We have previously selected a panel of human scFvs from a phage antibody library that bind to clinically represented, internalizing epitopes on the mesothelioma cell surface (
19). We have further shown that these scFvs can mediate tumor-specific intracellular delivery of small molecule drugs, which selectively kill mesothelioma cells
in vitro (
19). In this study, we sought to identify the target antigen bound by one of these antibodies, the M1 scFv. We focused our initial identification efforts on the M1 scFv because it has demonstrated payload delivery function and binds to several tumor cell lines in addition to mesothelioma cell lines, suggesting that it may be broadly useful as a tumor-targeting agent (
19). We used a novel expression cloning strategy based on yeast surface display of human protein fragments (
20,
21) to identify MCAM as the antigen bound by the M1 phage antibody. MCAM is a transmembrane glycoprotein that belongs to the immunoglobulin superfamily (
31,
32) and functions as a Ca
2+-independent adhesion molecule. It was originally described as a marker for advanced melanoma (
33-
36). In immunohistochemistry studies using a large panel of tissues, MCAM expression was observed in a relatively limited spectrum (9/42) of normal human adult tissues (endothelium, smooth muscle, Schwann cells, ganglion cells, myofibroblasts, cerebellar cortex, breast, hair follicles, and dendritic cells) (
37). Notably, CD146 expression was not observed in normal mesothelium nor any of the endocrine tissues tested and was only present in 1/12 epithelial tissues tested (breast) (
37). The expression on endothelium is limited to certain tissues. Among the 14 normal tissues studied, MCAM expression was found in 5 endothelium (stomach, colon, breast, ovary and lung) (
30).
The discovery of MCAM expression in mesothelioma tissues is significant for therapeutic development against this disease for several reasons. First, our study showed that MCAM is expressed by all subtypes of mesothelioma. In contrast, mesothelin, a currently used marker for mesothelioma, recognizes the epithelioid but not the sarcomatous subtype of mesothelioma (
16), a particularly recalcitrant form of this disease. Second, consistent with previous reports of MCAM expression on blood vessels (
29,
30), our study using mesothelioma tissue microarrays showed that MCAM is expressed on both mesothelioma cells and tumor-associated blood vessels, making MCAM a potentially attractive target for a combined anti-tumor and anti-angiogenesis therapy (
38). Finally, our results show that overlapping sets of cell surface antigens exist between tumors of diverse tissue origins. While the etiology of mesothelioma may be unique, it nevertheless shares characteristics with other commonly occurring tumors such as melanoma. Treatment of mesothelioma may thus benefit from ongoing therapeutic development for other oncological indications.
Using human tumor fragments cultured
ex vivo, we showed that the anti-MCAM scFv penetrates the tumor fragments and homes specifically to primary mesothelioma cells. To be useful for targeted therapy, antibodies or antibody fragments must be able to accumulate in tumor tissues
in vivo after systemic administration. The
in vivo biodistribution of the anti-MCAM M1 scFv was evaluated in a novel mesothelioma organotypic xenograft model using SPECT/CT. SPECT/CT combines functional imaging (SPECT) and structural imaging (CT) to achieve accurate and sensitive tumor detection
in vivo. We found that the anti-MCAM M1 scFv, but not the control scFv, preferentially accumulated in mesothelioma xenografts compared to surrounding soft tissues, demonstrating its potential in noninvasive imaging and targeted immunotherapy. This result is most impressive since the organotypic xenograft model is more clinically relevant compared to models based on cell lines (
24).
We have selected scFvs on live mesothelioma cells to identify those that target novel internalizing epitopes. These scFv-targeted epitopes are in their native conformation as opposed to MHC-presented ones. As such, these scFvs are well suited for targeting live tumor cells
ex vivo and in vivo, as we have demonstrated in this study, but may have limitations in detecting denatured epitopes such as those in paraffin-embedded tissues. For example, the M1 scFv binds to live mesothelioma cells and mesothelioma cells
in situ in frozen tissues as we have demonstrated previously (
19), but does not stain paraffin-embedded tissues. As such, we have used the commercial anti-MCAM antibody to stain the paraffin-embedded mesothelioma tissue arrays.
We used a novel, FACS-based expression cloning strategy based on yeast surface cDNA display to identify the target antigen. The yeast display technology was originally developed by Wittrup and colleagues to study eukaryotic protein functions (
39-
41). We have previously adapted this technology for human proteome display, and constructed a large yeast surface display human cDNA fragment library (
20,
21). We screened the library by FACS to identify cellular proteins binding to post-translational modifications (
20) and small molecules (
21). A major advantage of this cloning system is that the “bait” can be of diverse chemical and molecular composition, as long as it can be fluorescently detected (
20,
21). In this study, we used phage particles displaying the M1 scFv as the bait, greatly simplifying the identification process. Since 50,000-70,000 cells can be sorted per second, the FACS-based method allows the full diversity of large libraries to be practically screened. The combination of phage antibody library selection on the surface of living tumor cells and rapid target antigen identification by screening the yeast surface-displayed human proteome could be a powerful method for mapping the tumor cell surface epitope space.