利妥昔单抗耐药 B 淋巴细胞瘤细胞中 CD20 交联的扩增增强了无药物大分子治疗药物诱导的细胞凋亡。

Amplification of CD20 Cross-Linking in Rituximab-Resistant B-Lymphoma Cells Enhances Apoptosis Induction by Drug-Free Macromolecular Therapeutics.

出版信息

ACS Nano. 2018 Apr 24;12(4):3658-3670. doi: 10.1021/acsnano.8b00797. Epub 2018 Apr 2.

Abstract

Although the CD20-targeted monoclonal antibody rituximab (RTX) has revolutionized the therapeutic landscape for B-cell malignancy, relapsed and refractory disease due to RTX resistance continue to constitute major challenges, illustrating the need for better therapies. Here, we apply drug-free macromolecular therapeutics (DFMT) that amplifies CD20 cross-linking to enhance apoptosis in RTX-resistant cells. Bispecific engager (anti-CD20 Fab' conjugated with oligonucleotide1) pretargets CD20 and the deletion of Fc-region minimizes its premature endocytosis in resistant cells that rapidly internalize and consume CD20/RTX complexes. Second-step delivery of multivalent polymeric effector (linear copolymer conjugated with multiple copies of complementary oligonucleotide 2) simultaneously hybridizes multiple CD20-bound engagers and strengthens CD20 ligation. Moreover, the restoration of CD20 expression by the pretreatment of cells with a polymer-gemcitabine conjugate, a CD20 expression enhancer, unleashes the full potential of DFMT in the CD20-deficient resistant cells. Hence, amplification of CD20 cross-linking is achieved by (1) the enhancement of surface CD20 accessibility, (2) the increase in CD20 expression, and (3) multimeric CD20 binding, which ultimately translates into the amplified activation of a wide range of innate apoptotic responses. We demonstrated that the altered molecular signaling pathway that originally results in RTX resistance could be circumvented and compensated by other DFMT-augmented pathways. Of note, our preliminary data provide proof-of-concept that CD20 cross-linking amplification emerges as an important strategy for overcoming RTX resistance.

摘要

虽然针对 CD20 的单克隆抗体利妥昔单抗 (RTX) 彻底改变了 B 细胞恶性肿瘤的治疗格局,但由于 RTX 耐药导致的复发和难治性疾病仍然构成重大挑战,这表明需要更好的治疗方法。在这里,我们应用无药物大分子治疗学 (DFMT) 来增强 CD20 的交联,以促进 RTX 耐药细胞的凋亡。双特异性结合物(与寡核苷酸 1 共轭的抗-CD20 Fab')预先靶向 CD20,并且 Fc 区域的缺失可最大程度地减少其在耐药细胞中的过早内吞作用,这些细胞会迅速内化并消耗 CD20/RTX 复合物。多价聚合物效应物(与多个互补寡核苷酸 2 拷贝共轭的线性共聚物)的第二步递药会同时杂交多个结合于 CD20 的结合物,并增强 CD20 连接。此外,通过用聚合物-吉西他滨缀合物(CD20 表达增强剂)预处理细胞,可恢复 CD20 表达,从而在 CD20 缺乏的耐药细胞中释放 DFMT 的全部潜力。因此,通过以下方式增强 CD20 交联:(1) 增强表面 CD20 可及性;(2) 增加 CD20 表达;(3) 多聚体 CD20 结合,最终导致广泛的固有凋亡反应被激活。我们证明,最初导致 RTX 耐药的改变的分子信号通路可以被其他增强的 DFMT 途径绕过和补偿。值得注意的是,我们的初步数据提供了概念验证,即 CD20 交联放大成为克服 RTX 耐药的重要策略。

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