1. Introduction
Cluster of Differentiation 44 (CD44) is a type I transmembrane glycoprotein, and its variety of isoforms are expressed in various type of cells. [
1]. The alternative splicing of CD44 mRNA mediates the variety of isoforms [
2]. The CD44 standard (CD44s) isoform, the smallest isoform of CD44, is expressed in most vertebrate cells. CD44s mRNA is assembled by the first five (1 to 5) and the last five (16 to 20) constant region exons [
3]. The CD44 variant (CD44v) isoforms are assembled by the alternative splicing of middle variant exons (v1–v10) in various combinations with the standard exons of CD44s [
4]. Both CD44s and CD44v (pan-CD44) bind to hyaluronic acid (HA), which plays critical roles in cellular adhesion, migration, homing, and proliferation [
5].
The CD44 protein is further modified by variety of glycosylation, including
N-glycans,
O-glycans, and glycosaminoglycans (heparan sulphate, etc.) [
6]. Due to the post-translational modifications, the molecular weight of CD44s is enlarged to 80–100 kDa, and some CD44v isoforms surpass 200 kDa due to a high level of glycosylation [
7].
Several isoforms of the CD44 are associated with malignant progression in various tumors [
8], including head and neck squamous cell carcinomas (SCCs) [
9], pancreatic cancers [
10,
11], breast cancers [
12], gliomas [
13,
14], prostate cancers [
15], and colorectal cancers (CRC) [
16]. CD44 is also known as a cell surface marker of cancer stem-like cells (CSCs) in various carcinomas [
17]. Specific monoclonal antibodies (mAbs) to CD44s or CD44v are utilized for sorting CD44
high CSCs [
17]. The CD44
high population exhibited the increased stemness property, drug resistance, and tumor formation
in vivo [
17]. Therefore, development of anti-CD44 mAbs, which recognize each variant, is important for the further characterization of CSCs in various cancers.
The functions of CD44v have been reported in the promotion of tumor invasion, metastasis, CSC properties [
18], and resistance to chemotherapy and radiotherapy [
8,
19]. The v3-encoded region is modified by heparan sulfate, which promotes the binding to heparin-binding growth factors including fibroblast growth factors and heparin-binding epidermal growth factor-like growth factor. Therefore, the v3-encoded region functions as a co-receptor of receptor tyrosine kinases and potentiate their signal transduction [
20]. Furthermore, the v6-encoded region is essential for the activation of c-MET through ternary complex formation with the ligand hepatocyte growth factor [
21]. The v8–10-encoded region could bind to and stabilize a cystine–glutamate transporter (xCT), which promotes the defense
to reactive oxygen species (ROS) via cystine uptake-mediated glutathione synthesis [
22]. The regulation of redox status depends on the expression of CD44v8–10 that is associated with the xCT function and links to the poor prognosis of patients [
23]. Therefore, the establishment and characterization of mAbs, which recognize each CD44v, are essential for understanding each variant function and development of CD44-targeting cancer therapy. However, the function and distribution of the variant 9-encoded region in tumors have not been fully understood.
We previously developed an anti-pan-CD44 mAb, C
44Mab-5 (IgG
1, kappa) [
24] using the Cell-Based Immunization and Screening (CBIS) method. Furthermore, another anti-pan-CD44 mAb, C
44Mab-46 (IgG
1, kappa) [
25] was established by immunizing mice with CD44v3–10 ectodomain. We showed that both C
44Mab-5 and C
44Mab-46 could be applied to flow cytometry and immunohistochemistry in oral [
24] and esophageal SCCs [
25]. We also determined the epitopes of C
44Mab-5 and C
44Mab-46 within the standard exons (1 to 5)-encoding regions [26-28]. Furthermore, we produced a defucosylated version (5-mG
2a-f) using FUT8-deficient ExpiCHO-S cells (BINDS-09) and investigated the antitumor effects of 5-mG
2a-f in mouse xenograft models of oral SCC [
29]. Recently, we have been established various CD44v mAbs, including C
44Mab-108 (v4) [
30] and C
44Mab-9 (v6) [
31].
In this study, we established a novel anti-CD44v9 mAb, C44Mab-1 (IgG1, kappa) by CBIS method, and evaluated its applications, including flow cytometry, western blotting, and immunohistochemical analyses of oral squamous cell carcinoma and colorectal adenocarcinomas.
2. Materials and Methods
2.1. Cell Lines
COLO201 (a human colorectal cancer cell line), P3X63Ag8U.1 (P3U1; a mouse multiple myeloma), and Chinese hamster ovary (CHO)-K1 cell lines were obtained from the American Type Culture Collection (ATCC, Manassas, VA, USA). COLO205 (a human colorectal cancer cell line) was obtained from the Cell Resource Center for Biomedical Research Institute of Development, Aging, and Cancer at Tohoku University (Miyagi, Japan). To cultivate these cell lines, we used Roswell Park Memorial Institute (RPMI)-1640 medium (Nacalai Tesque, Inc., Kyoto, Japan), which is supplemented with 10% heat-inactivated fetal bovine serum (FBS; Thermo Fisher Scientific, Inc., Waltham, MA, USA). We further added the antibiotics, including 100 μg/mL streptomycin, 100 U/mL penicillin, and 0.25 μg/mL amphotericin B (Nacalai Tesque, Inc.). All cell lines were grown in a humidified incubator at 37°C with 5% CO2.
We amplified CD44s cDNA from LN229 cDNA using HotStar HiFidelity Polymerase Kit (Qiagen Inc., Hilden, Germany). We obtained CD44v3–10 ORF from the RIKEN BRC. CD44v3–10 and CD44s cDNAs were cloned into a pCAG-Ble-ssPA16 vector, which possesses the signal sequence and the N-terminal PA16 tag (GLEGGVAMPGAEDDVV) [24,32-35], which can be detected by an anti-human podoplanin mAb (NZ-1) [36-51]. Using a Neon transfection system (Thermo Fisher Scientific, Inc.), two stable transfectants, such as CHO/CD44v3–10 and CHO/CD44s, were established by introducing pCAG-Ble/PA16-CD44v3–10 and pCAG-Ble/PA16-CD44s into CHO-K1 cells, respectively.
2.2. Production of hybridoma cells
The 6-week-old female BALB/c mice were purchased from CLEA Japan (Tokyo, Japan). Mice were housed under specific pathogen-free conditions. To minimize animal suffering and distress in the laboratory, all mice experiments were performed according to relevant guidelines and regulations. Our animal experiments were approved by the Animal Care and Use Committee of Tohoku University (Permit number: 2019NiA-001). Mice were monitored every day for health during the period of experiments. Mice were intraperitoneally immunized with CHO/CD44v3–10 (1 × 108 cells) with Imject Alum (Thermo Fisher Scientific Inc.) as an adjuvant. We performed additional immunizations of CHO/CD44v3–10 (1 × 108 cells, three times), and performed a booster injection of CHO/CD44v3–10 (1 × 108 cells) 2 days before harvesting the spleen cells. We used polyethylene glycol 1500 (PEG1500; Roche Diagnostics, Indianapolis, IN, USA) to fuse the splenocytes and P3U1 cells. The hybridoma supernatants, which are negative for CHO-K1 cells and positive for CHO/CD44v3–10 cells, were selected using SA3800 Cell Analyzer (Sony Corp. Tokyo, Japan).
2.3. ELISA
Fifty-eight peptides, which cover the extracellular domain of CD44v3–10 [
26], were obtained from Sigma-Aldrich Corp. (St. Louis, MO, USA). We immobilized them on Nunc Maxisorp 96-well immunoplates (Thermo Fisher Scientific Inc) at 1 µg/mL for 30 min at 37°C. The palate washing was performed using HydroSpeed Microplate Washer (Tecan, Zürich, Switzerland) with phosphate-buffered saline (PBS) containing 0.05% (
v/
v) Tween 20 (PBST; Nacalai Tesque, Inc.). After the blocking with 1% (
w/v) bovine serum albumin (BSA) in PBST for 30 min at 37°C, C
44Mab-1 (10 µg/mL) was added to each well. Then, the wells were further incubated with anti-mouse immunoglobulins peroxidase-conjugate (1:2000 diluted; Agilent Technologies Inc., Santa Clara, CA, USA) for 30 min at 37°C. One-Step Ultra TMB (Thermo Fisher Scientific Inc.) was used for enzymatic reactions. An iMark microplate reader (Bio-Rad Laboratories, Inc., Berkeley, CA, USA) was used to mesure the optical density at 655 nm.
2.4. Flow Cytometry
CHO/CD44v3–10 and CHO-K1 cells were prepared using 0.25% trypsin and 1 mM ethylenediamine tetraacetic acid (EDTA; Nacalai Tesque, Inc.). COLO201 and COLO205 were obtained by pipetting. The cells were incubated with C44Mab-1, C44Mab-46, or blocking buffer (0.1% BSA in PBS; control) for 30 min at 4°C. Then, the cells were treated with anti-mouse IgG conjugated with Alexa Fluor 488 (1:2000; Cell Signaling Technology, Inc.) for 30 min at 4°C. Fluorescence data were collected and analyzed using the SA3800 Cell Analyzer and SA3800 software (ver. 2.05, Sony Corp.), respectively.
2.5. Determination of Apparent Dissociation Constant (KD) by Flow Cytometry
Serially diluted C44Mab-1 was suspended with CHO/CD44v3–10, COLO201, and COLO205 cells. Then, those cells were treated with anti-mouse IgG conjugated with Alexa Fluor 488 (1:200). Fluorescence data were collected and analyzed as indicated above. GraphPad Prism 8 (the fitting binding isotherms to built-in one-site binding models; GraphPad Software, Inc., La Jolla, CA, USA) was used to determine the apparent dissociation constant (KD).
2.6. Western Blot Analysis
The 10 μg of cell lysates were subjected to SDS-polyacrylamide gel for electrophoresis using polyacrylamide gels (5–20%; FUJIFILM Wako Pure Chemical Corporation, Osaka, Japan) and electrotransferred onto polyvinylidene difluoride (PVDF) membranes (Merck KGaA, Darmstadt, Germany). The blocking was performed using 4% skim milk (Nacalai Tesque, Inc.) in PBST. The membranes were incubated with 10 μg/mL of C
44Mab-1, 10 μg/mL of C
44Mab-46, or 1 μg/mL of an anti-isocitrate dehydrogenase 1 (IDH1; RcMab-1; rat IgG
2a) [
52,
53], and then incubated with peroxidase-conjugated anti-mouse immunoglobulins (diluted 1:1000; Agilent Technologies, Inc.) or peroxidase-conjugated anti-rat immunoglobulins (diluted 1:10000; Sigma-Aldrich Corp.). Finally, the signals were enhanced using a chemiluminescence reagent, ImmunoStar LD (FUJIFILM Wako Pure Chemical Corporation), and were detected by a Sayaca-Imager (DRC Co. Ltd., Tokyo, Japan).
2.7. Immunohistochemical Analysis
The formalin-fixed paraffin-embedded (FFPE) oral SCC tissues were obtained as described previously [
54]. We purchased a colorectal carcinoma tissue array (CO483a) from US Biomax Inc. (Rockville, MD, USA). The sections were autoclaved in EnVision FLEX Target Retrieval Solution High pH (Agilent Technologies, Inc.) for 20 min. After blocking with SuperBlock T20 (Thermo Fisher Scientific, Inc.), we incubated the tissue sections with C
44Mab-1 (1 μg/mL) and C
44Mab-46 (1 μg/mL) for 1 h, and treated with the EnVision+ Kit for mouse (Agilent Technologies Inc.) for 30 min at room temperature. The chromogenic reaction was conducted using 3,3′-diaminobenzidine tetrahydrochloride (DAB; Agilent Technologies Inc.). The counterstaining were performed using hematoxylin (FUJIFILM Wako Pure Chemical Corporation). To examine the sections and obtain images, we used Leica DMD108 (Leica Microsystems GmbH, Wetzlar, Germany).
4. Discussion
Ishimoto
et al. [
22] demonstrated that CD44v interacts with xCT, a glutamate-cystine transporter, and regulates the level of reduced glutathione (GSH) in gastric cancer cells. As a result, CD44v
contributes to the reduction of intracellular ROS. The knockdown of CD44 reduced the cell surface expression of xCT and suppressed tumor growth in a mouse gastric cancer model. Furthermore,
they showed that the v8–10
region of CD44v is required for the specific interaction between CD44v and xCT, and CD44v8–10 (S301A),
an N-linked glycosylation site mutant, failed to interact with xCT. These results showed an important function for CD44v in the regulation of ROS defense and tumor growth.
Ishimoto
et al. [
22]
also established a rat mAb (clone RV3) against CD44v8–10 by immunizing CD44v8–10-expressed RH7777 cells. The epitope of the mAb was determined as a variant 9-encoded region using the recombinant CD44v9 protein by ELISA. RV3 was mainly used in immunohistochemistry and revealed a predictive marker for recurrence of gastric [
55] and urothelial [
56] cancers, predicting survival outcome in hepatocellular carcinomas [
57], and an indicator for identifying a cisplatin-resistant population in urothelial cancers [
58]. Therefore, CD44v9 is a critical biomarker to evaluate the malignancy and prognosis of tumors. Furthermore, sulfasalazine, an xCT inhibitor, was shown to suppress the survival of CD44v9-positive CSCs both
in vitro [59-61] and
in vivo [
62]. A dose-escalation clinical study in patients with advanced gastric cancers revealed that sulfasalazine reduced the population of CD44v9-positive cells in tumors [
63], suggesting that CD44v9 is a biomarker for patient selection and efficacy of xCT inhibitors.
As mentioned above, RV3 recognized the recombinant CD44v9 protein by ELISA. Therefore, RV3 is thought to recognize the peptide or glycopeptide structure of CD44v9. However, the detailed binding epitope of RV3 has not been determined. As shown in
Supplementary Table S1, C
44Mab-1 recognized a synthetic peptide (CD44p471–490; STSHEGLEEDKDHPTTSTLT), which possesses multiple predicted and confirmed
O-glycan sites [
64]. As shown in
Figure 4A, C
44Mab-1 recognized a ~75kDa band in CHO/CD44v3–10 lysate,which is approximately identical to predicted molecular weight of CD44v3–10 from the amino acid length. Therefore, C
44Mab-1 could recognize CD44v3–10 regardless of the glycosylation. The detailed epitope mapping and the influence of the glycosylation on C
44Mab-1 recognition should be investigated in the future study.
By large-scale genomic analyses, CRCs are classified into 4 subtypes, including microsatellite instability immune, canonical, metabolic, and mesenchymal types [
65]. Since the CD44v9 was upregulated in 40% of CRC tissues (
Figure 5 and
Table 1), the relationship to the subtypes should be determined. Additionally, the mechanism of CD44v9 upregulation including the transcription and the v9 inclusion by alternative splicing should be investigated. Wielenga
et al. [
66] demonstrated that CD44 is a target gene of Wnt/β-catenin in mice intestinal tumor model, suggesting that β-catenin signaling pathway could upregulate CD44 transcription. However, the mechanism of the variant 9 inclusion during the CRC development remains to be determined.
In immunohistochemical analysis, we observed CD44v9 expression throughout CRC cells (
Figure 5A) and on the basolateral surface of CRC cells (
Figure 5C). The basolateral expression of CD44 was previously observed, and shown to be co-localized with HA [
67], EpCAM-Claudin-7 complex [
68], and Annexin II [
69]. Therefore, the basolateral expression of CD44 may function to promote HA/adhesion-mediated signal transduction and contribute CRC tumorigenesis.
Clinical trials of anti-pan CD44 and CD44v6 mAbs have been conducted [
70]. RG7356, an anti-pan CD44 mAb, exhibited an acceptable safety profile. However, the trial was terminated because of no clinical and dose-response relationship with RG7356 [
71]. Clinical trials of an antibody-drug conjugate (ADC), an anti-CD44v6 mAb bivatuzumab−mertansine, were conducted. However, it failed due to the high toxicity to skin [
72,
73]. The anti-CD44v6 mAb is further developed to chimeric antigen receptor T (CAR-T) cell therapy. The CD44v6 CAR-T showed antitumor effects against primary human multiple myeloma and acute myeloid leukemia [
74]. Furthermore, the CD44v6 CAR-T also suppressed the xenograft tumor growth of lung and ovarian carcinomas [
75], which is expected for the application against solid tumors. Although CD44v9 is rarely detected in normal colon epithelium by C
44Mab-1, CD44v9 could be detected in other normal tissues including oral squamous epithelium (
Supplementary Figure S2). For the development of therapeutic use of C
44Mab-1, further investigations are required to reduce the toxicity to above tissues.
Because anti-CD44 mAbs could have side effects by affecting normal tissues, the clinical applications of anti-CD44 mAbs are still limited We previously developed PDPN-targeting cancer-specific mAbs (CasMabs) [76-79] and podocalyxin-targeting CasMabs [
80], which are currently applied to CAR-T therapy in mice models [
46,
81,
82]. These CasMabs recognize cancer specific aberrant glycosylation of the target proteins [
83]. It is worthwhile to establish cancer-specific anti-CD44 mAbs using the CasMab method. Anti-CD44 CasMab production can be applicable as a basis for designing and optimizing potent immunotherapy modalities, including ADCs and CAR-T therapies.