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This protocol describes methods for studying FcγRIIIa-driven events in NK cells mediated by antibodies. These techniques permit the evaluation of potential mechanisms of action of therapeutic antibodies, which is suggested to be ADCC1,2. Specifically, these methods provide flexibility in studying underlying molecular signaling pathways and cellular processes that are responsible for ADCC. They also allow observation of other effector functions, such as chemokine and cytokine production. In addition, these methods allow the identification of potential biomarkers and molecules that may be targeted to modulate ADCC.
The basis for this protocol is the artificial stimulation of NK cells through the FcγRIIIa with antibodies in the absence of target cells. Antibody-bound target cells typically serve to promote the crosslinking of Fc receptors to form a platform that drives signaling and downstream effects. Instead, crosslinking is accomplished using an anti-human κ light chain antibody in this assay, bypassing the need for target cells to stimulate the NK cells. Without target cells, the results and observations can be attributed directly to the NK cells, assuming that the purification process is successful.
Importantly, using anti-human κ light chain antibody to crosslink the antibody does not interfere with the binding affinity of the Fc portion for the FcγRIIIa, an interaction that dictates the strength of response10,11,12,13. Indeed, studies have shown that afucosylated antibodies increase ADCC due to their increased affinity for the FcγRIIIa10,11,12,13. Subsequent studies showed that this increased affinity is unaffected by the anti-human κ light chain secondary antibody substitute and can be used to study the basis for increased ADCC8. To ensure that the NK cell is stimulated through crosslinking of the antibody, two negative controls should be included: 1) therapeutic antibody only without the secondary anti-human κ light chain antibody, and 2) the secondary anti-human κ light chain antibody only. In both cases, no signaling or effector function should be generated.
This method also provides flexibility for studying the effects of therapeutic antibodies on small molecule inhibitors. The inhibitor can be added before crosslinking with the secondary antibody so that the inhibitor has time to engage its target. However, studies should be performed to determine the optimal time of inhibitor pretreatment; thus, the inhibitor has a maximal effect on stimulation. With that said, researchers may also choose to study the effects of an inhibitor after stimulation. In this case, the inhibitor may be added after crosslinking to study how it influences signals and processes that are already generated. Together, the method described here provides maximal flexibility in studying combinatorial effects of different small molecule inhibitors with therapeutic antibodies.
As mentioned above, a variety of readouts can be performed after stimulation. Western blotting can be performed to study signaling using SDS-PAGE and membrane transfer systems from various vendors. Similarly, gene expression can also be assessed using various RNA extraction methods, reverse transcription reagents, and gene expression instruments. Finally, staining for intracellular or extracellular protein can also be performed in which samples can be analyzed using different flow cytometers. For intracellular cytokine and CD107a staining (step 3.4, which can be assessed simultaneously), monensin and/or brefeldin A should be added to maximize signals. We have used different platforms for each experimental goal and still observed similar results. Therefore, the method can be complemented with various reagents, platforms, and instruments, depending on the study.
The crosslinking time for stimulation will depend on the goal of the study. If signaling studies are desired, typical crosslinking stimulation time is between 2 min and 10 min. pAKT, pPRAS40, and pERK1/2 accumulation peaks at 2 min and disappears after 10 min8,9. For functional studies (i.e., those involving chemokine/cytokine production), cells must be stimulated for at least 30 min, depending on the analyte9. Gene expression analysis also typically requires 30 min of stimulation9. Caution should be exercised when using RANTES gene expression as a readout, as RANTES mRNA production is independent of transcriptional activation since it is already stored in cells for prompt translation and release of protein upon stimulation25. Degranulation, in contrast, requires at least 3 h of stimulation. Despite these general observations, researchers should perform kinetic studies to determine the optimal stimulation time for the particular molecules of interest.
Similarly, researchers should titrate the antibody of interest to determine the optimal concentration because antibodies with different specificities bind to FcγRIIIa with different affinities, even if they are of the same isotype. For example, rituximab and trastuzumab are both an IgG1 isotype but trastuzumab binds more strongly to the valine polymorphism of FcγRIIIa than rituximab26,27. This difference in affinity may lead to functional differences, such as degranulation, as observed in published studies8.
Determining the optimal concentration is also important because of the low affinity the Fc portion of the antibody has for the FcγRIIIa. This may result in washing off the antibody since the protocol includes washing steps after binding of the antibody to the Fc receptor. This may then lead to a lack of sensitivity in the assays as suggested by the low percentage of CD107a positive cells after stimulation (Figure 5). However, determination of the optimal concentration should provide confidence that results are not due to a lack of sensitivity. In addition, cells are clearly activated in the biochemical and functional assays that use bulk cell as opposed to single cell readouts (Figure 2, Figure 3, Figure 6).
The protocol is also limited since it does not entirely mimic what occurs physiologically. The secondary anti-human K antibody used is to imitate the crosslinking generated by target antigen expressed on cells. Here, a saturating amount of secondary antibody is added to generate the maximum response. However, distinct target cells will express different levels of antigen, which will affect crosslinking and response. Currently, this platform is not optimized to mimic the effects of different antigen expression levels.
Another factor to consider when performing these experiments is donor-to-donor variability due to different genetic backgrounds and immunological histories among individuals. Therefore, care must be taken when comparing NK cell responses from different donors across the same assays. Similarly, only general conclusions should be made when different donors are used.
Altogether, the described method is a simple and flexible stimulation platform to study antibody driven FcγRIIIa-mediated events in NK cells. It has been used to better understand the basis for the increased ADCC and efficacy observed with afucosylated antibodies8. This method was also employed in a study combining therapeutic antibodies and PI3K small molecule inhibitors9. Additionally, a previously unknown mechanism for chemokine and cytokine production regulated by pS6 was identified9. Therefore, future studies using this artificial signaling platform can further elucidate mechanisms of regulation for effector functions driven by the FcγRIIIa. It may also potentially identify new molecules important for these mechanisms as well as new roles for known molecules.