Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 21
Filter
1.
Proc Natl Acad Sci U S A ; 119(19): e2202439119, 2022 05 10.
Article in English | MEDLINE | ID: mdl-35512094

ABSTRACT

SignificanceMesothelin (MSLN) is a cell-surface protein that is a popular target for antibody-based therapies. We have identified shed MSLN as a major obstacle to successful antibody therapies and prepared a monoclonal antibody that inhibits shedding and makes very active CAR T cells whose activity is not blocked by shed MSLN and merits further preclinical development.


Subject(s)
Receptors, Chimeric Antigen , Antibodies, Monoclonal/metabolism , Cell Line, Tumor , GPI-Linked Proteins/metabolism , Mesothelin , T-Lymphocytes
2.
Proc Natl Acad Sci U S A ; 111(23): 8571-6, 2014 Jun 10.
Article in English | MEDLINE | ID: mdl-24799704

ABSTRACT

Nonhuman proteins have valuable therapeutic properties, but their efficacy is limited by neutralizing antibodies. Recombinant immunotoxins (RITs) are potent anticancer agents that have produced many complete remissions in leukemia, but immunogenicity limits the number of doses that can be given to patients with normal immune systems. Using human cells, we identified eight helper T-cell epitopes in PE38, a portion of the bacterial protein Pseudomonas exotoxin A which consists of the toxin moiety of the RIT, and used this information to make LMB-T18 in which three epitopes were deleted and five others diminished by point mutations in key residues. LMB-T18 has high cytotoxic and antitumor activity and is very resistant to thermal denaturation. The new immunotoxin has a 93% decrease in T-cell epitopes and should have improved efficacy in patients because more treatment cycles can be given. Furthermore, the deimmunized toxin can be used to make RITs targeting other antigens, and the approach we describe can be used to deimmunize other therapeutically useful nonhuman proteins.


Subject(s)
Epitopes, T-Lymphocyte/immunology , Immunotoxins/immunology , Neoplasms/immunology , Recombinant Fusion Proteins/immunology , ADP Ribose Transferases/genetics , ADP Ribose Transferases/immunology , Amino Acids/genetics , Amino Acids/immunology , Animals , Antibody Formation/immunology , Bacterial Toxins/genetics , Bacterial Toxins/immunology , Cell Line, Tumor , Cell Survival/drug effects , Cell Survival/immunology , Electrophoresis, Polyacrylamide Gel , Epitope Mapping , Exotoxins/genetics , Exotoxins/immunology , Female , Humans , Immunotherapy/methods , Immunotoxins/genetics , Immunotoxins/therapeutic use , Lymphocyte Activation/drug effects , Lymphocyte Activation/immunology , Mice , Mice, SCID , Models, Molecular , Neoplasms/pathology , Neoplasms/therapy , Peptides/genetics , Peptides/immunology , Point Mutation , Protein Structure, Tertiary , Recombinant Fusion Proteins/chemistry , Recombinant Fusion Proteins/therapeutic use , T-Lymphocytes/drug effects , T-Lymphocytes/immunology , T-Lymphocytes/metabolism , Virulence Factors/genetics , Virulence Factors/immunology , Xenograft Model Antitumor Assays , Pseudomonas aeruginosa Exotoxin A
3.
Proc Natl Acad Sci U S A ; 109(51): E3597-603, 2012 Dec 18.
Article in English | MEDLINE | ID: mdl-23213206

ABSTRACT

Recombinant immunotoxins (RITs) are chimeric proteins that are being developed for cancer treatment. We have produced RITs that contain PE38, a portion of the bacterial protein Pseudomonas exotoxin A. Because the toxin is bacterial, it often induces neutralizing antibodies, which limit the number of treatment cycles and the effectiveness of the therapy. Because T cells are essential for antibody responses to proteins, we adopted an assay to map the CD4(+) T-cell epitopes in PE38. We incubated peripheral blood mononuclear cells with an immunotoxin to stimulate T-cell expansion, followed by exposure to overlapping peptide fragments of PE38 and an IL-2 ELISpot assay to measure responses. Our observation of T-cell responses in 50 of 50 individuals correlates with the frequency of antibody formation in patients with normal immune systems. We found a single, highly immunodominant epitope in 46% (23/50) of the donors. The immunodominant epitope is DRB1-restricted and was observed in subjects with different HLA alleles, indicating promiscuity. We identified two amino acids that, when deleted or mutated to alanine, eliminated the immunodominant epitope, and we used this information to construct mutant RITs that are highly cytotoxic and do not stimulate T-cell responses in many donors.


Subject(s)
ADP Ribose Transferases/chemistry , Bacterial Toxins/chemistry , Epitopes, T-Lymphocyte/chemistry , Exotoxins/chemistry , Protein Engineering/methods , Virulence Factors/chemistry , Antibodies/chemistry , CD4-Positive T-Lymphocytes/cytology , Enzyme-Linked Immunosorbent Assay/methods , Epitopes/chemistry , Epitopes, T-Lymphocyte/immunology , Gene Deletion , Genetic Variation , Humans , Immune System , Interleukin-2/metabolism , Leukocytes, Mononuclear/cytology , Molecular Conformation , Peptides/chemistry , Protein Binding , Protein Conformation , Protein Structure, Tertiary , Pseudomonas aeruginosa Exotoxin A
4.
Proc Natl Acad Sci U S A ; 108(14): 5742-7, 2011 Apr 05.
Article in English | MEDLINE | ID: mdl-21436054

ABSTRACT

Many nonhuman proteins have useful pharmacological activities, but are infrequently effective in humans because of their high immunogenicity. A recombinant immunotoxin (HA22, CAT8015, moxetumomab pasudotox) composed of an anti-CD22 antibody variable fragment fused to PE38, a 38-kDa portion of Pseudomonas exotoxin A, has produced many complete remissions in drug-resistant hairy-cell leukemia when several cycles of the agent can be given, but has much less activity when antibodies develop. We have pursued a strategy to deimmunize recombinant immunotoxins by identifying and removing B-cell epitopes. We previously reported that we could eliminate most B-cell epitopes using a combination of point mutations and deletions. Here we show the location and amino acid composition of all of the B-cell epitopes in the remaining 25-kDa portion of Pseudomonas exotoxin. Using this information, we eliminated these epitopes to produce an immunotoxin (HA22-LR-8M) that is fully cytotoxic against malignant B-cell lines, has high cytotoxic activity against cells directly isolated from patients with chronic lymphocytic leukemia, and has excellent antitumor activity in mice. HA22-LR-8M does not induce antibody formation in mice when given repeatedly by intravenous injection and does not induce a secondary antibody response when given to mice previously exposed to HA22. HA22-LR-8M also has greatly reduced antigenicity when exposed to sera from patients who have produced antibodies to HA22. The properties of HA22-LR-8M make it an excellent candidate for further clinical development.


Subject(s)
ADP Ribose Transferases/metabolism , Bacterial Toxins/metabolism , Epitopes, B-Lymphocyte/genetics , Exotoxins/metabolism , Immunization, Passive/methods , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Models, Molecular , Protein Engineering/methods , Recombinant Fusion Proteins/immunology , Virulence Factors/metabolism , ADP Ribose Transferases/genetics , Amino Acid Sequence , Animals , Antibodies, Monoclonal , Bacterial Toxins/genetics , Cell Line, Tumor , Enzyme-Linked Immunosorbent Assay , Exotoxins/genetics , Leukemia, Lymphocytic, Chronic, B-Cell/immunology , Mice , Mice, Inbred BALB C , Molecular Sequence Data , Mutagenesis , Recombinant Fusion Proteins/biosynthesis , Recombinant Fusion Proteins/genetics , Recombinant Fusion Proteins/therapeutic use , Statistics, Nonparametric , Virulence Factors/genetics , Pseudomonas aeruginosa Exotoxin A
5.
Proc Natl Acad Sci U S A ; 105(32): 11311-6, 2008 Aug 12.
Article in English | MEDLINE | ID: mdl-18678888

ABSTRACT

Recombinant immunotoxins are hybrid proteins composed of an Fv that binds to a tumor antigen fused to a bacterial or plant toxin. Immunotoxin BL22 targets CD22 positive malignancies and is composed of an anti-CD22 Fv fused to a 38-kDa fragment of Pseudomonas exotoxin A (PE38). BL22 has produced many complete remissions in drug-resistant Hairy cell leukemia, where many treatment cycles can be given, because neutralizing antibodies do not form. In marked contrast, only minor responses have been observed in trials with immunotoxins targeting solid tumors, because only a single treatment cycle can be given before antibodies develop. To allow more treatment cycles and increase efficacy, we have produced a less immunogenic immunotoxin by identifying and eliminating most of the B cell epitopes on PE38. This was accomplished by mutation of specific large hydrophilic amino acids (Arg, Gln, Glu, Lys) to Ala, Ser, or Gly. The new immunotoxin (HA22-8X) is significantly less immunogenic in three strains of mice, yet retains full cytotoxic and anti-tumor activities. Elimination of B-cell epitopes is a promising approach to the production of less immunogenic proteins for therapeutic purposes.


Subject(s)
ADP Ribose Transferases/genetics , ADP Ribose Transferases/immunology , Antibodies/genetics , Antibodies/immunology , Bacterial Toxins/genetics , Bacterial Toxins/immunology , Enterotoxins/genetics , Enterotoxins/immunology , Epitopes, B-Lymphocyte/genetics , Epitopes, B-Lymphocyte/immunology , Exotoxins/genetics , Exotoxins/immunology , Recombinant Fusion Proteins/genetics , Recombinant Fusion Proteins/immunology , Virulence Factors/genetics , Virulence Factors/immunology , ADP Ribose Transferases/therapeutic use , Amino Acid Substitution/immunology , Animals , Antibodies/therapeutic use , Bacterial Toxins/therapeutic use , Drug Resistance, Neoplasm/drug effects , Drug Resistance, Neoplasm/immunology , Enterotoxins/therapeutic use , Exotoxins/therapeutic use , Humans , Leukemia, Hairy Cell/drug therapy , Leukemia, Hairy Cell/immunology , Mice , Mice, Inbred BALB C , Mice, SCID , Mutation, Missense/immunology , Rabbits , Recombinant Fusion Proteins/therapeutic use , Virulence Factors/therapeutic use , Pseudomonas aeruginosa Exotoxin A
6.
Toxins (Basel) ; 10(5)2018 05 21.
Article in English | MEDLINE | ID: mdl-29883379

ABSTRACT

Moxetumomab pasudotox is a fusion protein of a CD22-targeting antibody and Pseudomonas exotoxin. Minutes of exposure to Moxetumomab achieves similar cell killing than hours of exposure to a novel deimmunized variant against some acute lymphoblastic leukemia (ALL). Because blood levels fall quickly, Moxetumomab is more than 1000-fold more active than the deimmunized variant in vivo. We aimed to identify which part of Moxetumomab increases in vivo efficacy and generated five immunotoxins, tested time-dependent activity, and determined the efficacy in a KOPN-8 xenograft model. Full domain II shortened the time cells had to be exposed to die to only a few minutes for some ALL; deimmunized domain III consistently extended the time. Against KOPN-8, full domain II accelerated time to arrest protein synthesis by three-fold and tripled PARP-cleavage. In vivo efficacy was increased by more than 10-fold by domain II and increasing size, and therefore half-life enhanced efficacy two- to four-fold. In summary, in vivo efficacy is determined by the time cells have to be exposed to immunotoxin to die and serum half-life. Thus, domain II is most critical for activity against some ALL treated with bolus doses; however, immunotoxins lacking all but the furin-cleavage site of domain II may be advantageous when treating continuously.


Subject(s)
Antineoplastic Agents/therapeutic use , Bacterial Toxins/therapeutic use , Exotoxins/therapeutic use , Immunotoxins/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Protein Domains , Animals , Cell Line, Tumor , Disease Models, Animal , Humans , Mice , Pseudomonas , Treatment Outcome , Xenograft Model Antitumor Assays
7.
Clin Cancer Res ; 11(16): 5840-6, 2005 Aug 15.
Article in English | MEDLINE | ID: mdl-16115924

ABSTRACT

PURPOSE: Mesothelin is a cell surface protein that is highly expressed in some malignant tumors, and is a promising target for immunotherapy. Recent data suggests that mesothelin is an adhesive protein and may have a role in the metastases of ovarian cancer. Although a few monoclonal antibodies (MAb) to mesothelin have been produced, they have limitations for the study of expression of native mesothelin because of their low affinity or reactivity only with denatured mesothelin protein. We have produced novel MAbs to mesothelin to help study mesothelin function and to develop improved diagnosis and immunotherapy of mesothelin-expressing tumors. EXPERIMENTAL DESIGN: Mesothelin-deficient mice were immunized with plasmid cDNA encoding mesothelin, and boosted with a mesothelin-rabbit IgG Fc fusion protein prior to cell fusion. Hybridomas were screened by an ELISA using plates coated with mesothelin-Fc protein. RESULTS: Seventeen hybridomas producing anti-mesothelin antibodies were established and shown to react with two epitopes on mesothelin. One group reacts with the same epitope as the low affinity antibody K1 that was originally used to identify mesothelin. The other is a new group that reacts with a new epitope. One antibody from each group was chosen for further study and shown to react strongly on ELISA, on immunohistochemistry, and by fluorescence-activated cell sorting on living cells. CONCLUSION: Our two newly established MAbs, MN and MB, have different and useful properties compared with current antibodies used for the detection of mesothelin by immunohistochemistry, fluorescence-activated cell sorting, ELISA, and Western blotting.


Subject(s)
Antibodies, Monoclonal/immunology , Membrane Glycoproteins/immunology , Animals , Antibodies, Monoclonal/analysis , Antibody Specificity , Blotting, Western/methods , Cell Line , Cell Line, Tumor , Enzyme-Linked Immunosorbent Assay/methods , Female , Flow Cytometry/methods , GPI-Linked Proteins , Humans , Immunoglobulin Fc Fragments/genetics , Immunoglobulin Fc Fragments/immunology , Immunohistochemistry/methods , Membrane Glycoproteins/analysis , Membrane Glycoproteins/genetics , Mesothelin , Mice , Mice, Knockout , Recombinant Fusion Proteins/genetics , Recombinant Fusion Proteins/immunology , Reproducibility of Results , Tissue Array Analysis
8.
Clin Cancer Res ; 8(4): 995-1002, 2002 Apr.
Article in English | MEDLINE | ID: mdl-11948105

ABSTRACT

Recombinant immunotoxins are fusion proteins composed of the Fv domains of antibodies fused to bacterial or plant toxins that are being developed for the targeted therapy of cancer. RFB4 (Fv)-Pseudomonas exotoxin 38 (PE38) is an immunotoxin that targets CD22 expressed on B cells and B-cell malignancies. A disulfide-stabilized form of RFB4 (Fv)-PE38 is being evaluated in a Phase I clinical trial. The aim of the present study was to improve the activity of RFB4 (Fv)-PE38 to more effectively treat patients with leukemias and lymphomas. To increase the affinity of RFB4 (Fv), we used the techniques of phage display and hot spot mutagenesis. We identified mutational hot spot sequences in heavy chain complementary determining region 3 (V(H) CDR3) and randomized these in a phage display library. Mutant phages were panned on CD22-positive Daudi cells. A variety of mutant Fvs were obtained, and the corresponding immunotoxins were prepared. Several mutant immunotoxins with increased binding affinity and cytotoxic activity were obtained. The most active immunotoxin contained amino acid residues Thr-His-Trp (THW) in place of Ser-Ser-Tyr (SSY) at positions 100, 100A, and 100B of the Fv and had an affinity improved from 85 nM to 6 nM. The THW mutant had a 5- to 10-fold increase in activity on various CD22-positive cell lines and was up to 50 times more cytotoxic to cells from patients with chronic lymphocytic leukemia and hairy-cell leukemia.


Subject(s)
Antibodies, Monoclonal/pharmacology , Antigens, CD/immunology , Antigens, Differentiation, B-Lymphocyte/immunology , Cell Adhesion Molecules , Immunotoxins/pharmacology , Lectins , Leukemia/drug therapy , Amino Acid Sequence , Antibodies, Monoclonal/genetics , Antibody Affinity , Bacteriophages/genetics , Base Sequence , Cell Line , Gene Expression , Gene Library , Humans , Immunoglobulin Fragments/genetics , Immunoglobulin Fragments/pharmacology , Immunotoxins/genetics , Immunotoxins/immunology , Inhibitory Concentration 50 , Leukemia/pathology , Mutation , Plasmids/genetics , Protein Biosynthesis , Proteins/drug effects , Sialic Acid Binding Ig-like Lectin 2 , Tumor Cells, Cultured/drug effects
9.
Clin Cancer Res ; 8(7): 2345-55, 2002 Jul.
Article in English | MEDLINE | ID: mdl-12114439

ABSTRACT

PURPOSE: To develop a novel targeting reagent to CD30 expressed on Hodgkin'sdisease and anaplastic large cell lymphoma, we made a panel of recombinant immunotoxins specific for CD30 using Fvs of newly produced anti-CD30 monoclonal antibodies (MAbs) and a M(r) 38,000 truncated mutant of Pseudomonas exotoxin. EXPERIMENTAL DESIGN: A group of MAbs against CD30 was produced and characterized for their reactivity and epitopes. Recombinant immunotoxins were made using the Fv genes cloned from the hybridomas. Their cytotoxic activities were examined on various CD30-positive cell lines. RESULTS: Six MAbs were produced. All reacted with recombinant soluble CD30 and to a CD30-Fc fusion protein, and bound to native CD30 expressed on Hodgkin's lymphoma-derived cell lines. The epitopes of the six MAbs were classified into two groups by a mutual competition assay for the binding to CD30 on cells. Sequencing the cDNAs revealed that all of the variable chains are unique except one valiable light that is shared by two MAbs. We made four disulfide stabilized Fv-based recombinant immunotoxins, in which the valiable heavy, which is genetically fused with truncated mutant of Pseudomonas exotoxin, forms a disulfide bond with the valiable light. The purified immunotoxins bound to recombinant soluble CD30 immobilized on a biosensor chip with K(d)s of 4-400 nM. Fluorescence-activated cell sorter analysis confirmed their specific binding. In vitro cytotoxicity tests showed that the immunotoxins specifically kill a variety of CD30-positive lymphoma cell lines as well as CD30-transfected A431 cells. The IC(50) ranged from 0.3 to 100 ng/ml. CONCLUSIONS: Four anti-CD30 disulfide stabilized Fv immunotoxins were successfully produced. Two of these showed good cytotoxic activity to various CD30-positive cell lines. These newly produced immunotoxins should be additionally evaluated for the treatment of CD30-positive lymphomas.


Subject(s)
ADP Ribose Transferases/pharmacology , Bacterial Toxins/pharmacology , Exotoxins/pharmacology , Immunotoxins/pharmacology , Recombinant Fusion Proteins/pharmacology , Tumor Cells, Cultured/drug effects , Virulence Factors/pharmacology , Amino Acid Sequence , Animals , Antibodies, Monoclonal/genetics , Antibodies, Monoclonal/immunology , Cloning, Molecular , Disulfides , Humans , Immunoglobulin Fragments/genetics , Immunoglobulin Fragments/immunology , Immunoglobulin Light Chains/genetics , Immunoglobulin Light Chains/immunology , Immunoglobulin Variable Region/genetics , Immunoglobulin Variable Region/immunology , In Vitro Techniques , Ki-1 Antigen/genetics , Ki-1 Antigen/immunology , Mice , Molecular Sequence Data , Pseudomonas aeruginosa , Sequence Homology, Amino Acid , Tumor Cells, Cultured/immunology , Pseudomonas aeruginosa Exotoxin A
10.
Mol Cancer Ther ; 14(12): 2789-96, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26443804

ABSTRACT

SS1P is a recombinant immunotoxin (RIT) that targets mesothelin. It consists of an antimesothelin Fv fused to a portion of Pseudomonas exotoxin A. In clinical studies, it has produced dramatic responses in patients with advanced mesothelioma, when combined with immunosuppressive therapy so that several treatment cycles could be given. Otherwise its activity is limited by its immunogenicity. In this work, we describe the development and characterization of LMB-T20, a highly potent RIT targeted at mesothelin-expressing cancers with low immunogenicity due to removal of its eight T-cell epitopes. LMB-T20 was more active than SS1P when tested on four different mesothelin-expressing cell lines as well as on cells obtained from patients with mesothelioma. It also has potent antitumor activity in mice, and has reduced immunogenicity as measured by cytokine secretion assays. In conclusion, LMB-T20 is a favorable candidate for evaluation in clinical trials due to its reduced immunogenicity and excellent activity.


Subject(s)
Antibodies, Monoclonal/administration & dosage , Epitopes, T-Lymphocyte/immunology , GPI-Linked Proteins/immunology , Mesothelioma/drug therapy , Recombinant Proteins/administration & dosage , ADP Ribose Transferases/genetics , ADP Ribose Transferases/immunology , Animals , Antibodies, Monoclonal/genetics , Antibodies, Monoclonal/immunology , Bacterial Toxins/genetics , Bacterial Toxins/immunology , Cell Line, Tumor , Epitopes, T-Lymphocyte/genetics , Exotoxins/genetics , Exotoxins/immunology , GPI-Linked Proteins/biosynthesis , Humans , Immunogenetic Phenomena/drug effects , Mesothelin , Mesothelioma/genetics , Mesothelioma/immunology , Mice , Mutation , Recombinant Proteins/genetics , Recombinant Proteins/immunology , Virulence Factors/genetics , Virulence Factors/immunology , Xenograft Model Antitumor Assays , Pseudomonas aeruginosa Exotoxin A
11.
CNS Drugs ; 18(15): 1085-104, 2004.
Article in English | MEDLINE | ID: mdl-15581380

ABSTRACT

The anilidopiperidine opioid remifentanil has pharmacodynamic properties similar to all opioids; however, its pharmacokinetic characteristics are unique. Favourable pharmacokinetic properties, minimally altered by extremes of age or renal or hepatic dysfunction, enable easy titration and rapid dissipation of clinical effect of this agent, even after prolonged infusion. Remifentanil is metabolised by esterases that are widespread throughout the plasma, red blood cells, and interstitial tissues, whereas other anilidopiperidine opioids (e.g. fentanyl, alfentanil and sufentanil) depend upon hepatic biotransformation and renal excretion for elimination. Consequently, remifentanil is cleared considerably more rapidly than other anilidopiperidine opioids. In addition, its pKa (the pH at which the drug is 50% ionised) is less than physiological pH; thus, remifentanil circulates primarily in the non-ionised moiety, which quickly penetrates the lipid blood-brain barrier and rapidly equilibrates across the plasma/effect site interface. By virtue of these distinctive pharmacokinetic properties, the context-sensitive half-time (i.e. the time required for the drug's plasma concentration to decrease by 50% after cessation of an infusion) of remifentanil remains consistently short (3.2 minutes), even following an infusion of long duration (> or =8 hours). Remifentanil, a clinically versatile opioid, is useful for intravenous analgesia and sedation in spontaneously breathing patients undergoing painful procedures. Profound analgesia may be achieved with minimal effect on cognitive function. Remifentanil may also provide sedation and analgesia during placement of regional anaesthetic blocks, and in conjunction with topical anaesthesia and airway nerve blocks, it may be useful for blunting reflex responses and facilitating 'awake' fibreoptic intubation. Compared with fentanyl and alfentanil in a day-surgery setting, remifentanil supplementation of general anaesthesia may improve intraoperative haemodynamic control. Both emergence time and the incidence of respiratory depression during post-anaesthetic recovery may be reduced. However, outcomes such as home discharge time, post-emergence adverse effect profile, and patient and provider satisfaction are not significantly improved, and the incidence of intraoperative hypotension and bradycardia is greater. In addition, drug acquisition costs for remifentanil are higher and clinicians may need extra time to familiarise themselves with the drug's unique pharmacokinetics.Ironically, the quick dissipation of opioid analgesic effect following remifentanil discontinuation may be a significant clinical disadvantage. Unless little or no postoperative pain is anticipated, the clinician may wish to treat prospectively using local or regional anaesthesia, non-opioid analgesics, or longer-acting opioid analgesics.


Subject(s)
Analgesics, Opioid/therapeutic use , Anesthetics, Intravenous/therapeutic use , Hypnotics and Sedatives/therapeutic use , Piperidines/therapeutic use , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/pharmacokinetics , Anesthesia/methods , Anesthetics, Intravenous/administration & dosage , Anesthetics, Intravenous/pharmacokinetics , Clinical Trials as Topic , Dose-Response Relationship, Drug , Drug Interactions , Humans , Hypnotics and Sedatives/administration & dosage , Hypnotics and Sedatives/pharmacokinetics , Pain, Postoperative/drug therapy , Piperidines/administration & dosage , Piperidines/pharmacokinetics , Remifentanil
12.
J Clin Anesth ; 25(7): 521-8, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24008193

ABSTRACT

STUDY OBJECTIVE: To survey anesthesiologists to assess medication injection safety knowledge and practices, and to improve infection control programs of the New York City Department of Health and Mental Hygiene and the New York State Society of Anesthesiologists (NYSSA). DESIGN: Survey instrument. SETTING: Scientific Educational and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA. MEASUREMENTS: A confidential, 23-question survey was emailed to a total of 2,310 NYSSA members. Data from the survey were culled from the responses of NYSSA members who practiced in New York State only. MAIN RESULTS: Of the 607 survey respondents, 595 met inclusion criteria (response rate 26%). Of these, 94% to 99% correctly answered 4 categories of questions about injection-contamination mechanisms. Respondents reported unacceptable practices (eg, not using a new needle and syringe for each new patient [3%]; not using a new needle and syringe to access medication vials [28%]; and combining vial content leftovers [11%]). Resident physicians reported these unacceptable practices more often than attending physicians. Use of medication vials for multiple patients (permitted for multi-dose vials but a potentially high-risk practice) was reported by 49% of respondents and was more common among those who worked in outpatient settings. Reported barriers to using a new medication vial for each new patient were medication shortages (44%), reduction of waste (44%), and cost (27%). Unacceptable or potentially high-risk practices were more common among respondents who reported ≥ one barrier. CONCLUSIONS: Although they were not necessarily representative of all anesthesiologists in New York State, unacceptable or high-risk injection practices were common among respondents despite widespread knowledge regarding injection-contamination mechanisms. System barriers contribute to the use of medication vials for multiple patients.


Subject(s)
Anesthesiology/statistics & numerical data , Health Knowledge, Attitudes, Practice , Practice Patterns, Physicians'/statistics & numerical data , Anesthesiology/standards , Drug Contamination/prevention & control , Health Care Surveys , Humans , Infection Control/methods , Injections/adverse effects , Injections/methods , New York , Pharmaceutical Preparations/administration & dosage , Practice Patterns, Physicians'/standards
13.
Mol Cancer Ther ; 12(1): 48-57, 2013 Jan.
Article in English | MEDLINE | ID: mdl-23136186

ABSTRACT

SS1P is a recombinant immunotoxin (RIT) engineered for the targeted elimination of malignant cells that express the tumor-associated antigen mesothelin. It is composed of an antimesothelin antibody variable fragment (Fv) linked to a cytotoxic fragment of Pseudomonas exotoxin A (PE) that includes domains II and III of native PE. The clinical use of SS1P is limited by its propensity to induce neutralizing antibodies and to cause a dose-limiting capillary leak syndrome (CLS) in patients. In this article, we describe a reengineered SS1P with improved properties that overcome these deficits. The redesign of SS1P consists of (i) removing the bulk of PE domain II (residues 251-273 and 284-394 of native PE), leaving only an 11-residue furin cleavage site, (ii) adding a Gly-Gly-Ser peptide linker after the furin cleavage site, and (iii) replacing eight highly solvent-exposed residues in the catalytic domain of PE. The new molecule, SS1-LR/GGS/8M, has cytotoxic activity comparable with SS1P on several mesothelin-expressing cell lines and remarkably improved activity on primary cells from patients with mesothelioma. In a mouse xenograft tumor model, high doses of SS1-LR/GGS/8M elicit antitumor activity superior to the activity of SS1P at its maximum-tolerated dose. In addition, SS1-LR/GGS/8M has greatly decreased ability to cause CLS in a rat model and reduced antigenicity or reactivity with antibodies to the sera of patients previously treated with SS1P.


Subject(s)
Antineoplastic Agents/pharmacology , GPI-Linked Proteins/metabolism , Mesothelioma/drug therapy , Recombinant Fusion Proteins/pharmacology , Amino Acid Substitution , Animals , Antigens, Neoplasm , Antineoplastic Agents/adverse effects , Antineoplastic Agents/immunology , Capillary Leak Syndrome/chemically induced , Cell Line, Tumor , Female , GPI-Linked Proteins/immunology , Half-Life , Humans , Inhibitory Concentration 50 , Maximum Tolerated Dose , Mesothelin , Mesothelioma/pathology , Mice , Mice, Nude , Mutagenesis, Site-Directed , Rats , Rats, Wistar , Recombinant Fusion Proteins/adverse effects , Recombinant Fusion Proteins/genetics , Recombinant Fusion Proteins/immunology , Tumor Burden/drug effects , Xenograft Model Antitumor Assays
15.
J Immunother ; 33(3): 297-304, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20445350

ABSTRACT

Recombinant immunotoxins (RITs) are genetically engineered proteins designed to kill cancer cells. The RIT HA22 contains the Fv portion of an anti-CD22 antibody fused to a 38 kDa fragment of Pseudomonas exotoxin A (PE38). As PE38 is a bacterial protein, patients frequently produce antibodies that neutralize its activity, preventing retreatment. We have earlier shown in mice that PE38 contains 7 major B-cell epitopes located in domains II and III of the protein. Here we present a new mutant RIT, HA22-LR-6X, in which we removed most B-cell epitopes by deleting domain II and mutating 6 residues in domain III. HA22-LR-6X is cytotoxic to several lymphoma cell lines, has very low nonspecific toxicity, and retains potent antitumor activity in mice with CA46 lymphomas. To assess its immunogenicity, we immunized 3 MHC-divergent strains of mice with 5 microg doses of HA22-LR-6X, and found that HA22-LR-6X elicited significantly lower antibody responses than HA22 or other mutant RITs with fewer epitopes removed. Furthermore, large (50 microg) doses of HA22-LR-6X induced markedly lower antibody responses than 5 microg of HA22, indicating that high doses can be administered with low immunogenicity. Our experiments show that we have correctly identified and removed B-cell epitopes from PE38, producing a highly active immunotoxin with low immunogenicity and low animal toxicity. Future studies will determine if these properties carry over to humans with cancer.


Subject(s)
Burkitt Lymphoma/immunology , Immunotoxins/immunology , Sialic Acid Binding Ig-like Lectin 2/immunology , ADP Ribose Transferases/genetics , ADP Ribose Transferases/immunology , Animals , Antibodies/blood , Antibodies/immunology , Antibodies, Bacterial/blood , Antibodies, Bacterial/immunology , Bacterial Toxins/genetics , Bacterial Toxins/immunology , Burkitt Lymphoma/pathology , Burkitt Lymphoma/prevention & control , Cell Line, Tumor , Enzyme-Linked Immunosorbent Assay , Exotoxins/genetics , Exotoxins/immunology , Female , Humans , Immunization/methods , Immunotoxins/administration & dosage , Immunotoxins/genetics , Male , Mice , Mice, Inbred BALB C , Mice, Inbred C57BL , Mice, Inbred NOD , Mice, Inbred Strains , Mice, SCID , Recombinant Proteins/immunology , Species Specificity , Virulence Factors/genetics , Virulence Factors/immunology , Xenograft Model Antitumor Assays , Pseudomonas aeruginosa Exotoxin A
17.
Cancer Res ; 68(15): 6300-5, 2008 Aug 01.
Article in English | MEDLINE | ID: mdl-18676854

ABSTRACT

B-cell malignancies routinely express surface antigens CD19 and CD22. Immunotoxins against both antigens have been evaluated, and the immunotoxins targeting CD22 are more active. To understand this disparity in cytotoxicity and guide the screening of therapeutic targets, we compared two immunotoxins, FMC63(Fv)-PE38-targeting CD19 and RFB4(Fv)-PE38 (BL22)-targeting CD22. Six lymphoma cell lines have 4- to 9-fold more binding sites per cell for CD19 than for CD22, but BL22 is 4- to 140-fold more active than FMC63(Fv)-PE38, although they have a similar cell binding affinity (Kd, approximately 7 nmol/L). In 1 hour, large amounts of BL22 are internalized (2- to 3-fold more than the number of CD22 molecules on the cell surface), whereas only 5.2% to 16.6% of surface-bound FMC63(Fv)-PE38 is internalized. The intracellular reservoir of CD22 decreases greatly after immunotoxin internalization, indicating that it contributes to the uptake of BL22. Treatment of cells with cycloheximide does not reduce the internalization of BL22. Both internalized immunotoxins are located in the same vesicles. Our results show that the rapid internalization of large amounts of BL22 bound to CD22 makes CD22 a better therapeutic target than CD19 for immunotoxins and probably for other immunoconjugates that act inside cells.


Subject(s)
Antigens, CD19/immunology , Immunotoxins/pharmacology , Sialic Acid Binding Ig-like Lectin 2/immunology , Cell Line, Tumor , Humans , Lymphoma, B-Cell/immunology , Lymphoma, B-Cell/pathology
18.
Bioconjug Chem ; 18(3): 773-84, 2007.
Article in English | MEDLINE | ID: mdl-17346030

ABSTRACT

Recombinant immunotoxins exhibit targeting and cytotoxic functions needed for cell-specific destruction. However, antitumor efficacy, safety, and pharmacokinetics of these therapeutics might be improved by further macromolecular engineering. SS1P is a recombinant anti-mesothelin immunotoxin in clinical trials in patients with mesothelin-expressing tumors. We have modified this immunotoxin using several PEGylation strategies employing releasable linkages between the protein and the PEG polymers, and observed superior performance of these bioconjugates when compared to similar PEG derivatives bearing permanent linkages to the polymers. PEGylated derivatives displayed markedly diminished cytotoxicity on cultured mesothelin-overexpressing A431-K5 cells; however, the releasable PEGylated immunotoxins exhibited increased antitumor activity in A431-K5 xenografts in mice, with a diminished animal toxicity. Most significantly, complete tumor regressions were achievable with single dose administration of the bioconjugates but not the native immunotoxin. Pharmacokinetic analysis of the releasable PEGylated derivatives in mice demonstrated an over 80-fold expansion of the area under the curve exposure of bioactive protein when compared to native immunotoxin. A correlation in degree of derivatization, release kinetics, and polymer size with potency was observed in vivo, whereas in vitro cytotoxicity was not predictive of efficacy in animal models. The potent antitumor efficacy of the releasable PEGylated mesothelin-targeted immunotoxins was not exhibited by similar untargeted PEG immunotoxins in this model. Since the bioconjugates can also exhibit the attributes of passive targeting via enhanced permeability and retention, this is the first demonstration of a pivotal role of active targeting for immunotoxin bioconjugate efficacy.


Subject(s)
Antibodies, Monoclonal/chemistry , Antibodies, Monoclonal/pharmacokinetics , Carcinoma/drug therapy , Immunotoxins/chemistry , Immunotoxins/pharmacokinetics , Membrane Glycoproteins/antagonists & inhibitors , Polyethylene Glycols/chemistry , Animals , Antibodies, Monoclonal/therapeutic use , Carcinoma/metabolism , GPI-Linked Proteins , Humans , Immunotoxins/therapeutic use , Mesothelin , Mice , Mice, Inbred BALB C , Recombinant Proteins/chemistry , Recombinant Proteins/pharmacokinetics , Recombinant Proteins/therapeutic use , Xenograft Model Antitumor Assays
19.
J Immunol ; 177(12): 8822-34, 2006 Dec 15.
Article in English | MEDLINE | ID: mdl-17142785

ABSTRACT

Recombinant immunotoxins composed of an Ab Fv fragment joined to a truncated portion of Pseudomonas exotoxin A (termed PE38) have been evaluated in clinical trials for the treatment of various human cancers. Immunotoxin therapy is very effective in hairy cell leukemia and also has activity in other hemological malignancies; however, a neutralizing Ab response to PE38 in patients with solid tumors prevents repeated treatments to maximize the benefit. In this study, we analyze the murine Ab response as a model to study the B cell epitopes associated with PE38. Sixty distinct mAbs to PE38 were characterized. Mutual competitive binding of the mAbs indicated the presence of 7 major epitope groups and 13 subgroups. The competition pattern indicated that the epitopes are discrete and could not be reproduced using a computer simulation program that created epitopes out of random surface residues on PE38. Using sera from immunotoxin-treated patients, the formation of human Abs to each of the topographical epitopes was demonstrated. One epitope subgroup, E1a, was identified as the principal neutralizing epitope. The location of each epitope on PE38 was determined by preparing 41 mutants of PE38 in which bulky surface residues were mutated to either alanine or glycine. All 7 major epitope groups and 9 of 13 epitope subgroups were identified by 14 different mutants and these retained high cytotoxic activity. Our results indicate that a relatively small number of discrete immunogenic sites are associated with PE38, most of which can be eliminated by point mutations.


Subject(s)
ADP Ribose Transferases/immunology , Bacterial Toxins/immunology , Epitope Mapping , Epitopes, B-Lymphocyte/immunology , Exotoxins/immunology , Immunotoxins , Neoplasms/drug therapy , Pseudomonas , Virulence Factors/immunology , ADP Ribose Transferases/genetics , ADP Ribose Transferases/therapeutic use , Animals , Antibodies, Monoclonal , Antibody Formation , Bacterial Toxins/genetics , Bacterial Toxins/therapeutic use , Enzyme-Linked Immunosorbent Assay , Exotoxins/genetics , Exotoxins/therapeutic use , Humans , Immunoglobulin Fragments , Mice , Recombinant Fusion Proteins , Virulence Factors/genetics , Virulence Factors/therapeutic use , Pseudomonas aeruginosa Exotoxin A
20.
Reproduction ; 129(4): 515-24, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15798027

ABSTRACT

The PATE gene is expressed in prostate and testis. To determine if PATE is expressed in other accessory tissues of the male genital tract, RT-PCR of the epididymis and seminal vesicle was performed. PATE mRNA was highly expressed in the epididymis and seminal vesicle. In situ hybridization of the testis showed PATE mRNA is strongly expressed in the spermatogonia. The PATE gene encodes a 14-kDa protein with a predicted signal sequence and a cleavage site between residues G21 and S22. To determine if PATE is a secreted protein, 293T cells were transfected with a pcDNA-PATE-myc-His plasmid and protein immunoprecipitated with anti-myc monoclonal antibody. Western blot analysis showed the presence of PATE-myc-His protein was in the medium and the cell lysate. Confocal microscopy demonstrated that PATE-myc-His protein is found in the endoplasmic reticulum. The polyclonal antibody SOL-1 was generated by immunization of rabbits with recombinant PATE protein expressed and purified from Escherichia coli. Western blots were performed on extracts of prostate, testis, seminal vesicle and ejaculated spermatozoa, but PATE protein was only detected in the spermatozoa. Immunostaining of sperm smears revealed that PATE is located in a band-like pattern in the sperm head. Our data indicate that PATE is made by various sexual accessory tissues and secreted into the semen where it becomes associated with sperm, suggesting that PATE is a novel sperm-associated protein with a possible role in mammalian sperm maturation.


Subject(s)
Genitalia, Male/chemistry , Membrane Proteins/analysis , RNA, Messenger/analysis , Sperm Head/chemistry , Amino Acid Sequence , Animals , Blotting, Western/methods , Cell Line , Epididymis/chemistry , Humans , In Situ Hybridization/methods , Male , Membrane Proteins/genetics , Membrane Proteins/isolation & purification , Molecular Sequence Data , Rabbits , Reverse Transcriptase Polymerase Chain Reaction , Semen/chemistry , Seminal Vesicles/chemistry , Sperm Maturation , Transfection
SELECTION OF CITATIONS
SEARCH DETAIL