Vascular-homing peptides for targeted drug delivery and molecular imaging: Meeting the clinical challenges

The vasculature of each organ expresses distinct molecular signatures critically influenced by the pathological status. The heterogeneous profile of the vascular beds has been successfully unveiled by the in vivo phage display, a high-throughput tool for mapping normal, diseased, and tumor vasculature. Specific challenges of this growing field are targeted therapies against cancer and cardiovascular diseases, as well as novel bioimaging diagnostic tools. Tumor vasculature-homing peptides have been extensively evaluated in several preclinical and clinical studies both as targeted-therapy and diagnosis. To date, results from several Phase I and II trials have been reported and many other trials are currently ongoing or recruiting patients. In this review, advances in the identification of novel peptide ligands and their corresponding receptors on tumor endothelium through the in vivo phage display technology are discussed. Emphasis is given to recent findings in the clinical setting of vascular-homing peptides selected by in vivo phage display for the treatment of advanced malignancies and their altered vascular beds.     

血清CREG蛋白在急性心肌梗死早期的表达研究

目的：探讨血清中CREG蛋白在急性心肌梗死发作早期的表达情况,尝试为临床心肌缺血的极早期诊断提供一种新的血清标志分子。方法：在2010年6月至2010年11月期间,入选在沈阳军区总医院心内科住院治疗的急性ST段抬高型心肌梗死患者50例及非AMI对照50例,于AMI组胸痛发作后的不同时间点采血测定CK、CK—MB、LDH和cTnT,同时应用Westem blot技术测定血清中CREG蛋白的含量,并与对照组比较。结果：AMI组发病72小时内的血清中CREG蛋白表达均较对照组有不同程度的增高（P〈0．05）。胸痛开始2h内,AMI组血清中CREG的含量即明显增高,其在2h、4h及6h的含量显著高于对照组（P〈0．001）。在胸痛已经发作2小时内,两组间血清cTnT、CK、CK-MB及LDH水平比较无统计学意义（P〉0．05）。结论：CREG在AMI患者血清中的表达增高．其在血清中表达时间早于cTNT及CK-MB。     

Cellular repressor of E1A-stimulated genes regulates vascular endothelial cell migration by the ILK/AKT/mTOR/VEGF(165) signaling pathway

The migration of vascular endothelial cells plays a critical role in a variety of vascular physiological and pathological processes, such as embryonic development, angiogenesis, wound healing, re-endothelialization, and vascular remodeling. This study clarified the role and mechanism of a new vascular homeostasis regulator, Cellular repressor of E1A-stimulated genes (CREG), in the migration of primary human umbilical vein endothelial cells (HUVECs). A wound healing assay and transwell migration model showed that upregulation of CREG expression induced HUVEC migration and it was positively correlated with the expression of vascular endothelial growth factor. Furthermore, wild type integrin-linked kinase reversed the poor mobility of CREG knock-down HUVECs; in contrast, kinase-dead integrin-linked kinase weakened the migration of HUVECs. We also studied the effect of CREG on HUVEC migration by the addition of an mTOR inhibitor, recombinant vascular endothelial growth factor₁₆₅, neutralizing antibody of vascular endothelial growth factor₁₆₅ and AKT siRNA, and we concluded that CREG induces endothelial cell migration by activating the integrin-linked kinase/AKT/mTOR/VEGF₁₆₅ signaling pathway.     

E1A激活基因阻遏子(CREG)过表达通过抑制p38/JNK信号分子活化对抗人血管平滑肌细胞凋亡

血管平滑肌细胞(VSMCs)凋亡参与了动脉粥样硬化(AS)及冠状动脉介入治疗(PCI)术后再狭窄(RS)等心血管疾病的发生发展过程．E1A激活基因阻遏子(CREG)是新近发现的一种分泌型糖蛋白,在维持细胞和组织稳态方面发挥重要作用．前期研究发现CREG蛋白过表达能够对抗血清饥饿诱导的人血管平滑肌细胞(hVSMCs)凋亡,进一步探讨CREG对hVSMCs凋亡的调控作用及相关的分子机制．以逆转录病毒稳定转染的CREG过表达及表达抑制的hVSMCs为模型,应用两种药物Staurosporine (STS) 和Etoposide (VP-16) 诱导细胞发生凋亡,检测细胞凋亡和相关信号通路变化．结果显示,在药物干预后,CREG表达抑制时细胞凋亡明显增多,而CREG过表达明显抑制hVSMCs凋亡．同时也发现,CREG表达抑制时p38及JNK活性明显增强,而CREG过表达时p38和JNK活性被抑制．经腺病毒转染和药物干预抑制p38表达后,细胞凋亡均受到抑制,而且在p38活性被抑制的同时,JNK活化也受到抑制．说明p38和JNK表现为协同作用．结果也显示,VSMCs分化指标SM α-actin和SM MHC与CREG表达呈一致趋势,而细胞外基质蛋白Fibronection与CREG表达呈负相关．以上结果提示,CREG在维持VSMCs表型转换方面发挥重要作用,并且通过p38和JNK信号转导通路对hVSMCs凋亡进行调控．CREG可能对于AS和PCI术后RS的防治具有重要价值．     

过表达CREG抑制ox-LDL诱导的人血管平滑肌细胞增殖

目的：探讨E1A 激活基因阻遏子（Cellular repressor of E1A-stimulated genes，CREG）在氧化型低密度脂蛋白（Oxidized low density lipoprotein，ox-LDL）引起的人血管平滑肌细胞（Vascular smooth muscle cell，VSMC）增殖中的作用及可能机制。方法：用60 滋g/mL ox-LDL处理人胸主动脉VSMC，在不同时间点（0 h，12 h，24 h，48 h）计数细胞并绘制生长曲线；在48 h时间点进行BrdU 染色检测增殖细胞的比率；采用Western Blot 检测各时间点CREG 表达。通过向VSMC 中转染携带CREG基因的质粒载体，筛选 获得过表达CREG 的VSMC（VSMCCREG）。进一步用ox-LDL 处理VSMCCREG，采用前述方法绘制生长曲线、进行48 h时间点 BrdU染色并检测CREG 和磷酸化Erk1/2 的表达。结果：与未经处理的对照组VSMC 相比，ox-LDL处理的VMSC 细胞总数及 BrdU阳性细胞比率显著增加；并且，CREG 表达随处理时间延长逐渐降低。此外，与ox-LDL 处理的VSMC 组相比，ox-LDL 处理 的VSMCCREG 组细胞总数及BrdU 阳性细胞比率均显著下降；并且CREG 表达增加、磷酸化Erk1/2 水平下降。结论：过表达 CREG 可能通过降低Erk1/2 磷酸化抑制ox-LDL诱导的人VSMC 增殖。     

Cellular repressor of E1A-stimulated genes is a bona fide lysosomal protein which undergoes proteolytic maturation during its biosynthesis

Cellular repressor of E1A-stimulated genes (CREG) has been reported to be a secretory glycoprotein implicated in cellular growth and differentiation. We now show that CREG is predominantly localized within intracellular compartments. Intracellular CREG was found to lack an N-terminal peptide present in the secreted form of the protein. In contrast to normal cells, CREG is largely secreted by fibroblasts missing both mannose 6-phosphate receptors. This is not observed in cells lacking only one of them. Mass spectrometric analysis of recombinant CREG revealed that the protein contains phosphorylated oligosaccharides at either of its two N-glycosylation sites. Cellular CREG was found to cosediment with lysosomal markers upon subcellular fractionation by density-gradient centrifugation. In fibroblasts expressing a CREG-GFP fusion construct, the heterologous protein was detected in compartments containing lysosomal proteins. Immunolocalization of endogenous CREG confirmed that intracellular CREG is localized in lysosomes. Proteolytic processing of intracellular CREG involves the action of lysosomal cysteine proteinases. These results establish that CREG is a lysosomal protein that undergoes proteolytic maturation in the course of its biosynthesis, carries the mannose 6-phosphate recognition marker and depends on the interaction with mannose 6-phosphate receptors for efficient delivery to lysosomes.     

过表达CREG抑制高糖诱导的人脐静脉内皮细胞凋亡

目的：探讨E1A激活基因阻遏子（Cellular repressor of ElA-stimulated genes,CREG）在高糖引起的人脐静脉内皮细胞（Human Umbilical Vein Endothelial Cells,HUVECs）损伤中的作用,为寻找糖尿病血管病变新的治疗靶点提供实验依据。方法：采用胶原酶消化法分离原代HUVECs,并用内皮细胞标志物CD31免疫荧光染色进行鉴定。分别用含有5．5mmol／1葡萄糖（正常糖对照组）、5．5mmol／1葡萄糖＋27．5mmol／1甘露醇（渗透压对照组）或33mmol／l葡萄糖（高糖组）的培养液培养HUVECs48h。WesternBlot检测剪切体caspase-3表达;AnnexinV／PI双染后流式细胞术检测细胞凋亡。通过感染表达CREG基因的腺病毒获得CREG过表达的HUvECs,WesternBlot及流式细胞术评价CREG过表达对HUVECs凋亡的影响。结果：高糖处理48h后,HUVECs内剪切体caspase-3的蛋白表达增加,细胞凋亡率增加;过表达CREG后,高糖处理的HUVECs内剪切体Caspase-3表达和凋亡细胞比例均明显降低,但仍高于正常糖对照组。结论：CREG过表达可抑制高糖引起的HUVECs凋亡。     

Hepatocyte-specific deletion of cellular repressor of E1A-stimulated genes 1 exacerbates alcohol-induced liver injury by activating stress kinases

Alcohol-associated liver disease (ALD) encompasses a wide range of pathologies from simple steatosis to cirrhosis and hepatocellular carcinoma and is a global health problem. Currently, there are no effective pharmacological treatments for ALD. We have previously demonstrated that aging exacerbates the pathogenesis of ALD, but the underlying mechanisms are still poorly understood. Cellular repressor of E1A-stimulated genes 1 protein (CREG1) is a recently identified small glycoprotein that has been implicated in aging process by promoting cellular senescence and activating stress kinases. Thus, the current study aimed to explore the role of aging associated CREG1 in ALD pathogenesis and CREG1 as a potential therapeutic target. Hepatic and serum CREG1 protein levels were elevated in ALD patients. Elevation of hepatic CREG1 protein and mRNA was also observed in a mouse model of Gao-binge alcohol feeding. Genetic deletion of the Creg1 gene in hepatocytes (Creg1^∆hep) markedly exacerbated ethanol-induced liver injury, apoptosis, steatosis and inflammation. Compared to wild-type mice, Creg1^∆hep mice had increased phosphorylation of hepatic stress kinases such as apoptosis signal-regulating kinase 1 (ASK1), c-Jun N-terminal kinase (JNK) and p38 but not TGF-β-activated kinase 1 (TAK1) or extracellular signal-regulated kinase (ERK) after alcohol feeding. In vitro, ethanol treatment elevated the phosphorylation of ASK1, JNK, and p38 in mouse hepatocyte AML-12 cells. This elevation was further enhanced by CREG1 knockdown but alleviated by CREG1 overexpression. Last, treatment with an ASK1 inhibitor abolished ethanol-induced liver injury and upregulated hepatic lipogenesis, proinflammatory genes and stress kinases in Creg1^∆hep mice. Taken together, our data suggest that CREG1 protects against alcoholic liver injury and inflammation by inhibiting the ASK1-JNK/p38 stress kinase pathway and that CREG1 is a potential therapeutic target for ALD.     

心肌α肌球蛋白重链启动子驱动的CREG蛋白表达载体的构建及鉴定

目的：构建心肌特异性α-肌球蛋白重链（α—myosin heavy chain,α—MHC）启动子启动E1A基因阻遏子（cellular repressor of E1A—stimulated genes,CREG）和增强型绿色荧光蛋白（enhanced green fluorescent protein,EGFP）融合的真核表达载体。绿色荧光蛋白作为报告基因,方便在心肌细胞中直接观察CREG蛋白的表达,为心肌特异性转CREG基因动物模型制备提供载体。方法：用BamHI和EcoRI双酶切pcDNA3．1myc—His／hCREG质粒得到CREG基因,亚克隆入增强绿色荧光蛋白表达质粒pEGFP-N1中,构建pCREG-EGFP-N1;根据Genebank中公布的α-MHC基因的启动子序列,人工合成pUC57-α-MHC启动子基因序列,经AseI和NheI双酶切得到启动子α—MHC,亚克隆入pCREG—EGFP-N1中替代原CMV启动子,构建pα-MHC-CREG—EGFP-N1,测序鉴定。用脂质体法将该质粒转染体外培养的小鼠原代心肌细胞,荧光显微镜下观测绿色荧光蛋白的表达;Western blot检测CREG蛋白的表达。结果：成功构建pα—MHC—CREG-EGFP-N1质粒,酶切及测序结果正确;成功转染入原代培养小鼠心肌细胞,在荧光显微镜下可见绿色荧光蛋白的表达,Westem blot检测到CREG蛋白的表达。结论：重组质粒pα-MHC—CREG—EGFP-N1体外转染入原代培养小鼠心肌细胞后,目的基因能够在心肌细胞中有效表达,检测方法简便可靠,为下一步建立心肌细胞特异性表达CREG的过表达转基因小鼠、深入探讨CREG在心肌疾病发生中的生物学功能研究奠定了基础。     

Cellular repressor of E1A-stimulated genes attenuates cardiac hypertrophy and fibrosis

Cellular repressor of E1A-stimulated genes (CREG) is a secreted glycoprotein of 220 amino acids. It has been proposed that CREG acts as a ligand that enhances differentiation and/or reduces cell proliferation. CREG has been shown previously to attenuate cardiac hypertrophy in vitro . However, such a role has not been determined in vivo . In the present study, we tested the hypothesis that overexpression of CREG in the murine heart would protect against cardiac hypertrophy and fibrosis in vivo . The effects of constitutive human CREG expression on cardiac hypertrophy were investigated using both in vitro and in vivo models. Cardiac hypertrophy was produced by aortic banding and infusion of angiotensin II in CREG transgenic mice and control animals. The extent of cardiac hypertrophy was quantitated by two-dimensional and M-mode echocardiography as well as by molecular and pathological analyses of heart samples. Constitutive over-expression of human CREG in the murine heart attenuated the hypertrophic response, markedly reduced inflammation. Cardiac function was also preserved in hearts with increased CREG levels in response to hypertrophic stimuli. These beneficial effects were associated with attenuation of the mitogen-activated protein kinase (MAPK)-extracellular signal-regulated kinase 1 (MEK-ERK1)/2-dependent signalling cascade. In addition, CREG expression blocked fibrosis and collagen synthesis through blocking MEK-ERK1/2-dependent Smad 2/3 activation in vitro and in vivo . Therefore, the expression of CREG improves cardiac functions and inhibits cardiac hypertrophy, inflammation and fibrosis through blocking MEK-ERK1/2-dependent signalling.