1
|
Kessler T, Baumeier A, Brand C, Grau M, Angenendt L, Harrach S, Stalmann U, Schmidt LH, Gosheger G, Hardes J, Andreou D, Dreischalück J, Lenz G, Wardelmann E, Mesters RM, Schwöppe C, Berdel WE, Hartmann W, Schliemann C. Aminopeptidase N (CD13): Expression, Prognostic Impact, and Use as Therapeutic Target for Tissue Factor Induced Tumor Vascular Infarction in Soft Tissue Sarcoma. Transl Oncol 2018; 11:1271-1282. [PMID: 30125801 PMCID: PMC6113655 DOI: 10.1016/j.tranon.2018.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 12/20/2022] Open
Abstract
Aminopeptidase N (CD13) is expressed on tumor vasculature and tumor cells. It represents a candidate for targeted therapy, e.g., by truncated tissue factor (tTF)-NGR, binding to CD13, and causing tumor vascular thrombosis. We analyzed CD13 expression by immunohistochemistry in 97 patients with STS who were treated by wide resection and uniform chemo-radio-chemotherapy. Using a semiquantitative score with four intensity levels, CD13 was expressed by tumor vasculature, or tumor cells, or both (composite value, intensity scores 1-3) in 93.9% of the STS. In 49.5% tumor cells, in 48.5% vascular/perivascular cells, and in 58.8%, composite value showed strong intensity score 3 staining. Leiomyosarcoma and synovial sarcoma showed low expression; fibrosarcoma and undifferentiated pleomorphic sarcoma showed high expression. We found a significant prognostic impact of CD13, as high expression in tumor cells or vascular/perivascular cells correlated with better relapse-free survival and overall survival. CD13 retained prognostic significance in multivariable analyses. Systemic tTF-NGR resulted in significant growth reduction of CD13-positive human HT1080 sarcoma cell line xenografts. Our results recommend further investigation of tTF-NGR in STS patients. CD13 might be a suitable predictive biomarker for patient selection.
Collapse
Affiliation(s)
- Torsten Kessler
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany.
| | - Ariane Baumeier
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany
| | - Caroline Brand
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany
| | - Michael Grau
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany
| | - Linus Angenendt
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany
| | - Saliha Harrach
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany
| | - Ursula Stalmann
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany
| | - Lars Henning Schmidt
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany
| | - Georg Gosheger
- Department of Orthopedics and Tumor-Orthopedics, University Hospital Muenster, Germany
| | - Jendrik Hardes
- Department of Orthopedics and Tumor-Orthopedics, University Hospital Muenster, Germany
| | - Dimosthenis Andreou
- Department of Orthopedics and Tumor-Orthopedics, University Hospital Muenster, Germany
| | - Johannes Dreischalück
- Department of Orthopedics and Trauma Surgery, Sankt Elisabeth Hospital Guetersloh, Guetersloh
| | - Georg Lenz
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany; Translational Oncology, University Hospital Muenster, Muenster, Germany; Cluster of Excellence EXC 1003, Cells in Motion, Muenster, Germany
| | - Eva Wardelmann
- Gerhard-Domagk-Institute of Pathology, University of Muenster, Muenster, Germany
| | - Rolf M Mesters
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany
| | - Christian Schwöppe
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany
| | - Wolfgang E Berdel
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany; Cluster of Excellence EXC 1003, Cells in Motion, Muenster, Germany.
| | - Wolfgang Hartmann
- Gerhard-Domagk-Institute of Pathology, University of Muenster, Muenster, Germany
| | - Christoph Schliemann
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Muenster, Germany
| |
Collapse
|
2
|
Molecular Imaging of Aminopeptidase N in Cancer and Angiogenesis. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:5315172. [PMID: 30046296 PMCID: PMC6036854 DOI: 10.1155/2018/5315172] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 05/14/2018] [Indexed: 02/07/2023]
Abstract
This review focuses on recent advances in the molecular imaging of aminopeptidase N (APN, also known as CD13), a zinc metalloenzyme that cleaves N-terminal neutral amino acids. It is overexpressed in multiple cancer types and also on the surface of vasculature undergoing angiogenesis, making it a promising target for molecular imaging and targeted therapy. Molecular imaging probes for APN are divided into two large subgroups: reactive and nonreactive. The structures of the reactive probes (substrates) contain a reporter group that is cleaved and released by the APN enzyme. The nonreactive probes are not cleaved by the enzyme and contain an antibody, peptide, or nonpeptide for targeting the enzyme exterior or active site. Multivalent homotopic probes utilize multiple copies of the same targeting unit, whereas multivalent heterotopic molecular probes are equipped with different targeting units for different receptors. Several recent preclinical cancer imaging studies have shown that multivalent APN probes exhibit enhanced tumor specificity and accumulation compared to monovalent analogues. The few studies that have evaluated APN-specific probes for imaging angiogenesis have focused on cardiac regeneration. These promising results suggest that APN imaging can be expanded to detect and monitor other diseases that are associated with angiogenesis.
Collapse
|
3
|
Stucke-Ring J, Ronnacker J, Brand C, Höltke C, Schliemann C, Kessler T, Schmidt LH, Harrach S, Mantke V, Hintelmann H, Hartmann W, Wardelmann E, Lenz G, Wünsch B, Müller-Tidow C, Mesters RM, Schwöppe C, Berdel WE. Combinatorial effects of doxorubicin and retargeted tissue factor by intratumoral entrapment of doxorubicin and proapoptotic increase of tumor vascular infarction. Oncotarget 2018; 7:82458-82472. [PMID: 27738341 PMCID: PMC5347705 DOI: 10.18632/oncotarget.12559] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/04/2016] [Indexed: 12/14/2022] Open
Abstract
Truncated tissue factor (tTF), retargeted to tumor vasculature by GNGRAHA peptide (tTF-NGR), and doxorubicin have therapeutic activity against a variety of tumors. We report on combination experiments of both drugs using different schedules. We have tested fluorescence- and HPLC-based intratumoral pharmacokinetics of doxorubicin, flow cytometry for cellular phosphatidylserine (PS) expression, and tumor xenograft studies for showing in vivo apoptosis, proliferation decrease, and tumor shrinkage upon combination therapy with doxorubicin and induced tumor vascular infarction. tTF-NGR given before doxorubicin inhibits the uptake of the drug into human fibrosarcoma xenografts in vivo. Reverse sequence does not influence the uptake of doxorubicin into tumor, but significantly inhibits the late wash-out phase, thus entrapping doxorubicin in tumor tissue by vascular occlusion. Incubation of endothelial and tumor cells with doxorubicin in vitro increases PS concentrations in the outer layer of the cell membrane as a sign of early apoptosis. Cells expressing increased PS concentrations show comparatively higher procoagulatory efficacy on the basis of equimolar tTF-NGR present in the Factor X assay. Experiments using human M21 melanoma and HT1080 fibrosarcoma xenografts in athymic nude mice indeed show a combinatorial tumor growth inhibition applying doxorubicin and tTF-NGR in sequence over single drug treatment. Combination of cytotoxic drugs such as doxorubicin with tTF-NGR-induced tumor vessel infarction can improve pharmacodynamics of the drugs by new mechanisms, entrapping a cytotoxic molecule inside tumor tissue and reciprocally improving procoagulatory activity of tTF-NGR in the tumor vasculature via apoptosis induction in tumor endothelial and tumor cells.
Collapse
Affiliation(s)
- Janine Stucke-Ring
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Julian Ronnacker
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Caroline Brand
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Carsten Höltke
- Department of Clinical Radiology, University Hospital of Muenster, Muenster, Germany
| | - Christoph Schliemann
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Torsten Kessler
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Lars Henning Schmidt
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Saliha Harrach
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Verena Mantke
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Heike Hintelmann
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Wolfgang Hartmann
- Gerhard-Domagk Institute for Pathology, University Hospital of Muenster, Muenster, Germany
| | - Eva Wardelmann
- Gerhard-Domagk Institute for Pathology, University Hospital of Muenster, Muenster, Germany
| | - Georg Lenz
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Bernhard Wünsch
- Department of Pharmaceutical Chemistry, Westfalian Wilhelms-University, Muenster, Germany
| | - Carsten Müller-Tidow
- Department of Hematology and Oncology, University Hospital Halle, Halle, Germany
| | - Rolf M Mesters
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Christian Schwöppe
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| | - Wolfgang E Berdel
- Department of Medicine A (Hematology, Hemostaseology, Oncology and Pneumology), University Hospital of Muenster, Muenster, Germany
| |
Collapse
|
4
|
Pathuri G, Madka V, Hedrick AF, Lightfoot S, Awasthi V, Cowley BD, Rao CV, Gali H. Evaluation of (99m)Tc-probestin SPECT as a novel technique for noninvasive imaging of kidney aminopeptidase N expression. Mol Pharm 2014; 11:2948-53. [PMID: 24988047 PMCID: PMC4144757 DOI: 10.1021/mp5002872] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 05/23/2014] [Accepted: 07/02/2014] [Indexed: 01/04/2023]
Abstract
Aminopeptidase N (APN; CD13; EC 3.4.11.2) is a zinc-dependent membrane-bound exopeptidase that catalyzes the removal of N-terminal amino acids from peptides. APN is known to be highly expressed on renal cortical proximal tubules. APN expression levels are markedly decreased under the influence of nephrotoxins and in the tumor regions of renal cancers. Thus, molecular imaging of kidney APN expression could provide pathophysiological information about kidneys noninvasively. Probestin is a potent APN inhibitor and binds to APN. Abdominal SPECT imaging was conducted at 1 h postinjection of (99m)Tc-probestin in a group of 12 UPII-SV40T transgenic and wild-type mice. UPII-SV40T mice spontaneously develop urothelial carcinoma in situ and invasive transitional cell carcinoma (TCC) that invade kidneys. Histopathology and immunohistochemistry analysis were used to confirm the presence of tumor and to evaluate APN expression in kidney. Radioactivity in normal tissue regions of renal cortex was clearly visible in SPECT images, whereas tumor regions of renal cortex displayed significantly lower or no radioactivity uptake. Histopathological analysis of kidney sections showed normal morphology for both renal pelvic and cortical regions in wild-type mice and abnormal morphology in some transgenic mice. Proliferating cell nuclear antigen staining confirmed the presence of tumor in those abnormal regions. Immunohistochemical analysis of kidney sections using anti-CD13 antibody showed significantly lower APN expression in tumor regions compared to normal regions. Results obtained in this study demonstrate the potential use of (99m)Tc-probestin SPECT as a novel technique for noninvasive imaging of kidney APN expression.
Collapse
Affiliation(s)
- Gopal Pathuri
- Department
of Pharmaceutical Sciences, College of Pharmacy, Center for Cancer
Prevention and Drug Development, Hematology/Oncology Section, Department
of Medicine, PCS Oklahoma Cancer Center, and Nephrology Section, Department of Medicine,
College of Medicine, The University of Oklahoma
Health Sciences Center, Oklahoma
City, Oklahoma 73117, United States
| | - Venkateshwar Madka
- Department
of Pharmaceutical Sciences, College of Pharmacy, Center for Cancer
Prevention and Drug Development, Hematology/Oncology Section, Department
of Medicine, PCS Oklahoma Cancer Center, and Nephrology Section, Department of Medicine,
College of Medicine, The University of Oklahoma
Health Sciences Center, Oklahoma
City, Oklahoma 73117, United States
| | - Andria F. Hedrick
- Department
of Pharmaceutical Sciences, College of Pharmacy, Center for Cancer
Prevention and Drug Development, Hematology/Oncology Section, Department
of Medicine, PCS Oklahoma Cancer Center, and Nephrology Section, Department of Medicine,
College of Medicine, The University of Oklahoma
Health Sciences Center, Oklahoma
City, Oklahoma 73117, United States
| | - Stanley
A. Lightfoot
- Department
of Pharmaceutical Sciences, College of Pharmacy, Center for Cancer
Prevention and Drug Development, Hematology/Oncology Section, Department
of Medicine, PCS Oklahoma Cancer Center, and Nephrology Section, Department of Medicine,
College of Medicine, The University of Oklahoma
Health Sciences Center, Oklahoma
City, Oklahoma 73117, United States
| | - Vibhudutta Awasthi
- Department
of Pharmaceutical Sciences, College of Pharmacy, Center for Cancer
Prevention and Drug Development, Hematology/Oncology Section, Department
of Medicine, PCS Oklahoma Cancer Center, and Nephrology Section, Department of Medicine,
College of Medicine, The University of Oklahoma
Health Sciences Center, Oklahoma
City, Oklahoma 73117, United States
| | - Benjamin D. Cowley
- Department
of Pharmaceutical Sciences, College of Pharmacy, Center for Cancer
Prevention and Drug Development, Hematology/Oncology Section, Department
of Medicine, PCS Oklahoma Cancer Center, and Nephrology Section, Department of Medicine,
College of Medicine, The University of Oklahoma
Health Sciences Center, Oklahoma
City, Oklahoma 73117, United States
| | - Chinthalapally V. Rao
- Department
of Pharmaceutical Sciences, College of Pharmacy, Center for Cancer
Prevention and Drug Development, Hematology/Oncology Section, Department
of Medicine, PCS Oklahoma Cancer Center, and Nephrology Section, Department of Medicine,
College of Medicine, The University of Oklahoma
Health Sciences Center, Oklahoma
City, Oklahoma 73117, United States
| | - Hariprasad Gali
- Department
of Pharmaceutical Sciences, College of Pharmacy, Center for Cancer
Prevention and Drug Development, Hematology/Oncology Section, Department
of Medicine, PCS Oklahoma Cancer Center, and Nephrology Section, Department of Medicine,
College of Medicine, The University of Oklahoma
Health Sciences Center, Oklahoma
City, Oklahoma 73117, United States
| |
Collapse
|