- Open Access
Targeted delivery of CD40L promotes restricted activation of antigen-presenting cells and induction of cancer cell death
- Kim L Brunekreeft1, 2,
- Corinna Strohm2,
- Marloes J Gooden1,
- Anna A Rybczynska3,
- Hans W Nijman1,
- Götz U Grigoleit5,
- Wijnand Helfrich4,
- Edwin Bremer4,
- Daniela Siegmund2,
- Harald Wajant†2 and
- Marco de Bruyn†1, 2Email author
© Brunekreeft et al.; licensee BioMed Central Ltd. 2014
- Received: 6 December 2013
- Accepted: 8 April 2014
- Published: 17 April 2014
Stimulation of CD40 can augment anti-cancer T cell immune responses by triggering effective activation and maturation of antigen-presenting cells (APCs). Although CD40 agonists have clinical activity in humans, the associated systemic activation of the immune system triggers dose-limiting side-effects.
To increase the tumor selectivity of CD40 agonist-based therapies, we developed an approach in which soluble trimeric CD40L (sCD40L) is genetically fused to tumor targeting antibody fragments, yielding scFv:CD40L fusion proteins. We hypothesized that scFv:CD40L fusion proteins would have reduced CD40 agonist activity similar to sCD40L but will be converted to a highly agonistic membrane CD40L-like form of CD40L upon anchoring to cell surface exposed antigen via the scFv domain.
Targeted delivery of CD40L to the carcinoma marker EpCAM on carcinoma cells induced dose-dependent paracrine maturation of DCs ~20-fold more effective than a non-targeted control scFv:CD40L fusion protein. Similarly, targeted delivery of CD40L to the B cell leukemia marker CD20 induced effective paracrine maturation of DCs. Of note, the CD20-selective delivery of CD40L also triggered loss of cell viability in certain B cell leukemic cell lines as a result of CD20-induced apoptosis.
Targeted delivery of CD40L to cancer cells is a promising strategy that may help to trigger cancer-localized activation of CD40 and can be modified to exert additional anti-cancer activity via the targeting domain.
- Fusion protein
The tumor necrosis factor (TNF) receptor family member CD40 is a critical regulator of cellular and humoral immunity. In line with this, CD40 is broadly expressed on immune cells, although predominantly on antigen-presenting cells (APCs) such as dendritic cells (DC) and B cells [1–3]. One of the main functions of the CD40L/CD40 system is to activate and “license” DCs to prime effective cytotoxic CD8+ T cell responses [4, 5]. In brief, CD40 ligand (CD40L) expressed on CD4+ helper T cells engages CD40 on APCs and induces APC activation and maturation. In turn, such CD40-licensed APCs induce activation and proliferation of antigen-specific CD8+ cytotoxic T cells [6, 7]. In the absence of CD40 signalling, the interaction of CD8+ T cells with so-called “unlicensed” APCs induces T cell anergy or triggers formation of regulatory T cells . Thus, CD40 is crucial for effective generation of cytotoxic CD8+ T cell immune responses. Although normally induced by helper T cells, CD40 signalling on APCs can also be effectively triggered using agonistic antibodies or CD40L, thus bypassing the need for CD4+ T cell help [4, 9]. These features delineate a clear rationale for CD40 agonist-based cancer immunotherapy.
CD40 has been explored as a target for the treatment of several forms of cancer using recombinant soluble CD40L (sCD40L) or agonistic therapeutic antibodies (Abs). In pre-clinical models, sCD40L and agonistic CD40 Abs are highly effective at inducing DC maturation and eradicating tumors (reviewed in ). However, an important concern for this type of immunotherapy in humans is the potential for systemic over activation of the immune system and concomitant toxicity. Indeed, dose-limiting toxicity using sCD40L or agonistic CD40 antibodies has been reported in humans [10–12]. Importantly, whereas systemic treatment with agonistic CD40 Abs in pre-clinical mouse models was associated with significant liver toxicity, local administration of agonistic CD40 Abs proved equally effective, yet without the associated toxicity [13, 14].
The efficacy of CD40 signaling is dependent on the clustering of CD40 within the membrane of the targeted cells. For instance, CD40-signaling induced by soluble CD40L (sCD40L) was potentiated ~10-fold upon secondary cross-linking of CD40L into higher order multimers [15–17]. In line with this, CD40 signaling induced by anti-CD40 antibodies critically depends on the presence of Fc-receptor positive cells . Based on these crosslinking requirements for CD40/CD40L signaling, CD40L has also been evaluated in a proof-of-concept study with a fibroblast activation protein (FAP)-targeted scFv:CD40L fusion protein. In brief, antibody fragment-mediated anchoring to FAP-expressing cells enabled the scFv:CD40L fusion protein to trigger IL-8 production in target cells with an ~25-fold lowered ED50 value .
Antibody fragment-specific binding of scFv:CD40L fusion proteins
CD40L remains biologically active within scFv:CD40L fusion proteins
Next, the anti-EpCAM:CD40L-matured DCs were analyzed for their capacity to induce T cell proliferation in allogeneic PBMCs. Hereto, allogeneic PBMCs were labeled with CFSE and mixed with DCs at the indicated ratios, whereupon T-cell proliferation in mixed cultures of iDC/PBMC and anti-EpCAM:CD40L matured DCs/PBMCs was analyzed after 7 days. In these mixed cultures, anti-EpCAM:CD40L matured DCs proved more potent at inducing T cell proliferation than iDC (exemplary proliferation plots in Figure 3F, quantified in Figure 3G), with a significant increase in the percentage of proliferating T cells (Figure 3H). Taken together, these data demonstrated that the soluble CD40L domain in scFv:CD40L fusion proteins remains biologically active and, in correspondence with its mode of action as a soluble molecule, requires high concentrations over prolonged periods of time to trigger efficient CD40 responses.
Cell surface-immobilization of CD40L on cancer cells augments paracrine maturation of iDC
To subsequently assess the potentiating effect of targeted delivery of CD40L on DC maturation, monocyte-derived iDC were co-cultured with HEK293.EpCAM and overnight production of IL-12 was determined as read-out for iDC maturation. Monocultures of HEK293.EpCAM and iDCs treated with increasing concentrations of anti-EpCAM:CD40L did not produce IL-12 even at 1 μg/mL (Figure 4B: left panel). By contrast, in iDC/HEK.EpCAM co-cultures, treatment with anti-EpCAM:CD40L dose-dependently induced IL-12 production (Figure 4B: middle panel). IL-12 production was dependent on EpCAM-specific binding since pre-incubation with the parental EpCAM blocking antibody largely blocked IL-12 production (Figure 4B: right panel). In control mixed cultures of iDC with HEK.YFP and HEK.EpICD only marginal levels of IL-12 were detectable (Figure 4B: middle panel). Furthermore, in co-culture experiments of iDCs with a panel of EpCAM+ cancer cell lines, treatment with anti-EpCAM:CD40L induced significant IL-12 production that was inhibited by the EpCAM blocking antibody (Figure 4C). By contrast, no IL-12 was detected upon treatment of co-cultures of iDCs and EpCAM- cancer cell lines with anti-EpCAM:CD40L (Figure 4C), nor when EpCAM+ cells were treated with an scFv:CD40L fusion protein of irrelevant specificity (Additional file 1: Figure S1G).
In line with this IL-12 production, treatment of co-cultures of iDC and HEK.EpCAM-YFP with anti-EpCAM:CD40L also triggered phagocytic uptake of high numbers of HEK.EpCAM cells (Figure 4D), whereas no such phagocytic uptake was detected in co-cultures with HEK or HEK.EpICD cells (Figure 4D). Next, we assessed whether these findings extended to DC-induced T cell proliferation. To this end, we co-cultured a panel of five EpCAM+ cancer cell lines with iDCs and allogeneic T cells in the presence or absence of anti-EpCAM:CD40L using a modified procedure of the proliferation assay described above. Importantly, in 4 out of 5 cells lines, treatment with anti-EpCAM:CD40L was associated with increased T cell proliferation (Figure 4E).
Targeted delivery of CD40L to CD20 induces paracrine maturation of dendritic cells
Targeted delivery of CD40L to leukemic cell lines induces non-proliferative CD40 signaling
In leukemic cells, signaling via CD40 has been linked to both pro-survival and anti-cancer effects [21, 22]. However, most of these studies have been performed using varying CD40-targeted agents (e.g. crosslinked CD40L or antibodies), complicating interpretation. Therefore, to assess the direct effects of anti-CD20:CD40L on leukemic B cells, BJAB and Raji were treated for 3 days with increasing concentrations of anti-CD20:CD40L and changes in cell surface expression of B cell maturation markers were assessed. In these experiments, the optimal dose for non-saturating induction of signaling was determined at 250 ng/mL (not shown). In both cell lines, treatment with anti-CD20:CD40L induced an increase in cell surface CCR7 (Additional file 1: Figure S1H and S1I), whereas no significant changes were observed in the cell surface levels of HLA-DR, CD80 or CD86 (Additional file 1: Figure S1H and S1I). Interestingly, treatment with anti-CD20:CD40L induced an upregulation of CD83 on BJAB cells and a downregulation of CD83 on Raji cells, indicating cell type-specific effects of CD40 signaling (Additional file 1: Figure S1H and S1I). As expected, treatment of leukemic B cell lines with control fusion protein anti-EpCAM:CD40L had no effect in this setting even when applied at concentrations up to 1 μg/mL (not shown). Finally, we did not observe proliferation or cell death as a result of treatment with anti-CD20:CD40L within this time frame (not shown).
scFv-mediated delivery of CD40L induces secondary scFv-dependent effects in cancer cells
We explored targeted delivery of CD40 ligand to the cancer cell-surface as a therapeutic option for treatment of malignancies. To this end, we generated EpCAM- and CD20-targeted fusion proteins, anti-EpCAM:CD40L and anti-CD20:CD40L, respectively, and analyzed functional immune parameters. Based on our findings, CD40L remains biologically active in scFv fusion proteins, with an activity profile similar to soluble CD40L. However, binding of CD40L fusion proteins to target antigens on the cancer cell surface promotes oligomerization and augmented activation of CD40 on neighboring immature DC. As a result, maturation of iDC occurred at approximately 20 fold lower concentrations as in the case of stimulation with “unbound” CD40L. In addition, we describe how targeted delivery of CD40L to CD20+ leukemic B cells can induce simultaneous B cell death and paracrine maturation of iDC. Importantly, B cell lines did not undergo additional proliferation as a result of treatment with anti-CD20:CD40L. These findings are in agreement with earlier reports on therapeutic exploitation of CD40 and highlight our approach as a means of achieving loco-regional maturation of DC in the tumor micro-environment . Furthermore, rational incorporation of scFv fragments into these fusion proteins can be used to confer additional anti-cancer effects.
Our data on the cell surface anchoring requirements of soluble CD40L for optimal induction of CD40 signaling highlight the importance of choosing the right preparation of TNF family ligands for therapeutic exploitation. Typically, ligands of the TNF family are transmembrane proteins of which a significant fraction can be cleaved to yield soluble molecules [23–25]. In general, these soluble molecules have a reduced receptor activating potential that can be (partially) restored upon artificial (antibody-mediated) crosslinking or by artificial cell surface anchoring. While constitutively inducing ligand oligomerization to optimize signaling activity could promote off-target systemic toxicity, cell surface immobilization can “open” the therapeutic window.
This might also be of relevance for therapies that base on CD40 activation. Both pre-clinical and clinical studies have highlighted toxicity concerns with the use of agonistic CD40-targeted agents for treating cancer [10, 11, 26]. Indeed, in the first clinical trials with the agonistic anti-CD40 antibody CP-870,893, grade 1 to 2 toxicities in the form of cytokine release syndrome were observed in ~55% of patients and two grade 3 toxicities out of 27 patients were reported. Nevertheless, 4 out of 27 patients had a partial response indicating the potential of targeting CD40 . Similarly, 2 out of 32 patients administered soluble recombinant human CD40L (rhCD40L) displayed signs of a partial response, although treatment was associated with transient elevations of serum liver transaminases (grade 3 or 4 severity) in 28% of the patients treated with the maximum tolerated dose (MTD; of 0.1 mg/kg) . Of note, these transient signs of liver toxicity have also frequently been reported in preclinical work on CD40-targeted therapeutics (discussed in .
To overcome these toxicity issues in the preclinical setting, the group of Melief et al. has previously evaluated a local release strategy for immunomodulatory antibodies . In their approach, an anti-CD40 antibody is dissolved in a slow release formulation of the adjuvant Montanide and injected near the tumor site. After this loco-regional application, the antibody is proposed to drain into the lymphatic system and (re-)activate resident DCs to mount an anti-tumor immune response. Since DC in the draining nodes are exposed to tumor associated antigens, a systemic immune response is induced that could eradicate contra lateral tumor masses in these animals. Importantly, this approach was associated with significantly reduced liver toxicity compared to systemic injection, and allowed for much higher local dosage. Nevertheless, loco regional application remains unfeasible for most cancers.
For targeting B cells, we chose the antigen CD20. CD20 is expressed on both healthy and malignant B cells and is a well-established target for therapy of B cell leukaemia (i.e. Rituximab) [31, 32]. CD20-targeted therapeutics are generally well tolerated and transient depletion of healthy B cells can be clinically managed [31, 32]. However, care should be taken with targeted delivery of CD40L for treatment of B cell malignancies as several studies have demonstrated a role for CD40 in promoting progression of malignancies, and antagonistic anti-CD40 antibodies have met with clinical success in the treatment of certain haematological cancers [21, 22, 33]. Nevertheless, in line with earlier findings we observed no growth or survival promoting effects of anti-CD20:CD40L on leukemic B cells at doses up to 1 μg/mL and/or extended 5 day treatment. However, we cannot exclude the possibility that concurrent signalling via CD20 abrogates the proliferative aspects that are normally observed with activation of CD40. Indeed, crosslinking of CD20 via the rituximab-derived anti-CD20 scFv induced a potent loss of cell viability in a subset of leukemic B cells.
We describe how targeted delivery of CD40L to cancer antigens can be exploited to achieve localized activation of CD40 and can be modified to exert additional anti-cancer action via the targeting domain. To our knowledge, this is first report of antigen-restricted maturation of antigen presenting cells by CD40L. Further studies should aim to elucidate whether this approach can be used to improve the anti-tumor efficacy and safety profile of CD40 activation in vivo.
Expression vectors encoding the Flag-tagged CD40 ligand are derived from a variant of pCR3 (Invitrogen), which was provided by P. Schneider (University of Lausanne, Epalinges, Switzerland) and encodes an Ig signal peptide followed by a Flag tag. To obtain scFvRit:CD40L (anti-CD20:CD40L), amplicons of CD40L encoding amino acids 116–261 including a stop codon were first inserted in frame 5’ to the Flag tag by standard cloning techniques. Next, the leader encoding fragment of the Flag-ligand encoding plasmid was replaced by an amplicon encoding the leader sequence plus the scFvRit cDNA as previously reported . scFvC54 (anti-EpCAM) was generated analogously using PCR from vector pEE14-scFvC54:TRAIL and inserted 5’ to the Flag tag as described above.
Production and purification
ScFvRit:CD40L (anti-CD20:CD40L) and scFvC54:CD40L (anti-EpCAM:CD40L) were produced in HEK293 cells by transient transfection of the expression vector. In brief, cells were electroporated (50 × 106 cells/ml, 4-mm cuvette, 250 V, 1800 μF, maximum resistance) with 30 μg of DNA in 1 ml of culture medium containing 10% FCS using an Easyject Plus electroporator (PeqLab). Electroporated cells were recovered overnight in RPMI 1640 with 10% FCS (PAA Laboratories), and the next day the medium was replaced by low serum RPMI 1640 (0.5% FCS). After 3–4 days supernatants were collected and clarified by centrifugation. Fusion proteins were purified by affinity chromatography on anti-Flag M2 agarose beads (Sigma-Aldrich) and eluted with TBS containing 100 μg/ml Flag peptide (Sigma-Aldrich). The fractions containing the recombinant proteins were finally dialyzed against PBS, purity assessed by gel electrophoresis (Figure 1B) and stored at -20°C for further analysis.
OvCAR-3, HT-29, DLD-1, HCT-8, Sw480, Sw620, Caco-2, HT1080, HEK293, A375M, 786-O, BJAB, Jurkat, Daudi, Jeko and Mino were obtained from the American Tissue Culture Collection (ATCC) and characterized by short tandem repeat profiling, karyotyping and isoenzyme analysis. HT1080.CD40 cells were generated as described before. HEK293.YFP, HEK293.EpICD-YFP and HEK.EpCAM-YFP were a kind gift from Dr. O. Gires (University of München) . Cells were cultured in RPMI 1640 medium supplemented with 10% fetal calf serum and 500 μg/ml Geneticin.
Isolation, cultivation, and stimulation of primary cells
Monocytes and PBMCs were isolated from rests of blood buffy coats of fully anonymized donors obtained from the Institute of Clinical Transfusion Medicine and Hämotherapy of the University Hospital Würzburg and required no special written informed consent. PBMCs were isolated by density gradient centrifugation with lymphocyte separation medium (PAA Laboratories) . Monocytes were separated from PBMCs by MACS magnetic bead separation with anti-CD14-coated beads (Miltenyi Biotec). Monocytes were seeded in 6-well plates (3 × 106 cells) with RPMI 1640, 10% FCS, and penicillin/streptomycin. For DC differentiation 100 ng/ml GM-CSF and 20 ng/ml IL-4 (ImmunoTools) were added every second day. On day 7, cells were stimulated as indicated. On day 10, functional analyses were performed as indicated.
FACS analysis and fluorescent microscopy
To determine cell surface expression of the indicated markers by flow cytometry, cells were incubated on ice with anti-CD14-FITC, anti-CD80-PE, anti-CD83-FITC, anti-CD86-APC, anti-CCR7-APC, anti-HLA-DR-PE and/or indicated combinations thereof or the appropriate isotype control Abs (all from Becton Dickinson, Amsterdam, The Netherlands). After three washes with ice-cold PBS, cell-associated immunofluorescence was determined by FACS analysis. For binding studies with the scFv:CD40L constructs, indicated cell lines were incubated on ice for 1 h with scFv:CD40L fusion proteins, washed three times with ice-cold PBS and stained with anti-CD40L-PE antibody (Becton Dickinson, Amsterdam, The Netherlands) on ice for another 1 h. Subsequently, cells were washed three more times with ice-cold PBS and used for flow cytometry. For blocking studies, cells were pre-incubated with control antibodies (Rituximab or MOC31-Fc) for 1 h on ice prior to incubation with fusion protein.
For immunofluorescence, cells were washed and stained with the indicated PE-conjugated antibodies (anti-CD40-PE, anti-CD80-PE, anti-CD83-PE, anti-CD86-PE and anti-HLA-DR-PE all from Becton Dickinson, Amsterdam, The Netherlands) on ice. After three washes with ice-cold PBS, cell-associated immunofluorescence was determined by fluorescent microscopy. All fluorescent microscopy was performed on an EVOS fl Digital Fluorescence Microscope.
Cancer cells were seeded (2 × 104 cells/well) in 96-well tissue cultures plates in 100 μl of RPMI 1640 medium with 10% FCS and grown overnight. On the next day, medium was exchanged to minimize the background of constitutive cytokine production, and cells were stimulated for 16 h with the indicated concentrations of fusion protein ± blocking antibody in the presence or absence of indicated HT1080 transfectants or Dendritic cells. Supernatants were analyzed for production of IL-8 or IL-12 using the BD human IL-8 ELISA or IL-12/IL-23 Duoset ELISA (BD Biosciences) according to the manufacturer’s instructions.
T cell proliferation
Dendritic cells (DCs) matured as indicated (or relevant controls) were harvested, washed three times and resuspended at a density of 1×107 cells/mL. DCs were subsequently incubated with 50 μg/mL Mitomycin C solution in PBS (freshly prepared and filter sterilized at 0.5 mg/mL) in the dark for 20 min. at 37°C. After incubation, Mitomycin C was rapidly diluted by addition of an excess of warm culture medium and cells were washed three more times by centrifugation. Cells were resuspended at a density of 10×106 cells/mL and plated at the indicated densities/ratios in round-bottom 96-well plates in the presence of 1×105 T cells/well. DC-T cell co-cultures were briefly centrifuged (1 min, 100 g) to promote cell-cell contact, incubated for 6 days at 37°C in a humidified 5% CO2 incubator and T cell proliferation assessed by CFSE dilution on a flow cytometer. For CFSE-labeling, the Vybrant® CFDA SE Cell Tracer Kit (Invitrogen) was used according to the manufacturer’s instructions. In all experiments, T cells autologous to the Dendritic cell population were used as control and never displayed >5% proliferation. For co-cultures of dendritic cells and tumor cells this procedure was slightly modified. First, the ratios used in co-culture of immature dendritic cells and tumor cells were optimized per cell line to prevent cancer cells from overgrowing. Second, the percentage of viable dendritic cells within the mixed population after 3 day maturation was assessed using CD86/CD83/PI staining on flow cytometry and cell counts adjusted accordingly to a PBMC/DC ratio of 32. Of note, mitomycin C treatment did not fully abrogate cancer cell growth during the 6 day MLR, but slowly proliferating cancer cells did not affect T cell viability within this time frame.
HEK293.YFP, HEK293.EpICD-YFP or HEK293.EpCAM-YFP cells were harvested and kept in suspension. Cells were added at a 1:1 ratio to cultures of iDC in the presence or absence of anti-EpCAM:CD40L for 2 h, washed three times with ice cold PBS and stained with anti-CD80 and anti-CD86 antibodies as described in the section on flow cytometry. Cells were gated exclusively on the single cell population by FSC/SSC analysis to exclude DC:HEK cell doublets. DCs were identified based on co-expression of CD80 and CD86 expression and the increase in YFP signal assessed in the FL1 channel by means of the indicated histograms. Percentages were determined based on the amount of YFP+ cells within the total CD80/CD86 population.
B cell maturation and cell death
Primary B cells were cultured for up to 5d as indicated in 6-well plates (1×106 cells/well; 3 mL/well) in the presence or absence of the indicated concentrations of anti-CD20:CD40L and harvested for analysis. To determine specific maturation, binding of anti-CD20:CD40L was blocked by pre- and subsequently co-incubating cells with 10 μg/mL of parental antibody rituximab. Where indicated, B cells were also treated with (Fab-fragment crosslinked) Rituximab, an irrelevant IgG1 control, or anti-EpCAM:CD40L, all at a final concentration of 1 μg/mL. B cell maturation was assessed by flow cytometry as described above. Cell death in B cell lines was evaluated by loss of mitochondrial membrane potential (ΔΨ) using DioC6 according to the manufacturer’s instructions (Molecular Probes).
Data reported are mean values ± SD of at least three independent experiments. Statistical analysis was performed by one-way ANOVA followed by Tukey-Kramer post test or, where appropriate, by two-sided unpaired Student’s t-test. p < 0.05 was defined as a statistically significant difference. Where indicated * = p < 0.05; ** = p < 0.01; *** = p < 0.001.
This work was supported by a grant from the Alexander von Humboldt Foundation to MB and grants from the Netherlands Organization for Scientific Research (NWO) and Dutch Cancer Society (KWF) to EB.
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