Departments of Surgery.
Immunology.
J Immunother. 2019 Sep;42(7):237-243. doi: 10.1097/CJI.0000000000000290.
Administration of interleukin (IL)-2 has led to a durable response in patients with advanced renal cancer and melanoma but is restricted for clinical application because of adverse effects, including the vascular leak syndrome (VLS). VLS is associated with increased circulating levels of the Tie2 antagonist ligand, angiopoietin 2, and decreased Tie2 receptor phosphorylation and downstream signaling in endothelial cells (ECs). Given that vascular endothelial protein tyrosine phosphatase (VE-PTP) is a specific membrane phosphatase in ECs that dephosphorylates Tie2, the effects of targeting VE-PTP by a selective inhibitor AKB-9778 (AKB) in terms of VLS and antitumor efficacy were examined in this study. The authors found, by targeting VE-PTP, that the antitumor effects induced by IL-2 were augmented [tumor-free 44% (IL-2 alone) vs. 87.5% (IL-2+AKB)], associated with enhanced immune cell infiltrate (90% increase for CD8 T cells and natural killer cells). In addition, the side effects of IL-2 therapy were lessened, as demonstrated by diminished lung weight (less vascular leakage) as well as reduced cytokine levels (serum HMGB1 from 137.04±2.69 to 43.86±3.65 pg/mL; interferon-γ from 590.52±90.52 to 31.37±1.14 pg/mL). The authors further sought to determine the potential mechanism of the action of AKB-9778. The findings suggest that AKB-9778 may function through reducing serum angiopoietin 2 level and regulating EC viability. These findings provide insights into the targeting VE-PTP to improve tolerance and efficacy of IL-2 therapy and highlight the clinical potential of AKB-9778 for treating patients with VLS and cancer.
白细胞介素(IL)-2 的给药导致晚期肾细胞癌和黑色素瘤患者出现持久缓解,但由于不良反应,包括血管渗漏综合征(VLS),其临床应用受到限制。VLS 与循环中 Tie2 拮抗剂配体血管生成素 2 水平升高以及内皮细胞(EC)中 Tie2 受体磷酸化和下游信号转导减少有关。鉴于血管内皮蛋白酪氨酸磷酸酶(VE-PTP)是 EC 中一种特异性膜磷酸酶,可使 Tie2 去磷酸化,因此本研究检查了通过选择性抑制剂 AKB-9778(AKB)靶向 VE-PTP 对 VLS 和抗肿瘤疗效的影响。作者发现,通过靶向 VE-PTP,IL-2 诱导的抗肿瘤作用增强[无肿瘤 44%(单独使用 IL-2)与 87.5%(IL-2+AKB)],与免疫细胞浸润增强相关(CD8 T 细胞和自然杀伤细胞增加 90%)。此外,IL-2 治疗的副作用减轻,如肺重减轻(血管渗漏减少)以及细胞因子水平降低(血清高迁移率族蛋白 1 从 137.04±2.69 降至 43.86±3.65 pg/mL;干扰素-γ 从 590.52±90.52 降至 31.37±1.14 pg/mL)。作者进一步试图确定 AKB-9778 作用的潜在机制。研究结果表明,AKB-9778 可能通过降低血清血管生成素 2 水平和调节 EC 活力起作用。这些发现为靶向 VE-PTP 以提高 IL-2 治疗的耐受性和疗效提供了思路,并突出了 AKB-9778 治疗 VLS 和癌症患者的临床潜力。