Overview

Vascular dysfunction, caused by factors such as aging, genetic risk and diseases, including hypertension and diabetes, leads to the toxic accumulation of fibrin deposits outside of blood vessels, which sparks chronic innate immune cell activation.

Fibrin’s inflammatory epitope binds complement receptors CD11b/c on microglia, macrophages, and dendritic cells, triggering a toxic and chronic inflammatory response that is destructive to neurons and further erodes blood vessel walls.

Based on the work of world-renowned neurovascular and brain immunology expert and Therini Bio scientific founder Dr. Katerina Akassoglou, the Director of the Center for Neurovascular Brain Immunology and Professor of Neurology at the University of California, San Francisco and Gladstone Institutes, we are developing potentially first-in-class, fibrin-targeting immunotherapies for the treatment of severe retinal and neurological diseases driven by vascular dysfunction.

Fibrin

Our novel approach is designed to selectively block the devastating effects of neuroinflammation triggered by fibrin without impacting coagulation or protective innate immunity.

Therini’s lead candidate, THN391, a selective, monoclonal antibody, targets the “inflammatory epitope” on fibrin deposits outside of blood vessels and prevents the activation of microglia and macrophages, which cause destructive neuroinflammation leading to severe diseases, such as Alzheimer’s disease and Diabetic Macular Edema, Therini’s initial clinical indications.

Therini’s second candidate, THN622, is a bispecific antibody that simultaneously blocks fibrin’s inflammatory epitope and inhibits VEGF – uniting the proven efficacy of the current anti-VEGF standard of care with Therini’s neuroinflammation-targeting approach in a single molecule.

Pipeline

Pipeline

Publications

THN391 – An Anti-fibrin Antibody Targeting Fibrin-Driven Inflammation in Early Alzheimer’s Disease: Update from an Ongoing Phase 1b Study

Kantor AB, Hoffman TA, Kavanagh S, Mendonca N, Mutsaerts HJMM, Dicks E, Barkhof F, Abd-Elaziz K, Vijverberg E(J)GB, Mummery C, Ritchie C

AAIC. 2026 July

Therapeutic Targeting of Fibrin–Microglia Interactions Ameliorates Alzheimer’s Disease-Related Hyperexcitability and Brain Network Dysfunction

Lauderdale K, Yan Z, Mendiola AS, Zhang Y, Mallen D, Nambiar P, Brady E, Miller SR, Acevedo RM, Cabriga B, Jiang F, Kaliss N, Shen K, Shin J, Herbert J, Ma K, Ryu JK, Agarwal A, Schuck R, Alzamora MPS, Sanz-Ros J, Cobos I, Stavenhagen J, Kantor AB, Ellisman MH, Akassoglou K, Palop JJ.

bioRxiv. 2026 May 06

Development of a Humanized Anti-fibrin Monoclonal Antibody for the Treatment of Neuroinflammatory and Retinal Diseases

Kantor AB, Rickert M, Cheng H, Flanagan K, Salgotra V, Suppahia A, Ryu JK, Widboom PF, Warfield JR, Akassoglou K, Stavenhagen JB

J Neuroinflammation. 2025 Dec 17;23(1):19

THN391 – A Novel, First-In-Class Anti-fibrin Antibody for Treatment of Inflammation in Alzheimer’s Disease: An Ongoing Phase 1b Study for the Treatment of Early Alzheimer’s Disease

Navia B, Kantor AB, Hoffman TA, Kaplow J, Mutsaerts HJMM, Barkhof F, Abd-Elaziz K, Vijverberg E(J)GB, Mummery C, Ritchie C

CTAD.  2025 Dec

Translation Studies and Clinical Development of THN391, a Novel Anti-Fibrin Antibody for the Treatment of Dementia

Kantor AB, Rickert M, Cheng H, Flannagan K, Salgotra V, Suppahia A, Ryu JK, Widboom P, Warfield J, Akassoglou K, Stavenhagen J

CTAD. 2023 Oct

Fibrin-Targeting Immunotherapy for Dementia

Kantor AB, Akassoglou K, Stavenhagen JB

J Prev Alz Dis. 2023 Oct; 10, 647–660

Coagulation and Immunity: Caught in the Fibrin Web

Sozmen EG, Akassoglou K.

Immunity. 2021 Nov 9;54(11):2439-2441.

The Immunology of Blood: Connecting the Dots at the Neurovascular Interface

Akassoglou K.

Nat Immunol. 2020 Jul;21(7):710-712.

Fibrinogen Induces Microglia-Mediated Spine Elimination and Cognitive Impairment in an Alzheimer’s Disease Model

Merlini M, Rafalski VA, Rios Coronado PE, Gill TM, Ellisman M, Muthukumar G, Subramanian KS, Ryu JK, Syme CA, Davalos D, Seeley WW, Mucke L, Nelson RB, Akassoglou K.

Neuron. 2019 Mar 20;101(6):1099-1108.

Fibrin-Targeting Immunotherapy Protects Against Neuroinflammation and Neurodegeneration

Ryu JK, Rafalski VA, Meyer-Franke A, Adams RA, Poda SB, Rios Coronado PE, Pedersen LØ, Menon V, Baeten KM, Sikorski SL, Bedard C, Hanspers K, Bardehle S, Mendiola AS, Davalos D, Machado MR, Chan JP, Plastira I, Petersen MA, Pfaff SJ, Ang KK, Hallenbeck KK, Syme C, Hakozaki H, Ellisman MH, Swanson RA, Zamvil SS, Arkin MR, Zorn SH, Pico AR, Mucke L, Freedman SB, Stavenhagen JB, Nelson RB, Akassoglou K.

Nat Immunol. 2018 Nov;19(11):1212-1223.

Fibrinogen in Neurological Diseases: Mechanisms, Imaging and Therapeutics

Petersen MA, Ryu JK, Akassoglou K. Fibrinogen in neurological diseases: mechanisms, imaging, and therapeutics.

Nat Rev Neurosci. 2018, 19(5):283-301.

Fibrinogen as a Key Regulator of Inflammation in Disease

Davalos D, Akassoglou K. Fibrinogen as a key regulator of inflammation in disease.

Semin Immunopathol. 2012. 34:43-62.