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METOXIA training course Maastricht 2012
    Carbonic anhydrase IX:
 regulation and role in cancer




          S. Pastorekova
Department of Molecular Medicine,
       Institute of Virology
   Slovak Academy of Sciences
        Bratislava, Slovakia
Carbonic anhydrases




                                                         M75




                             Pastorekova et al, Virology, 1992
CO2 + H2O       HCO3- + H+    Zavada et al, Int J Cancer, 1993
                              Pastorek et al,, Oncogene, 1994
                               Opavsky et al, Genomics, 1996
Carbonic anhydrase IX

        PG Domain             PG Domain




                    TM   TM

                    I    I
                    C    C
                                 Hilvo et al, J Biol Chem, 2008
                                      Alterio et al: PNAS 2009
CA IX expression                           CAIX Expression     CAIX Expression
   Broad range of solid tumors            in Normal tissues   in Solid tumors




                 Oosterwijk et al, 1986-
                   Parkkila et al, 1997-
                     Harris et al, 2000-
                          >400 papers
CA IX expression
   Transcription activated by hypoxia (+ VHL inactivation, high cell
    density, modulating factors e.g. acidosis)
   Alternative splicing (hypoxia-related)
   Shedding of ectodomain (hypoxia-related, ADAM17-driven)




                             Kaluz et al, JBC, 1999
                    Wykoff et al,, Cancer Res, 2000
                          Kopacek et al, BBA, 2005
                 Zatovicova et al, Br J Cancer, 2005
                 Barathova et al, Br J Cancer, 2008
IHC
  biomarker
  of hypoxia                           Marker
                                       for
                                       in vivo
                                       imaging



Indicator
       of
prognosis         CA IX expression pattern
                                   Target for
                                   immunotherapy
                                      G250
    Circulating
   marker for
  non-invasive
    monitoring
Hypoxia in tumor tissue

• Acid-base imbalance
                          Reduced cell-cell
• Activation of pH         adhesion
  regulating machinery
• Reversed pH gradient    Increased cell
                           migration/invasion
                        >
Adhesion – motility - invasion


                            Purpose: tumor expansion,
                            escape of cells from hostile
                            microenvironment




Pouyssegur, Nature, 2006
Shift in metabolism
Purpose:
Maintain biomass and
energy production
                                HIF-1




 Vander Heiden, Science, 2009
pH regulation
Purpose:
Maitain neutral pHi &
survive


acidify pHe
& facilitate invasion
CA IX role in tumor cells
 • I EW S
REVpH regulation
                                                                                            Acidosis not only due
                                                                                             tois interesting toprotons in tum
                                                                                              It
                                                                                                 lactate and note that
                                                                                           that were treated with compound 1 (
                                                                                           compound 2, the acidic pH e was revers
                                                                                           normal pH values, which was undoub
                                                                                             Glycolysis-deficient
                                                                                           inhibition of the tumour-associated
                                                                                              cells form acidic
                                                                                           drases28,45,46. Compound 1 (n=1), with a
                                                                                           CA9, was shown via non-invasive fluo
                                                                                              tumors in vivo
                                                                                           to bind to cells only when the CA9 prote
                                                                                           and when cells were hypoxic, in an i
                                                                                           cancer 46. Fluorescently labelled sulph
                                                                                             Shift (rather than
                                                                                           therefore provide a powerful tool for vis
                                                                                           responses in in metabolism could
                                                                                              switch) solid tumours and
                                                                                           patients for CA9-directed therapies46.
                                                                                               An i nteresti ng study repor ted t
                                                                                          LS CO2 – important overexpres
                                                                                              174Tr tumour cells that
                                                                                           CA12, it was possible to genetically sile
                                                                                              component of
                                                                                           carbonic anhydrase isoforms47. Genetic
                                               β    β
                                                                                              acidosis
                                                                                           alone caused a 40% reduction in xen
                                                                                           volume and led to the overexpression of
                                                                                           these cells were kept at an artificially low
                                                                                             Not just proton
                                                                                           tration, and this observation has not been
                                                                                           Genetic silencing of both CA9 and CA
                                                                                              extrusion, but also
                                                                                           reduction in tumour growth, which su
                                                                                              bicarbonate import
                                                                                           and CA12 are major tumour prosurviv
                                                                                           enzymes47.
                                                                                               Membrane-impermeable sulphonam
                                                                                           (compounds 4 and 5), which are based o
Figure 1 | Proteins involved in pH regulation within a tumour cell. The figure
shows various proteins that are involved in regulating pH within tumours, including:       mide scaffold to which either fluorescein
monocarboxylate transporters (MCT Discovery, 2011 lactic acid and other
  Neri & Supuran, Nature Rev Drugs), which transport                                       or albumin-binding moieties were attac
monocarboxylates formed by the glycolytic degradation of glucose; Na+/H+ exchangers        tumour growth in mice with xenograf
CA IX role in tumor cells

 pH regulation




                            CA IX activity = inhibited by
                            bicarbonate but not lactate

 Bicarbonate metabolon
CA IX & extracellular acidification

A                   B

 N   H   N      H
                                              lactate



                                              CA IX


  mock  CA IX
     MDCK



 C                  Normoxia        Hypoxia
         CA IX
             mock




Svastova e al, FEBS Letters, 2004
CA IX & intracellular neutralization




          Swietach, Vaughan-Jones, Harris, Cancer Mestast Rev, 2007
CA IX role in tumor cells
CA IX role in tumor cells
• Reduced E cadherin-mediated                       CA IX
  cell-cell adhesion



                                  E cadherin




                                       Svastova et al, Exp Cell Res, 2003
CA IX & cell dissociation




neo
               CA IX




                            Svastova et al, Exp Cell Res, 2003
CA IX domains


                Cell de-adhesion




                pH regulation
                cell de-adhesion




                ?
                Removal leads to loss
                of membrane
                localization
„Inside-out
  signaling“
   from IC




               Hulikova et al, FEBS Letters, 2009
!   !
                                       !
                                       !   !
      CA IX phosphorylation at Thr443 regulates
                                       !   !
                                       !
                                           !
      the acidification of pHe         !
                                       !   !
                                       !   !
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!
!                                          !
!!
      Diite et al., Cancer Res, 2011
!
!
  !
!
!
!
CA IX is a PKA substrate




!                     Diite et al., Cancer Res, 2011
!
!
!
!
!   PKA is activated by hypoxia
!
!
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!                   Diite et al., Cancer Res, 2011
!
PKA activation in hypoxia
CA IX & PKA




CA IX & PKA SUBSTRATE
CA IX role in tumor cells
• pH regulation - survival in hypoxia/acidosis

                                                 pH~6.8




                                                 pH~7.4
CA IX role in tumor cells
                                       • pH regulation and
                                         cell migration




                                    MDCK-CA IX, 4h HGF




Stock & Schwab,
Pflugers Arch, 2009
CA IX improves migration

        MDCK-neo           MDCK-CA IX


start




24 h




                            Svastova et al., J Biol Chem, 2012
A549 Hy 48h, wound healing with HGF in hypoxia

                      CA IX                  actin        merge




15 min




  1h
CA IX role in tumor cells

    • Increased scattering (EMT)
      and cell migration




     Svastova et al, J Biol Chem 2012
CA IX co-localizes with bicarbonate transporters




CA IX                  NBC                   merge



        Svatova et al., J Biol Chem, 2012




        CA IX                          AE2           merge
CA IX interacts with bicarbonate transporters




                                    Svastova et al., J Biol Chem, 2012
CA IX phosphorylation affects   CA IX is present
cell migration                  in invading tumor cells
CA IX role in tumor cells
• CA IX role in
  cell migration
  /invasion
  /EMT
  Svastova et al, J Biol
  Chem, 2012


• Role in focal
  adhesion
  Radvak et al, submitted
Expression pattern & function >>>
       CA IX as a target for therapy

           1. Antibodies
                (immunotherapy,
                 drug delivery)

                                     G250
                                     Girentuximab
       2. Inhibitors
           (blocking enzyme
           function from outside)




3. Small molecules
 (blocking enzyme
 function from inside)
aidepolcycne eerf eht ,aidepikiW morF
           edimalozatecA                                           cinobrac a si ,xomaiD eman edart eht rednu dlos ,edimalozatecA
                                                                ,seruzies citpelipe ,amocualg taert ot desu si taht rotibihni esardyhna
                                                           ,ssenkcis edutitla ,)irberec romutoduesp( noisnetrepyh lainarcartni ngineb
                                                           gurd cireneg a sa elbaliava si edimalozatecA .aisatce larud dna ,airunitsyc
                                                                                                         .citeruid a sa desu osla si dna
                                                                                                                          stnetnoC
                                                                                                            noitca fo msinahceM 1
                                                                                                                            sesU 2
                                                                                                               amocualG 1.2
                                                                                                              cigolorueN 2.2
                                                                                                       emordnys nafraM 3.2
                                                                                                             aenpa peelS 4.2
     eman )CAPUI( citametsyS
                                                                                                ssenkcis niatnuom etucA 5.2
edimateca)ly-2-lozaidaiht-4,3,1-lyomaflus-5(-N
                                                                                                eruliaF traeH evitsegnoC 6.2
              atad lacinilC                                                                        amedE decudnI-gurD 7.2
             )SU(C )UA(3B           .tac ycnangerP                                                                   stceffe-ediS 3
   )SU( ylno-℞ )KU(   M OP             sutats lageL                                                            snoitacidniartnoC 4
                                                                                                                       yrtsimehC 5
                   VI ,larO                      setuoR
                                                                                                                      secnerefeR 6
        atad citenikocamrahP
                      enoN             msilobateM
              sruoh 9 ot 3                  efil-flaH                                                    noitca fo msinahceM
                      laneR               noitercxE
                                                           desu eb yam ti yllacidem ;rotibihni esardyhna cinobrac a si edimalozatecA
                srefiitnedI                                .sisolakla yrotaripser ro cilobatem ereves ot etaredom fo snoitidnoc taert ot
                   5-66-95            r e bm u n S A C           eht ni noitproser )-3OCH( etanobracib htiw gnirefretni yb siht seod tI
                  10CE10S                 edoc CTA         .)eniru eht gnizinilakla suht dna( doolb eht gniyfidica-er ybereht ,syendik
                  6891 DIC                mehCbuP
                                                                    gniwollof eht fo trap tsrfi eht sezylatac )AC( esardyhna cinobraC
             91100DRPA                   knaBgurD            era )O H( retaw dna )2OC( edixoid nobrac hcihw ni ,noitcaer elbisrever
                                                                   2
                       9091           redipSmehC                                 :asrev-eciv dna )3OC2H( dica cinobrac ot detrevnoc
            I0V569XF3O                            I INU
                                                                                      -
                   81200D                        GGEK                                     3
                                                                                              OCH + +H >--< 3OC2H >--AC--< O2H + 2OC
             02LBMEHC                     L B M Eh C
                                                             enibmoc yllamron snoi negordyh deterces yllacol ,selubut yendik eht nI
             atad lacimehC

                                                     Inhibitors
                                                                                                                     d
                                                                  .)3OC2H( dica cinobrac mrof ot )-3OCH( etanobracib eretl fi htiw
                                           alumroF              ,esardyhna cinobra c yb nopu detca yllamron si nrut ni dica cinobraC
            2 3
             S O 4 N 6H 4 C
           lom /g 542.222                 ssam .loM               yb selubut eht sevael yldipar 2OC sA .2OC fo noitamrof ot gnidael
mehCbuP & seluceloMe                       SELIMS          detfihs snur yllamron noitcaer evoba eht ,senarbmem llec ssorca gnisuffid
Inhibitors:
              Opportunities & Challenges
• Combination therapy – uptake
  of drugs, radiosenitization,
  blocking adaptation to
  hypoxia induced by anti-
  angiogenic therapy
• Specificity, selectivity –
  membrane impermeant, bulky
• Toxicity, solubility, off-target
  effects (HIF pathway)
• Unexpected inhibition by
  other drugs (pazopanib,
  celecoxib, imanitib, nilotinib,
  steroid sulfatase inhibitiors)
• Acetazolamide (AAA) – general CA inhibitor
• HeLa cervical carcinoma cells – no CA II, no CA
XII, but
    hypoxia-induced CA IX
• 3D sferoids to mimic hypoxia in tumors, CA IX in
core
• Long-term treatments (up to 20 days), cDNA
microarray
• Transcriptional effects – CA IX down, ADAM17 up
>
   increased CA IX shedding – loss of target?
CA IX shedding


           CA IX
           ectodomain


Membrane
-bound
                        ?
CA IX




?

                            ?
Antibodies
Renal cell carcinoma immunotherapy – ADCC related

G250 monoclonal antibody-based
        3rd phase of clinical trials




                      Shuch-BJU-08
Tumor uptake of VII/20 MAb
HT-29-Luc cells, Luciferin i.p.   MAb-Alexa Fluor 750
Internalization – yes or not?
                                                                                      1
                            V II/2 0 M A b



                                               C A IX
                                                                                                     2

                                               o r re cy
                                          pt




                                 e




                                                             cl
                               rec




                                                             in g
                                                                                          P
                                                                                                                                    3
                                                                                             ?
                                               6

                                                                                                              ly e n d o s
                                                                                                         ar                  o




                                                                                                     e




                                                                                                                              m
                                                                                                                                    e
                              li g




                                                         n
                                     nd
                                                                                                                                           4



                                a




                                                    io
                                                         t
                                          d e g ra d a




                                                                    lo w p H
                                                                                                                                          ly s
                                                                                                                                                 osom e        5
                                                                               nd




                                                                         e
                                                                                    osom e




                                                                                                                        lig a n d




                                                                                                                                                                a t io n
                                                                                                                                                               ad
                                                                                                                                    nd




                                                                                                                             a




                                                                                                                                                          gr
                                                                                                                                         re c              e
                                                                                                                                                e p to r d

                          n u cle us                                                  cyto p la sm
VII/20
                           Zatovicova et al, Curr Pharm Design, 2010
SUMMARY

CA IX – transmembrane CA isoform, high enzyme activity,
active site exposed extracellularly

Expression associated with tumors

Complex regulation, hypoxia as a key factor,
HRE near to transcription initiation site

Functionally implicated in pH control and cell adhesion, migration, invasion

Clinical application as a marker of hypoxia, prognostic indicator , monitoring
marker and potential therapeutic target

Specific monoclonal antibodies & selective inhibitors
as tools for the research and clinical use in cancer detection,
prognostication and therapy
Jaromir Pastorek
Eliska Svastova
Peter Ditte
Miriam Zatovicova
Lucia Csaderova
Martina Takacova
Juraj Kopacek
Peter Radvak
& other lab members     FUNDING

Franck Dequiedt         EU STRUCTURAL FUNDS
University of Liege     6FP EUROXY
                        7FP METOXIA
Claudiu Supuran         6FP CELLCHCECK
Univerity of Florence
                        7FP ENGCABRA
Seppo Parkkila
                        COST HypoxiaNet
Univerity of Tampere    WILEX A.G.
                        BAYER PHARMA
METOXIA partners        APVV SLOVAK GA
E. Svastova and S. Pastor ekova



N. M asson and P. J. Ratcliffe            A. Gör lach

T. M . F Connor and P. H. M axwell        O. Kr izanova

C. M ichiels                              S. Winning and J. Fandr ey

                                          M . Takacova, T. Goliasova
K. J. Nytko, D. P. Stiehl, R. H. Wenger   and J. Kopacek




                                          S. Peeter s, P. Lambin
                                          and L. Dubois
A. Loboda, H. Was, U. Flor czyk ,
A. Jozkowicz and J. Dulak
                                          B. Reymen and P. Lambin

E. O. Petter sen
                                          K. J. Williams and S. R. M cKeown

E. P. Cummins, S. F. Fitzpatr ick
and C. T. Taylor
                                          A. Rapisar da, N. Fer and G. M elillo
R. Hr stka, P. M üller, P. J. Coates,
B. Vojtesek
                                          C. T. Supur an

T. Kietzmann

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Carbonic Anhydrase IX: regulation and role in cancer

  • 1. METOXIA training course Maastricht 2012 Carbonic anhydrase IX: regulation and role in cancer S. Pastorekova Department of Molecular Medicine, Institute of Virology Slovak Academy of Sciences Bratislava, Slovakia
  • 2. Carbonic anhydrases M75 Pastorekova et al, Virology, 1992 CO2 + H2O HCO3- + H+ Zavada et al, Int J Cancer, 1993 Pastorek et al,, Oncogene, 1994 Opavsky et al, Genomics, 1996
  • 3. Carbonic anhydrase IX PG Domain PG Domain TM TM I I C C Hilvo et al, J Biol Chem, 2008 Alterio et al: PNAS 2009
  • 4. CA IX expression CAIX Expression CAIX Expression  Broad range of solid tumors in Normal tissues in Solid tumors Oosterwijk et al, 1986- Parkkila et al, 1997- Harris et al, 2000- >400 papers
  • 5. CA IX expression  Transcription activated by hypoxia (+ VHL inactivation, high cell density, modulating factors e.g. acidosis)  Alternative splicing (hypoxia-related)  Shedding of ectodomain (hypoxia-related, ADAM17-driven) Kaluz et al, JBC, 1999 Wykoff et al,, Cancer Res, 2000 Kopacek et al, BBA, 2005 Zatovicova et al, Br J Cancer, 2005 Barathova et al, Br J Cancer, 2008
  • 6. IHC biomarker of hypoxia Marker for in vivo imaging Indicator of prognosis CA IX expression pattern Target for immunotherapy G250 Circulating marker for non-invasive monitoring
  • 7. Hypoxia in tumor tissue • Acid-base imbalance  Reduced cell-cell • Activation of pH adhesion regulating machinery • Reversed pH gradient  Increased cell migration/invasion  >
  • 8. Adhesion – motility - invasion Purpose: tumor expansion, escape of cells from hostile microenvironment Pouyssegur, Nature, 2006
  • 9. Shift in metabolism Purpose: Maintain biomass and energy production HIF-1 Vander Heiden, Science, 2009
  • 10. pH regulation Purpose: Maitain neutral pHi & survive acidify pHe & facilitate invasion
  • 11. CA IX role in tumor cells • I EW S REVpH regulation  Acidosis not only due tois interesting toprotons in tum It lactate and note that that were treated with compound 1 ( compound 2, the acidic pH e was revers normal pH values, which was undoub  Glycolysis-deficient inhibition of the tumour-associated cells form acidic drases28,45,46. Compound 1 (n=1), with a CA9, was shown via non-invasive fluo tumors in vivo to bind to cells only when the CA9 prote and when cells were hypoxic, in an i cancer 46. Fluorescently labelled sulph  Shift (rather than therefore provide a powerful tool for vis responses in in metabolism could switch) solid tumours and patients for CA9-directed therapies46. An i nteresti ng study repor ted t  LS CO2 – important overexpres 174Tr tumour cells that CA12, it was possible to genetically sile component of carbonic anhydrase isoforms47. Genetic β β acidosis alone caused a 40% reduction in xen volume and led to the overexpression of these cells were kept at an artificially low  Not just proton tration, and this observation has not been Genetic silencing of both CA9 and CA extrusion, but also reduction in tumour growth, which su bicarbonate import and CA12 are major tumour prosurviv enzymes47. Membrane-impermeable sulphonam (compounds 4 and 5), which are based o Figure 1 | Proteins involved in pH regulation within a tumour cell. The figure shows various proteins that are involved in regulating pH within tumours, including: mide scaffold to which either fluorescein monocarboxylate transporters (MCT Discovery, 2011 lactic acid and other Neri & Supuran, Nature Rev Drugs), which transport or albumin-binding moieties were attac monocarboxylates formed by the glycolytic degradation of glucose; Na+/H+ exchangers tumour growth in mice with xenograf
  • 12. CA IX role in tumor cells  pH regulation CA IX activity = inhibited by bicarbonate but not lactate Bicarbonate metabolon
  • 13. CA IX & extracellular acidification A B N H N H lactate CA IX mock CA IX MDCK C Normoxia Hypoxia CA IX mock Svastova e al, FEBS Letters, 2004
  • 14. CA IX & intracellular neutralization Swietach, Vaughan-Jones, Harris, Cancer Mestast Rev, 2007
  • 15. CA IX role in tumor cells
  • 16. CA IX role in tumor cells • Reduced E cadherin-mediated CA IX cell-cell adhesion E cadherin Svastova et al, Exp Cell Res, 2003
  • 17. CA IX & cell dissociation neo CA IX Svastova et al, Exp Cell Res, 2003
  • 18. CA IX domains Cell de-adhesion pH regulation cell de-adhesion ? Removal leads to loss of membrane localization
  • 19. „Inside-out signaling“ from IC Hulikova et al, FEBS Letters, 2009
  • 20. ! ! ! ! ! CA IX phosphorylation at Thr443 regulates ! ! ! ! the acidification of pHe ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !! Diite et al., Cancer Res, 2011 ! ! !
  • 21. ! ! ! CA IX is a PKA substrate ! Diite et al., Cancer Res, 2011 !
  • 22. ! ! ! ! PKA is activated by hypoxia ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Diite et al., Cancer Res, 2011 !
  • 23. PKA activation in hypoxia
  • 24. CA IX & PKA CA IX & PKA SUBSTRATE
  • 25. CA IX role in tumor cells • pH regulation - survival in hypoxia/acidosis pH~6.8 pH~7.4
  • 26. CA IX role in tumor cells • pH regulation and cell migration MDCK-CA IX, 4h HGF Stock & Schwab, Pflugers Arch, 2009
  • 27. CA IX improves migration MDCK-neo MDCK-CA IX start 24 h Svastova et al., J Biol Chem, 2012
  • 28. A549 Hy 48h, wound healing with HGF in hypoxia CA IX actin merge 15 min 1h
  • 29. CA IX role in tumor cells • Increased scattering (EMT) and cell migration Svastova et al, J Biol Chem 2012
  • 30. CA IX co-localizes with bicarbonate transporters CA IX NBC merge Svatova et al., J Biol Chem, 2012 CA IX AE2 merge
  • 31. CA IX interacts with bicarbonate transporters Svastova et al., J Biol Chem, 2012
  • 32. CA IX phosphorylation affects CA IX is present cell migration in invading tumor cells
  • 33. CA IX role in tumor cells • CA IX role in cell migration /invasion /EMT Svastova et al, J Biol Chem, 2012 • Role in focal adhesion Radvak et al, submitted
  • 34. Expression pattern & function >>> CA IX as a target for therapy 1. Antibodies (immunotherapy, drug delivery) G250 Girentuximab 2. Inhibitors (blocking enzyme function from outside) 3. Small molecules (blocking enzyme function from inside)
  • 35. aidepolcycne eerf eht ,aidepikiW morF edimalozatecA cinobrac a si ,xomaiD eman edart eht rednu dlos ,edimalozatecA ,seruzies citpelipe ,amocualg taert ot desu si taht rotibihni esardyhna ,ssenkcis edutitla ,)irberec romutoduesp( noisnetrepyh lainarcartni ngineb gurd cireneg a sa elbaliava si edimalozatecA .aisatce larud dna ,airunitsyc .citeruid a sa desu osla si dna stnetnoC noitca fo msinahceM 1 sesU 2 amocualG 1.2 cigolorueN 2.2 emordnys nafraM 3.2 aenpa peelS 4.2 eman )CAPUI( citametsyS ssenkcis niatnuom etucA 5.2 edimateca)ly-2-lozaidaiht-4,3,1-lyomaflus-5(-N eruliaF traeH evitsegnoC 6.2 atad lacinilC amedE decudnI-gurD 7.2 )SU(C )UA(3B .tac ycnangerP stceffe-ediS 3 )SU( ylno-℞ )KU( M OP sutats lageL snoitacidniartnoC 4 yrtsimehC 5 VI ,larO setuoR secnerefeR 6 atad citenikocamrahP enoN msilobateM sruoh 9 ot 3 efil-flaH noitca fo msinahceM laneR noitercxE desu eb yam ti yllacidem ;rotibihni esardyhna cinobrac a si edimalozatecA srefiitnedI .sisolakla yrotaripser ro cilobatem ereves ot etaredom fo snoitidnoc taert ot 5-66-95 r e bm u n S A C eht ni noitproser )-3OCH( etanobracib htiw gnirefretni yb siht seod tI 10CE10S edoc CTA .)eniru eht gnizinilakla suht dna( doolb eht gniyfidica-er ybereht ,syendik 6891 DIC mehCbuP gniwollof eht fo trap tsrfi eht sezylatac )AC( esardyhna cinobraC 91100DRPA knaBgurD era )O H( retaw dna )2OC( edixoid nobrac hcihw ni ,noitcaer elbisrever 2 9091 redipSmehC :asrev-eciv dna )3OC2H( dica cinobrac ot detrevnoc I0V569XF3O I INU - 81200D GGEK 3 OCH + +H >--< 3OC2H >--AC--< O2H + 2OC 02LBMEHC L B M Eh C enibmoc yllamron snoi negordyh deterces yllacol ,selubut yendik eht nI atad lacimehC Inhibitors d .)3OC2H( dica cinobrac mrof ot )-3OCH( etanobracib eretl fi htiw alumroF ,esardyhna cinobra c yb nopu detca yllamron si nrut ni dica cinobraC 2 3 S O 4 N 6H 4 C lom /g 542.222 ssam .loM yb selubut eht sevael yldipar 2OC sA .2OC fo noitamrof ot gnidael mehCbuP & seluceloMe SELIMS detfihs snur yllamron noitcaer evoba eht ,senarbmem llec ssorca gnisuffid
  • 36. Inhibitors: Opportunities & Challenges • Combination therapy – uptake of drugs, radiosenitization, blocking adaptation to hypoxia induced by anti- angiogenic therapy • Specificity, selectivity – membrane impermeant, bulky • Toxicity, solubility, off-target effects (HIF pathway) • Unexpected inhibition by other drugs (pazopanib, celecoxib, imanitib, nilotinib, steroid sulfatase inhibitiors)
  • 37. • Acetazolamide (AAA) – general CA inhibitor • HeLa cervical carcinoma cells – no CA II, no CA XII, but hypoxia-induced CA IX • 3D sferoids to mimic hypoxia in tumors, CA IX in core • Long-term treatments (up to 20 days), cDNA microarray • Transcriptional effects – CA IX down, ADAM17 up > increased CA IX shedding – loss of target?
  • 38. CA IX shedding CA IX ectodomain Membrane -bound ? CA IX ? ?
  • 39. Antibodies Renal cell carcinoma immunotherapy – ADCC related G250 monoclonal antibody-based 3rd phase of clinical trials Shuch-BJU-08
  • 40. Tumor uptake of VII/20 MAb HT-29-Luc cells, Luciferin i.p. MAb-Alexa Fluor 750
  • 41. Internalization – yes or not? 1 V II/2 0 M A b C A IX 2 o r re cy pt e cl rec in g P 3 ? 6 ly e n d o s ar o e m e li g n nd 4 a io t d e g ra d a lo w p H ly s osom e 5 nd e osom e lig a n d a t io n ad nd a gr re c e e p to r d n u cle us cyto p la sm VII/20 Zatovicova et al, Curr Pharm Design, 2010
  • 42. SUMMARY CA IX – transmembrane CA isoform, high enzyme activity, active site exposed extracellularly Expression associated with tumors Complex regulation, hypoxia as a key factor, HRE near to transcription initiation site Functionally implicated in pH control and cell adhesion, migration, invasion Clinical application as a marker of hypoxia, prognostic indicator , monitoring marker and potential therapeutic target Specific monoclonal antibodies & selective inhibitors as tools for the research and clinical use in cancer detection, prognostication and therapy
  • 43. Jaromir Pastorek Eliska Svastova Peter Ditte Miriam Zatovicova Lucia Csaderova Martina Takacova Juraj Kopacek Peter Radvak & other lab members FUNDING Franck Dequiedt EU STRUCTURAL FUNDS University of Liege 6FP EUROXY 7FP METOXIA Claudiu Supuran 6FP CELLCHCECK Univerity of Florence 7FP ENGCABRA Seppo Parkkila COST HypoxiaNet Univerity of Tampere WILEX A.G. BAYER PHARMA METOXIA partners APVV SLOVAK GA
  • 44. E. Svastova and S. Pastor ekova N. M asson and P. J. Ratcliffe A. Gör lach T. M . F Connor and P. H. M axwell O. Kr izanova C. M ichiels S. Winning and J. Fandr ey M . Takacova, T. Goliasova K. J. Nytko, D. P. Stiehl, R. H. Wenger and J. Kopacek S. Peeter s, P. Lambin and L. Dubois A. Loboda, H. Was, U. Flor czyk , A. Jozkowicz and J. Dulak B. Reymen and P. Lambin E. O. Petter sen K. J. Williams and S. R. M cKeown E. P. Cummins, S. F. Fitzpatr ick and C. T. Taylor A. Rapisar da, N. Fer and G. M elillo R. Hr stka, P. M üller, P. J. Coates, B. Vojtesek C. T. Supur an T. Kietzmann