Targeted cancer therapeutics specifically inhibit oncoproteins and oncogenic pathways and are thus being used as a personalized therapy option with fewer side effects compared to chemotherapy and other conventional cancer treatments. Currently available targeted therapeutics can be categorized into small molecule inhibitors1,2, often binding protein kinases and few other intracellular enzymes, and biologics, mostly therapeutic antibodies3–6, which target extracellular and membrane-bound proteins. While their clinical application has led to therapeutic breakthroughs in recent years, several limitations of these drugs have arisen7. Small molecule inhibitors often lack high selectivity, leading to off-target binding and resulting in adverse effects, leaving many potential targets “undruggable”. Therapeutic antibodies, while highly specific, are complex structures with large sizes and limited tissue/tumor penetration. Importantly, antibodies are precluded from inhibiting intracellular targets, as they cannot cross cellular membranes. These drawbacks highlight the need for alternative targeted therapeutics and efficient approaches for the intracellular delivery of biologics.
Synthetic binding proteins are a recent development in the field of targeted therapeutics. These binding proteins are engineered from stable scaffold proteins, using molecular display techniques. The obtained binders can target the protein of interest with high affinity and selectivity and often result in preventing protein-protein interactions or inhibiting enzymatic activity of the target. Commonly used engineered binding proteins include derivatives of immunoglobulin scaffolds (scFvs, Fabs, nanobodies) and non-immunoglobulin scaffolds (monobodies, DARPins, affibodies, anticalins)8–11. Due to their small size (~ 6–20 kDa) and their ability to bind with high affinity and selectivity, they overcome limitations of current targeted therapeutics and thus have substantial therapeutic potential7.
Among the most commonly used synthetic binder classes are monobodies (Mb), which are developed based on the protein scaffold derived from a human fibronectin type III domain12. We have engineered and characterized several monobodies as potent antagonists of oncoproteins, including kinases (BCR::ABL113–15, LCK16), phosphatases (SHP217), transcription factors (STAT318) and small GTPases (H-/K-RAS19–21), demonstrating that it is possible to develop selective monobodies to challenging intracellular targets. These monobodies were introduced into cells as genetically encoded reagents using DNA transfection and viral gene delivery, where they inhibit the function of their targets. Monobodies lack endogenous disulfides, and consequently they readily fold into the fully functional form in the reducing environment of the cytoplasm. A number of studies have demonstrated the effectiveness of monobodies against intracellular targets for discovering and validating therapeutic approaches and elucidating the structural basis for specific recognition of challenging targets22,23. Additionally, recent advances have substantially improved the plasma stability and pharmacokinetics of monobodies, providing a solid groundwork for future therapeutic translation24.
The limited availability of efficient intracellular drug delivery systems poses a major roadblock for macromolecular therapeutics like peptides and nucleic acids, but in particular for proteins. Although monobodies and other synthetic binding proteins can achieve high selectivity and potency against the most challenging targets, the inability of monobodies to readily pass the plasma membrane barrier has so far limited their use as protein therapeutics against cytoplasmic and nuclear targets.
Several protein delivery strategies have been explored, ranging from physical methods (e.g. electroporation, microinjection) and viral delivery to nanoparticles25–28. In particular, various fusion strategies have been studied for the delivery of proteins such as bacterial toxin subunits28,29 and cell-penetrating peptides (CPPs)30,31. Often these delivery strategies were tested with model cargoes, such as fluorescent proteins or highly active enzymes, where cytosolic delivery of very low amounts is already sufficient for a measurable readout. By contrast, few studies have shown an effect on oncogenic signaling after delivery of protein-based inhibitors. We have already demonstrated the cytosolic delivery of monobodies by fusing them to a chimeric bacterial toxin subunit32,33. Further modification even allowed target degradation after uptake33, but we also experienced difficulties during recombinant production and also assume high immunogenicity using this system due to the large size of the toxin.
Most cellular delivery methods rely on uptake of the cargo protein through endocytosis, which in turn requires efficient endosomal escape afterwards to prevent cargo degradation in lysosomes. Inefficient endosomal escape and thus insufficient cytosolic amounts of binders is a common challenge that still has not been fully overcome29. Different endosomal escape strategies have been proposed34–36, but their efficiency is highly cargo-, cell- and delivery strategy-dependent and thus no universal strategy can promise cytosolic delivery of a wide variety of cargos. Hence, delivery tools that can circumvent endocytosis and directly deliver functional binders into the cytosol are of particular interest.
The bacterial type III secretion system (T3SS) is used by many bacteria to directly inject proteins into eukaryotic host cells37, using a hollow needle attached to an export machinery in the bacterial membranes and cytosol (Fig. 1a). As a system evolutionary optimized for the efficient delivery of proteins into the cytosol, the T3SS has been used to deliver different cargo proteins38,39 into eukaryotic target cells, including cell lines difficult to manipulate by transfection or other means40.
Cargo proteins are targeted to the T3SS by a short (15–150 amino acids) unstructured N-terminal secretion signal41, which can be removed by site-specific proteases or cleavage at the C-terminus of a ubiquitin domain by the native host cell machinery in the target cell42,43. While the properties of cargo proteins can influence translocation rates, and very large or stably folded proteins are exported at a lower rate, most proteins, including molecular weights above 60 kDa, can be exported by the T3SS and delivered to eukaryotic cells at rates of up to 100 proteins per second, allowing the specific delivery of hundreds of thousands of cargo proteins per host cell42,44–48. Cargo proteins pass the needle unfolded with the N-terminus first, facilitating their native folding, and consequently function, in the target cell. The amount of injection into host cells can be titrated by adjusting the expression level and multiplicity of infection (MOI; ratio of bacteria to host cells). Taken together, these properties make the T3SS an efficient and versatile tool for protein delivery into eukaryotic cells40.
In this study, we use the T3SS of an avirulent Yersinia enterocolitica strain, ΔHOPEMTasd49.
Yersinia features a well-characterized and remarkably efficient T3SS, which can secrete large concentrations of effectors within short time (> 90% of all extracellular proteins are T3SS export substrates50). Y. enterocolitica has an unusually low number of native effector proteins, which can easily be deleted for increased biosafety and possibly increased export of heterologous cargo proteins. Given that Y. enterocolitica actively targets tumors51–53, the Yersinia T3SS is a highly promising carrier for monobodies, as evidenced by an ongoing clinical trial for cancer therapy54.
To establish the T3SS of Y. enterocolitica as a monobody delivery tool, we focus on the well-characterized AS25 monobody and its target, the Abelson tyrosine kinase 1 (Abl1). The oncogenic counterpart of Abl1 is BCR::ABL1, the product of the Philadelphia chromosomal translocation, which results in the fusion of the breakpoint cluster region (BCR) and ABL1 genes55. The fusion protein BCR::ABL1 is a constitutively active kinase that is a central driver of chronic myeloid leukemia (CML)56. When expressed intracellularly, AS25 inhibits BCR::ABL1 kinase activity by targeting an intramolecular allosteric interface formed by the Src Homology 2 (SH2) domain and the kinase domain. AS25 thus disrupts BCR::ABL1-mediated signaling in CML cells, inhibiting their proliferation and survival13.
Here, we show the efficient direct cytosolic delivery of the AS25 monobody to different human cell lines using the T3SS of Y. enterocolitica. Concentrations in the cytosol reached mid-micromolar, ~ 100-fold higher than in previous studies and well above the binding affinity. The delivered monobodies readily refold and are able to engage their targets in cells. We demonstrate specific inhibition of BCR::ABL1 signaling and induction of apoptosis in CML cells by T3SS-mediated delivery of AS25.