Evaluating therapeutic plasma exchange and protease inhibitors as mechanisms to reduce soluble mesothelin

Abstract Cell surface mesothelin (MSLN) can be solubilized and released into the systemic circulation. The resulting soluble MSLN (sMSLN) may interfere with therapies targeting surface MSLN. We investigated the effects of sMSLN on anetumab, an antibody-based therapy against MSLN, anetumab ravtansine...

Full description

Saved in:
Bibliographic Details
Main Authors: Katherine E. R. Smith, Jennifer R. Ayers-Ringler, Jacob J. Orme, Fabrice Lucien, Yohan Kim, Jeffrey L. Winters, Aaron S. Mansfield
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-025-97952-x
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850156591591981056
author Katherine E. R. Smith
Jennifer R. Ayers-Ringler
Jacob J. Orme
Fabrice Lucien
Yohan Kim
Jeffrey L. Winters
Aaron S. Mansfield
author_facet Katherine E. R. Smith
Jennifer R. Ayers-Ringler
Jacob J. Orme
Fabrice Lucien
Yohan Kim
Jeffrey L. Winters
Aaron S. Mansfield
author_sort Katherine E. R. Smith
collection DOAJ
description Abstract Cell surface mesothelin (MSLN) can be solubilized and released into the systemic circulation. The resulting soluble MSLN (sMSLN) may interfere with therapies targeting surface MSLN. We investigated the effects of sMSLN on anetumab, an antibody-based therapy against MSLN, anetumab ravtansine, an antibody drug conjugate, and mechanisms to decrease sMSLN. Whole blood samples were collected before and after one plasma volume of therapeutic plasma exchange (TPE). sMSLN levels were measured with ELISA assays in matched pre- and post-TPE plasma samples, and anetumab-immunoprecipitated samples. We also used protease inhibitors (PIs) as a mechanism to stabilize surface MSLN, then evaluated the cytotoxic effects of anetumab ravtansine. Our findings indicate that sMSLN sequesters and may impair the efficacy of this anti-MSLN antibody based on results showing that anetumab decreases the concentration of MSLN in plasma (p < 0.05) and reduced cytotoxicity of anetumab ravtansine in the presence of recombinant MSLN in cell lines, a surrogate for sMSLN. TPE consistently reduced sMSLN (p < 0.05) with an average decrease of 43.6% (15.4 ng/mL). Surface MSLN stabilization was inconsistently observed with PIs. Overall, sMSLN could represent a predictive biomarker for MSLN directed therapies. TPE may be more reliable than PIs to reduce sMSLN and ultimately restore sensitivity to these therapies in patients with high sMSLN.
format Article
id doaj-art-9346d6f1b9d9468ea265fb0c60017604
institution OA Journals
issn 2045-2322
language English
publishDate 2025-04-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-9346d6f1b9d9468ea265fb0c600176042025-08-20T02:24:29ZengNature PortfolioScientific Reports2045-23222025-04-011511910.1038/s41598-025-97952-xEvaluating therapeutic plasma exchange and protease inhibitors as mechanisms to reduce soluble mesothelinKatherine E. R. Smith0Jennifer R. Ayers-Ringler1Jacob J. Orme2Fabrice Lucien3Yohan Kim4Jeffrey L. Winters5Aaron S. Mansfield6Medical Oncology, Mayo ClinicMedical Oncology, Mayo ClinicMedical Oncology, Mayo ClinicDepartment of Urology, Mayo ClinicDepartment of Urology, Mayo ClinicDivision of Transfusion Medicine, Mayo ClinicMedical Oncology, Mayo ClinicAbstract Cell surface mesothelin (MSLN) can be solubilized and released into the systemic circulation. The resulting soluble MSLN (sMSLN) may interfere with therapies targeting surface MSLN. We investigated the effects of sMSLN on anetumab, an antibody-based therapy against MSLN, anetumab ravtansine, an antibody drug conjugate, and mechanisms to decrease sMSLN. Whole blood samples were collected before and after one plasma volume of therapeutic plasma exchange (TPE). sMSLN levels were measured with ELISA assays in matched pre- and post-TPE plasma samples, and anetumab-immunoprecipitated samples. We also used protease inhibitors (PIs) as a mechanism to stabilize surface MSLN, then evaluated the cytotoxic effects of anetumab ravtansine. Our findings indicate that sMSLN sequesters and may impair the efficacy of this anti-MSLN antibody based on results showing that anetumab decreases the concentration of MSLN in plasma (p < 0.05) and reduced cytotoxicity of anetumab ravtansine in the presence of recombinant MSLN in cell lines, a surrogate for sMSLN. TPE consistently reduced sMSLN (p < 0.05) with an average decrease of 43.6% (15.4 ng/mL). Surface MSLN stabilization was inconsistently observed with PIs. Overall, sMSLN could represent a predictive biomarker for MSLN directed therapies. TPE may be more reliable than PIs to reduce sMSLN and ultimately restore sensitivity to these therapies in patients with high sMSLN.https://doi.org/10.1038/s41598-025-97952-xSoluble mesothelinMesotheliomaSoluble oncogenic proteinsTherapeutic plasma exchangeProtease inhibitors
spellingShingle Katherine E. R. Smith
Jennifer R. Ayers-Ringler
Jacob J. Orme
Fabrice Lucien
Yohan Kim
Jeffrey L. Winters
Aaron S. Mansfield
Evaluating therapeutic plasma exchange and protease inhibitors as mechanisms to reduce soluble mesothelin
Scientific Reports
Soluble mesothelin
Mesothelioma
Soluble oncogenic proteins
Therapeutic plasma exchange
Protease inhibitors
title Evaluating therapeutic plasma exchange and protease inhibitors as mechanisms to reduce soluble mesothelin
title_full Evaluating therapeutic plasma exchange and protease inhibitors as mechanisms to reduce soluble mesothelin
title_fullStr Evaluating therapeutic plasma exchange and protease inhibitors as mechanisms to reduce soluble mesothelin
title_full_unstemmed Evaluating therapeutic plasma exchange and protease inhibitors as mechanisms to reduce soluble mesothelin
title_short Evaluating therapeutic plasma exchange and protease inhibitors as mechanisms to reduce soluble mesothelin
title_sort evaluating therapeutic plasma exchange and protease inhibitors as mechanisms to reduce soluble mesothelin
topic Soluble mesothelin
Mesothelioma
Soluble oncogenic proteins
Therapeutic plasma exchange
Protease inhibitors
url https://doi.org/10.1038/s41598-025-97952-x
work_keys_str_mv AT katherineersmith evaluatingtherapeuticplasmaexchangeandproteaseinhibitorsasmechanismstoreducesolublemesothelin
AT jenniferrayersringler evaluatingtherapeuticplasmaexchangeandproteaseinhibitorsasmechanismstoreducesolublemesothelin
AT jacobjorme evaluatingtherapeuticplasmaexchangeandproteaseinhibitorsasmechanismstoreducesolublemesothelin
AT fabricelucien evaluatingtherapeuticplasmaexchangeandproteaseinhibitorsasmechanismstoreducesolublemesothelin
AT yohankim evaluatingtherapeuticplasmaexchangeandproteaseinhibitorsasmechanismstoreducesolublemesothelin
AT jeffreylwinters evaluatingtherapeuticplasmaexchangeandproteaseinhibitorsasmechanismstoreducesolublemesothelin
AT aaronsmansfield evaluatingtherapeuticplasmaexchangeandproteaseinhibitorsasmechanismstoreducesolublemesothelin