Targeted degradation using cell-specific
lysosome targeting
receptors
is emerging as a new therapeutic strategy for the elimination of disease-associated
proteins. The liver-specific human asialoglycoprotein receptor (ASGPR)
is a particularly attractive lysosome targeting receptor leveraged
for targeted protein degradation (TPD). However, the efficiency of
different glycan ligands for ASGPR-mediated lysosomal delivery remains
to be further characterized. In this study, we applied a chemoenzymatic
Fc glycan remodeling method to construct an array of site-specific
antibody–ligand conjugates carrying natural bi- and tri-antennary N-glycans as well as synthetic tri-GalNAc ligands. Alirocumab,
an anti-PCSK9 (proprotein convertase subtilisin/kexin type 9) antibody,
and cetuximab (an anti-EGFR antibody) were chosen to demonstrate the
ASGPR-mediated degradation of extracellular and membrane-associated
proteins, respectively. It was found that the nature of the glycan
ligands and the length of the spacer in the conjugates are critical
for the receptor binding and the receptor-mediated degradation of
PCSK9, which blocks low-density lipoprotein receptor (LDLR) function
and adversely affects clearance of low-density lipoprotein cholesterol.
Interestingly, the antibody–tri-GalNAc conjugates showed a
clear hook effect for its binding to ASGPR, while antibody conjugates
carrying the natural N-glycans did not. Both the antibody–tri-antennary
N-glycan conjugate and the antibody–tri-GalNAc conjugate could
significantly decrease extracellular PCSK9, as shown in the cell-based
assays. However, the tri-GalNAc conjugate showed a clear hook effect
in the receptor-mediated degradation of PCSK9, while the antibody
conjugate carrying the natural N-glycans did not. The cetuximab–tri-GalNAc
conjugates also showed a similar hook effect on degradation of the
membrane-associated protein, epidermal growth factor receptor (EGFR).
These results suggest that the two types of ligands may involve a
distinct mode of interactions in the receptor binding and target-degradation
processes. Interestingly, the alirocumab–tri-GalNAc conjugate
was also found to upregulate LDLR levels in comparison with the antibody
alone. This study showcases the potential of the targeted degradation
strategy against PCSK9 for reducing low-density lipoprotein cholesterol,
a risk factor for heart disease and stroke.