An intact C-terminal end of albumin is required for its long half-life in humans

Albumin has an average plasma half-life of three weeks and is thus an attractive carrier to improve the pharmacokinetics of fused therapeutics. The half-life is regulated by FcRn, a cellular receptor that protects against intracellular degradation. To tailor-design the therapeutic use of albumin, it is crucial to understand how structural alterations in albumin affect FcRn binding and transport properties. In the blood, the last C-terminal residue (L585) of albumin may be enzymatically cleaved. Here we demonstrate that removal of the L585 residue causes structural stabilization in regions of the principal FcRn binding domain and reduces receptor binding. In line with this, a short half-life of only 3.5 days was measured for cleaved albumin lacking L585 in a patient with acute pancreatitis. Thus, we reveal the structural requirement of an intact C-terminal end of albumin for a long plasma half-life, which has implications for design of albumin-based therapeutics. Nilsen et al. show that structural alterations in the last C-terminal α-helix of albumin strongly reduce its binding to the neonatal Fc receptor, decreasing the half-life of albumin in humans. This study suggests the structural requirement of the C-terminal of albumin for its long plasma half-life, providing insights into the design of albumin used to carry drugs.