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LAIR-1 agonism as a therapy for acute myeloid leukemia
Rustin R. Lovewell, … , Dallas B. Flies, Tae Kon Kim
Rustin R. Lovewell, … , Dallas B. Flies, Tae Kon Kim
Published November 15, 2023
Citation Information: J Clin Invest. 2023;133(22):e169519. https://doi.org/10.1172/JCI169519.
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Research Article Oncology

LAIR-1 agonism as a therapy for acute myeloid leukemia

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Abstract

Effective eradication of leukemic stem cells (LSCs) remains the greatest challenge in treating acute myeloid leukemia (AML). The immune receptor LAIR-1 has been shown to regulate LSC survival; however, the therapeutic potential of this pathway remains unexplored. We developed a therapeutic LAIR-1 agonist antibody, NC525, that induced cell death of LSCs, but not healthy hematopoietic stem cells in vitro, and killed LSCs and AML blasts in both cell- and patient-derived xenograft models. We showed that LAIR-1 agonism drives a unique apoptotic signaling program in leukemic cells that was enhanced in the presence of collagen. NC525 also significantly improved the activity of azacitidine and venetoclax to establish LAIR-1 targeting as a therapeutic strategy for AML that may synergize with standard-of-care therapies.

Authors

Rustin R. Lovewell, Junshik Hong, Subhadip Kundu, Carly M. Fielder, Qianni Hu, Kwang Woon Kim, Haley E. Ramsey, Agnieszka E. Gorska, Londa S. Fuller, Linjie Tian, Priyanka Kothari, Ana Paucarmayta, Emily F. Mason, Ingrid Meza, Yanira Manzanarez, Jason Bosiacki, Karla Maloveste, Ngan Mitchell, Emilia A. Barbu, Aaron Morawski, Sebastien Maloveste, Zac Cusumano, Shashank J. Patel, Michael R. Savona, Solomon Langermann, Han Myint, Dallas B. Flies, Tae Kon Kim

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Figure 4

NC525 agonism of LAIR-1 induces AML cell death.

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NC525 agonism of LAIR-1 induces AML cell death.
(A–C) Blood leukocytes a...
(A–C) Blood leukocytes after ex vivo treatment with 10 μg/mL isotype (gray) or NC525 (red) with (A) or without (B) exogenous collagen or CD45loSSClo blasts with collagen (C). n = 3 technical replicates. (D) Percentage dead leukocytes or blasts treated as in A and B relative to LAIR-1 surface expression. Each dot represents an individual patient. Red or blue shading indicates LAIR-1 greater or less than 20,000 arbitrary units, respectively. Line represents linear regression. (E) Total live cells or blasts from healthy or AML donors after treatment as indicated in A and B. n = 4–7 donors. (F) AlphaLISA of phosphorylated SHP-1 relative to total SHP-1 in AML PBMCs, normalized to isotype treatment. n = 3 technical replicates. (G and H) Duplicate dot blots from phospho-arrays of AML PBMCs quantified for MAPK (G) or mTOR and NF-κB activity (H). (I) Schematic of LAIR-1 (blue) clustering using anti-IgG (green) and NC525 (red). In vitro growth of MV4-11-LAIR-1overexpressing cells treated with isotype (gray) or NC525 (red) in the absence or presence of anti-IgG. (J) Annexin V staining of cells treated as in I, with representative scatterplot of apoptotic annexin V+ Live-Dead Aqua– cells at day 3 of culture. (K and L) 4E-BP1 expression as measured by Lumit assay (K) or cleaved caspase-7 as measured by Western blot (L) of cells treated as shown in I. Mean pixel density normalized to histone-3 for triplicate samples. (M) Percentage TUNEL+ MV4-11-LAIR-1overexpressing cells at day 3 of treatment plus DMSO vehicle, 50 μM 220509-74-0 (caspase-3/7 inhibitor), or 50 μM MHY1485 (mTOR activator). Values normalized to isotype for each respective condition. n = 3–4 technical replicates. P values calculated by Student’s t test. Error bars represent SEM.

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