Angiogenesis is the process of blood vessel formation that occurs when new capillaries sprout from pre-existing vessels
[1]. It is a biological process that is normally only seen in the female reproductive system, in fetal development, and in wound healing
[1]–
[4]. Angiogenesis is required for any process that results in the accumulation of more than a few microns of new tissue, as well as many processes involving tissue remodeling. As such, it is a characteristic of multiple common disease pathologies that involve inappropriate tissue development
[5], including cancer
[6],
[7], cardiovascular disease, arthritis, psoriasis, several rare genetic diseases
[8], and a variety of eye disorders, including macular degeneration
[9], diabetic retinopathy
[10], herpetic keratitis, trachoma, and retinopathy of prematurity
[11]. Therapies that target angiogenesis can thus be used to halt or slow the development of these disorders, and have been shown to be effective in a variety of diseases
[12]–
[15].
We have previously demonstrated that protective antigen (PA), a non-pathogenic component of the anthrax toxin which binds to endothelial cell surface receptors, can inhibit angiogenesis
[16]. Treatment with a PA mutant (PA
SSSR), with three altered amino acids
[17], increased inhibition of vessel growth in both VEGF-and bFGF-induced corneal neovascularization assays, inhibited migration of endothelial cells, and resulted in pronounced (≥40%) reductions in tumor growth
[16]. Anthrax toxin binds and co-opts two endothelial cell surface receptors, anthrax toxin receptor 1 (ANTXR1; also called tumor endothelial marker 8, TEM8)
[18], and anthrax toxin receptor 2 (ANTXR2; also called capillary morphogenesis gene 2 protein, CMG2)
[19]. Significantly, PA mutants that do not bind these receptors do not inhibit angiogenesis, and the binding affinity of individual PA mutants for the receptors correlates with their degree of inhibition
[16]. These data strongly suggest that interaction with an anthrax receptor is responsible for the anti-angiogenic effects of PA
SSSR.
The normal biological function(s) of TEM8 and CMG2 have not been fully described, although the existing data indicates that these receptors are involved in angiogenic processes, consistent with the observed impact of PA
SSSR binding on angiogenesis. Both receptors contain a von Willebrand A or integrin-like inserted I domain, with 60% identity in this region, and are the closest related proteins to integrins, which are involved in cell binding to a variety of extracellular matrix components. TEM8 was initially identified as a protein expressed on colon tumor endothelium, but not on normal endothelial cells
[20], and was subsequently detected in a variety of angiogenic or cancerous endothelial cell types
[21],
[22]. TEM8 knockout mice demonstrate alterations in extracellular matrix deposition, and changes in the growth rate of specific tumors
[23]. Importantly, TEM8 expression is upregulated in tumor-associated endothelial cells, and receptor expression is linked to disease progression in several cancer types
[22],
[24],
[25]. Protein overexpression and gene knockdown experiments demonstrate that TEM8 is involved in endothelial cell migration and tube formation
[26] via interactions with the extracellular cellular matrix component collagen a3(VI)
[27], and linkage to the actin cytoskeleton
[28]. Finally, TEM8-specific antibodies strongly inhibit the growth of a variety of solid tumors, but have no effect on either the matrigel plug angiogenesis assay, or on wound healing, suggesting some tumor specificity in TEM8 expression
[29]. CMG2 is similarly involved in antiangiogenic processes. The receptor was initially identified as the product of the capillary morphogenesis gene 2, which is upregulated in endothelial cells during capillary formation in collagen gels
[30]. CMG2 binds both laminin and collagen type IV
[30], suggesting that like TEM8, this receptor's physiological role involves interactions with the extracellular matrix that are required for angiogenesis. Indeed, the receptor is highly expressed in both normal and cancerous vasculature, and its pattern of expression colocalizes with collagen type IV
[31]. Genetic mutations in CMG2 result in the related disorders juvenile hyaline fibromatosis and infantile systemic hyalinosis
[32] that are characterized by multiple recurring tumors and inappropriate deposition of hyalin, an extracellular matrix material. Like TEM8 knockout mice, female mice which lack the CMG2 receptor do not give birth, an effect apparently mediated by defects in uterine extracellular matrix remodeling
[33]–
[35]. Importantly, venous endothelial cells that overexpress CMG2 show increased proliferation and formation of capillary-like networks, while CMG2 knockdown cells demonstrate significantly impaired endothelial cell proliferation
[31]. Together, the TEM8 and CMG2 data suggest that binding of endogenous ligands to anthrax toxin receptors is involved in angiogenic processes
in vivo, and that inhibition of these interactions by competing ligands should inhibit vascular growth. Hence, ANTXR-targeted small molecule angiogenesis inhibitors represent a new strategy for anti-angiogenic therapy.
Inhibition of the receptor-ligand interaction could also be used as an anthrax therapy. Anthrax intoxication begins when PA binds to CMG2 or TEM8 on the cell surface, prompting cleavage of PA by cell-surface proteases
[36], oligomerization to a heptameric species, complex formation with the pathogenic toxin components, Lethal Factor (LF) and Edema Factor (EF)
[37], and their subsequent delivery to the interior of the cell via endocytosis
[38]–
[40]. The low pH of the mature endosome then prompts toxin rearrangement and translocation of EF and LF to the cytosol
[41]. Since receptor binding is the first step in this process, inhibition of receptor binding is a plausible treatment for anthrax intoxication, and small molecules that block the interaction(s) of PA with its receptors would be effective anthrax toxin inhibitors. Previous attempts to generate anthrax therapies
[42]–
[56] have targeted several individual steps in the process of anthrax endocytosis, but only a single study addresses receptor inhibition via receptor binding
[57]. Importantly, unlike other proposed therapies, receptor-targeted therapies can circumvent the traditional difficulty of testing anthrax inhibitors with active toxin
in vivo, because compounds could be initially tested for their safety and cytotoxicity in the context of ocular or cancer related angiogenesis.
We have developed a high throughput screening assay to identify potential inhibitors of the interaction between PA and the ATR2 (CMG2) receptor. The assay is based on fluorescence or Förster resonance energy transfer (FRET) observed upon interaction of dye-labeled PA and a dye-labeled CMG2 truncation. Steady-state FRET-based assays like this are ideally suited for high throughput screening (HTS) methodology because they are simple, sensitive, and easily automated. When conducted ratiometrically, these measurements yield a quantitative readout of the macromolecular association state that is corrected for experimental fluctuations occurring between or across well-plates, including differences in excitation power, pathlength, and photobleaching. Here we demonstrate a ratiometric steady-state FRET-based screening assay that is highly effective and capable of identifying potential PA-CMG2 inhibitors. The anti-angiogenic effects of compounds identified from preliminary screens of small molecule libraries are characterized and described.