Highly potent anti-CD20-RLI immunocytokine targeting established human B lymphoma in SCID mouse

Rituximab (RTX), a chimeric IgG1 monoclonal antibody directed against the CD20 antigen, has revolutionized the treatment of B-cell malignancies. Nevertheless, the relapsed/refractory rates are still high. One strategy to increase the clinical effectiveness of RTX is based on antibody-cytokine fusion protein (immunocytokine; ICK) vectorizing together at the tumor site the antibody effector activities and the cytokine co-signal required for the generation of cytotoxic cellular immunity. Such ICKs linking various antibody formats to interleukin (IL)-2 are currently being investigated in clinical trials and have shown promising results in cancer therapies. IL-15, a structurally-related cytokine, is now considered as having a better potential than IL-2 in antitumor immunotherapeutic strategies. We have previously engineered the fusion protein RLI, linking a soluble form of human IL-15Rα-sushi+ domain to human IL-15. Compared with IL-15, RLI displayed better biological activities in vitro and higher antitumor effects in vivo in murine and human cancer models. In this study, we investigated the advantages of fusing RLI to RTX. Anti-CD20-RLI kept its binding capacity to CD20, CD16 and IL-15 receptor and therefore fully retained both antibody effector functions (ADCC and CDC), and the cytokine potential of RLI. In a severe combined immunodeficiency (SCID) mouse model of disseminated residual lymphoma, anti-CD20-RLI was found to induce long-term survival of 90% of mice up to at least 120 days whereas RLI and RTX, alone or in combination, just delayed the disease onset (100% of death at 28, 40 and 51 days respectively). These findings suggest that such ICK could improve the clinical efficacy of RTX, particularly in patients with refractory B-cell lymphoma.     

Nanoscale mapping and organization analysis of target proteins on cancer cells from B-cell lymphoma patients

CD20, a membrane protein highly expressed on most B-cell lymphomas, is an effective target demonstrated in clinical practice for treating B-cell non-Hodgkin's lymphoma (NHL). Rituximab is a monoclonal antibody against CD20. In this work, we applied atomic force microscopy (AFM) to map the nanoscale distribution of CD20 molecules on the surface of cancer cells from clinical B-cell NHL patients under the assistance of ROR1 fluorescence recognition (ROR1 is a specific cell surface marker exclusively expressed on cancer cells). First, the ROR1 fluorescence labeling experiments showed that ROR1 was expressed on cancer cells from B-cell lymphoma patients, but not on normal cells from healthy volunteers. Next, under the guidance of ROR1 fluorescence, the rituximab-conjugated AFM tips were moved to cancer cells to image the cellular morphologies and detect the CD20-rituximab interactions on the cell surfaces. The distribution maps of CD20 on cancer cells were constructed by obtaining arrays of (16×16) force curves in local areas (500×500 nm²) on the cell surfaces. The experimental results provide a new approach to directly investigate the nanoscale distribution of target protein on single clinical cancer cells.     

抗人B淋巴细胞单克隆抗体清除中国恒河猴体内B淋巴细胞效果观察

目的用抗人B淋巴细胞单克隆抗体（利妥昔单抗注射液,Rituximab）通过静脉滴注的方法敲除中国恒河猴体内B淋巴细胞,并观察其敲除效果,为建立B淋巴细胞缺失的恒河猴动物模型提供基础的实验数据。方法选取健康的中国恒河猴两只,静脉滴注抗人B淋巴细胞单克隆抗体,定期采集外周血、腹股沟淋巴结和十二指肠黏膜组织,制备淋巴细胞悬液,应用流式细胞术的方法系统性测定B淋巴细胞及T淋巴细胞亚群的变化。结果静脉滴注利妥昔单抗注射液后24 h,中国恒河猴外周血中B淋巴细胞的缺失即能达到100%,持续约14 d;腹股沟淋巴结中B淋巴细胞在静注后7 d缺失100%;十二指肠黏膜组织中B淋巴细胞在静脉滴注后7 d缺失达到90%,维持28 d。并且在成功敲除B淋巴细胞的情况下,CD4＋T及CD8＋T淋巴细胞无明显波动,维持在一个稳定的水平。结论利妥昔单抗注射液能有效去除中国恒河猴体内B淋巴细胞,为建立B淋巴细胞缺失动物模型奠定基础。     

Monoclonal antibodies in the treatment of lymphoid malignancies

Rituximab (Rit) was the first monoclonal antibody approved for therapeutic use in cancer patients. Rit is a chimeric mouse/human monoclonal antibody, consisting of the human IgG1 and k constant Fc region, and a mouse variable Fab region specific against the B-cell antigen CD20. Rit exerts its antilymphoma activity through many different mechanisms. Binding of antibody to CD20 antigen, provokes apoptosis through downstream signals that lead to caspase-3 activation. Complement activation by the Fc portion of the antibody results in complement-dependent cytotoxicity. However, the most effective mechanism of action seems to be antigen-dependent cellular cytotoxicity. Effector cytotoxic cells such as natural killer cells (NK) are activated after binding to the Fc portion of the anti-CD20 molecule. Activated NK cells kill the coated lymphoma cells with the use of granzyme-perforin system. More recently, pre-clinical data support the concept that Rituximab can provoke a vaccination-like effect. Finally in-vitro experiments and clinical trials have shown that co-administration of the antibody with cytotoxics confers a strong synergistic effect. The relative contribution of these mechanisms in vivo and in different lymphoma subtypes is not well known and remains to be further evaluated.

Among the different histological groups, follicular lymphoma (FL) has been proven to be the most sensitive to Rit when used as a single agent, with overall response rates of 80% and 50% in untreated and previously treated patients, respectively. Moreover, Rit in combination with chemotherapy is superior to chemotherapy alone in terms of response rate and event-free survival, while early data indicate a significant prolongation in overall survival as well. Similarly, the addition of Rit to standard chemotherapy improves the disease-free and overall survival of patients with diffuse large B-cell lymphoma. There is no doubt that Rit represents one of the greatest achievements of biotechnology engineering. However, we need to understand better the mechanisms of its action as well as the mechanisms of resistance to Rit, in order to design more effective treatment modalities.     

小剂量利妥昔单抗联合龙花胶囊对成人血小板减少症患者促血小板生成素及肾功能水平的影响

目的:探讨小剂量利妥昔单抗联合龙花胶囊对成人血小板减少症患者促血小板生成素,肾功能水平及临床疗效的影响。方法:收集我院就收治的90例免疫性血小板减少症患者,随机分为实验组和对照组,每组45例。对照组患者给予小剂量利妥昔单抗治疗;实验组患者在对照组基础上使用龙花胶囊治疗。观察并比较两组患者血小板(PLT)计数、促血小板生成素(TPO)、肾功能水平以及临床治疗总有效率。结果:与治疗前相比,治疗后两组患者的PLT、TPO水平均升高,差异具有统计学意义(P0.05);与治疗前相比,治疗后两组患者的肌酐(Scr)、尿素氮(BUN)水平均下降,差异具有统计学意义(P0.05);与对照组相比,实验组患者PLT、TPO水平较低,Scr、BUN水平较高,差异具有统计学意义(P0.05);与对照组相比,实验组患者临床治疗有效率较高,差异具有统计学意义(P0.05)。结论:小剂量利妥昔单抗联合龙花胶囊能够升高血小板减少症患者血小板以及促血小板生成素水平,改善患者肾功能,临床疗效较好,提高了治疗效果。     

Resolving the micro-heterogeneity and structural integrity of monoclonal antibodies by hybrid mass spectrometric approaches

For therapeutic monoclonal antibodies (mAbs), detailed analysis of the structural integrity and heterogeneity, which results from multiple types of post-translational modifications (PTMs), is relevant to various processes, including product characterization, storage stability and quality control. Despite the recent rapid development of new bioanalytical techniques, it is still challenging to completely characterize the proteoform profile of a mAb. As a nearly indispensable tool in mAb analysis, mass spectrometry (MS) provides unique structural information at multiple levels. Here, we tested a hybrid strategy for the comprehensive characterization of micro-heterogeneity by integrating 2 state-of-the-art MS-based approaches, high-resolution native MS and targeted glycan profiling, to perform complementary analysis at the intact protein level and released glycan level, respectively. We compared the performance of these methods using samples of engineered half-body IgG4s and a panel of mAbs approved for human use. The glycosylation characterization data derived from these approaches were found to be mutually consistent in composition profiling, and complementary in identification and relative-quantitation of low-abundant uncommon glycoforms. In addition, multiple other sources of micro-heterogeneity, such as glycation, lack of glycosylation, and loss of light chains, could be detected by this approach, and the contribution of multiple types of modifications to the overall micro-heterogeneity could be assessed using our superposition algorithm. Our data demonstrate that the hybrid strategy allows reliable and thorough characterization of mAbs, revealing product characteristics that would easily be missed if only a single approach were used.     

糖皮质激素联合利妥昔单抗对特发性膜性肾病患者血脂、Th17/Treg失衡和血清PLA2R抗体、THSD7A抗体的影响

摘要 目的：探讨糖皮质激素联合利妥昔单抗对特发性膜性肾病（IMN）患者血脂、辅助性T细胞17（Th17）/调节性T细胞（Treg）失衡和血清抗磷脂酶A2受体（PLA2R）抗体、抗I型血小板反应蛋白7A域（THSD7A）抗体的影响。方法：收集空军军医大学唐都医院2022年3月~2023年3月期间收治的IMN患者112例。根据随机数字表法将入组患者分为对照组（56例,糖皮质激素治疗）与治疗组（56例,对照组的基础上接受利妥昔单抗治疗）。观察两组疗效、血脂[低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）]、肾功能[胱抑素C（CysC）、血肌酐（Scr）、血尿素氮（BUN）、24 h尿蛋白定量]、Th17/Treg相关指标[Th17细胞百分比、白细胞介素-17（IL-17）、Treg细胞百分比、转化生长因子β1（TGF-β1）、肿瘤坏死因子-α（TNF-α）]和血清PLA2R抗体、THSD7A抗体水平变化情况,并观察两组治疗安全性。结果：与对照组相比,治疗组的临床总有效率更高（P<0.05）。与对照组相比,治疗组治疗6个月后TC、TG、LDL-C、CysC、Scr、BUN、24 h尿蛋白定量、Th17、IL-17、TNF-α、PLA2R抗体、THSD7A抗体更低,HDL-C、Treg、TGF-β1更高（P<0.05）。两组不良反应发生率对比未见差异（P>0.05）。结论：糖皮质激素联合利妥昔单抗应用于IMN患者,可有效改善患者血脂、Th17/Treg失衡和血清PLA2R抗体、THSD7A抗体水平,且不增加不良反应发生率,具有较好的临床应用价值。     

Imaging and measuring the rituximab-induced changes of mechanical properties in B-lymphoma cells using atomic force microscopy

The topography and mechanical properties of single B-lymphoma cells have been investigated by atomic force microscopy (AFM). With the assistance of microfabricated patterned pillars, the surface topography and ultrastructure of single living B-lymphoma cell were visualized by AFM. The apoptosis of B-lymphoma cells induced by rituximab alone was observed by acridine orange/ethidium bromide (AO/EB) double fluorescent staining. The rituximab-induced changes of mechanical properties in B-lymphoma cells were measured dynamically and the results showed that B-lymphoma cells became dramatically softer after incubation with rituximab. These results can improve our understanding of rituximab’effect and will facilitate the further investigation of the underlying mechanisms.     

One-pot enzymatic glycan remodeling of a therapeutic monoclonal antibody by endoglycosidase S (Endo-S) from Streptococcus pyogenes

A facile, one-pot enzymatic glycan remodeling of antibody rituximab to produce homogeneous high-mannose and hybrid type antibody glycoforms is described. This method was based on the unique substrate specificity of the endoglycosidase S (Endo-S) from Streptococcus pyogenes. While Endo-S efficiently hydrolyzes the bi-antennary complex type IgG Fc N-glycans, we found that Endo-S did not hydrolyze the “ground state” high-mannose or hybrid glycoforms, and only slowly hydrolyzed the highly activated high-mannose or hybrid N-glycan oxazolines. Moreover, we found that wild-type Endo-S could efficiently use high-mannose or hybrid glycan oxazolines for transglycosylation without product hydrolysis. The combination of the remarkable difference in substrate specificity of Endo-S allows the deglycosylation of heterogeneous rituximab and the transglycosylation with glycan oxazoline to take place in one-pot without the need of isolating the deglycosylated intermediate or changing the enzyme to afford the high-mannose type, hybrid type, and some selectively modified truncated form of antibody glycoforms.