Profiling the immune responses of human patients treated with recombinant streptokinase after myocardial infarct.

The SPOT synthesis of peptide arrays on continuous cellulose membranes should be generally applicable in the analysis of sequential antibody binding sites using the enzyme-substrate or other standard detection protocols. The use of total serum is limited by the occurrence of high background levels. This may be overcome if affinity purified antibodies or sera with high antibody titers are used, which allows work at high dilutions and a consequent reduction of background level. Here we demonstrate the mapping of antigenic regions located on recombinant streptokinase SK-2 (Heberkinase) using cellulose-bound peptide scans and human total sera from patients treated with SK-2 (Heberkinase). Streptokinase (SK) is a 47 kDa protein produced by various strains of hemolytic streptococci and is a potent activator of the fibrinolytic enzyme system in humans. SK is in widespread clinical use to treat acute infarction because of its function as an activator of vascular fibrinolysis. Since streptococcal infections are common, normal individuals are immunized with SK and antibodies (Abs) to SK can be detected in most of them. This therapy generates significant T-cell responses to SK and the neutralizing capacity of the Abs rises significantly. Neutralizing Abs reduces the efficiency of thrombolytic therapy and may cause allergic reactions. The widespread use of SK in humans makes its antigenicity an important clinical problem. In this regard the study of the immunodominant regions of SK becomes an important aspect for the improvement of this thrombolytic agent.

A mutant streptokinase lacking the C-terminal 42 amino acids is less reactive with preexisting antibodies in patient sera.

Streptokinase (SK) is an efficacious thrombolytic drug for the treatment of myocardial infarction. Because of its immunogenicity, patients receiving SK therapy develop high anti-SK antibody (Ab) titers, which might provoke severe allergic reactions and neutralize SK activity. In this report we studied the reactivity of a synthetic 42-residue peptide resembling SKC-2 C-terminus with patient sera. SKC-2(373-414) peptide was recognized by 39 and 64% of patients, before and after SKC-2 therapy, respectively. An SKC-2 deletion mutant (mut-C42), lacking the same 42 C-terminal residues, was constructed and expressed in Escherichia coli. Recognition of mut-C42 by preexisting Abs from patient sera was 51 and 68% of reactivity to SKC-2, as assessed by direct binding and competition assays, respectively. For most of the patients, mut-C42-neutralizing activity titer (NAT) significantly decreased with respect to SKC-2-NAT. This study opens the possibility of producing a less immunogenic variant of SK, which could constitute a preferred alternative for thrombolytic therapy.

Prevalence of circulating antibodies against a streptokinase C-terminal peptide in normal blood donors.

Streptokinase (SK) is a streptococcal protein widely used as a thrombolytic agent. Anti-SK antibodies (Abs) are found in most individuals due to common streptococcal infections. The presence of these Abs increases the possibility of allergic reactions and may reduce the thrombolytic efficacy of SK upon a first therapy. Previous studies report on the immunodominance of the SK C-terminus and the role of this region in plasminogen (Plg) activation. The aim of this study was to assess the prevalence of circulating Abs to the SK C-terminus in normal blood donors. Sera from 1008 subjects aged 30 to 60 years were tested by Ultra-Micro-ELISA using a synthetic peptide resembling the SKC-2 C-terminus. An overall prevalence of 30. 4% was found. Prevalence was significantly higher among male than among female donors (RR = 1.70, 1.13 < CI < 2.55). No age effect was observed. This is the first extensive study about Abs directed against a particular region of SK in normal subjects.

Characterization of epitopes on human interleukin-2 using phage displayed-peptide libraries: insights into antibody-peptide interactions.

We have characterized the binding epitopes of two monoclonal antibodies (MAbs) reacting with human Interleukin-2 (IL-2), using a phage display peptide library. The first antibody (CB-IL2.1) recognizes the sequence LSFL, amino acid 72 to amino acid 80, numbered in the IL-2. The second antibody (CB-IL2.2) binds the sequence TTFM (amino acids 101 to 104) located at the opposite site of the four-helix bundle of IL-2. Enzyme-linked immunoadsorbent assay (ELISA) and Western blot using different IL-2 protein construct expressed in bacteria and phage display demonstrate the specificities of this antibody. The data presented here show that the antibodies characterized in this study are raised against linear epitopes and suggest that these epitope are accessible from the outside in the native IL-2 molecule.

Mapping of the antigenic regions of streptokinase in humans after streptokinase therapy.

Streptokinase (SK) is efficaciously used as a thrombolytic drug for the treatment of myocardial infarction. Being a bacterial protein, SK is immunogenic in humans. Therefore, resulting from SK therapy, patients become immunized and anti-SK antibody (Ab) titers rise post-treatment. High Ab titers might provoke severe immune reactions during SK therapy and neutralize SK activity, preventing effective thrombolysis. Spot synthesis combined with peptide library techniques is a useful tool for studying protein-peptide interactions on continuous cellulose membranes. Here, we report on the mapping of antigenic regions of SK using a spot-synthesized peptide library and human total sera from patients receiving SK therapy. All tested samples have high anti-SK Ab titers and most of them show significant SK neutralizing capacity. Individual variations in peptide recognition were detected. However, patients treated with SK tend, in general, to show a common regional binding pattern, including residues 1-20, 130-149, 170-189, and 390-399. This is the first study reporting the probing of a cellulose-bound set of peptides with total human sera.

A mutant streptokinase lacking the C-terminal 42 amino acids is less immunogenic.

Streptokinase (SK) is the most widely used compound for the treatment of myocardial infarction and the least expensive thrombolytic agent, but a drawback to its use is the widespread presence of anti-SK antibodies (Abs). Clinical failure of the activation of the fibrinolytic system by SK has been reported due to the presence of a high titer of anti-SK neutralizing Abs. Patients receiving SK therapy develop high anti-SK antibody titers, which might provoke severe allergic reactions. These Abs are sufficient to neutralize a standard dose of SK up to four years after initial SK administration. This is a clinical problem because of the increasing number of patients who have been treated once with SK for acute myocardial infarction (AMI) and are likely to require plasminogen activator treatment in the future. In previous in vitro studies, we have shown that a deletion mutant (mut-C42), lacking the 42 C-terminal residues, was significantly less antigenic when compared with the native molecule (SKC-2). In this study, 14 monkeys were subjected to treatment with SKC-2 and mut-C42 in order to compare their humoral response by determining SK neutralizing activity in monkey's sera. All monkeys developed anti-SKC-2 Ab titers, but in the case where treatment induced Abs directed against the C-terminus of SKC-2, neutralizing activity against the native protein was significantly higher than that developed against mutant SK mut-C42.

Displaying human interleukin-2 on the surface of bacteriophage.

Previous attempts to produce active human Interleukin-2 (hIL-2) in E. coli have failed, due to its aggregation in the form of cytoplasmic inclusion bodies, and the inability of the protein to enter the periplasmic export pathway, when fused to bacterial signal sequences. We have reasoned that these limitations could be overcome by introducing changes in the signal sequence and/or in some hIL-2 residues, not critical for its biological activity; and proceeded to test this hypothesis using a phagemid vector carrying the pelB secretion signal sequence, and the filamentous phage display system. Deletion of the Pro +2 in hIL-2 led to the export of a correct size (processed) molecule to the bacterial periplasm of Su- cells by the phagemid vector. However, this was achieved under growth conditions that would not favor phage assembly in Su+ strains. Changing the hydrophobic core of the leader peptide reversed this situation and allowed phage assembly and display of a pIII/hIL-2 hybrid protein in TG1 cells. The phage-displayed hIL-2 is correctly folded, as judged by its ability to interact with a conformation-specific anti-hIL-2 monoclonal antibody, and maintains its biological activity when tested in a CTLL-2 cell proliferation assay. The changes introduced in hIL-2 and the signal sequence will make possible to use the powerful phage display technology for the selection of high-affinity variants from libraries of hIL-2 mutants.