Biology and potential clinical implications of tissue inhibitor of metalloproteinases-1 in colorectal cancer treatment.

Colorectal cancer (CRC) is the second leading cause of cancer-related death in the industrialized world. About half of "curatively" resected patients develop recurrent disease within the next 3-5 years despite the lack of clinical, histological and biochemical evidence of remaining overt disease after resection of the primary tumour. Availability of validated biological markers for early detection, selection for adjuvant therapy, prediction of treatment efficacy and monitoring of treatment efficacy would most probably increase survival. Tissue inhibitor of metalloproteinases-1 (TIMP-1) may be such a marker. TIMP-1 inhibits the proteolytic activity of metalloproteinases, which are centrally involved in tumour invasion and metastases. However, in clinical investigations high tumour tissue or plasma levels of TIMP-1 have shown a strong and independent association with a shorter survival time in CRC patients, suggesting that TIMP-1 could have a tumour-promoting function. Furthermore, measurement of plasma TIMP-1 has been shown to be useful for disease detection, with a high sensitivity and high specificity for early-stage colon cancer. This review describes some basic information on the current knowledge of the biology of TIMP-1 as well as the potential use of TIMP-1 as a biological marker in the management of CRC patients.

Evaluation of an improved tissue inhibitor of metalloproteinase 1 dual monoclonal sandwich immunoassay.

BACKGROUND: It has previously been shown that increased levels of plasma tissue inhibitor of metalloproteinase 1 (TIMP-1) is associated with shorter survival for patients with colorectal cancer (CRC). Furthermore, plasma TIMP-1 levels have been found to be elevated in patients with early-stage CRC. OBJECTIVE: It was the aim of this study to develop a new dual monoclonal antibody (mAb) sandwich immunoassay for TIMP-1 in order to achieve better resolution of non-cancer and cancer plasma specimens. METHODS: Chemiluminescence immunoassay techniques were used to screen 240 combinations of TIMP-1 mAbs for their ability to interact with each other and to allow for further characterization of the sandwiching antibody pairs. Five mAb pair combinations were selected for assessment of their ability to resolve non-cancerous and cancerous plasma specimens by TIMP-1 measurement. Based on this testing, a final assay format was chosen for further validation. The results for the final assay were compared with measurements obtained in a TIMP-1 ELISA that had previously demonstrated the ability to resolve healthy blood donors and CRC specimens. RESULTS: The clinical results support that the new dual monoclonal immunoassay has statistical discrimination equivalent to the ELISA. Additionally, the immunoassay had a high reproducibility and specificity. CONCLUSION: The clinical evaluation of five TIMP-1 immunoassays resulted in the development of a new immunoassay. The new TIMP-1 immunoassay showed superior analytical performance to our previously used ELISA.

Establishment and characterization of 7 new monoclonal antibodies to tissue inhibitor of metalloproteinases-1.

Tissue inhibitor of metalloproteinases-1 (TIMP-1) plays a pivotal role in tissue remodeling processes, such as inflammation, wound healing and cancer invasion. Experimental results have pointed to a role in angiogenesis, cell proliferation, apoptosis and in malignant transformation. In clinical investigations high tumor tissue or plasma levels of TIMP-1 have been shown to have a strong and independent association with shorter survival time for breast and colorectal cancer patients, respectively. The purpose of this study has been to develop and characterize new anti-TIMP-1 monoclonal antibodies that may be useful in future development of TIMP-1 immunoassays.Peptide-based epitope mapping reveals linear epitopes. Surface plasmon resonance was used to determine antibody affinity and ability of antibodies to sandwich with each other. Antigen recognition was tested using ELISA and a chemiluminescence microtiter immunoassay format. Three antibodies recognized linear peptides. Estimated antibody affinities for TIMP-1 ranged from 6.6 x 10(8) to>10(10) 1/M. Antibodies demonstrated different abilities in 'capture' and 'detection' positions in the sandwich experiment. All antibody pairs bound TIMP-1:ProMMP-9 complexes. TIMP-1:MMP-9 complexes were marginally reactive with five antibody pairs. The results suggest that the antibodies are unique. They may be useful in designing assays that recognize various forms of TIMP-1. Future studies will clarify whether the use of different combinations of antibodies will increase the clinical value of TIMP-1 measurements in the treatment of cancer patients.