A Dual-Action Mechanism to Prevent OX40 Signaling: The Structural Basis for the Differentiated Antagonist STAR-0310

Atopic dermatitis (AD) is a chronic inflammatory disease sustained by dysregulated T cell activity. The OX40/OX40L pathway drives effector and memory T cell proliferation, survival, and cytokine production, making it a key therapeutic target. STAR-0310, a novel anti-OX40 antibody, binds a noncanonical epitope that sterically blocks receptor trimerization without inducing agonism. Structural and functional studies demonstrated a dual mechanism: prevention of new OX40/OX40L interactions and efficient disruption of pre-formed complexes, outperforming comparator antibodies. The pure antagonism and complex disruption capacity of STAR-0310 support its clinical evaluation ( NCT06782477 ) as a differentiated OX40-targeted therapy for AD.