The Yin and Yang of Current Antifungal Therapeutic Strategies: How Can We Harness Our Natural Defenses?

Fungal infections have aroused much interest over the last years because of their involvement in several human diseases. Immunocompromission due to transplant-related therapies and malignant cancer treatments are risk factors for invasive fungal infections, but also aggressive surgery, broad-spectrum antibiotics and prosthetic devices are frequently associated with infectious diseases. Current therapy is based on the administration of antifungal drugs, but the occurrence of resistant strains to the most common molecules has become a serious health-care problem. New antifungal agents are urgently needed and it is essential to identify fungal molecular targets that could offer alternatives for development of treatments. The fungal cell wall and plasma membrane are the most important structures that offer putative new targets which can be modulated in order to fight microbial infections. The development of monoclonal antibodies against new targets is a valid therapeutic strategy, both to solve resistance problems and to support the immune response, especially in immunocompromised hosts. In this review, we summarize currently used antifungal agents and propose novel therapeutic approaches, including new fungal molecular targets to be considered for drug development

Development and in vitro characterization of a humanized scFv against fungal infections

: The resistance and the birth of new intrinsic and multidrug-resistant pathogenic species like C. auris is creating great concern in the antifungal world. Given the limited drug arsenal and the lack of effectiveness of the available compounds, there is an urgent need for innovative approaches. The murine mAb 2G8 was humanized and engineered in silico to develop a single-chain fragment variable (hscFv) antibody against β-1,3-glucans which was then expressed in E. coli. Among the recombinant proteins developed, a soluble candidate with high stability and affinity was obtained. This selected protein is VL-linker-VH oriented, and it is characterized by the presence of two ubiquitin monomers at the N-terminus and a His tag at the C-terminus. This construct, Ub2-hscFv-His, guaranteed stability, solubility, efficient purification and satisfactory recovery of the recombinant product. HscFv can bind β-1,3-glucans both as coated antigens and on C. auris and C. albicans cells similarly to its murine parental and showed long stability and retention of binding ability when stored at 4°, -20° and -80° C. Furthermore, it was efficient in enhancing the antifungal activity of drugs caspofungin and amphotericin B against C. auris. The use of biological drugs as antifungals is limited; here we present a promising hscFv which has the potential to be useful in combination with currently available antifungal drugs

A new humanized antibody is effective against pathogenic fungi in vitro

Invasive fungal infections mainly affect patients undergoing transplantation, surgery, neoplastic disease, immunocompromised subjects and premature infants, and cause over 1.5 million deaths every year. The most common fungi isolated in invasive diseases are Candida spp., Cryptococcus spp., and Aspergillus spp. and even if four classes of antifungals are available (Azoles, Echinocandins, Polyenes and Pyrimidine analogues), the side effects of drugs and fungal acquired and innate resistance represent the major hurdles to be overcome. Monoclonal antibodies are powerful tools currently used as diagnostic and therapeutic agents in different clinical contexts but not yet developed for the treatment of invasive fungal infections. In this paper we report the development of the first humanized monoclonal antibody specific for β-1,3 glucans, a vital component of several pathogenic fungi. H5K1 has been tested on C. auris, one of the most urgent threats and resulted efficient both alone and in combination with Caspofungin and Amphotericin B showing an enhancement effect. Our results support further preclinical and clinical developments for the use of H5K1 in the treatment of patients in need

AFM evaluation of a humanized recombinant antibody affecting C. auris cell wall and stability

: Fungal infections are increasingly impacting on the health of the population and particularly on subjects with a compromised immune system. The resistance phenomenon and the rise of new species carrying sometimes intrinsic and multi-drug resistance to the most commonly used antifungal drugs are greatly concerning healthcare organizations. As a result of this situation, there is growing interest in the development of therapeutic agents against pathogenic fungi. In particular, the Candida genus is responsible for severe life-threatening infections and among its species, C. auris is considered an urgent threat by the Center for Disease Control and Prevention, and is one of the three leading causes of morbidity and mortality worldwide. H5K1 is a humanized monoclonal antibody (hmAb) that selectively binds to β-1,3-glucans, vital components of the fungal cell wall. It has been previously demonstrated that it is active against Candida species, especially against C. auris, reaching its greatest potential when combined with commercially available antifungal drugs. Here we used atomic force microscopy (AFM) to assess the effects of H5K1, alone and in combination with fluconazole, caspofungin and amphotericin B, on C. auris cells. Through an extensive exploration we found that H5K1 has a significant role in the perturbation and remodeling of the fungal cell wall that is reflected in the loss of whole cell integrity. Moreover, it contributes substantially to the alterations in terms of chemical composition, stiffness and roughness induced specifically by caspofungin and amphotericin B. In addition to this, we demonstrated that AFM is a valuable technique to evaluate drug-microorganism interaction

The Yin and Yang of Current Antifungal Therapeutic Strategies: How Can We Harness Our Natural Defenses?

Fungal infections have aroused much interest over the last years because of their involvement in several human diseases. Immunocompromission due to transplant-related therapies and malignant cancer treatments are risk factors for invasive fungal infections, but also aggressive surgery, broad-spectrum antibiotics and prosthetic devices are frequently associated with infectious diseases. Current therapy is based on the administration of antifungal drugs, but the occurrence of resistant strains to the most common molecules has become a serious health-care problem. New antifungal agents are urgently needed and it is essential to identify fungal molecular targets that could offer alternatives for development of treatments. The fungal cell wall and plasma membrane are the most important structures that offer putative new targets which can be modulated in order to fight microbial infections. The development of monoclonal antibodies against new targets is a valid therapeutic strategy, both to solve resistance problems and to support the immune response, especially in immunocompromised hosts. In this review, we summarize currently used antifungal agents and propose novel therapeutic approaches, including new fungal molecular targets to be considered for drug development

Humanization of Antibodies using a Statistical Inference Approach

Antibody humanization is a key step in the preclinical phase of the development of therapeutic antibodies, originally developed and tested in non-human models (most typically, in mouse). The standard technique of Complementarity-Determining Regions (CDR) grafting into human Framework Regions of germline sequences has some important drawbacks, in that the resulting sequences often need further back-mutations to ensure functionality and/or stability. Here we propose a new method to characterize the statistical distribution of the sequences of the variable regions of human antibodies, that takes into account phenotypical correlations between pairs of residues, both within and between chains. We define a "humanness score" of a sequence, comparing its performance in distinguishing human from murine sequences, with that of some alternative scores in the literature. We also compare the score with the experimental immunogenicity of clinically used antibodies. Finally, we use the humanness score as an optimization function and perform a search in the sequence space, starting from different murine sequences and keeping the CDR regions unchanged. Our results show that our humanness score outperforms other methods in sequence classification, and the optimization protocol is able to generate humanized sequences that are recognized as human by standard homology modelling tools

Development and characterization of DIA 12.3, a fully human intact anti-CEACAM1 monoclonal antibody.

Carcinoembryonic antigen cell adhesion molecule-1 (CEACAM1), a homotypic cell adhesion molecule glycoprotein with apical expression on normal epithelial cells and activated lymphocytes, is overexpressed on many tumors and acts as an inhibitory receptor on NK cells, preventing their killing of CEACAM1 positive tumors. Production of humanized anti-CEACAM1 antibodies to block the inhibitory activity of CEACAM1 for immunotherapy and immunoimaging. Starting from a scFv, a fully human intact anti-CEACAM1 (DIA 12.3) that recognizes the N-terminal domain of CEACAM1 was developed and shown to bind CEACAM1 positive tumor cells and enhanced NK cell killing of CEACAM1 positive targets. DIA 12.3 bound to human neutrophils without activation, indicating they would be safe for human use. DIA 12.3 exhibited some cross-reactivity to CEACAM5, a tumor marker with high sequence homology to the N-terminal domain of CEACAM1. CEACAM1 PET imaging with 64Cu-COTA-DIA 12.3 showed excellent imaging of CEACAM1 positive tumors with reduced binding to CEACAM5 tumors. Based on its immunoinhibitory an immunoimaging activities, DIA 12.3 shows promise for therapeutic studies in man

A biotechnological approach for the production of new protein bioplastics

The future of biomaterial production will leverage biotechnology based on the domestication of cells as biological factories. Plants, algae and bacteria can produce low-environmental impact biopolymers. Here, we have developed two strategies to produce a biopolymer derived from a bioengineered vacuolar storage protein of the common bean (phaseolin; PHSL). The cys-added PHSL* forms linear-structured biopolymers when expressed in the thylakoids of transplastomic tobacco leaves by exploiting the formation of inter-chain disulfide bridges. The same protein without signal peptide (ΔPHSL*) accumulates in E. coli inclusion bodies as high-molar-mass species polymers that can subsequently be oxidized to form disulfide crosslinking bridges in order to increase the stiffness of the biomaterial, a valid alternative to the use of chemical crosslinkers. The E. coli cells produced 300 times more engineered PHSL, measured as percentage of total soluble proteins, than transplastomic tobacco plants. Moreover, the thiol groups of cysteine allow the site-specific PEGylation of ΔPHSL*, which is a desirable functionality in the design of a protein-based drug carrier. In conclusion, ΔPHSL* expressed in E. coli has the potential to become an innovative biopolymer

Development of the antibody-producing stable cell line and antibody characterization.

(a) Construction of the bicistronic vector for the antibody expression. Three separate pcDNA 3.1 (-) vectors were used to clone the encoding gene sequences of scFvDiathis LC and IgG1 HC. The expression cassette bearing the CMV promoter, scFvDIATHIS1 LC encoding gene and the polyA chain, was amplified by PCR in order to add the sequence of BglII and NruI restriction sites, upstream and downstream the LC gene, respectively. The PCR product and the vector bearing the IgG1 HC encoding gene were both digested by BglII and Nru restriction enzymes. The digestion was followed by the ligation reaction to finally develop the bicistronic vectors for the simultaneous expression of the LC and the HC. Absorbance values obtained by ELISA assays on 100 μl of the supernatants collected from the transfected cellular pools (b), clones (c) and subclones (d) for the production of the IgG1 antibody. The statistical significance of the pool differences in the abs values was tested with unpaired t-test. (e) SEC-HPLC chromatogram of IgG1 antibody purified from the subclone #12.3. The molecular weights were calculated based on a standard curve obtained by calibrating the system with molecules of known molecular weight: thyroglobulin 660 kDa, gamma- globulin 150 kDa, ovalbumin 44.3 kDa, ribonuclease A 43.7 kDa, 4-aminobenzoic acid 13.71 kDa. (f) Freshly purified antibody analyzed by SDS-PAGE under reducing (gel on the left) and non-reducing (gel on the right) conditions. (g) SDS- PAGE analysis of the antibody in reducing conditions after eight months of storage at 4°C.</p

Characterization of the antibody-producing stable cell line.

(a) Monoclonality of the subclone #12.3 is evaluated by ELISA assay. The graph shows the absorbance values of 50 clones grown 15 days after subjecting the subclone #12.3 to the limiting dilution. (b) Stability studies of antibody production from the subclone #12.3 by ELISA assay. The graphs report the absorbance values of the clones grown on the 20th, 40th and on the 60th day of culture without the pressure of the selective antibiotic.</p