Autoantibodies (aAbs) have yielded productive venues for both diagnostics (eg. tumor‐associated antigens, TAAs) and therapeutics (eg. engineered drug conjugated TAAs). The paradigm for TAAs are intracellular or cell‐surface cancer cell components that are either overexpressed, expressed in a novel location, or have an altered structure or sequence that yields an immunogenic response. Another group of cancer‐relevant aAbs are directed against host proteins yet influence tumor progression and either predate the cancer and/or have arisen in response to comorbid conditions. The paradigm for this is an activating aAb against angiotensin II type 1 receptor (AT1R). This G protein coupled receptor is expressed by many cell types. In addition to a classic role in homeostatic regulation of blood pressure, AT1R activation has been implicated in altering tissue remodeling, wound repair, inflammation, energy metabolism, and thrombosis ‐ processes dysregulated in the setting of cancer. AT1RaAbs whose epitope maps to extracellular loop 2 significantly associated with levels of markers for apoptosis (sFas, sFasL), macrophage activation (neopterin, chitotriosidase) and inflammation (pro‐inflammatory cytokines) when serum from normal or lung cancer subjects was analyzed by ELISA. High serum levels of AT1RaAb were associated with poor outcomes following treatment. Lung cancer cells treated with isolated AT1RaAbs were analyzed for signaling pathways, cellular proliferation, survival (clonogenic assay following methotrexate challenge) and invasiveness (Boyden chamber assay). The data are consistent with (a) AT1RaAb binding of target receptors and constitutively activating NFkB‐dependent chronic inflammatory/remodeling state promoting tumor progression, and (b) serum AT1aAb levels being predictive of disease recurrence.
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