IntroductionTargeted intracellular drug delivery needed for more effective and safe therapies requires both cell-specific recognition and subsequent internalization. Many internalizable determinants (eg, transferrin receptor) do not enable cell-specific recognition. [1][2][3] Immunotargeting permits more specific targeting, 4-7 but many antibodies (even some antibodies against internalizable antigens, eg, thrombomodulin [TM]) are poorly internalized. [8][9][10] Antibody polymerization, coupling with internalizable entities (eg, transferrin or urokinase), and other strategies have been explored to facilitate internalization. [11][12][13] Constraints for intracellular delivery depend on cell type and the nature of a target antigen. Among other cells, vascular endothelium is an important target. Stably and highly expressed endothelial antigens, such as platelet endothelial cell adhesion molecule 1 (PECAM-1) or CD31 (a glycoprotein involved in transmigration of leukocytes) [14][15][16][17][18] and TM (CD 141, a glycoprotein controlling enzymatic activities of thrombin), 19 may be used as target determinants, since their blood levels are several orders of magnitude lower than in endothelial cells. [20][21][22] In addition to the targeting function, anti-PECAM may suppress inflammation. [23][24][25] Recent studies showed that monoclonal antibodies directed against these determinants (ie, anti-PECAM and anti-TM) could be used for immunotargeting to endothelial cells in vitro and in vivo. [26][27][28][29] Although endothelial cells poorly internalize anti-PECAM, anti-PECAM conjugated with streptavidin (SA) is readily internalized. 28 Both anti-PECAM/SA and anti-TM/SA serve as a carrier to deliver active enzymes and genes to pulmonary endothelial cells in intact animals. [26][27][28][29][30][31][32] However, the carrier properties optimal for intracellular targeting to endothelium have not been established.Conceivably, carrier size is an important parameter for the intracellular uptake, yet this issue has not been systematically addressed in the literature. Available data show that optimal particle size threshold for intracellular uptake varies in different cell types. 7,12,[33][34][35][36] Although macrophages internalize large complexes of 1 m in diameter or larger, [37][38][39] little is known about how the size of complexes affects their uptake by other cell types. There For personal use only. on May 9, 2018. by guest www.bloodjournal.org From are no studies on effects of size on endothelial internalization via constitutive surface adhesion molecules.The goal of the present study was (1) to determine whether size controls uptake of anti-PECAM conjugates and to define the maximum size threshold for the uptake by endothelial cells and (2) to evaluate whether the size of immunoconjugates directed against endothelial antigens controls their targeting and effect in vivo. We generated diverse anti-PECAM conjugates ranging from 80-to 5000-nm diameter and found that the conjugates smaller than 350 nm were preferentially inte...