Engineering Calreticulin-Targeting Monobodies to Detect Immunogenic Cell Death in Cancer Chemotherapy

SIMPLE SUMMARY: Cancer cell surface–exposed calreticulin (ecto-CRT) is the primitive form of signal during immunogenic cell death (ICD). It is a well-known candidate to allow “eat-me” signal from dying cells, which further contributes to their perception in directing the immune system. Various forms of anticancer agents and ionizing radiation can facilitate the ICD via ecto-CRT exposure. We engineered CRT-specific human fibronectin domain III (FN3) monobodies (FN3-CRT-Rluc8) fused with peptide sequences for CRT imaging. We assessed the theragnostic use of engineered monobodies for ecto-CRT imaging during ICD for early therapeutic prediction response. Our findings demonstrated that engineered monobodies could involve in targeting dying cells via anticancer-related immunogenic chemotherapeutic treatments, and the obtained imaging results could be used to detect pre-apoptotic cells in ICD. Our data provides the novel FN3-based ecto-CRT imaging method and enables the early immuno-therapeutic response predictions, thereby facilitating early determinations in cancer chemotherapies. ABSTRACT: Surface-exposed calreticulin (ecto-CRT) plays a crucial role in the phagocytic removal of apoptotic cells during immunotherapy. Ecto-CRT is an immunogenic signal induced in response to treatment with chemotherapeutic agents such as doxorubicin (DOX) and mitoxantrone (MTX), and two peptides (KLGFFKR (Integrin-α) and GQPMYGQPMY (CRT binding peptide 1, Hep-I)) are known to specifically bind CRT. To engineer CRT-specific monobodies as agents to detect immunogenic cell death (ICD), we fused these peptide sequences at the binding loops (BC and FG) of human fibronectin domain III (FN3). CRT-specific monobodies were purified from E. coli by affinity chromatography. Using these monobodies, ecto-CRT was evaluated in vitro, in cultured cancer cell lines (CT-26, MC-38, HeLa, and MDA-MB-231), or in mice after anticancer drug treatment. Monobodies with both peptide sequences (CRT3 and CRT4) showed higher binding to ecto-CRT than those with a single peptide sequence. The binding affinity of the Rluc8 fusion protein–engineered monobodies (CRT3-Rluc8 and CRT4-Rluc8) to CRT was about 8 nM, and the half-life in serum and tumor tissue was about 12 h. By flow cytometry and confocal immunofluorescence of cancer cell lines, and by in vivo optical bioluminescence imaging of tumor-bearing mice, CRT3-Rluc8 and CRT4-Rluc8 bound specifically to ecto-CRT and effectively detected pre-apoptotic cells after treatment with ICD-inducing agents (DOX and MTX) but not a non-ICD-inducing agent (gemcitabine). Using CRT-specific monobodies, it is possible to detect ecto-CRT induction in cancer cells in response to drug exposure. This technique may be used to predict the therapeutic efficiency of chemo- and immuno-therapeutics early during anticancer treatment.