1. Nucleic acid Aptamers as Potential Therapeutic and Diagnostic agents for Lymphoma Presented by Naila Sajjad PhD Biochemistry 10-arid-1766 1

2. List of Abbreviation used ALCLAnaplastic large cell lymphoma PEIPolyethyleneimine BCL2B cell lymphoma 2 AMLAcute myeloid lymphoma ALLAcute lymphoid lymphoma 2

3. Aptamers Oligonucleotide or peptide molecules that bind to specific target molecules Created by selecting them from large random sequences Used for research and clinical purposes as macromolecular drug 3

4. Conti….. 4

5. Classification of Aptamers DNA/RNA aptamers Consist of short strand of oligonucleotide Peptide aptamers Consist of short variable peptide domain attached at both ends to a protein scaffold 5

6. Nucleic acid Aptamers Nucleic acid species engineered through repeated rounds of in vitro selection or SELEX (Systematic evolution of ligand by exponential enrichment) Bind to molecular targets such as small molecule, protein, nucleic acid 6

7. SELEX 7

8. LYMPHOMA Blood cancers develops in the lymphatic system arise from affecting lymphocyte There are at least 35 types of lymphoma which are grouped based on cell histology, genetic mutations and expression of certain genes Hodgkin’s and non-Hodgekin’s lymphoma are two major categories 8

9. Aptamers As a potential “next generation” of diagnostic tools Therapeutic applications of aptamers in lymphoma Aptamer “small bomb” mediates delivery of drugs to cancer cells 9

10. Aptamers as a potential “next- generation” of diagnostic tools Lymphoma is fatal if left untreated or diagnosed at a late stage Burkitt lymphoma (BL) Methods to diagnose Immunophenotyping by flow cytometry (IFC) Karyotyping analysis of peripheral blood & bone marrow Detection of malignant cell mutations through PCR 10

11. BL 11

12. Conti… Limitations IFC requires the use of monoclonal antibodies. Complicating diagnose and increasing cost PCR can sensitively examine RNA expression of certain genes to detect cancer cells have very low signal levels Advantages of nucleic acid aptamers over antibodies tolerant of chemical and temp changes Longer shelf lives Reduce manufacturing cost Better tissue penetration & cellular uptake 12

13. Anti-CD30 Aptamers CD30 Antigen expressed in activated T & B (Transmembrane protein cells but over expressed in ALCL Receptors of TNF) Hodgkin’s lymphoma Marker for diagnosing these lymphoma Anti-CD30 antibodies used in CD30 expression Anti-CD30RNA Aptamers binds to CD30 Proteins (identified using extracellular domain of receptor activator of nuclear factor KB) 13

14. ALCL 14

15. Use of anti-CD30 Aptamers as probe Explored using flow cytometry and immunostaining Fluorescently labeled tested with cultured ALCL & Hodgkin’s anti-CD30 aptamers lymphoma flow ctometry & fluoroscene microscopy shows binding to lymphoma cells 15

16. Immunostaining Anti-CD30 Aptamers binds to CD30 Proteins serves as replace & antibodies ment of CD30 antibodies Biotinylated anti-CD30 Aptamers Used to study expression of CD30 on lymphoma cells subsequently visualized by horseradish peroxidase Specifically stain the lymphoma cells and required a shorter incubation time and lower temp 16

17. TD05 Aptamers Burkitt’s lymphoma (BL) Acute blood cancer Diagnosed through morphological inspection of blood cells & biopsied tissue sample TD05 aptamers have been designed to diagnosed BL 17

18. Conti…….. TD05 Aptamers initially panel of DNA aptamers (Evolved by applying cell-SELEX were selected for Ramos cells Against BL cell lines i.e. Ramos cells Not bind only recognize shows strong binding To normal CD19 B Ramos cells affinity cells or other bone marrow cells Subsequent experiments immunoglobulin heavy mu chain (B-cell activated receptor) expressed on the surface of BL cells binding target for TD05 Aptamers 18

19. Aptamer nanoparticle strip biosensors Flow based detection of BL Development of simple, sensitive dipstick test Litmus test type of assay Gold nanoparticles aggregate immobiized on thiolated TD05 Responsive to Ramos cells aptamers Was designed Test zone of strip immobilized TE02 aptamer 19

20. Principle of assay sample solution or capillary action move along strip If in the presence of Ramos cells TD05 aptamers immobilized on Au nanoparticles interact with Ramos cells Au- nanoparticles aptamers cell complex migrate along strip complex was captured by TE02 immobilized on strip complex accumulation at test zone producing red line migration control zone Complex captured by DNA sequence complimentary to TD05 aptamer 2 nd red line 20

21. Conti… 21

22. In vivo studies by TD05 Aptamers as molecular probe TD05 aptamers were labeled with fluorescent dyes such as cy 5 & injected into mice engrafted with Ramos cells Cy 5 labeled TD05 Aptamer accumulate in tumor tissues 22

23. PEI Aptamer probe Used in vivo cancer imaging Degradation ratio of aptamer is reduced when TD05 aptamer are immobilized on PEI Polymer Fluorescence signal remained elevated for five hours post injection while signal when naked TD05 only stayed for 45 minutes Feasible method to image tumor in vivo with high specificity and sensitivity 23

24. Sgc 8 Aptamers DNA aptamers generated for specific recognition of leukemia cells Two tumor cell lines were selected as ligands An ALL cell line, CCRF-CEM Ramos cell line was used as counter selection Protein tyrosine kinase 7 (PTK 7) is a molecular target of sgc 8 aptamers 24

25. Conti.. 25

26. In vivo visualization of tumor Reporter bearing probes are used Cell recognizing ligend are labeled with reporter mol such as fluorescent dye & then bind to target cancer cells Signals are generated Acivable aptamer reporter probe Tumor targeting A poly T linker Short DNA sequence complementary to part of aptamer that has a fluorophore & a quencher linked at either terminus 26

27. Conti…. In absence of target protein probe is in active form It keeps fluorophore & quencher in close proximity leading to quenched fluorescence In presence of cancer cells conformation of aptamer probe is recognized on binding Fluorophore get separated from quencher Strong signals are generated in response to interaction of probe with target cells Thus sgc 8 aptamers diagnosed cancer cells shorten the diagnostic time 27

28. Therapeutic Applications of Aptamers in Lymphoma In past radiotherapy & chemotherapy were used Aptamers based therapeutic have emerged as an alternative 28

29. AS1411 Aptamer A 26-nt G quadruplex DNA aptamer identified as a first anticancer nucleic acid agent for treatment of renal cell carcinoma AS1411+nucleolin+nuclear activate transcription factor Factor KB essential NK-KB modulator 29

30. Conti….. Nucleolin over expressed in cancer cells (multifunctional protein Roles in cell growth & death) Binds Au-rich element modulate interleukin 9 In 3 UTR of expression in T- cell lymphoma Bcl2 mRNA Protect Anti-apoptic Bcl2 from degradation & stabilized Bcl2 mRNA overproduction of Bcl2 in cancer cells AS1411 inhibit proliferation of tumor cell lines & suppressed tumor growth 30

31. Conti…. Phase I clinical trials (involving 30 patients) were completed in 2006 and indicated that AS1411 was safe and well-tolerated Phase II trials for AML are showing positive interim results (ClinicalTrials.gov Identifier: NCT00512083 and NCT01034410) Recent research has explored the use of AS1411 as a carrier for the delivery of cancer drugs specifically into cancer cells by nucleolin mediated internalization 31

32. NOX-A12 Spiegelmers 45-nucleotide long (L Steroisomer) RNA aptamer High binding affinity, selectivity to the target, passive immunogenicity Evolved from natural D-RNA library by using mirror image target D-amino acid Synthesized as L-RNA to bind natural target (L amino acid) 32

33. Conti…. NOXA12 Antagonize CXCL12/SDF-1 CXCR5 & CXCR7 metastasis pathophysiology of chronic lymphocytic leukemia 33

34. Conti… A Phase 1 clinical trial involving 48 healthy subjects was launched in 2009 and showed that NOX-A12 spiegelmers were safe and well- tolerated Recently, two Phase IIa clinical studies of NOX-A12 have begun for hematological oncology indications, including non-Hodgkin’s lymphoma, chronic lymphocytic leukemia and multiple myeloma (Clinical- Trials.gov Identifier: NCT01486797 and NCT-01486797) This study will involve 33 relapsed CLL patients who will receive NOX-A12 spiegelmers in combination with a background therapy of chemotherapeutic agents. In-terim results are expected to be available in early 2013. 34

35. Aptamer “smart bomb” mediates delivery of drugs to cancer cells Antibody drug conjugates have a cytotoxic potential of chemotherapy Two antibody –drug conjugates have been approved by FDA for treatment of hematological cancer Gemutuzumab ozogamium was 1 st FDA approved designed for patients with replased AML It target CD33 antigen expressed on leukemia blast cells 35

36. Conti…. Brentuximab vedotin was 2 nd FDA approved for treatment of Hodgkin’s lymphoma It target CD30 which is a establish marker for hodgkin’s lymphoma Aptamers have advantages over antibodies used in target delivery, particularly for cancer therapy 36

37. TD05 Aptamer-mediated delivery of photosensitizer TD05 aptamer were engineered with photosensitizer for selective photodynamic therapy of targeted tumor cells It exploit the ability of non toxic light sensitive compound called photosensitizer to produce cytotoxic reactive oxygen species An aptamer photosensitizer conjugate (APC) was engineered Conjugate contain cytotoxic porphyrin-based photosensitizer reagent chlorin 6 37

38. Conti…. APC was selective to Ramos cells TD05 aptamers were designed to attach a lipid tail at the end of aptamers to form self- assembled aptamer-micelle nanostructure 38

39. AS1411 Nucleolin Aptamer-mediated drug delivery Nuclear delivery It acts as a shuttle to transfer molecules between cell surface & nucleus Scientist have reported a novel strategy of using AS1411 aptamers as drug carrier to target cancer cells for photodynamic therapy 39

40. Conti… AS1411 aptamer+ multivalent AS1411apt- 6photodynamic molecules TMPy4 TMPy4 conjugate nucleolin expressing cells damage cells upon exposure to light 40

41. Lipid polymer hybrid nanoparticles (LPHN) These lipid-polymer hybrid nanoparticles were composed of 6 elements 1) a hydrophobic polymeric core made of poly D, L lactic-co-glycolic acid (PLGA) 2) a chemotherapeutic drug, paclitaxel 3) a fluorescent dye 4) a lipid layer made of lecithin, 5) a PEGylated phospholipid, DSPE-PEG2000- COOH and 6) AS1411 aptamers on the surface 41

42. Theranostic probe (TP) Scientist developed a cancer-targeting probe that can detect & inhibit cancer cells at the same time Probe used micro-RNA as a cancer biomarker & magnetic fluorescence nanoparticle conjugated with AS1411 aptamers and an miRNA-221 molecular beacon to simultaneously target cancer cells Collectively, resulting nanoparticles displayed superior selectivity in nucleolin expressing cancer cells 42

43. Conti…. When incubated with target cells, the nanoparticles were internalized and released the miR-221 molecular beacon in the cytoplasm In the presence of miR-221, the unloaded miR- 221 molecular beacon hybridized with endogenous miR-221, resulting in a strong fluorescence signal & simultaneously miRNA- 221 inhibition, thereby reducing expression of oncogenes 43

44. Conti… 44

45. Anti-CD Aptamer-mediated siRNA Delivery Used to deliver siRNA to Anaplastic lymphoma kinase (ALK) positive ALCL,which is an aggressive T-cell lymphoma that over expresses ALK oncogenes & CD30 surface proteins Nanoparticle of 140nm were formed ALK,siRNA and CD30 aptamer were incorporated onto cationic PEI-Citrate carriers to form nanoparticles Inside the cell ALK siRNA were released from the nanoparticles to specifically silence ALK gene expression Result in growth arrest and apoptosis in CD30-expressing ALCL cells 45

46. Conclusions Lymphoma are cancers that arise from white blood cells & usually present as solid tumors Aptamers are single stranded DNA or RNA oligonucleotides The immense diversity in function and structure of nucleic acids enable numerous aptamers to be generated through in vitro selection technique known as SELEX Aptamers may inhibit the function of target proteins, and can be used as potential therapeutic and diagnostic agents for lymphoma 46

47. References Shum., K. T., J. Zhou and J. J. Rossi. 2013. Nucleic acid aptamers as potential therapeutic and diagnostic agents for lumphoma. J. Cancer therapy. 4: 872-890. Hu, S. Z., Y. Xu-Monette, A. Balasubramanyam, G. C. Manyam, C. Visco, A. Tzankov. 2013. “CD30 Expression Defines a Novel Subset of Diffuse Large B-Cell Lym- phoma with Favorable Prognosis and Distinct Gene Ex- pression Signature: A Report from the International DLBCL Rituximab- CHOP Consortium Program Study,” Blood. 4: 2715-2724. Mori., T. A. Oguro, T. Ohtsu and Y. Nakamura.2004. “RNA Aptamers Selected against the Receptor Activator of NF-kappaB Acquire General Affinity to Proteins of the Tumor Necrosis Factor Receptor Family,” Nucleic Acids Research. 32. 6120-6128. Shieh., Y. A., S. J. Yang, M. F. Wei and M. J. Shieh.2010. “Ap- tamer- Based Tumor-Targeted Drug Delivery for Photo- dynamic Therapy,” ACS Nano, Vol.3: 1433-1442. 47