MG7 mimotope-based DNA vaccination for gastric cancer

Preclinical Chimeric Antibody Chimeric Antigen Receptor T Cell Progress in Digestive System Cancers

Digestive system cancers, including hepatocellular carcinoma, colorectal and gastric tumors, are characterized by high rates of incidence and mortality. Digestive cancers are difficult to diagnose during the early stages, and the side effects of chemotherapy are often severe and may outweigh the therapeutic benefits. Chimeric antibody chimeric antigen receptor T cell (CAR-T) therapy, a novel immunotherapy, has achieved excellent results for the treatment of hematological tumors. However, CAR-T treatment of solid tumors has struggled due to a lack of target specificity, a difficult tumor microenvironment, and T cell homing. Despite the challenges, CAR-T treatment of digestive cancers is progressing. Combining CAR-T with other targets and/or modifying the CAR may represent the most promising approaches for future treatment of digestive cancers.

TLRs as a Promise Target Along With Immune Checkpoint Against Gastric Cancer

Gastric cancer (GC) is one of the most common cancers in the world, and the incidence of gastric cancer in Asia appears to increase in recent years. Although there is a lot of improvement in treatment approaches, the prognosis of GC is poor. So it is urgent to search for a novel and more effective treatment to improve the survival rate of patients. Both innate immunity and adaptive immunity are important in cancer. In the innate immune system, pattern recognition receptors (PRRs) activate immune responses by recognizing pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs). Toll-like receptors (TLRs) are a class of pattern recognition receptors (PRRs). Many studies have reported that TLRs are involved in the occurrence, development, and treatment of GC. Therefore, TLRs are potential targets for immunotherapy to gastric cancer. However, gastric cancer is a heterogeneous disorder, and TLRs function in GC is complex. TLRs agonists can be potentially used not only as therapeutic agents to treat gastric cancer but also as adjuvants in conjunction with other immunotherapies. They might provide a promising new target for GC treatment. In the review, we sort out the mechanism of TLRs involved in tumor immunity and summarize the current progress in TLRs-based therapeutic approaches and other immunotherapies in the treatment of GC.

Gastric cancer vaccines synthesized using a TLR7 agonist and their synergistic antitumor effects with 5-fluorouracil

Background

Vaccines play increasingly important roles in cancer treatment due to their advantages of effective targeting and few side effects. Our laboratory has attempted to construct vaccines by conjugating TLR7 agonists with tumor-associated antigens. Furthermore, immunochemotherapy has recently become an appealing approach to cancer therapy. 5-fluorouracil (5-FU), a commonly used chemotherapeutic agent, can reportedly potently and selectively kill tumor-associated MDSCs in vivo.

Methods

Gastric cancer vaccines were synthesized by the covalent attachment of our TLR7 agonist with the gastric cancer antigen MG7-Ag tetra-epitope, leading to T7 − ML (linear tetra-epitope) and T7 − MB (branched tetra-epitope). Cytokines induced by the vaccines in vitro were assessed by ELISA. A tumor challenge model was created by treating BALB/c mice on either a prophylactic or therapeutic vaccination schedule. 5-FU was simultaneously applied to mice in the combination treatment group. CTL and ADCC activities were determined by the LDH method, while CD3⁺/CD8⁺, CD3⁺/CD4⁺ T cells and MDSCs were evaluated by flow cytometry.

Results

In vitro, rapid TNF-α and IL-12 inductions occurred in BMDCs treated with the vaccines. In vivo, among all the vaccines tested, T7 − MB most effectively reduced EAC tumor burdens and induced CTLs, antibodies and ADCC activity in BALB/c mice. Immunization with T7 − MB in combination with 5-FU chemotherapy reduced tumor sizes and extended long-term survival rates, mainly by improving T cell responses, including CTLs, CD3⁺/CD8⁺ and CD3⁺/CD4⁺ T cells. 5-FU also enhanced the T7 − MB efficiency by reversing immunosuppressive factors, i.e., MDSCs, which could not be validly inhibited by the vaccines alone. In addition, T7 − MB repressed tumor growth and immune tolerance when the therapeutic schedule was used, although the effects were weaker than those achieved with either T7 − MB alone or in combination with 5-FU on the prophylactic schedule.

Conclusions

A novel effective gastric cancer vaccine was constructed, and the importance of branched multiple antigen peptides and chemical conjugation to vaccine design were confirmed. The synergistic effects and mechanisms of T7 − MB and 5-FU were also established, observing mainly T cell activation and MDSC inhibition.

Electronic supplementary material

The online version of this article (10.1186/s12967-018-1501-z) contains supplementary material, which is available to authorized users.

Application of phage peptide display technology for the study of food allergen epitopes

Phage peptide display technology has been used to identify IgE-binding mimotopes (mimics of natural epitopes) that mimic conformational epitopes. This approach is effective in the characterization of those epitopes that are important for eliciting IgE-mediated allergic responses by food allergens and those that are responsible for cross-reactivity among allergenic food proteins. Application of this technology will increase our understanding of the mechanisms whereby food allergens elicit allergic reactions, will facilitate the discovery of diagnostic reagents and may lead to mimotope-based immunotherapy.

The value of MG7-Ag and COX-2 for predicting malignancy in gastric precancerous lesions

Here we aimed to first investigate the clinical value of combined detection of MG7-Ag and COX-2 (cyclo-oxygenase 2) in prediction of advances in gastric precancerous lesions. Immunohistochemical analysis was used to examine the expression of MG7-Ag and COX-2 in 396 cases of patients with gastric precancerous lesions, including 66 cases of atrophic gastritis, 106 cases of intestinal metaplasia, 174 cases of low-moderate-grade dysplasia and 50 cases of high-grade dysplasia. The relation of MG7-Ag and COX-2 staining with various clinicopathological features was analysed by follow-up study. The positive rates of MG7-Ag and COX-2 were increased gradually from atrophic gastritis (21.2%, 28.8%), intestinal metaplasia (36.8%, 44.3%), low-moderate-grade dysplasia (51.4%, 58.6%) to high-grade dysplasia (72%, 80%). Double positive staining of MG7-Ag and COX-2 in gastric precancerous lesions had an increased risk of precancerous progression over 22 times, compared with negative ones. However, the expression of MG7-Ag and COX-2 was not significantly correlated with age and gender of patients. MG7-Ag and COX-2 might play an important role in the process of carcinogenesis and progression of gastric cancer. Combined detection of MG7-Ag and COX-2 was of value of predicting early gastric cancer from precancerous lesions.

Screening and Identification of Recombinant Anti-Idiotype Antibodies against Gastric Cancer and Colon Cancer Monoclonal Antibodies by a Phage-Displayed Single-Chain Variable Fragment Library

Several monoclonal antibodies (McAbs) have been developed that show high sensitivity and specificity to gastric cancer and colorectal cancer. However, few of the antigens recognized by these antibodies have been identified. The authors now report the selection of anti-idiotype (anti-id) antibodies of MGb1 McAb against gastric cancer and MC5 McAb against colorectal cancer using phage-displayed single-chain variable fragment (ScFv) libraries. After purification, the anti-id antibodies were approximately 30 kd and could be recognized by MGb1/MC5 McAb. Anti-id antibodies significantly blocked the binding of MGb1 and MC5 to gastric cancer/colorectal cancer cells, respectively, suggesting that the antibodies were specific to MGb1 and MC5. Antibodies against gastric and colorectal cancer could be detected in mice at 6 weeks after immunization with the anti-id antibodies. At week 8, antibody titers reached 1:400. The anti-id antibodies may be useful as novel reagents for developing vaccines against gastric cancer and colorectal cancer.

Overview of mimotopes and related strategies in tumor vaccine development

Tumor vaccine has been studied extensively as an alternative or adjuvant therapy in the treatment of malignant tumors in the hope of prolonging the overall survival rates of cancer patients. The efficacy largely relies on the specificity of the target. In the last decade, many antibody epitopes, called mimotopes, have been revealed as candidates through phage-display technology. These mimotopes do not necessarily consist of amino acid sequences that are identical to the native antigen but they do mimic their structure. Tumor vaccines based on these mimotopes have been proposed as an important developing strategy. Some peptide mimotopes have produced encouraging clinical outcomes. Although most studies are still in the preclinical phase, these findings will possibly pave the way for the development of novel mimotope-based tumor vaccines.