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Antikörper, die gegen eine klinisch relevante Gruppe von Rezeptoren innerhalb der Tumornekrosefaktor-Rezeptor-Superfamilie (TNFRSF) gerichtet sind, darunter CD40 und CD95 (Fas/Apo-1), benötigen ebenfalls eine Bindung an Fc-Gamma-Rezeptoren (FcγRs), um eine starke agonistische Wirkung zu entfalten. Diese FcγR-Abhängigkeit beruht weitgehend auf der bloßen zellulären Verankerung durch die Fc-Domäne des Antikörpers und benötigt dabei kein FcγR-Signalling. Ziel dieser Doktorarbeit war es, das agonistische Potenzial von αCD40- und αCD95-Antikörpern unabhängig von der Bindung an FcγRs durch die Verankerung an Myelomzellen zu entfalten. Zu diesem Zweck wurden verschiedene Antikörpervarianten (IgG1, IgG1-N297A, Fab2) gegen die TNFRSF-Mitglieder CD40 und CD95 genetisch mit einem einzelkettig kodierten B-Zell-aktivierenden Faktor (scBaff) Trimer als C-terminale myelom-spezifische Verankerungsdomäne fusioniert, welche die Fc-Domäne-vermittelte FcγR-Bindung ersetzt. Diese bispezifischen Antikörper-scBaff-Fusionsproteine wurden in Bindungsstudien und funktionellen Assays mit Tumorzelllinien untersucht, die einen oder mehrere der drei Baff-Rezeptoren exprimieren: BaffR, Transmembran-Aktivator und CAML-Interaktor (TACI) und B-Zell-Reifungsantigen (BCMA). Zelluläre Bindungsstudien zeigten, dass die Bindungseigenschaften der verschiedenen Domänen innerhalb der Antikörper-scBaff-Fusionen gegenüber der Zielantigene vollständig intakt blieben. In Ko-Kulturversuchen von CD40- und CD95-responsiven Zellen mit BaffR-, BCMA- oder TACI-exprimierenden Verankerungszellen zeigten die Antikörper-Fusionsproteine einen starken Agonismus, während in Ko-Kulturen mit Zellen ohne Expression von Baff-interagierenden Rezeptoren nur eine geringe Rezeptorstimulation beobachtet wurde. Die hier vorgestellten αCD40- und αCD95-Antikörper-scBaff-Fusionsproteine zeigen also Myelom-spezifische Aktivität und versprechen im Vergleich zu herkömmlichen CD40- und CD95-Agonisten geringere systemische Nebenwirkungen.
Burkitt lymphoma (BL) is a highly aggressive B cell malignancy. Rituximab, a humanized antibody against CD20, in a combination with chemotherapy is a current treatment of choice for B-cell lymphomas including BL. However, certain group of BL patients are resistant to Rituximab therapy. Therefore, alternative treatments targeting survival pathways of BL are needed.
In BL deregulation of MYC expression, together with additional mutations, inhibits differentiation of germinal centre (GC) B cells and drives proliferation of tumor cells. Pro-apoptotic properties of MYC are counteracted through the B-cell receptor (BCR) and phosphoinositide-3-kinase (PI3K) pathway to ensure survival of BL cells. In normal B-cells BCR triggering activates both NF-κB and NFAT-dependent survival signals. Since BL cells do not exhibit constitutive NF-κB activity, we hypothesized that anti-apoptotic NFATc1A isoform might provide a major survival signal for BL cells.
We show that NFATc1 is constitutively expressed in nuclei of BL, in BL cell lines and in Eµ-Myc–induced B cell lymphoma (BCL) cells. Nuclear residence of NFATc1 in these entities depends on intracellular Ca2+ levels but is largely insensitive to cyclosporine A (CsA) treatment and therefore independent from calcineurine (CN) activity. The protein/protein interaction between the regulatory domain of NFATc1 and DNA binding domain of BCL6 likely contributes to sustained nuclear residence of NFATc1 and to the regulation of proposed NFATc1-MYC-BCL6-PRDM1 network in B-cell lymphomas.
Our data revealed lack of strict correlation between the expression of six NFATc1 isoforms in different BL-related entities suggesting that both NFATc1/alphaA and -betaA isoforms provide survival functions and that NFATc1alpha/betaB and -alpha/betaC isoforms either do not possess pro-apoptotic properties in BL cells or these properties are counterbalanced. In addition, we show that in BL entities expression of NFATc1 protein is largely regulated at post-transcriptional level, including MYC dependent increase of protein stability.
Functionally we show that conditional inactivation of Nfatc1 gene in Eµ-Myc mice prevents development of BCL tumors with mature B cell immunophenotype (IgD+). Loss of NFATc1 expression in BCL cells ex vivo results in apoptosis of tumor cells.
Together our results identify NFATc1 as an important survival factor in BL cells and, hence, as a promising target for alternative therapeutic strategies for BL.
Ibrutinib serves as an efficient second-line therapy in relapsed/refractory mantle cell lymphoma. However, resistance to the BTK inhibitor results in a poor prognosis for patients. Since the mechanisms leading to resistance in initially responding tumor cells are poorly understood, this work aimed to decipher acquired features in ibrutinib-surviving cells of a sensitive mantle cell lymphoma cell line and evaluate these potential therapeutic targets in ibrutinib-treated mantle cell lymphoma.
Time-resolved single-cell RNA sequencing was performed to track the transcriptomic evolution of REC-1 cells across 6 and 48 hours of treatment. Single-cell analysis uncovered a subpopulation of REC-1 with potentially greater aggressiveness and survival advantage by benefiting from interaction with the tumor microenvironment. Upregulation of B-cell receptor genes, elevated surface antigen expression of CD52 and metabolic rewiring to higher dependence on oxidative phosphorylation were identified as further potential resistance features of ibrutinib-surviving cells. RNA sequencing after prolonged incubation corroborated the increase in CD52 and oxidative phosphorylation as dominant characteristics of the cells surviving the 4-day treatment, highlighting their potential as therapeutic targets in combination with ibrutinib treatment. Concomitant use of ibrutinib and the oxidative phosphorylation inhibitor IACS-010759 increased toxicity compared to ibrutinib monotherapy due to higher apoptosis and greater inhibition of proliferation. For anti-CD52 therapy, a consecutive approach with ibrutinib pretreatment followed by incubation of surviving cells with a CD52 monoclonal antibody and human serum yielded a synergistic effect, as ibrutinib-surviving mantle cell lymphoma cells were rapidly depleted by complement-dependent cytotoxicity. Regarding the effects on primary tumor cells from mantle cell lymphoma patients, ibrutinib induced upregulation of CD52 in some cases, and increased toxicity of anti-CD52 therapy was observed in ibrutinib-sensitive patient samples after pretreatment with the BTK inhibitor. The likely favorable in vivo efficacy of an anti-CD52 therapy might therefore be restricted to a subgroup of mantle cell lymphoma patients, also in view of the associated side effects.
Given the need for new therapeutic options in mantle cell lymphoma to overcome resistance to ibrutinib, this work highlights the potentially beneficial use of an oxidative phosphorylation inhibitor as add-on therapy. In addition, the findings suggest to further assess the value of anti-CD52 therapy as consolidation to ibrutinib in ibrutinib-sensitive patients with elevated CD52 surface levels on tumor cells to target resistant clones and minimize risk of minimal residual disease and relapse.