Synthesis of hapten and preparation of specific polyclonal antibody with high affinity for lenalidomide, the potent drug for treatment of multiple myeloma
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For therapeutic monitoring and pharmacokinetic studies of lenalidomide (LND), the potent drug for treatment of multiple myeloma (MM), a specific antibody was required for the development of a sensitive immunoassay system for the accurate determination of LND in plasma.
In this study, a hapten of LND (N-glutaryl-LND) was synthesized by introducing the glutaryl moiety, as a spacer, into the primary aromatic amine site of the LND molecular structure. The structure of the hapten (G-LND) was confirmed by mass, 1H-NMR, and 13C spectrometric techniques. G-LND was coupled to each of bovine serum albumin (BSA) and keyhole limpet hemocyanin (KLH) proteins by ethyl-3-(3-dimethylaminopropyl) carbodiimide as a coupling reagent. LND-KLH conjugate was used as an immunogen. Four female 2-3 months old New Zealand white rabbits were immunized with an emulsion of LND-KLH with Freund`s adjuvant. The immune response of the rabbits was monitored by direct enzyme-linked immunosorbent assay (ELISA) using LND-BSA immobilized onto microwell plates as a solid phase. The rabbit that showed the highest antibody titer and affinity to LND was scarified and its sera were collected. The IgG fraction was isolated and purified by affinity chromatography on protein A column. The specificity of the purified antibody for LND was evaluated by indirect competitive ELISA using dexamethasone as a competitor as it is used with LND in a combination therapy.
The high affinity of the antibody (IC50 = 10 ng/mL) will be useful in the development of an immunoassay system for the determination of plasma LND concentrations. Current research is going to optimize the assay conditions and validate the procedures for the routine application in clinical laboratories.
KeywordsMultiple myeloma Lenalidomide Polyclonal antibody ELISA Therapeutic monitoring Pharmacokinetic studies
1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride
Bovine serum albumin
Lenalidomide conjugate of bovine serum albumin
Keyhole limpt hemocyanin
Lenalidomide conjugate of keyhole limpt hemocyanin
Enzyme-linked immunosorbent assay
United States Food and Drug Administration
Horseradish peroxidase labeled goat anti-rabbit immunoglobulin IgG
Phosphate buffered saline
Phosphate buffered saline containing 0.05% Tween-20.
Cancer is one of the greatest health concerns, as it is the principal cause of mortality among men and women worldwide; it accounted for 7.4 million deaths (around 13% of all deaths each year). Deaths from cancer worldwide are projected to continue rising, with an estimated 12 million deaths in 2030 . Multiple myeloma (MM) is a B-cell malignancy characterized by proliferation of monotypic plasma cells. It is the second most common hematological malignancy; approximately 20,000 cases of MM have been diagnosed in 2007 .
The hallmark of MM is the production of a homogeneous immunoglobulin fraction, called myeloma protein, by the malignant plasma cells . Pathologic bone damage is the most characteristic feature of MM and is caused by the production of osteoclastic factors by the malignant plasma cells. Bone pain is the predominant presenting symptoms, but other symptoms such as anemia, hypercalcemia, renal insufficiency, neuropathy, and spinal cord compression may be present at the time of diagnosis. The classical triad of symptoms is plasmacytosis (> 30% of plasma cells in the bone marrow), myeloma protein either in the urine or blood, and lytic bone lesions [3, 4]. MM is ultimately fatal with most patients relapsing after an initial response to the conventional chemotherapy. Autologous stem cell transplantation and melphalan have prolonged overall survival rates in patient populations, but most individuals eventually succumb to a refractory form of the disease.
In the 1990s, thalidomide (Thalomid®, Celgene Corporation) was used empirically in treatment of MM based on its antiangiogenic activity and clinical activity in refractory or relapsed myeloma . However, thalidomide has significant and dose-limiting somnolence, constipation, neuropathy, and teratogenicity . These toxic effects promoted the search for more potent but less toxic thalidomide derivatives . Lenalidomide (LND) is a potent novel thalidomide analog which demonstrated remarkable clinical activity against myeloma cells [8, 9, 10, 11, 12] via a multiple-pathways mechanism [7, 13, 14, 15, 16, 17]. The strong evidences-based clinical success of LND in patients has led to its recent approval by US-FDA under the trade name of Revlimid® capsules by Celgene Corporation .
Lenalidomide has a more improved side effects profile than its parent compound thalidomide, nevertheless, it causes some dose-dependent side effects such as thrombocytopenia, venous thromboembolism, and myelosuppression [19, 20]. These side effects can be managed by combination therapy and/or careful dose adjustment [21, 22]. Because LND is primarily excreted via kidneys, patients with renal insufficiency or failure must be dose adjusted to prevent the exacerbation of its myelosuppressive effects [9, 16]. Because of the structural relation of LND to thalidomide, a teratogenic effect can not ruled out, thus effective contraception must be used by female patients [23, 24]. Furthermore, studies showed large inter-individual pharmacokinetic variability with concentration–toxicity relationship . For these reasons, a risk management, monitoring blood counts, and therapeutic drug monitoring are required to achieve the highest therapeutic benefits of LND and prevent its fatal complications [8, 26, 27]. Nevertheless, the therapeutic profile of LND is anticipated to encourage the development of new pharmaceutical preparations for LND. As a consequence, there is an increasing demand for proper analytical technologies for determination of pharmacokinetic parameters in bioequivalence studies for LND, as well as in its therapeutic monitoring.
Extensive literature survey showed that there were only two methods for the determination of LND in plasma [28, 29]. These two methods involved liquid chromatography-coupled with mass spectrometric detectors. These two methods offered adequate sensitivities; however they employed the expensive mass detectors that are not available in most laboratories, and involved laborious liquid-liquid sample extraction procedures that negatively affected the accuracy of the results. Furthermore, these methods, as relied on sequential samples analysis, are not suited for screening of large number of specimens. Accordingly, the development of a new alternative analytical technology for the determination of LND in plasma with adequate sensitivity, improved simplicity, lower cost, and higher throughput is urgently needed.
Immunoassays are preferable in the field of clinical analysis because of their applicability for a wide range of analytes, high-throughput, low cost, convenience for screening of a large number samples, and their specificity for the analyte of interest even in multi-component complex sample matrix such as plasma . The antibody is the most important key reagent in the development of any immunoassay system. As well, specificity of the antibody to the analyte of interest is the limiting factor in the validity of the assay. In order to establish a specific and sensitive immunoassay for LND, a specific antibody with high affinity for LND was required. The present study describes, for the first time, the synthesis of hapten for LND (modified LND with a 5-carbon glutaryl moiety as a spacer, and capable for direct linking to a protein) and preparation of a polyclonal antibody that can specifically recognizes LND with high affinity. This antibody will be useful for the establishment of a specific immunoassay for the determination of plasma LND concentrations. Optimization of the assay conditions and validation of the method for the routine application in clinical laboratories will be published elsewhere.
Microplate/cuvette reader (Spectramax M5, Molecular Devices, California, USA). Automatic microplate strip washer (MW-12A, Bio-Medical Electronics Co. Ltd., Shenzhen, China). EM-36N microtube shaker (Taitec, Japan). Biofuge Pico centrifuge (Heraeus Instruments, Germany). Incubator (KARL KOLB, Scientific Technical Supplies, Dreieich, Germany). Microprocessor laboratory pH meter (Mettler-Toledo International Inc., Zürich, Switzerland). Direct reading balance (XB 120A, Precisa Instruments Ltd., Switzerland). UV–vis Spectrophotometer (V-530, JASCO, Tokyo, Japan). Water purification (distillation apparatus, D-30938, GFL, Burgwedel, Germany). HPLC apparatus consisted of a Shimadzu system (Shimadzu Corporation, Kyoto, Japan) equipped with LC-10AD VP pump with FCV-10AL VP low pressure flow control valve, SCL-10A VP system controller, Rheodyne-7725 injection valve with variable loops, SPD-10A VP UV-visible detector, and RF-10A XL fluorescence detector. The system control and data acquisition are performed by Shimadzu CLASS-VP software, version 5.032 (Shimadzu Corporation, Kyoto, Japan). Mass spectrometric spectrum was conducted at the Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Saudi Arabia on Agilent Ion Trap 6320 LC/MS (Agilent Technologies, Saugus, MA, USA. NMR Spectra were scanned in DMSO-d6 on a Bruker NMR spectrophotometer operating at 500 MHz for 1H and 125.76 MHz for 13C at the research center, College of Pharmacy, King Saud University, Saudi Arabia. Chemical shifts were expressed in δ-values (ppm) relative to TMS as an internal standard. D2O was added to confirm the exchangeable protons
Lenalidomide (LND) was obtained from LC Laboratories (Woburn, USA). Horseradish peroxidase labeled goat anti-rabbit IgG (HRP-IgG), bovine serum albumin (BSA), 2,4,6-trinitrobenzene sulfonic acid, 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC), 3,3`,5,5`-Tetramethylbenzidine (TMB) peroxidase substrate, glutaric anhydride, and Freund's adjuvants (complete and incomplete) were purchased from Sigma Chemical Co. (St. Louis, MO, USA). Keyhole limpet hemocyanin (KLH) was purchased from Novabiochem Co. (La Jolla, CA, USA). BCA protein assay kit was purchased from Pierce Chemical Co., Rockford, USA). ELISA high-binding microwell plates were a product of Corning/Costar, Inc. (Cambridge, MA, USA). Dialysis tubes were from Sigma Chemical Co., St. Louis, MO, USA). All other chemicals and solvents used throughout the work were of analytical grade.
Synthesis of hapten (N-Glutrayl Lenalidomide; G-LND)
Lenalidomide (130 mg, 0.5 mmole) was added to glutaric anhydride (57 mg, 0.5 mmole) dissolved in 10 mL of benzene. The reaction was allowed to proceed under reflux for 24 hours. The reaction was monitored by HPLC system to confirm the formation of N-glutaryl LND. The chromatographic conditions were; reversed phase column (Nucleosil C8, 150 × 4.6 mm, 5 μm), isocratic elution by a mobile phase consisted of 20% acetonitrile containing 0.1% trifluoroacetic acid, and the flow rate was set at 1 mL/min. The eluted peaks were detected by UV detector at 254 nm. After completing the reaction, the N-glutaryl LND (G-LND) was purified by crystallization from ethanol. The purity of the product was confirmed by HPLC system. The chemical structure of the purified G-LND was confirmed by mass, 1H-NMR, and 13 C spectrometric techniques.
Preparation of LND protein conjugates
Fifty milligrams of G-LND (hapten) was dissolved in dimethylformamide. To this solution, 100 mg of EDC was added, and the pH was rapidly adjusted to 5–5.5 with 0.01 M HCl. After 5 min, the protein (BSA and KLH) solution (5 mg/mL) was added. Protein solutions were prepared by dissolving 50 mg of each of BSA and KLH in 5 mL of 50 mM phosphate buffer (PB) of pH 7.2. After addition of the protein solution, the pH of the reaction mixture was rapidly adjusted to 6.4 and maintained constant for 90 min. The reaction was left overnight in the dark at 4°C. The residual unreacted small LND hapten molecules were removed from the LND-protein conjugates by dialysis. The degree of conjugation of LND to each of BSA and KLH was then estimated by protein assay and UV spectral analysis .
Immunization of animals, preparation and purification of anti-LND antibody
Four rabbits were subjected to the immunization by LND-KLH conjugate. The immunization protocol, and monitoring the immune response of the animals have been conducted according to the procedures described by Darwish et al. . The affinities of the raised antibodies to LND were determined by a competitive ELISA described by Darwish et al. . The antibody that showed the highest affinity to LND was purified by affinity chromatography on protein A column.
Results and discussion
Synthesis and structure confirmation of LND Hapten (N-Glutaryl-LND)
The 1H NMR spectrum (DMSO-d6) of the product is given in Figure 3A. δ 1.81-1.84 (m, 2H, -CH2-CH2-COOH of glutaryl moiety) 2.2-2.6(m, 4H, -CH2-CH2-of piperidine ring), 3.4 (t, 4H,-CH2-CH2-CH2-COOH), 4.32-4.38, 4.35-4.4 (dd, J=32Hz, -CH2-N- of pyrrolidone ring), 5.16 (t, 1H, J=9, -CH of piperidine ring), 7.4-7.8 (m, 3H, ArH), 9.8 (s, 1H, NH, of the amide side chain, D2O exchangeable), 11.04 (s, 1H, NH of piperidine ring, D2O exchangeable), 12.13 (s, 1H, -COOH, D2O exchangeable). The figure depicts the aromatic protons part of the1H NMR spectrum and the three D2O exchangeable protons of the synthesized compound (two NH and one COOH protons).
The 13C spectrum of the product is given in Figure 3B: δ 18.5 (−CH2-CH2-COOH of glutaryl moiety), 20.3 (−CH2-CH2-C=O of piperidine ring), 22.5 (−CH2-CH2-C=O of piperidine ring), 31.1 (−CH2-CH2-COOH), 32.9 (−CH2-CONH of glutaryl moiety), 34.8 (−CH2-N- of pyrrolidone ring), 55.9 (−CH of piperidine ring), 118.9, 125.2, 128.5-132.6, 133.6 (−CH Aromatic), 167.8 (−CH-C=O of piperidine ring), 171 (−CH2-C=O of piperidine ring), 172.8 (−COOH), 174.1 (C=O amide of glutaryl moiety). Upon comparing these data with those of the starting material (standard LND), it was clear the difference between LND and the synthesized compound at the upfield region of the spectra indicating the aliphatic part of the side chain as well as the appearance of new two signals downfield indicating the presence of C=O carboxylic acid and C=O amide.
Preparation and characterization of LND-Protein conjugates
The hapten (G-LND) was used for its linking to carrier proteins. Bovine serum albumin (BSA) and keyhole limpet hemocyanin (KLH) proteins were selected as carrier proteins because they are rich in lysine residues that can couple with the carboxylic moiety of the G-LND . Linking of G-LND with BSA and KLH proteins was achieved by carbodiimide method  as illustrated in Figure 1.
Preparation and characterization of anti-LND antibody
Purification of anti-LND antibody
Immunoreactivity and specificity of the purified anti-LND antibody
The specificity of the antibody was determined by carrying out the competitive assay using dexamethasone that is administered in combined therapy with LND , as a competitor. It was found that dexamethasone does not show any immunoreactivity with the anti-LND antibody. In conclusion, this antibody will be useful for the establishment of a specific immunoassay system for accurate determination of plasma concentrations of LND. Optimization of the assay conditions, validation of the method, and clinical applications are currently going on in our laboratory, and the results will be published elsewhere.
The present study described the synthesis of N-glutaryl LND as a hapten, and the preparation of a highly specific polyclonal antibody against LND. The antibody recognizes LND with high affinity. The high specificity and affinity of the produced antibody enables the development of highly specific and sensitive immunoassay system for the accurate determination of LND in plasma. The method is expected to contribute to the therapeutic monitoring and pharmacokinetic studies of LND.
The authors thank King Abdulaziz City for Science and Technology for funding the work by research grant number (A-S-12-0842).
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