Development of a first-in-class antibody and a specific assay for α-1,6-fucosylated prostate-specific antigen.

Prostate-specific antigen (PSA) levels are widely used to screen for prostate cancer, yet the test has poor sensitivity, specificity and predictive value, which leads to overdiagnosis and overtreatment. Alterations in the glycosylation status of PSA, including fucosylation, may offer scope for an improved biomarker. We sought to generate a monoclonal antibody (mAb) targeting α-1,6-fucosylated PSA (fuc-PSA) and to develop a tissue-based immunological assay for fuc-PSA detection. Immunogens representing fuc-PSA were used for immunisation and resultant mAbs were extensively characterised. The mAbs reacted specifically with fuc-PSA-specific glycopeptide, but not with aglycosylated PSA or glycan without the PSA peptide. Reactivity was confirmed using high-throughput surface plasmon resonance spectroscopy. X-ray crystallography investigations showed that the mAbs bound to an α-helical form of the peptide, whereas the native PSA epitope is linear. Protein unfolding was required for detection of fuc-PSA in patient samples. Peptide inhibition of fuc-PSA mAbs was observed with positive screening reagents, and target epitope specificity was observed in formalin-fixed, paraffin-embedded tissue samples. This research introduces a well-characterised, first-in-class antibody targeting fuc-PSA and presents the first crystal structure of an antibody demonstrating glycosylation-specific binding to a peptide.

Discovery of a haptoglobin glycopeptides biomarker panel for early diagnosis of hepatocellular carcinoma.

Background: There is a need for new serum biomarkers for early detection of hepatocellular carcinoma (HCC). Haptoglobin (Hp) N-glycosylation is altered in HCC, but the diagnostic value of site-specific Hp glycobiomarkers is rarely reported. We aimed to determine the site-specific glycosylation profile of Hp for early-stage HCC diagnosis. Method: Hp glycosylation was analyzed in the plasma of patients with liver diseases (n=57; controls), early-stage HCC (n=50) and late-stage HCC (n=32). Hp phenotype was determined by immunoblotting. Hp was immunoisolated and digested into peptides. N-glycopeptides were identified and quantified using liquid chromatography-mass spectrometry. Cohort samples were compared using Wilcoxon rank-sum (Mann-Whitney U) tests. Diagnostic performance was assessed using receiver operating characteristic (ROC) curves and area under curve (AUC). Results: Significantly higher fucosylation, branching and sialylation of Hp glycans, and expression of high-mannose glycans, was observed as disease progressed from cirrhosis to early- and late-stage HCC. Several glycopeptides demonstrated high values for early diagnosis of HCC, with an AUC of 93% (n=1), >80% (n=3), >75% (n=13) and >70% (n=11), compared with alpha-fetoprotein (AFP; AUC of 79%). The diagnostic performance of the identified biomarkers was only slightly affected by Hp phenotype. Conclusion: We identified a panel of Hp glycopeptides that are significantly differentially regulated in early- and late-stage HCC. Some glycobiomarkers exceeded the diagnostic value of AFP (the most commonly used biomarker for HCC diagnosis). Our findings provide evidence that glycobiomarkers can be effective in the diagnosis of early HCC - individually, as a panel of glycopeptides or combined with conventional serological biomarkers.

Glycosylation of recombinant rabbit immunoglobulins influences protease susceptibility as shown by comprehensive mass spectrometric glycan analysis.

Recombinant immunoglobulins (rIgGs) have become increasingly important as therapeutic agents and diagnostic tools in recent years. Genetic engineering allows the introduction of non-natural features such as the Sortase motif for site-directed labeling. In this study, the enzyme Sortase A (SrtA) was used for the proteolytic cleavage of rIgGs to produce their biotinylated Fab fragments by locating the cleavage site close to the hinge region. However, SrtA cleavage of engineered rabbit IgGs (rRb-IgGs) derived from human embryonic kidney (HEK) 293 cells showed significantly lower yields compared with their mouse counterparts. Nonrecombinant Rb-IgGs have N- and O-glycans, and the presence of O-glycans close to the hinge region of the rRb-IgGs might affect the susceptibility of these antibodies to SrtA cleavage. In addition, the glycosylation pattern of rIgGs differs depending on the host cell used for expression. Therefore, we analyzed the N- and O-glycans of various rRb-IgGs expressed in HEK293 cells, detecting and quantifying 13 different N-glycan and 3 different O-glycan structures. The distribution of the different detected glycoforms in our rRb-IgG N-glycan analysis is in agreement with previous studies on recombinant human IgG N-glycans, confirming the hypothesis that the host cell defines the glycosylation of the recombinant produced IgGs. O-glycosylation could be mapped onto the threonine residue within the hinge region sequence XPTCPPPX, as already described previously for nonrecombinant Rb-IgGs. Substitution of this threonine allowed an almost complete Fab fragment cleavage. Therefore, we could confirm the hypothesis that the O-glycans affect the SrtA activity, probably due to steric hindrance.

Sensitization of Tumors for Attack by Virus-Specific CD8+ T-Cells Through Antibody-Mediated Delivery of Immunogenic T-Cell Epitopes.

Anti-tumor immunity is limited by a number of factors including the lack of fully activated T-cells, insufficient antigenic stimulation and the immune-suppressive tumor microenvironment. We addressed these hurdles by developing a novel class of immunoconjugates, Antibody-Targeted Pathogen-derived Peptides (ATPPs), which were designed to efficiently deliver viral T-cell epitopes to tumors with the aim of redirecting virus-specific memory T-cells against the tumor. ATPPs were generated through covalent binding of mature MHC class I peptides to antibodies specific for cell surface-expressed tumor antigens that mediate immunoconjugate internalization. By means of a cleavable linker, the peptides are released in the endosomal compartment, from which they are loaded into MHC class I without the need for further processing. Pulsing of tumor cells with ATPPs was found to sensitize these for recognition by virus-specific CD8+ T-cells with much greater efficiency than exogenous loading with free peptides. Systemic injection of ATPPs into tumor-bearing mice enhanced the recruitment of virus-specific T-cells into the tumor and, when combined with immune checkpoint blockade, suppressed tumor growth. Our data thereby demonstrate the potential of ATPPs as a means of kick-starting the immune response against "cold" tumors and increasing the efficacy of checkpoint inhibitors.

Differential percentage of serum prostate-specific antigen subforms suggests a new way to improve prostate cancer diagnosis.

BACKGROUND: Prostate-specific antigen (PSA) is the tumor marker currently used for prostate cancer (PCa) screening and diagnosis. However, its use is controversial as serum PSA levels are also increased in other non-malignant prostatic diseases such as benign prostatic hyperplasia (BPH). PSA sialic acid content is altered in tumor situation and modifies PSA's isoelectric point (pI). Our goal has been to evaluate serum PSA subforms from PCa and BPH patients by two-dimensional electrophoresis (2-DE) and to investigate whether they could be used to improve PCa diagnosis. METHODS: PSA from 20 PCa and 20 BPH patients' sera was subjected to a four-step method to obtain serum PSA 2-DE subforms from free PSA (fPSA) plus PSA released from the complex with alpha-1-antichymotrypsin. Relative percentages of PSA spots were quantified and subjected to statistical analysis. RESULTS: Five PSA subforms (F1, F2, F3, F4, and F5) of different pI were obtained. Relative percentages of F3 (%F3) and F4 (%F4) were different between PCa and BPH groups. %F3 decreased in cancers and this decrease correlated with the cancer stage, while F4 behaved oppositely. These observations were also found when only focusing on the patients within the low total PSA (tPSA) range 2-20 ng/ml. CONCLUSIONS: %F3 showed a tendency of higher sensitivity and specificity than the currently used tPSA and %fPSA tests. Therefore, %F3 measurement should be investigated in a larger cohort of patients to study whether it could be introduced to improve PCa diagnosis.

Matriz de procesos críticos: propuesta para estudiar condiciones de vida y salud / Critical processes matrix: A proposal to study life and health conditions

Objetivo: Presentar elementos teórico-metodológicos delestudio de condiciones de vida y salud en el municipio deMarinilla, Colombia, con base en una matriz de procesoscríticos. Material y métodos: Análisis documental histórico, aplicación de ficha familiar a 4284 familias, talleres con líderes comunitarios e institucionales, entrevistas a actores clave, análisis de planes y programas municipales.Resultados: Condiciones protectoras: riqueza cultural,conservación de tradiciones artísticas; proyectos de vivienda; promotores ambientales y juntas administradorasde acueductos en zona rural; programas de gestores ypromotores de salud. Condiciones de deterioro: Dimensióndel trabajo: Grupos urbano y rural con alto deterioro, gran inestabilidad laboral, baja calificación, jornadas laborales extensas. Dimensión del consumo: grupos urbano y rural con alto deterioro sin vivienda propia; viviendas rurales y deterioradas sin electrificación. Entorno: Contaminación ambiental, especialmente en el barrio más pobre; grupo rural con gran contaminación de las fuentes de agua y deforestación. Proceso salud enfermedad: Problemas comunes: Desnutrición infantil, enfermedad respiratoria y diarreica aguda, hipertensión arterial, diabetes, cáncer; intoxicaciones por plaguicidas, lesiones, accidentes, abuso sexual, muerte violenta mayor frecuencia en grupo rural con alto deterioro. Conclusiones: La matriz es una propuesta teórico-metodológica útil para investigadores sociales, administradores municipales y sector salud, porque articula el conocimiento de las necesidades de poblaciones diferenciadas por grupos, con proyectos políticos y vigilancia de condiciones de vida medianteprocesos participativos.

Free PSA forms in prostatic tissue and sera of prostate cancer patients: analysis by 2-DE and western blotting of immunopurified samples.

OBJECTIVE: The isoform pattern of free prostate-specific antigen (fPSA) from sera of patients with prostate cancer (PCa) and no evidence of prostate cancer (NPCa), cancerous and non-cancerous tissues and seminal plasma, have been compared, above all regarding the degree of sialylation, with the aim to show a better discrimination of PCa and NPCa. DESIGN AND METHODS: The samples have been immunopurified and analyzed by two dimensional gel electrophoresis and western blotting. It was investigated which patterns were obtained when looking for the fPSA and the (-5/-7)proPSA (precursor form) before and after desialylation. RESULTS: The fPSA sialylation and the proPSA pattern in cancerous and non-cancerous prostate tissues were similar to each other and only slightly different from PCa and NPCa sera. The different fPSA isoforms observed could not be due solely to differences in the degree of sialylation, because different fPSA and (-5/-7)proPSA precursor isoforms were still present after complete desialylation. CONCLUSIONS: Although slight differences in the fPSA and (-5/-7) proPSA glycosylation and isoform pattern were observed, they were not large enough to be considered to improve PCa diagnosis.

Glycosylation of serum ribonuclease 1 indicates a major endothelial origin and reveals an increase in core fucosylation in pancreatic cancer.

Human pancreatic ribonuclease 1 (RNase 1) is a glycoprotein expressed mainly by the pancreas and also found in endothelial cells. The diagnosis of pancreatic cancer (PaC) remains difficult and therefore the search for sensitive and specific markers is required. Previous studies showed that RNase 1 from human healthy pancreas contained only neutral glycans, whereas RNase 1 from PaC cell lines contained sialylated structures. To determine whether these glycan tumor cell-associated changes were also characteristic of serum RNase 1 and could be used as a marker of PaC, we have analyzed the glycosylation of serum RNase 1. The origin of serum RNase 1 was also investigated. Serum RNase 1 from two PaC patients and two controls was purified and the glycans analyzed by high-performance liquid chromatography (HPLC)-based sequencing and mass spectrometry. Although normal and tumor serum RNase 1 contained the same glycan structures, there was an increase of 40% in core fucosylation in the main sialylated biantennary glycans in the PaC serum RNase 1. This change in proportion would be indicative of a subset of tumor-associated glycoforms of RNase 1, which may provide a biomarker for PaC. Two-dimensional electrophoresis of the RNase 1 from several endothelial cell lines, EA.hy926, human umbilical vein endothelial cells (HUVEC), human mammary microvessel endothelial cells (HuMMEC), and human lung microvessel endothelial cells (HuLEC), showed basically the same pattern and was also very similar to that of serum RNase 1. RNase 1 from EA.hy926 was then purified and presented a glycosylation profile very similar to that from serum RNase 1, suggesting that endothelial cells are the main source of this enzyme.

Evaluación ética de proyectos de investigación. una experiencia pedagógica, Universidad de Antioquia, Colombia / Ethic evaluation of investigation projects: a pedagogic experience, Universidad de Antioquia, Colombia

Objetivo: presentar una reflexión sobre la práctica de la evaluación de proyectos de investigación desde el punto de vista de la ética y la bioética, para contribuir a la formación de profesionales e investigadores en salud. En todos los momentos del proceso de desarrollo de una investigación, desde su concepción, la discusión de la pregunta, la definición de los objetivos, la metodología y las formas de difusión, se desarrolla, en forma paralela, otro proceso de autorregulación y seguimiento en las distintas fases de realización de la investigación, en las cuales deben estar presentes la ética de la convicción y la ética de la responsabilidad, ejercidas por investigadores con actitudes y virtudes orientadas a procurar el bien para todos, es decir, de los investigadores, los sujetos de la investigación y la ciencia. Se concluye que la evaluación de proyectos de investigación, como parte del proceso de validación de nuevos conocimientos, debe incluir una evaluación basada en la ética de las virtudes, la convicción y la responsabilidad, por el bien de la ciencia y el progreso de la humanidad...

Different glycan structures in prostate-specific antigen from prostate cancer sera in relation to seminal plasma PSA.

Prostate-specific antigen (PSA), the tumor marker currently used for prostate cancer (PCa), is not specific enough to distinguish between PCa and benign prostate hyperplasia (BPH). Glycan processing is normally perturbed in tumors, therefore we investigated whether changes in glycosylation of PSA could be useful diagnostic indicators. Previously we determined that the glycosylation of PSA secreted by the tumor prostate cell line LNCaP differs significantly from that of PSA from seminal plasma (normal control). We therefore undertook a detailed glycan analysis of PSA derived from sera from PCa patients and, importantly, established that the glycosylation of the PCa serum PSA was significantly different from the PSA from the LNCaP cell line. In comparison with seminal plasma PSA, the fucose content of PSA from the PCa patient serum was significantly lower and there was a decrease in alpha2,3-linked sialic acid. Differences in the glycosylation of PSA derived from PCa patients' sera, seminal plasma, and LNCaP cells were further established by lectin detection, glycosylation immunosorbent assay, and two-dimensional electrophoresis. We also investigated whether the impact of glycosylation changes initiated by the tumor was reflected in the serum glycome. By comparing the glycans released from the total glycoproteins in PCa patient serum with those of normal serum we found an increase in the proportion of sialyl-Lewis x structures. Further analysis of the glycosylation of PSA from PCa and BPH sera will be required in order to determine the utility of these glycan differences to discriminate specifically between benign and malignant prostate states.

Role of sialyltransferases involved in the biosynthesis of Lewis antigens in human pancreatic tumour cells.

The sialylated carbohydrate antigens, sialyl-Lewisx and sialyl-Lewisa, are expressed in pancreatic tumour cells and are related to their metastatic potential. While the action of the fucosyltransferases involved in the synthesis of these antigens has already been investigated, no studies have been carried out on the activity and expression of the alpha 2,3-sialyltransferases in pancreatic tumour cells. We describe the sialyltransferase (ST) activity, mRNA expression, and analysis of the cell carbohydrate structures in four human pancreatic adenocarcinoma cell lines of a wide range of neoplastic differentiation stages and in normal human pancreatic tissues. Total ST activity measured on asialofetuin, employing a CMP fluorescent sialic acid, varied among the pancreatic cell lines and could be correlated to the expression of their cell surface antigens. However, in some of the pancreatic cell lines, no relationship could be established with their ST3Gal III and IV mRNA expression. Human pancreatic tissues also showed ST expression and activity. However, it presented a much higher expression of neutral fucosylated structures than sialylated structures. In conclusion, ST activity levels in pancreatic cells could be correlated to their expression of sialylated epitopes, which indicates their involvement in the formation of the sialyl-Lewis antigens, in addition to fucosyltransferase activities.

Altered glycosylation pattern allows the distinction between prostate-specific antigen (PSA) from normal and tumor origins.

Prostate-specific antigen (PSA) is a glycoprotein secreted by prostate epithelial cells. PSA is currently used as a marker of prostate carcinoma because high levels of PSA are indicative of a tumor situation. However, PSA tests still suffer from a lack of specificity to distinguish between benign prostate hyperplasia and prostate cancer. To determine whether PSA glycosylation could provide a means of differentiating between PSA from normal and tumor origins, N-glycan characterization of PSA from seminal fluid and prostate cancer cells (LNCaP cell line) by sequencing analysis and mass spectrometry was carried out. Glycans from normal PSA (that correspond to low and high pI PSA fractions) were sialylated biantennary complex structures, half of them being disialylated in the low pI PSA fraction and mostly monosialylated in the high pI PSA. PSA from LNCaP cells was purified to homogeneity, and its glycan analysis showed a significantly different pattern, especially in the outer ends of the biantennary complex structures. In contrast to normal PSA glycans, which were sialylated, LNCaP PSA oligosaccharides were all neutral and contained a higher fucose content. In 10-15% of the structures fucose was linked alpha1-2 to galactose, forming the H2 epitope absent in normal PSA. GalNAc was increased in LNCaP glycans to 65%, whereas in normal PSA it was only present in 25% of the structures. These carbohydrate differences allow a distinction to be made between PSA from normal and tumor origins and suggest a valuable biochemical tool for diagnosis and follow-up purposes.

Glycosylation of human pancreatic ribonuclease: differences between normal and tumor states.

Characterization of the N-glycans from human pancreatic ribonuclease (RNase 1) isolated from healthy pancreas and from pancreatic adenocarcinoma tumor cells (Capan-1 and MDAPanc-3) revealed completely different glycosylation patterns. RNase 1 from healthy cells contained neutral complex biantennary structures, with smaller amounts of tri- and tetraantennary compounds, and glycans with poly-N-acetyllactosamine extensions, all extensively fucosylated. In contrast, RNase 1 glycans from tumor cells (Capan-1) were fucosylated hybrid and complex biantennary glycans with GalNAc-GlcNAc antennae. RNase 1 glycans from Capan-1 and MDAPanc-3 cells also contained sialylated structures completely absent in the healthy pancreas. Some of these features provide distinct epitopes that were clearly detected using monoclonal antibodies against carbohydrate antigens. Thus monoclonal antibodies to Lewis(y) reacted only with normal pancreatic RNase 1, whereas, in contrast, monoclonal antibodies to sialyl-Lewis(x) and sialyl-Lewis(a) reacted only with RNase 1 secreted from the tumor cells. These glycosylation changes in a tumor-secreted protein, which reflect fundamental changes in the enzymes involved in the glycosylation pathway, open up the possibility of using serum RNase 1 as a tumor marker of pancreatic adenocarcinoma.

Producción científica de enfermeras egresadas de la Universidad de Antioquia. Relaciones salud y sociedad. Colombia, 1980-1990 / University of Antioquia’s nurses alumni scientific production. Relationship between health and society. Colombia 1980 – 1990

El presente artículo es el resumen de un estudio más amplio que trata de dar una visión panorámica, desde la mirada de la medicina social, de las investigaciones realizadas por las enfermeras egresadas de la Universidad de Antioquia durante el periodo 1980-1990. Para ello se analizó el contenido de 44 investigaciones: el tema estudiado, el enfoque teórico de referencia, los conceptos y las categorías, la coherencia, las técnicas y procedimientos de análisis y aportes a la salud y a la profesión en Antioquia. Además, se incluyó el análisis cuantitativo de 78 investigaciones.

Producción científica de enfermeras egresadas de la Universidad de Antioquia. Relaciones salud y sociedad, Antioquía, Colombia, 1980-1990 / Scientific production of nurses egresadas of the University of Antioquía. Relate health and society, Antioquía, Colombia, 1980-1990

En la transformación de la práctica de enfermería desde un conjunto de actos rituales y míticos hacia una práctica profesional con mayor sustento científico técnico, la investigación desempeña un papel importante, pues se entiende que sólo ella puede generar, refinar y aumentar el conocimiento y propiciar acciones para transformar tanto en la práctica profesional como en la salud de grandes grupos de población.No es claro si existe bajo rendimiento en términos de producción intelectual de profesionales de enfermería. En los últimos años ochenta, la producción ha aumentado cuantitativamente, pero se conoce poco acerca de su calidad y pertinencia en relación con los temas tratados, las teorías y los métodos utilizados, los impactos y transformaciones logrados a partir de los resultados y las limitaciones para llevar a cabo tal actividad