Previous Article | Next Article 
Antimicrobial Agents and Chemotherapy, March 2009, p. 1210-1212, Vol. 53, No. 3
0066-4804/09/$08.00+0 doi:10.1128/AAC.01294-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
Efficient Neutralization of Antibody-Resistant Forms of Anthrax Toxin by a Soluble Receptor Decoy Inhibitor
Shilpi Sharma,1
Diane Thomas,2
John Marlett,1
Marianne Manchester,2 and
John A. T. Young1*
The Salk Institute for Biological Studies, Infectious Disease Laboratory, 10010 North Torrey Pines Road, La Jolla, California 92037,1
Department of Cell Biology and Center for Integrative Molecular Biosciences, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 920372
Received 26 September 2008/
Returned for modification 18 November 2008/
Accepted 2 December 2008

ABSTRACT
A soluble receptor decoy inhibitor (RDI), comprised of the extracellular
I domain of ANTXR2, is a candidate anthrax therapeutic. Here
we show that RDI can effectively neutralize altered forms of
the protective antigen toxin subunit that are resistant to 14B7
monoclonal antibody neutralization. These data highlight the
potential of RDI to act as an adjunct to existing antibody-based
therapies and indicate that inhibitors based on RDI might be
useful as a stand-alone treatment against specifically engineered
strains of
Bacillus anthracis.

INTRODUCTION
Bacillus anthracis, the causative agent of anthrax, is a spore-forming
gram-positive bacterium that is one of the most dangerous Centers
for Disease Control and Prevention category A agents (
6). Of
the two major virulence factors expressed by this bacterium,
the bipartite anthrax toxin is believed to be responsible for
the majority of disease symptoms. The toxin is comprised of
a cellular receptor-binding moiety, a protective antigen (PA),
and the following two enzymatic moieties: lethal factor (LF),
a zinc-dependent metalloprotease that cleaves multiple mitogen-activated
protein kinase kinases (
7,
24), and edema factor (EF), a calcium-
and calmodulin-dependent adenylate cyclase (
11). LF and EF combine
with PA to form lethal toxin (LeTx) and edema toxin (EdTx),
respectively.
The toxin action begins with the binding of the 83-kDa monomeric form of PA (PA83) to either of the two cellular receptors, ANTXR1 or ANTXR2 (5, 22). Both receptors contain an extracellular domain, similar to the I domains of integrins, which is involved in PA binding. Receptor-bound PA is cleaved by a cell surface furin-like enzyme to generate a 63-kDa form (PA63) which spontaneously oligomerizes to form a heptameric prepore, (PA63)7, bound by up to seven copies of the receptor (10). Alternatively, (PA63)7 that is formed in the bloodstream of an infected host can bind directly to the receptor (8, 15). By binding to PA, the ANTXR2 I domain serves as an effective molecular clamp that prevents prepore-to-pore conversion until the toxin-receptor complex is trafficked to an acidic endosomal compartment (10, 16, 19, 21, 27). Each PA heptamer can bind up to three moieties of LF and/or EF (12, 13). The toxin-receptor complexes are internalized primarily by clathrin-mediated endocytosis (2, 4) and trafficked to an acidic endosomal compartment. Under the influence of acidic pH, conformational changes occur, leading to the formation of the (PA63)7 pore in either endosomal or intraluminal vesicle membranes (1). Consequently, LF and EF are delivered into the cytosol where they disrupt cellular processes (28).
Various strategies are being pursued to combat anthrax, the most advanced of which are monoclonal antibodies directed against toxin components (3, 17, 28). Although these reagents are expected to be effective against most strains of B. anthracis, they may not be effective against weaponized strains of bacteria that have been specifically engineered to express fully functional, antibody-resistant forms of PA. Cysteine-scanning mutagenesis of PA63 has already shown PA to be a highly malleable protein that can accommodate numerous independent amino acid substitutions (14). Furthermore, antibody-resistant forms of PA that are fully competent to mediate intoxication can be easily generated (18). PA is the major immunogen within the currently licensed vaccine, AVA, and several reports have suggested that modified, vaccine-resistant strains of B. anthracis were generated previously as part of biowarfare programs (3, 9).
Previously, we showed that PA could be effectively neutralized by a soluble receptor decoy inhibitor (RDI) consisting of the ANTXR2 I domain (23). In this report, we tested whether RDI could also efficiently neutralize four independent variants of PA that are resistant to neutralization by the 14B7 monoclonal antibody, which acts by blocking PA receptor binding. These studies evaluate the potential of using soluble receptor decoys as candidate therapeutics against engineered strains of B. anthracis.
To test the ability of RDI to neutralize antibody-resistant forms of PA, four amino acid substitutions were engineered into PA83 (K684A, L685A, L687A, and Y688A) (Fig. 1). These substitutions were previously shown to interfere with 14B7 monoclonal antibody neutralization without significantly compromising the function of this toxin subunit (18). QuikChange mutagenesis (Stratagene) was performed on the previously described PA-pET22b construct (25) to generate genes encoding the PAK684A, PAL685A, PAL687A, and PAY688A variants. The open reading frames of all constructs were confirmed by DNA sequencing. Wild-type PA and mutant PA forms were isolated from the periplasm of Escherichia coli BL21 cells (25) and purified as previously described (20). The soluble ANTXR2 I domain (RDI) was purified as previously described (26). Concentrations of the proteins were determined using the bicinchoninic acid protein assay kit (Thermo Scientific, IL). The purity of each sample was judged using densitometric analysis (Fluorchem; Alpha Innotech Corporation, CA), following sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Coomassie blue staining. Confirming the results of a previous study (18), we found that the mutant PA proteins could efficiently mediate LF-dependent intoxication of RAW264.7 cells and, furthermore, that this killing was resistant to 14B7 antibody neuralization (data not shown).
An important feature of a candidate receptor decoy-based anthrax
therapeutic is that it forms a stable complex with PA and prevents
cellular receptor binding. Monomeric RDI-wild-type PA (WT-PA)
complexes display a very high binding affinity (a dissociation
constant [
Kd] of 170 pM) due in large part to a very slow off-rate
with the lifetime of the complex estimated at around 30 h (
26).
To determine if the mutations that render PA resistant to 14B7
antibody neutralization significantly alter this off-rate, a
capture enzyme-linked immunosorbent assay (ELISA) was performed.
The WT-PA and mutant PA proteins were immobilized overnight
at 4°C by adding each protein at 1 µg/well in phosphate-buffered
saline (PBS) to the wells of a 96-well plate. The wells were
blocked with 3% nonfat milk in Tris-buffered saline (TBS), pH
7.0, for 1 h at room temperature. RDI was then added to each
well at 50 ng/well, diluted in 1% nonfat milk in TBS, pH 7.0,
with 0.05% Tween 20 (mTBST) and incubated for 1 h at room temperature.
RDI dissociation was then followed over a 24-h period using
chicken anti-ANTXR2 antibody (diluted 1:200 in mTBST) (
20),
followed by rabbit anti-chicken antibody coupled to horseradish
peroxidase (HRP; Zymed; diluted 1:30,000 in mTBST). A 1-step
Ultra TMB ELISA (Pierce) was used as the HRP substrate, and
the reactions were stopped using 2 M H
2SO
4 and monitored at
450 nm. All of the incubation steps were performed in a volume
of 100 µl per well, except for the dissociation step for
which 300 µl/well was used. The wells were washed five
times with mTBST after each incubation step. The experiment
was set up so that all of the samples were processed at the
same time with the antibodies and the HRP substrate. These studies
revealed that there was no significant difference in the rate
of RDI loss from the altered PA proteins compared to that of
WT-PA as judged by one-way analysis of variance (Prism; GraphPad
Software, Inc., San Diego, CA), indicating a similar off-rate
(Fig.
2). These results demonstrate that RDI forms stable complexes
with the antibody-resistant forms of PA.
Previously, we showed that RDI was capable of efficiently neutralizing
the anthrax toxin in cultured cells, and in vivo using a rat
model system, when it was added at between 1:1 and 2:1 stoichiometric
concentrations relative to those of PA (
23). To test its efficacy
against antibody-resistant forms of PA, the RDI was titrated
against fixed amounts of LF (5
x 10
–9 M) and WT-PA or
mutant PA proteins. The amounts of each PA protein used were
those that gave rise to maximal killing of RAW264.7 cells, i.e.,
0.5
x 10
–7 M of WT-PA, PA
K684A, PA
L685A, and PA
Y688A and
1
x 10
–7 M of PA
L687A. The toxin-RDI samples (in a total
volume of 100 µl) were then added to cultures of 10
4 RAW264.7
cells that were seeded overnight in a 96-well plate. Following
an overnight incubation, cell viability was then assessed using
CellTiter-Glo (Promega, WI). The results clearly demonstrate
that RDI is as effective against antibody-resistant forms of
PA as it is against WT-PA (neutralizing each when added at a
2:1 ratio) (Fig.
3).
We next tested the ability of RDI to neutralize LeTx containing
an antibody-resistant form of PA (PA
L685A) in a rat model system.
Male Harlan Sprague-Dawley rats (180 to 200 g; Harlan, Indianapolis,
IN) were anesthetized with isofluoranes and inoculated with
500 µl LeTx mixture by intravenous injection in the tail
vein. The anthrax LeTx was prepared for each group by mixing
12 µg LF (List Biological Laboratories, Campbell, CA)
with 40 µg PA (List Biological Laboratories, Campbell,
CA) or with 40 µg PA
L685A in 250 µl PBS vehicle
per rat. RDI was prepared in PBS vehicle with a total volume
of 250 µl per rat so that it would be at a 2:1 molar ratio
relative to PA when combined with the LeTx samples immediately
prior to injection. The LeTx sample (250 µl per rat) was
mixed with the RDI sample (250 µl per rat) for groups
that received the inhibitor or with PBS (250 µl per rat)
for groups that did not receive the inhibitor. These samples
were immediately coinjected into rats. Control rats injected
with 500 µl of PBS per rat were also included in the analysis.
Rats recovered from anesthesia within 5 min and were monitored
for symptoms of intoxication and death as determined by cessation
of respiration. The group of rats that received LF and either
form of PA died with similar kinetics in the absence of RDI
(Table
1). Importantly, RDI protected all rats against intoxication
even when the antibody-resistant form of PA was used (Table
1). These results highlight the potential for the future development
of RDI-based therapeutics as candidates for the treatment of
disease caused by both wild-type and engineered strains of
B. anthracis.

ACKNOWLEDGMENTS
We thank the members of the Young and Manchester labs for stimulating
discussions and John Naughton for help with figure preparation.
We thank Stephen Leppla for providing the 14B7 antibody.
This study was supported by a grant from the National Institutes of Health AI076852 to J.A.T.Y. and M.M.

FOOTNOTES
* Corresponding author. Mailing address: The Salk Institute for Biological Studies, Infectious Disease Laboratory, 10010 North Torrey Pines Road, La Jolla CA 92037. Phone: (858) 453-4100, ext. 1903. Fax: (858) 554-0341. E-mail:
jyoung{at}salk.edu 
Published ahead of print on 15 December 2008. 

REFERENCES
1 - Abrami, L., M. Lindsay, R. G. Parton, S. H. Leppla, and F. G. van der Goot. 2004. Membrane insertion of anthrax protective antigen and cytoplasmic delivery of lethal factor occur at different stages of the endocytic pathway. J. Cell Biol. 166:645-651.[Abstract/Free Full Text]
2 - Abrami, L., S. Liu, P. Cosson, S. H. Leppla, and F. G. van der Goot. 2003. Anthrax toxin triggers endocytosis of its receptor via a lipid raft-mediated clathrin-dependent process. J. Cell Biol. 160:321-328.[Abstract/Free Full Text]
3 - Baillie, L. W. 2006. Past, imminent and future human medical countermeasures for anthrax. J. Appl. Microbiol. 101:594-606.[CrossRef][Medline]
4 - Boll, W., M. Ehrlich, R. J. Collier, and T. Kirchhausen. 2004. Effects of dynamin inactivation on pathways of anthrax toxin uptake. Eur. J. Cell Biol. 83:281-288.[CrossRef][Medline]
5 - Bradley, K. A., J. Mogridge, M. Mourez, R. J. Collier, and J. A. Young. 2001. Identification of the cellular receptor for anthrax toxin. Nature 414:225-229.[CrossRef][Medline]
6 - Darling, R. G., C. L. Catlett, K. D. Huebner, and D. G. Jarrett. 2002. Threats in bioterrorism I: CDC category A agents. Emerg. Med. Clin. N. Am. 20:273-309.[CrossRef][Medline]
7 - Duesbery, N. S., and G. F. Vande Woude. 1999. Anthrax lethal factor causes proteolytic inactivation of mitogen-activated protein kinase kinase. J. Appl. Microbiol. 87:289-293.[CrossRef][Medline]
8 - Ezzell, J. W., Jr., and T. G. Abshire. 1992. Serum protease cleavage of Bacillus anthracis protective antigen. J. Gen. Microbiol. 138:543-549.[Abstract/Free Full Text]
9 - Greenfield, R. A., and M. S. Bronze. 2003. Prevention and treatment of bacterial diseases caused by bacterial bioterrorism threat agents. Drug Discov. Today 8:881-888.[CrossRef][Medline]
10 - Lacy, D. B., D. J. Wigelsworth, R. A. Melnyk, S. C. Harrison, and R. J. Collier. 2004. Structure of heptameric protective antigen bound to an anthrax toxin receptor: a role for receptor in pH-dependent pore formation. Proc. Natl. Acad. Sci. USA 101:13147-13151.[Abstract/Free Full Text]
11 - Leppla, S. H. 1984. Bacillus anthracis calmodulin-dependent adenylate cyclase: chemical and enzymatic properties and interactions with eucaryotic cells. Adv. Cyclic Nucleotide Protein Phosphorylation Res. 17:189-198.[Medline]
12 - Melnyk, R. A., K. M. Hewitt, D. B. Lacy, H. C. Lin, C. R. Gessner, S. Li, V. L. Woods, Jr., and R. J. Collier. 2006. Structural determinants for the binding of anthrax lethal factor to oligomeric protective antigen. J. Biol. Chem. 281:1630-1635.[Abstract/Free Full Text]
13 - Mogridge, J., K. Cunningham, D. B. Lacy, M. Mourez, and R. J. Collier. 2002. The lethal and edema factors of anthrax toxin bind only to oligomeric forms of the protective antigen. Proc. Natl. Acad. Sci. USA 99:7045-7048.[Abstract/Free Full Text]
14 - Mourez, M., M. Yan, D. B. Lacy, L. Dillon, L. Bentsen, A. Marpoe, C. Maurin, E. Hotze, D. Wigelsworth, R. A. Pimental, J. D. Ballard, R. J. Collier, and R. K. Tweten. 2003. Mapping dominant-negative mutations of anthrax protective antigen by scanning mutagenesis. Proc. Natl. Acad. Sci. USA 100:13803-13808.[Abstract/Free Full Text]
15 - Panchal, R. G., K. M. Halverson, W. Ribot, D. Lane, T. Kenny, T. G. Abshire, J. W. Ezzell, T. A. Hoover, B. Powell, S. Little, J. J. Kasianowicz, and S. Bavari. 2005. Purified Bacillus anthracis lethal toxin complex formed in vitro and during infection exhibits functional and biological activity. J. Biol. Chem. 280:10834-10839.[Abstract/Free Full Text]
16 - Rainey, G. J., D. J. Wigelsworth, P. L. Ryan, H. M. Scobie, R. J. Collier, and J. A. Young. 2005. Receptor-specific requirements for anthrax toxin delivery into cells. Proc. Natl. Acad. Sci. USA 102:13278-13283.[Abstract/Free Full Text]
17 - Rainey, G. J., and J. A. Young. 2004. Antitoxins: novel strategies to target agents of bioterrorism. Nat. Rev. Microbiol. 2:721-726.[CrossRef][Medline]
18 - Rosovitz, M. J., P. Schuck, M. Varughese, A. P. Chopra, V. Mehra, Y. Singh, L. M. McGinnis, and S. H. Leppla. 2003. Alanine-scanning mutations in domain 4 of anthrax toxin protective antigen reveal residues important for binding to the cellular receptor and to a neutralizing monoclonal antibody. J. Biol. Chem. 278:30936-30944.[Abstract/Free Full Text]
19 - Santelli, E., L. A. Bankston, S. H. Leppla, and R. C. Liddington. 2004. Crystal structure of a complex between anthrax toxin and its host cell receptor. Nature 430:905-908.[CrossRef][Medline]
20 - Scobie, H. M., D. J. Wigelsworth, J. M. Marlett, D. Thomas, G. J. Rainey, D. B. Lacy, M. Manchester, and J. A. Young. 2006. Anthrax toxin receptor 2-dependent lethal toxin killing in vivo. PLoS Pathog. 2:e111.[CrossRef][Medline]
21 - Scobie, H. M., J. M. Marlett, G. J. Rainey, D. B. Lacy, R. J. Collier, and J. A. Young. 2007. Anthrax toxin receptor 2 determinants that dictate the pH threshold of toxin pore formation. PLoS One 2:e329.[CrossRef][Medline]
22 - Scobie, H. M., G. J. Rainey, K. A. Bradley, and J. A. Young. 2003. Human capillary morphogenesis protein 2 functions as an anthrax toxin receptor. Proc. Natl. Acad. Sci. USA 100:5170-5174.[Abstract/Free Full Text]
23 - Scobie, H. M., D. Thomas, J. M. Marlett, G. Destito, D. J. Wigelsworth, R. J. Collier, J. A. Young, and M. Manchester. 2005. A soluble receptor decoy protects rats against anthrax lethal toxin challenge. J. Infect. Dis. 192:1047-1051.[CrossRef][Medline]
24 - Vitale, G., R. Pellizzari, C. Recchi, G. Napolitani, M. Mock, and C. Montecucco. 1999. Anthrax lethal factor cleaves the N-terminus of MAPKKS and induces tyrosine/threonine phosphorylation of MAPKS in cultured macrophages. J. Appl. Microbiol. 87:288.[CrossRef][Medline]
25 - Wesche, J., J. L. Elliott, P. O. Falnes, S. Olsnes, and R. J. Collier. 1998. Characterization of membrane translocation by anthrax protective antigen. Biochemistry 37:15737-15746.[CrossRef][Medline]
26 - Wigelsworth, D. J., B. A. Krantz, K. A. Christensen, D. B. Lacy, S. J. Juris, and R. J. Collier. 2004. Binding stoichiometry and kinetics of the interaction of a human anthrax toxin receptor, CMG2, with protective antigen. J. Biol. Chem. 279:23349-23356.[Abstract/Free Full Text]
27 - Wolfe, J. T., B. A. Krantz, G. J. Rainey, J. A. Young, and R. J. Collier. 2005. Whole-cell voltage clamp measurements of anthrax toxin pore current. J. Biol. Chem. 280:39417-39422.[Abstract/Free Full Text]
28 - Young, J. A., and R. J. Collier. 2007. Anthrax toxin: receptor binding, internalization, pore formation, and translocation. Annu. Rev. Biochem. 76:243-265.[CrossRef][Medline]
Antimicrobial Agents and Chemotherapy, March 2009, p. 1210-1212, Vol. 53, No. 3
0066-4804/09/$08.00+0 doi:10.1128/AAC.01294-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
This article has been cited by other articles:
-
Oscherwitz, J., Yu, F., Cease, K. B.
(2009). A Heterologous Helper T-Cell Epitope Enhances the Immunogenicity of a Multiple-Antigenic-Peptide Vaccine Targeting the Cryptic Loop-Neutralizing Determinant of Bacillus anthracis Protective Antigen. Infect. Immun.
77: 5509-5518
[Abstract]
[Full Text]
-
Oscherwitz, J., Yu, F., Jacobs, J. L., Liu, T.-H., Johnson, P. R., Cease, K. B.
(2009). Synthetic Peptide Vaccine Targeting a Cryptic Neutralizing Epitope in Domain 2 of Bacillus anthracis Protective Antigen. Infect. Immun.
77: 3380-3388
[Abstract]
[Full Text]