How Nanobody Technology Can Redefine Respiratory Care

In the early 1990s, researchers observed that camels, llamas, and alpacas produce a distinct class of antibodies that lack the light chains found in conventional human antibodies known as heavy chains. This inspired the creation of a single, compact variable domain, known as a Nanobody subunit, roughly one-tenth the size of a traditional antibody.¹ 

This scientific approach was validated in 2018 with the first approved Nanobody medicine to treat a rare, life-threatening blood clotting disorder. Since then, our researchers have continued to evolve the platform, applying computational biology and protein engineering to expand what these proteins can do. Because Nanobody subunits are compact and stable, several can be linked together in a “beads-on-a-string” design, allowing scientists to construct a single molecule that engages multiple biological targets at once, with the geometry and durability of the molecule tuned to fit the specific pathways involved. 

It is this multivalent, adaptable design, not simply the small size of a single subunit, that gives Nanobody technology its potential relevance to diseases driven by multiple biological pathways. This novel platform is being researched in chronic respiratory diseases, where single pathway treatments may not address the entire scope of patient needs.  

Asthma, COPD, and CRSwNP are complex, heterogeneous conditions, often driven by multiple overlapping inflammatory pathways rather than a single one. When one pathway is blocked, another can take over, which can quickly result in inadequate disease management. 

This helps explain a persistent clinical challenge. Asthma affects an estimated 363 million people globally² and, despite the availability of biologic therapies, 60% of adult patients continue to live with poorly controlled symptoms, including recurrent flare-ups, wheezing, and coughing that can disrupt daily life and, in some cases, become life threatening.3 Individuals with CRSwNP experience a similar disease burden with persistent nasal congestion, with up to 40% of patients continuing to experience debilitating symptoms despite treatment, including sinus surgery.4 

Uncontrolled disease remains a challenge for people living with chronic obstructive pulmonary disease (COPD) as it’s the third common cause of death globally.5 A study showed that patients with one or two exacerbations in the previous year had an increased risk of exacerbation in the subsequent year, respectively.5 

Targeted therapies have improved outcomes for many patients, but for those whose disease is driven by multiple pathways at once, a single-target approach may not be enough. 

Our researchers are exploring an investigational Nanobody treatment specifically designed to simultaneously engage two distinct drivers of inflammation connected to chronic respiratory diseases. 

This research is ongoing and has not yet been evaluated by any regulatory authority. 

This reflects our broader approach to immunology: Starting from pathway biology, identifying where intervention may change the course of disease and applying the platform best suited to that biology, including Nanobody technology where multi-pathway targeting could change what’s possible for patients.