Today, hemolytic anemia is mainly treated with blood transfusion. This treatment is associated with mechanical shearing forces that accelerate red blood cell rupture (
31), and lead to severe clinical complications, including intravascular hemolysis, tissue oxidative stress, and multi-organ dysfunctions (
32).
The aim of the present study was to extend our availability to human HPX with the outlook of therapeutic employment for hemolytic patients. First, the HPX gene was isolated through RT-PCR. Second, the pcDNA3.1-HPX recombinant vector was constructed, and HPX gene cloning was confirmed with colony PCR, restriction digestion, and DNA sequencing. Third, CHO cells were transfected with linearized pcDNA3.1-HPX, and the CHO-HPX cellular population was enriched under the selective pressure of G418 sulfate. Finally, RT-PCR and Western blot analyses confirmed the stable expression of human rHPX at both transcriptional and translational levels.
Since human rHPX bears extensive human-specific glycosylation, mammalian expression systems, such as HEK293 or CHO cell lines, could be suitable hosts to provide sufficient post-translational modifications to afford heme binding and expected rHPX bioactivity (
15). The CHO cell line is the premier expression host for therapeutic protein production due to its adaptability to various culture conditions, plasticity in terms of genetic alterations (
18) and human-like glycosylation (
24).
In a pioneering work during the early 1990s, Satoh et al. expressed human rHPX using different expression systems. Their initial attempts to express human HPX in an
E. coli system produced a non-glycosylated protein with no heme-binding ability (
15). Protein expression in prokaryotic system is associated with challenges such as limited eukaryotic post-translational machinery function, protein aggregation, and generation of inclusion bodies (
33). Therefore, re-solubilization and refolding of recombinant polypeptide chains are required, leading to reduced quality and unexpected biological activity of the final proteins (
34).
However, using baculovirus vector expression system, Satoh et al. were able to express human rHPX with 55 kDa molecular weight (MW) that was less than expected (60 kDa) (
15). It should be noted that protein expression in insect cells is associated with some limitations. The decreased molecular mass of the rHPX is probably due to the N-glycosylation deficient system of insect cells (
35). Besides, it is necessary to include a signal sequence, such as melittin peptide (
15) along with the transgene in baculovirus vector, in order to render the rHPX protein secretory (
35). Moreover, since baculovirus-contaminated insect cells are cultured in Serum-Free Media (SFM), the secreted proteins are highly exposed to proteolysis (35).
Bakker et al. exploited Pichia pastoris expression system to express human rHPX. Their research resulted in a 85-kDa rHPX (
16) that was more than plasma HPX MW. This could be attributed to the hyper-glycosylation ability of
P. pastoris expression system. Human HPX receives O-linked oligosaccharides composed of a variety of sugars including N-acetylgalactosamine, galactose, and sialic acid. In contrast,
P. pastoris only performs high mannosylation. This limits the pharmaceutical use of secreted proteins due to the exceeding immunogenicity of the recombinant drug upon intravenous administration (
36).
Although different studies reported various molecular weights for human rHPX due to different levels of glycosylation, the results of this research are consistent with human HPX being the molecule involved. This does not mean, however, that CHO expression system necessarily produced an identical isoform of HPX as compared with plasma-derived HPX. This needs further investigations with regards to rHPX structural and functional properties.
In contrast to the previous studies, the primers used in this study were designed in such a way that the forward primer contained the kozak sequence (5'-A/GNNATGG-3') in order to promote rHPX translation efficiency in CHO cells, which is considered as an advantage of this research.
Additionally, in this research, the rHPX PCR product was cloned in the pcDNA3.1(+) shuttle vector, which contains both the ampicillin and neomycin resistant genes along with strong CMV promoter (
37). Thus, it could eliminate the sub-cloning step leading to cost-effectiveness of the procedure and saving of time. However, in Bakker’s study, the rHPX PCR product was first cloned in pCRII-TOPO cloning vector, and then, sub-cloned in pPICZaA expression vector (
16) with AOX-1 promoter and zeocin resistant gene (
38).
Furthermore, successful transfection is influenced by the type of transfection reagent and the duration of transfection. Satoh et al. used Lipofectin transfection reagent based on cationic liposomes (
15), while in Bakker’s study,
P. pastoris strain GS115 was transfected with hemopexin/pPICZaA construct using electroporation (
16). Herein, the CHO cells were transfected using x-tremeGENE HP DNA transfection reagent that is highly compatible with mammalian cell line and suitable for both transient and stable transfection. It produces the least cytotoxicity or change in cellular morphology after transfection (
39). Although recent studies have shown that the condensation of DNA in cationic liposomes and/or the overall positive charges of the cationic liposome/DNA complex enhance gene delivery, their mechanism of action still remains to be elucidated (
40). Other factors, such as the health and viability of the cells, the quality of the nucleic acid used and the presence or absence of serum could also play a part.
Expression of functional, recombinant human glycoproteins often requires mammalian expression systems. In order to frequently express a recombinant protein, it will be best to generate a stable cell line instead of performing repeated transient transfections in mammalian cells (
41). It is noteworthy that stable cell lines often lose their protein expression with time, due to the heterogeneity of the transfected cell population (
41). Therefore, in this research, screening for CHO-HPX and picking up single colonies of G418-resistant cells led to obtaining an even more homogenous population of successfully-transfected CHO cells, which was further expanded.
It is expected for a large-scale stable expression of rHPX in an efficient mammalian cell line to provide an increased source of rHPX to be clinically employed upon blood transfusion in order to supplement the depleted level of HPX in hemolytic patients and reduce their heme-related complications.
To date, little has been done regarding rHPX expression, in particular the human type. In this study, a stable CHO cell line capable of expressing human rHPX was established, which raises many questions and perspectives for further investigations. Undoubtedly, future research is recommended in terms of increasing rHPX expression rate in CHO cells using vectors containing matrix attachment regions (MAR) or ubiquitous chromatin opening element (UCOE) (
25), rHPX purification by chromatography, protein characterization, and in vivo studies in murine models to further improve the understanding of rHPX biological activities and therapeutic roles for future clinical settings.