Kufer P, Mack M, Gruber R, Lutterbüse R, Zettl F, Riethmüller G
Institute of Immunology, University of Munich, Germany.
Cancer Immunol Immunother. 1997 Nov-Dec;45(3-4):193-7. doi: 10.1007/s002620050431.
Unlike monoclonal antibodies, clinical application of bispecific antibodies has so far lagged behind because of difficult, low-yield production techniques as well as considerable toxicity attributed to bispecific antibody preparations containing immunoglobulin-Fc parts and anti-CD3 homodimers. These difficulties were overcome by recombinant generation of a bispecific single-chain antibody (bscAb) joining two single-chain Fv fragments via a five-amino-acid glycine-serine linker. The anti-CD3 specificity directed against human T cells was combined with another specificity against the epithelial 17-1A antigen. The following domain arrangement was critical in this individual case to obtain a fully functional bscAb: VL17-1A-VH17-1A-VHCD3-VLCD3. The bscAb was expressed in chinese hamster ovary cells with a yield of 15 mg/l culture supernatant whereas numerous attempts to obtain a functional protein expression in Escherichia coli failed. The low-molecular-mass bispecific construct (60 kDa) could easily be purified by its C-terminal histidine tail. The antigen-binding properties are indistinguishable from those of the corresponding univalent single-chain Fv fragments as shown by enzyme immunoassay and flow cytometry. We could show that the bscAb, which lacks Fc parts and anti-CD3 homodimers is highly cytotoxic for 17-1A positive tumor cells in nanomolar concentrations and in the presence of human T cells. Most remarkable, it does not stimulate T lymphocyte proliferation in the absence of tumor cells and, moreover, does not induce CD25 up-regulation and the secretion of potentially toxic lymphokines such as tumor necrosis factor alpha, interleukin-6 and interferon gamma. Maximal cytotoxicity (51Cr release) was achieved without notable costimulation and was not further enhanced by adding costimulatory signals such as those delivered by anti-CD28 antibodies. CD8+ as well as CD4+ T cell subpopulations were recruited to exert cytotoxicity against tumor cells with different kinetics. CD8+ cells induced high 51Cr release within 4 h while CD4+ cells required a 20-h incubation. The systemic application of the 17-1A/CD3-bscAb could be a major improvement in therapy against disseminated micrometastatic tumor cells. A prospective, randomized clinical trial showing that an anti-17-1A monoclonal antibody could prolong survival of colorectal cancer patients after 5 and 7 years, warrants an assessment of the clinical efficacy of this bscAb exhibiting a 1000-fold higher specific cytotoxicity against tumor cells in vitro.
与单克隆抗体不同,双特异性抗体的临床应用迄今滞后,原因在于生产技术困难、产量低,以及含免疫球蛋白-Fc部分和抗-CD3同二聚体的双特异性抗体制剂存在相当大的毒性。通过重组生成双特异性单链抗体(bscAb)克服了这些困难,该抗体通过一个五氨基酸的甘氨酸-丝氨酸接头连接两个单链Fv片段。针对人T细胞的抗-CD3特异性与针对上皮17-1A抗原的另一种特异性相结合。在这个具体案例中,以下结构域排列对于获得功能完全的bscAb至关重要:VL17-1A-VH17-1A-VHCD3-VLCD3。bscAb在中国仓鼠卵巢细胞中表达,培养上清液产量为15 mg/l,而在大肠杆菌中进行功能性蛋白表达的多次尝试均失败。低分子量双特异性构建体(60 kDa)可通过其C末端组氨酸尾轻松纯化。酶免疫测定和流式细胞术显示,其抗原结合特性与相应单价单链Fv片段的特性无差异。我们能够证明,缺乏Fc部分和抗-CD3同二聚体的bscAb在纳摩尔浓度且存在人T细胞的情况下,对17-1A阳性肿瘤细胞具有高度细胞毒性。最显著的是,在无肿瘤细胞时它不会刺激T淋巴细胞增殖,此外,也不会诱导CD25上调以及分泌潜在有毒的淋巴因子,如肿瘤坏死因子α、白细胞介素-6和干扰素γ。在无明显共刺激的情况下实现了最大细胞毒性(51Cr释放),添加共刺激信号(如抗-CD28抗体传递的信号)也不会进一步增强细胞毒性。CD8+以及CD4+ T细胞亚群被募集以对肿瘤细胞发挥细胞毒性作用,但动力学不同。CD8+细胞在4小时内诱导高51Cr释放,而CD4+细胞需要20小时孵育。17-1A/CD3-bscAb的全身应用可能是治疗播散性微转移肿瘤细胞的一项重大改进。一项前瞻性随机临床试验表明,一种抗-17-1A单克隆抗体可延长结直肠癌患者5年和7年的生存期,这使得评估这种在体外对肿瘤细胞具有高1000倍特异性细胞毒性的bscAb的临床疗效成为必要。