 200,000 cases per year. Unlike viral and bacterial infections that have benefited from advances in vaccines and immunotherapies, mucormycosis has lacked effective targeted treatments.
"Mucormycosis is a devastating disease that usually occurs in patients who suffer from weakened immune system," explained Dr. Ibrahim, who has been investigating fungal and bacterial infections at The Lundquist Institute for over 33 years. He noted that the disease's prevalence has increased due to rising rates of diabetes and cancer, as well as advancements in transplant procedures that require immunosuppression.
Novel Mechanism of Action
The research team's breakthrough centers on targeting CotH, a critical cell surface protein that enables the fungus to invade human cells and blood vessels. This invasion mechanism is particularly problematic because it damages the very blood vessels needed to deliver antifungal medications to infected tissues.
VX-01, the humanized monoclonal antibody developed by Ibrahim and Gu, has demonstrated superior binding to fungal cells compared to earlier antibody versions. By preventing the fungus from damaging blood vessels, VX-01 allows conventional antifungal drugs to reach infected areas more effectively.
"Our humanized monoclonal antibody allows antifungal drug therapy to reach infected tissues because it prevents fungal cells from damaging human cells and blood vessels," Dr. Ibrahim stated.
Clinical Implications and Future Directions
Mucormycosis is currently treated as a medical emergency, often requiring extensive and disfiguring surgical removal of infected tissues alongside antifungal medications. The development of VX-01 represents a significant advancement that could potentially reduce the need for such aggressive surgical interventions.
Preliminary safety testing has shown that VX-01 has no harmful effects on healthy human cells, suggesting a favorable safety profile. The humanized nature of the antibody is particularly important for clinical applications, as it reduces immunogenicity—the tendency to provoke an unwanted immune response—while enhancing therapeutic effectiveness in humans.
This represents a major translational step toward clinical use, potentially offering new hope for patients with this devastating infection. The researchers believe their findings will significantly increase the efficiency of current treatment options and improve outcomes for patients with lethal mucormycosis.
Patient Impact
For patients with mucormycosis, the development of VX-01 could mean less invasive treatments and better survival rates. The infection is particularly aggressive, often requiring immediate medical attention and surgical intervention that can leave patients permanently disfigured.
The antibody-based approach could be especially valuable for vulnerable populations, including the growing number of individuals with diabetes and cancer, as well as transplant recipients who must take immunosuppressive medications to prevent organ rejection.
As research continues, VX-01 shows promise as a targeted immunotherapy that could transform the treatment landscape for one of medicine's most challenging fungal infections, potentially saving thousands of lives globally each year.
