Pseudomonas exotoxin (PE)-containing immunotoxins (ITs) act by arresting protein synthesis and promoting apoptosis, but the mechanisms of the induced apoptosis and the relationship to protein synthesis inhibition is not well elucidated. We studied these effects in MA
Key words: immunotoxin; apoptosis; Mcl-1; breast cancerITs represent one group of targeted therapeutics that have shown promising efficacy in patients for whom standard treatment is no longer an option. 1,2 ITs are dimeric proteins consisting of a targeting moiety linked to a toxin (ricin, PE, DT), which induce arrest of protein synthesis and result in cell death. 1 The targeting moiety binds to molecules expressed on cancer cells, theoretically leaving normal cells unaffected.The mechanism of action of such toxins and ITs is not, as previously believed, merely inhibition of protein synthesis in the cell. Thus, ricin, PE and DT may also induce apoptosis, a feature of major importance in cancer therapy. 3,4 Two common features of apoptotic cell death are activation of a group of cysteine proteases called caspases and caspase-catalyzed cleavage of so-called death substrates, such as the nuclear repair enzyme PARP. 5 Caspases are present in cells as inactive precursors, which are proteolytically activated upon induction of apoptosis. The protein substrates of caspases include proteins of regulatory or structural function in cell life. Caspases play a central role in the apoptotic program, functioning as initiators and executors of the apoptotic pathway. Caspase-3, e.g., is directly involved in apoptosis induced by both toxins and ITs in several human tumor cell lines. 6 -8 The Bcl-2 protein family is a major molecular modulator of apoptosis. 9,10 These proteins can be divided into 2 groups, including antiapoptotic (Bcl-2, Mcl-1, Bcl-X L ) and proapoptotic (Bax, Bak, Bad) molecules that regulate cellular sensitivity to drugs at the mitochondrial level. Pro-and antiapoptotic family members can heterodimerize and titrate each other's function, implying that their relative concentration may act as a balance in the suicide program. 11 Therapeutic drugs can modulate the expression of Bcl-2 family members, their activity and their subcellular localization.We have previously shown that the 425.3PE IT increased symptom-free survival in a human breast cancer model in nude rats 12 and wanted to investigate the mechanisms underlying the ITinduced cell death. This IT consists of the 425.3 MAb, which targets the EGFr and covalently links to the bacterial toxin PE. 12 It is well known that PE-containing ITs induce protein synthesis arrest by inactivation of EF-2, but it remains to be elucidated how this is linked to apoptosis.In the present study, we demonstrate simultaneous induction of apoptosis and protein synthesis inhibition by the holo-PE-containing IT in MA-11 breast cancer cells. Thus, upon IT treatment, expression of the antiapoptotic protein Mcl-1 was quickly and markedly reduced. The IT also induced loss of ⌬⌿ mito and activation of the caspase cascade, f...