U.S. patent application number 11/588973 was filed with the patent office on 2007-06-28 for compositions and methods for the treatment and prevention of fibrotic, inflammatory and neovascularization conditions.
Invention is credited to William A. Garland, Roger A. Sabbadini, Glenn L. Stoller.
Application Number | 20070148168 11/588973 |
Document ID | / |
Family ID | 38006397 |
Filed Date | 2007-06-28 |
United States Patent
Application |
20070148168 |
Kind Code |
A1 |
Sabbadini; Roger A. ; et
al. |
June 28, 2007 |
Compositions and methods for the treatment and prevention of
fibrotic, inflammatory and neovascularization conditions
Abstract
The present invention relates to compositions and methods for
prevention and treatment of diseases and conditions, including
ocular diseases and conditions, characterized by aberrant
fibrogenesis or scarring, inflammation and/or aberrant
neovascularization or angiogenesis. The compositions and methods of
the invention utilize immune-derived moieties that are specifically
reactive against bioactive lipids and which are capable of
decreasing the effective concentration of said bioactive lipid. In
some embodiments, the immune-derived moiety is a monoclonal
antibody that is reactive against sphingosine-1-phosphate (S1P) or
lysophosphatidic acid (LPA).
Inventors: |
Sabbadini; Roger A.;
(Lakeside, CA) ; Garland; William A.; (San
Clemente, CA) ; Stoller; Glenn L.; (Long Island,
NY) |
Correspondence
Address: |
BIOTECHNOLOGY LAW GROUP;C/O PORTFOLIOIP
PO BOX 52050
MINNEAPOLIS
MN
55402
US
|
Family ID: |
38006397 |
Appl. No.: |
11/588973 |
Filed: |
October 27, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11261935 |
Oct 28, 2005 |
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11588973 |
Oct 27, 2006 |
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Current U.S.
Class: |
424/133.1 |
Current CPC
Class: |
A61P 29/00 20180101;
C07K 2317/92 20130101; A61P 9/10 20180101; A61P 37/06 20180101;
A61P 37/02 20180101; C07K 2317/73 20130101; A61P 3/10 20180101;
A61P 31/22 20180101; C07K 2317/24 20130101; A61K 31/685 20130101;
A61P 17/00 20180101; A61P 27/02 20180101; C07K 2317/76 20130101;
C07K 16/3076 20130101; A61K 2039/505 20130101; A61P 43/00 20180101;
C07K 16/18 20130101; A61P 33/00 20180101 |
Class at
Publication: |
424/133.1 |
International
Class: |
A61K 39/395 20060101
A61K039/395 |
Claims
1. A method of decreasing or preventing aberrant fibrogenesis,
fibrosis or scarring of the eye of an animal comprising
administering to said animal an immune-derived moiety reactive
against a bioactive lipid, wherein said immune-derived moiety is
capable of decreasing the effective concentration of said bioactive
lipid.
2. The method of claim 1 wherein said immune-derived moiety is a
monoclonal antibody or a fragment, variant or a derivative
thereof.
3. The method of claim 1 wherein the bioactive lipid is a
lysolipid.
4. The method of claim 3 wherein the lysolipid is S1P or LPA or a
variant thereof.
5. The method of claim 2 wherein said immune-derived moiety is a
monoclonal antibody which is reactive against S1P or LPA or a
variant thereof.
6. The method of claim 1 wherein the animal is a human.
7. A method of modulating surgical and traumatic wound healing
responses of the eye of an animal comprising administering to said
animal an immune-derived moiety reactive against a bioactive lipid,
wherein said immune-derived moiety is capable of decreasing the
effective concentration of said bioactive lipid.
8. The method of claim 7 wherein said immune-derived moiety is a
monoclonal antibody or a fragment, variant or a derivative
thereof.
9. The method of claim 7 wherein the bioactive lipid is a
lysolipid.
10. The method of claim 9 wherein the lysolipid is S1P or LPA or a
variant thereof.
11. The method of claim 8 wherein said immune-derived moiety is a
monoclonal antibody which is reactive against S1P or LPA or a
variant thereof.
12. The method of claim 7 wherein the animal is a human.
13. A method of decreasing or preventing inflammation of the eye of
an animal comprising administering to said animal an immune-derived
moiety reactive against a bioactive lipid, wherein said
immune-derived moiety is capable of decreasing the effective
concentration of said bioactive lipid.
14. The method of claim 13 wherein said immune-derived moiety is a
monoclonal antibody or a fragment, variant or a derivative
thereof.
15. The method of claim 13 wherein the bioactive lipid is a
lysolipid.
16. The method of claim 15 wherein the lysolipid is S1P or LPA or a
variant thereof.
17. The method of claim 14 wherein said immune-derived moiety is a
monoclonal antibody which is reactive against S1P or LPA or a
variant thereof.
18. The method of claim 13 wherein the animal is a human.
19. A method of decreasing or preventing aberrant
neovascularization of the eye of an animal comprising administering
to said animal an immune-derived moiety reactive against a
bioactive lipid, wherein said immune-derived moiety is capable of
decreasing the effective concentration of said bioactive lipid.
20. The method of claim 19 wherein said immune-derived moiety is a
monoclonal antibody or a fragment, variant or a derivative
thereof.
21. The method of claim 19 wherein the bioactive lipid is a
lysolipid.
22. The method of claim 21 wherein the lysolipid is S1P or LPA or a
variant thereof.
23. The method of claim 20 wherein said immune-derived moiety is a
monoclonal antibody which is reactive against S1P or LPA or a
variant thereof.
24. The method of claim 19 wherein the animal is a human.
25. A method for attenuating an ocular immune response in an animal
comprising administering to said animal an immune-derived moiety
reactive against a bioactive lipid, wherein said immune-derived
moiety is capable of decreasing the effective concentration of said
bioactive lipid.
26. The method of claim 25 wherein said immune-derived moiety is a
monoclonal antibody or a fragment, variant or a derivative
thereof.
27. The method of claim 25 wherein the bioactive lipid is a
lysolipid.
28. The method of claim 27 wherein the lysolipid is S1P or LPA or a
variant thereof.
29. The method of claim 26 wherein said immune-derived moiety is a
monoclonal antibody which is reactive against S1P or LPA or a
variant thereof.
30. The method of claim 25 wherein the animal is a human.
31. A method for decreasing the effective ocular concentration or
activity of bioactive lipid in an animal comprising administering
to said animal an immune-derived moiety reactive against a
bioactive lipid, wherein said immune-derived moiety is capable of
decreasing the effective concentration of said bioactive lipid.
32. The method of claim 31 wherein said immune-derived moiety is a
monoclonal antibody or a fragment, variant or a derivative
thereof.
33. The method of claim 31 wherein the bioactive lipid is a
lysolipid.
34. The method of claim 33 wherein the lysolipid is S1P or LPA or a
variant thereof.
35. The method of claim 32 wherein said immune-derived moiety is a
monoclonal antibody which is reactive against S1P or LPA or a
variant thereof.
36. The method of claim 31 wherein the animal is a human.
37. A method of treating an ocular disease or condition in a
subject comprising administering to said subject a pharmaceutical
composition comprising an immune-derived moiety reactive against a
bioactive lipid, wherein said immune-derived moiety is capable of
decreasing the effective concentration of said bioactive lipid.
38. The method of claim 37 wherein said immune-derived moiety is a
monoclonal antibody or a fragment, variant or a derivative
thereof.
39. The method of claim 37 wherein the bioactive lipid is a
lysolipid.
40. The method of claim 39 wherein the lysolipid is S1P or LPA or a
variant thereof.
41. The method of claim 38 wherein said immune-derived moiety is a
monoclonal antibody which is reactive against S1P or LPA or a
variant thereof.
42. The method of claim 37 wherein the subject is a human
subject.
43. The method of claim 37 wherein the ocular disease or condition
is characterized, at least in part, by aberrant fibrogenesis,
fibrosis, or scarring.
44. The method of claim 43 wherein the ocular disease or condition
characterized, at least in part, by aberrant fibrogenesis, fibrosis
or scarring is selected from the group consisting of age-related
macular degeneration, diabetic retinopathy, retinopathy of
prematurity, sickle cell retinopathy, ischemic retinopathies,
retinal venous occlusive disease, macular pucker, cellophane
retinopathy, ERM formation, contact lens overwear, tractional
retinal detachment, proliferative vitreoretinopathy, traumatic
injury, ocular cicatricial pemphigoid, Stevens Johnson Syndrome,
toxic epidermal necrolysis, pterygium, and consequences of ocular
surgery, including refractive surgery, vitrectomy and glaucoma
surgery.
45. The method of claim 37 wherein the ocular disease or condition
is an inflammatory or immunologic condition.
46. The method of claim 45 wherein the inflammatory or immunologic
condition is selected from the group consisting of age-related
macular degeneration, uveitis, vitritis, infections, including
herpes simplex infection, herpes zoster infection and protozoan
infection; corneal graft rejection and ocular histoplasmosis.
47. The method of claim 37 wherein the ocular disease or condition
is characterized, at least in part, by aberrant
neovascularization.
48. The method of claim 47 wherein the ocular disease or condition
characterized, at least in part, by aberrant neovascularization is
selected from the group consisting of age-related macular
degeneration, diabetic retinopathy, retinopathy of prematurity,
corneal graft rejection, neovascular glaucoma, contact lens
overwear, infections of the cornea, including herpes simplex
infection, herpes zoster infection and protozoan infection;
pterygium, ischemic retinopathy, retinal venous occlusive disease,
infectious uveitis, chronic retinal detachment, laser injury,
sickle cell retinopathy, venous occlusive disease, choroidal
neovascularization, retinal angiomatous proliferation, and
idiopathic polypoidal choroidal vasculopathy.
49. The method of claim 37 wherein the immune-derived moiety is
administered systemically, topically, by intravitreal or periocular
injection, iontophoresis, spray or drops, or as part of an in situ
gel, ocular insert, corneal shield or contact lens, liposome,
niosome/discome, mucoadhesive system, lyophilized carrier system,
particulate, submicron emulsion, dendrimer, microsphere,
nanosphere, or collasome, or combination thereof.
50. The method of claim 37 wherein the immune-derived moiety is
modified, unmodified, or provided as a prodrug, with or without
enhancers and/or penetration enhancers.
51. A pharmaceutical composition comprising an immune-derived
moiety reactive against a bioactive lipid, in a pharmaceutically
acceptable carrier.
52. The pharmaceutical composition of claim 51 which is suitable
for use in and/or on the eye.
53. The pharmaceutical composition of claim 51 where the
pharmaceutical composition comprises phosphate-buffered saline.
54. A method of treating scleroderma in a subject comprising
administering to said subject a pharmaceutical composition
comprising an immune-derived moiety reactive against a bioactive
lipid, wherein said immune-derived moiety is capable of decreasing
the effective concentration of said bioactive lipid.
55. The method of claim 54 wherein the pharmaceutical composition
is administered systemically, intradermally, subcutaneously,
mucosally, by inhalation or topically.
56. The method of claim 54 wherein the subject is a human subject.
Description
RELATED APPLICATIONS
[0001] This application claims priority to, the benefit of, and
incorporates by reference for all purposes the following
patent-related documents, each in its entirety: U.S. provisional
patent application Ser. No. __/______ [attorney docket no
LPT-3010-PV, entitled "Compositions and Methods for Binding
Sphingosine-1-Phosphate"], and U.S. provisional patent application
Ser. No. __/______ [attorney docket no LPT-3020-PV, entitled
"Humanized Antibodies to Sphingosine-1-Phosphate in the Treatment
of Ocular Disorders"], both filed concurrently with the instant
application; U.S. provisional patent application Ser. No. __/______
[attorney docket no LPT-3100-PV2], filed 12 Aug., 2006, and U.S.
patent application Ser. No. 11/261,935, filed 28 Oct., 2005, of
which this application is a continuation-in-part.
TECHNICAL FIELD
[0002] The present invention relates to methods of treatments for
ocular disorders using immune-derived moieties which are reactive
against bioactive lipid molecules that play role in human and/or
animal disease as signaling molecules. One particular class of
signaling bioactive lipids considered in accordance with the
invention is lysolipids. Particularly preferred signaling
lysolipids are sphingosine-1-phosphate (S1P) and the various
lysophosphatidic acids (LPAs). Antibodies against signaling lipids,
and derivatives and variants thereof, can be used in the treatment
and/or prevention of ocular diseases or disorders through the
delivery of pharmaceutical compositions that contain such
antibodies, alone or in combination with other therapeutic agents
and/or treatments.
BACKGROUND OF THE INVENTION
I. Introduction
[0003] The following description includes information that may be
useful in understanding the present invention. It is not an
admission that any such information is prior art, or relevant, to
the presently claimed inventions, or that any publication
specifically or implicitly referenced is prior art or even
particularly relevant to the presently claimed invention.
II. Background
[0004] The present invention relates to methods of decreasing or
attenuating aberrant neovascularization, angiogenesis, aberrant
fibrogenesis, fibrosis and scarring, and inflammation and immune
responses. These processes, separately or together are involved in
many diseases and conditions. These diseases or conditions may be
systemic or may be relatively localized, for example to the skin or
to the eye.
A. Ocular Diseases and Conditions
[0005] Pathologic or aberrant angiogenesis/neovascularization,
aberrant remodeling, fibrosis and scarring and inflammation occur
in association with retinal and ocular ischemic diseases such as
age-related macular degeneration (AMD), diabetic retinopathy (DR)
and in retinopathy of prematurity (ROP) and other developmental
disorders [Eichler et al. (2006), Curr Pharm Des, vol 12: 2645-60]
as well as being a result of infections and mechanical injury to
the eye [Ciulla et al. (2001), Curr Opin Ophthalmol, vol 12: 442-9
and Dart et al (2003), Eye, vol 17: 886-92].
[0006] Pathologic ocular angiogenesis is a leading cause of
blindness in a variety of clinical conditions. Choroidal
neovascularization (CNV) occurs in a number of ocular diseases, the
most prevalent of which is the exudative or "wet" form of AMD. As a
result of an increasingly aged population, AMD is a modern day
epidemic and the leading cause of blindness in the western world in
patients over age 60. Despite the epidemic of vision loss caused by
AMD, only a few therapies, mostly anti-VEGF based, can slow the
progression of AMD and even fewer can reverse vision loss [Bylsma
and Guymer (2005), Clin Exp Optom,. vol 88: 322-34, Gryziewicz
(2005), Adv Drug Deliv Rev, vol 57: 2092-8 and Liu and Regillo
(2004), Curr Opin Ophthalmol, vol 15: 221-6.]. Therefore,
discovering new treatments for pathologic neovascularization is
extremely important.
[0007] AMD is used here solely for illustrative purposes in
describing ocular conditions relating to aberrant
angiogenesis/neovascularization, aberrant remodeling, fibrosis and
scarring, and inflammation, which conditions are found in other
ocular diseases and disorders as disclosed and claimed herein. AMD
involves age-related pathologic changes [Tezel, Bora and Kaplan
(2004), Trends Mol Med, vol 10: 417-20 and Zarbin (2004), Arch
Ophthalmol, 122: 598-614]. Multiple theories exist but, the exact
etiology and pathogenesis of AMD are still not well understood.
Aging is associated with cumulative oxidative injury, thickening of
Bruch's membrane and drusen formation. Oxidative stress results in
injury to retinal pigment epithelial (RPE) cells and, in some
cases, the choriocapillaris [Zarbin (2004), Arch Ophthalmol, vol
122: 598-614 and Gorin et al. (1999), Mol Vis,. vol 5: 29]. Injury
to RPE likely elicits a chronic inflammatory response within Bruchs
membrane and the choroid [Johnson et al. (2000), Exp Eye Res,. vol
70: 441-9]. This injury and inflammation fosters and potentates
retinal damage by stimulating CNV and atrophy [Zarbin (2004), Arch
Ophthalmol, vol 122: 598-614 and Witmer et al. (2003), Prog Retin
Eye Res, vol 22: 1-29]. CNV results in defective and leaky blood
vessels (BV) that are likely to be recognized as a wound [Kent and
Sheridan (2003), Mol Vis, vol 9: 747-55]. Wound healing arises from
the choroid and invades the subretinal space through Bruchs
membrane and the RPE. Wound healing responses are characterized by
a typical early inflammation response, a prominent angiogenic
response and tissue formation followed by end-stage maturation of
all involved elements. Wound remodeling may irreversibly compromise
photoreceptors and RPEs thereby, justifying the need to treat CNV
with more than anti-angiogenic therapies [La Cour, Kiilgaard and
Nissen (2002), Drugs Aging, vol 19: 101-33.12].
[0008] Alterations in the normal retinal and sub-retinal
architecture as a result of CNV related fibrosis, edema and
inflammation individually or cumulatively, leads to AMD related
visual loss [Tezel and Kaplan (2004), Trends Mol Med, vol 10:
417-20 and Ambati et al. (2003), Surv Ophthalmol, vol 48: 257-93].
The multiple cellular and cytokine interactions which are
associated with exudative AMD greatly complicate the search for
effective treatments. While CNV and edema are manageable in part by
anti-VEGF therapeutics, potential treatments to mitigate scar
formation and inflammation have not been adequately addressed
[Bylsma and Guymer (2005), Clin Exp Optom, vol 88: 322-34 and
Pauleikhoff (2005), Retina, vol 25: 1065-84]. As long as the
neovascular complex remains intact, as appears to be the case in
patients treated with anti-VEGF agents, the potential for
subretinal fibrosis and future vision loss persists.
[0009] Anti-VEGF-A therapies represent a recent, significant
advance in the treatment of exudative AMD. However, the phase III
VISION Trial with PEGAPTANIB, a high affinity aptamer which
selectively inhibits the 165 isoform of VEGF-A, demonstrated that
the average patient continues to lose vision and only a small
percent gained vision [Gragoudas et al. (2004), N Engl J Med, vol
351: 2805-16]. Inhibition of all isoforms of VEGF-A (pan-VEGF
inhibition) with the antibody fragment RANIBIZUMAB yielded much
more impressive results [Brown et al. N Eng Med, 2006 355:1432-44,
Rosenfeld et al. N Eng J Med 2006355:1419-31]. The 2 year MARINA
trial and the 1 year ANCHOR trial demonstrated that approximately
40% of patients achieve some visual gain. Although these results
represent a major advance in our ability to treat exudative AMD,
they also demonstrate that 60% of patients do not have visual
improvement. Furthermore, these patients had to meet strictly
defined inclusion and exclusion criteria. The results in a larger
patient population may be less robust.
[0010] There is still a well defined need to develop further
therapeutic agents that target other steps in the development of
CNV and the processes that ultimately lead to photoreceptor
destruction. First, the growth of choroidal BVs involves an
orchestrated interaction among many mediators, not just VEGF,
offering an opportunity to modulate or inhibit the entire process
[Gragoudas et al. (2004), N Engl J Med, vol 351: 2805-16]. Second,
exudative AMD is comprised of vascular and extravascular
components. The vascular component involves vascular endothelial
cells (EC), EC precursors and pericytes. The extravascular
component, which volumetrically appears to be the largest
component, is composed of inflammatory, glial and retinal pigment
epithelium (RPE) cells and fibroblasts. Tissue damage can result
from either component. These other aspects of the pathologic
process are not addressed by current anti-VEGF treatments.
Targeting additional elements of the angiogenic cascade associated
with AND could provide a more effective and synergistic approach to
therapy [Spaide RF (2006), Am J Ophthalmol, vol 141: 149-156].
1. Inflammation in Ocular Disease
[0011] There is increasing evidence that inflammation, specifically
macrophages and the complement system [Klein et al. (2005),
Science, vol 308: 385-9 and Hageman et al. (2005), Proc Natl Acad
Sci USA, vol 102: 7227-32] play an important role in the
pathogenesis of exudative AMD. Histopathology of surgically excised
choroidal neovascular membranes demonstrates that macrophages are
almost universally present [Grossniklaus, et al. (1994),
Ophthalmology, vol 101: 1099-111 and Grossniklaus et al. (2002),
Mol Vis, vol 8: 119-26]. There is mounting evidence that
macrophages may play an active role in mediating CNV formation and
propagation [Grossniklaus et al. (2003), Mol Vis, vol 8: 119-26;
Espinosa-Heidmann, et al. (2003), Invest Ophthalmol Vis Sci, vol
44: 3586-92; Oh et al. (1999), Invest Ophthalmol Vis Sci, vol 40:
1891-8; Cousins et al. (2004), Arch Ophthalmol, vol 122: 1013-8;
Forrester (2003), Nat Med, vol 9: 1350-1 and Tsutsumi et al.
(2003), J Leukoc Biol, vol 74: 25-32] by multiple effects which
include secretion of enzymes that can damage cells and degrade
Bruchs membrane as well as release pro-angiogenic cytokines [Otani
et al. (1999), Ophthalmol Vis Sci, vol 40: 1912-20 and Amin, Puklin
and Frank (1994), Invest Ophthalmol Vis Sci, vol 35: 3178-88] At
the site of injury, macrophages exhibit micro-morphological signs
of activation, such as degranulation [Oh et al. (1999), Invest
Ophthalmol Vis Sci, vol 40: 1891-8 and Trautmann et al. (2000), J
Pathol, vol 190: 100-6]. Thus it is believed that a molecule which
limited macrophage infiltration into to the choroidal neovascular
complex may help limit CNV formation.
2. Choroidal Neovascularization and Blood Vessel Maturation in
Ocular Disease
[0012] Angiogenesis is an essential component of normal wound
healing as it delivers oxygen and nutrients to inflammatory cells
and assists in debris removal [Lingen (2001), Arch Pathol Lab Med,
vol 125: 67-71]. Progressive angiogenesis is composed of two
distinct processes: Stage I: Migration of vascular ECs, in response
to nearby stimuli, to the tips of the capillaries where they
proliferate and form luminal structures; and Stage II: Pruning of
the vessel network and optimization of the vasculature [Guo et al.
(2003), Am J Pathol, vol 162: 1083-93].
[0013] Stage I: Neovascularization. Angiogenesis most often aids
wound healing. However, new vessels when uncontrolled, are commonly
defective and promote leakage, hemorrhaging and inflammation.
Diminishing dysfunctional and leaky BVs, by targeting
pro-angiogenic GFs, has demonstrated some ability to slow the
progression of AMD [Pauleikhoff (2005), Retina, vol 25: 1065-84.14
and van Wijngaarden, Coster and Williams (2005), JAMA, vol
293:1509-13].
[0014] Stage II: Blood vessel maturation and drug desensitization.
Pan-VEGF inhibition appears to exert its beneficial effect mostly
via an anti-permeability action resulting in resolution of intra-
and sub-retinal edema, as the actual CNV lesion does not markedly
involute [Presentation. at Angiogenesis 2006 Meeting. 2006. Bascom
Palmer Eye Institute Miami, Fla.]. The lack of marked CNV
involution may in part be a result of maturation of the newly
formed vessels due to pericyte coverage. Pericytes play a critical
role in the development and maintenance of vascular tissue. The
presence of pericytes seems to confer a resistance to anti-VEGF
agents and compromise their ability to inhibit angiogenesis
[Bergers and Song (2005), Neuro-oncol, vol 7: 452-64; Yamagishi and
Imaizumi (2005), Int J Tissue React, vol 27: 125-35; Armulik,
Abramsson and Betsholtz (2005), Circ Res, vol 97: 512-23; Ishibashi
et al. (1995), Arch Ophthalmol, vol 113: 227-31]. An agent which
has an inhibitory effect on pericyte recruitment would likely
disrupt vascular channel assembly and the maturation of the
choroidal neovascular channels thereby perpetuating their
sensitivity to anti-angiogenic agents.
[0015] Remodeling of the vascular network involves adjustments in
BV density to meet nutritional needs [Gariano and Gardner (2005),
Nature, 438: 960-6]. Periods of BV immaturity corresponds to a
period in which new vessels are functioning but have not yet
acquired a pericyte coating [Benjamin, Hemo and Keshet (1998),
Development, 125: 1591-8 and Gerhardt and Betsholtz (2003), Cell
Tissue Res, 2003. 314: 15-23]. This delay is essential in providing
a window of plasticity for the fine tuning of the developing
vasculature according to the nutritional needs of the retina or
choroid.
[0016] The bioactive lipid sphingosine-1-phosphate (S1P), VEGF,
PDGF, angiopoietins (Ang). and other growth factors (GF) augment
blood vessel growth and recruit smooth muscle cells (SMC) and
pericytes to naive vessels which promote the remodeling of emerging
vessels [Allende and Proia (2002), Biochim Biophys Acta, vol 582:
222-7; Gariano and Gardner (2005), Nature, vol 438: 960-6;
Grosskreutz et al. (1999), Microvasc Res, vol 58: 128-36;
Nishishita, and Lin (2004), J Cell Biochem, vol 91: 584-93 and
Erber et al. (2004), FASEB J, vol 18: 338-40.32]. Pericytes, most
likely generated by in situ differentiation of mesenchymal
precursors at the time of EC sprouting or from the migration and
de-differentiation of arterial smooth muscle cells, intimately
associate and ensheath ECs resulting in overall vascular maturity
and survival [Benjamin, Hemo and Keshet (1998), Development, vol
125: 1591-8]. Recent studies have demonstrated that S1P, and the
S1P1 receptor, are involved in cell-surface trafficking and
activation of the cell-cell adhesion molecule N-cadherin [Paik et
al. (2004), Genes Dev, vol 18: 2392-403]. N-cadherin is essential
for interactions between EC, pericytes and mural cells which
promote the development of a stable vascular bed [Gerhardt and
Betsholtz (2003), Cell Tissue Res, vol 314: 15-23]. Global deletion
of the S1P1 gene results in aberrant mural cell ensheathment of
nascent BVs required for BV stabilization during embryonic
development [Allende and Proia (2002), Biochim Biophys Acta, vol
1582: 222-7]. Local injection of siRNA to S1P1 suppresses vascular
stabilization in tumor xenograft models [Chae et al. (2004), J Clin
Invest, vol 114: 1082-9]. Transgenic mouse studies have
demonstrated that VEGF and PDGF-B promote the maturation and
stabilization of new BVs [Guo et al. (2003), Am J Pathol, 162:
1083-93 and Gariano and Gardner (2005), Nature, vol 438: 960-6.50].
VEGF up-regulates Ang-1 (mRNA and protein) [Asahara et al. (1998),
Circ Res, vol 83: 233-40]. Ang-1 plays a major role in recruiting
and sustaining peri-endothelial support by pericytes [Asahara et
al. (1998), Circ Res, vol 83: 233-40]. Intraocular injection of
VEGF accelerated pericyte coverage of the EC plexus [Benjamin, Hemo
and Keshet (1998), Development, vol 125: 1591-8]. PDGF-B deficient
mouse embryos lack micro-vascular pericytes, which leads to edema,
micro-aneurisms and lethal hemorrhages [Lindahl et al. (1997),
Science, vol 277: 242-5]. Murine pre-natal studies have
demonstrated that additional signals are required for complete
VEGF- and PDGF-stimulation of vascular bed maturation. Based upon
the trans-activation of S1P noted above, this factor could be S1P
[Erber et al. (2004), FASEB J, vol 18: 338-40]. Vessel
stabilization and maturation is associated with a loss of
plasticity and the absence of regression to VEGF and other GF
withdrawal and resistance to anti-angiogenic therapies [Erber et
al. (2004), FASEB J, vol 18: 338-40 and Hughes. and Chan-Ling
(2004), Invest Ophthalmol Vis Sci, vol 45: 2795-806]. Resistance of
BVs to angiogenic inhibitors is conferred by pericytes that
initially stabilize matured vessels and those that are recruited to
immature vessels upon therapy [Erber et al. (2004), FASEB J, vol
18: 338-40]. After ensheathment of the immature ECs, the pericytes
express compensatory survival factors (Ang-1 and PDGF-B) that
protect ECs from pro-apoptotic agents.
3. Edema and Vascular Permeability
[0017] CNV membranes are composed of fenestrated vascular ECs that
tend to leak their intravascular contents into the surrounding
space resulting in subretinal hemorrhage, exudates and fluid
accumulation [Gerhardt and Betsholtz (2003), Cell Tissue Res, vol
14: 15-23]. For many years the CNV tissue itself, and more recently
intra-retinal neovascularization, have been implicated as being
responsible for the decrease in visual acuity associated with AMD.
It is now thought however, that macular edema caused by an increase
in vascular permeability (VP) and subsequent breakdown of the blood
retinal barrier (BRB), plays a major role in vision loss associated
with AMD and other ocular diseases [Hughes and Chan-Ling (2004),
Invest Ophthalmol Vis Sci, vol 45: 2795-806; Felinski and Antonetti
(2005), Curr Eye Res, vol 30: 949-57; Joussen et al. (2003), FASEB
J, vol 17: 76-8 and Strom et al. (2005), Invest Ophthalmol Vis Sci,
vol 46: 3855-8].
4. Fibrosis, Fibrogenesis and Scar Formation
[0018] The formation of subretinal fibrosis leads to irreversible
damage to the photoreceptors and permanent vision loss. As long as
the neovascular complex remains intact, as appears to be the case
in patients treated with anti-VEGF agents, the potential for
subretinal fibrosis and future vision loss persists. In an update
of the PRONTO study of RANIBIZUMAB, it was discovered that those
patients who lost vision did so as a result of either subretinal
fibrosis or a RPE tear [Presentation. at Angiogenesis 2006 Meeting.
2006. Bascom Palmer Eye Institute Miami, Fla.]. An agent that could
diminish the degree of fibroblast infiltration and collagen
deposition would likely be of value.
[0019] Fibroblasts, particularly myofibroblasts, are key cellular
elements in scar formation in response to cellular injury and
inflammation [Tomasek et al. (2002), Nat Rev Mol Cell Biol, vol 3:
349-63 and Virag and Murry (2003), Am J Pathol, vol 163: 2433-40].
Collagen gene expression by myofibroblasts is a hallmark of
remodeling and necessary for scar formation [Sun and Weber (2000),
Cardiovasc Res, vol 46: 250-6 and Sun and Weber (1996), J Mol Cell
Cardiol, vol 28: 851-8]. S1P promotes wound healing by activating
fibroblast migration and proliferation while increasing collagen
production [Sun et al. (1994), J Biol Chem, vol 269: 16512-7]. S1P
produced locally by damaged cells could be responsible for the
maladaptive wound healing associated with remodeling and scar
formation. Thus it is believed that S1P inhibitors are useful in
diseases or conditions characterized, at least in part, by aberrant
fibrogenesis or fibrosis. Herein, "fibrogenesis" is defined as
excessive activity or number of fibroblasts, and "fibrosis" is
defined as excessive activity or number of fibroblasts that leads
to excessive or inappropriate collagen production and scarring,
destruction of the physiological tissue structure and/or
inappropriate contraction of the matrix leading to such pathologies
as retinal detachment or other processes leading to impairment of
organ function.
B. Other Diseases or Conditions
[0020] The role of bioactive signaling lipids such as S1P and LPA
is not limited to ocular diseases and conditions. Because of the
involvement of biolipid signaling in many processes, including
neovascularization, angiogenesis, aberrant fibrogenesis, fibrosis
and scarring, and inflammation and immune responses, it is believed
that antibody-based inhibitors of these bioactive lipids will be
helpful in a variety of diseases and conditions associated with one
or more of these processes. Such diseases and conditions may be
systemic (e.g., systemic scleroderma) or localized to one or more
specific body parts or organ s (e.g., skin, lung, or eye).
C. Bioactive Signaling Lipids
[0021] Lipids and their derivatives are now recognized as important
targets for medical research, not as just simple structural
elements in cell membranes or as a source of energy for
.beta.-oxidation, glycolysis or other metabolic processes. In
particular, certain bioactive lipids function as signaling
mediators important in animal and human disease. Although most of
the lipids of the plasma membrane play an exclusively structural
role, a small proportion of them are involved in relaying
extracellular stimuli into cells. "Lipid signaling" refers to any
of a number of cellular signal transduction pathways that use cell
membrane lipids as second messengers, as well as referring to
direct interaction of a lipid signaling molecule with its own
specific receptor. Lipid signaling pathways are activated by a
variety of extracellular stimuli, ranging from growth factors to
inflammatory cytokines, and regulate cell fate decisions such as
apoptosis, differentiation and proliferation. Research into
bioactive lipid signaling is an area of intense scientific
investigation as more and more bioactive lipids are identified and
their actions characterized.
[0022] Examples of bioactive lipids include the eicosanoids
(including the cannabinoids, leukotrienes, prostaglandins,
lipoxins, epoxyeicosatrienoic acids, and isoeicosanoids),
non-eicosanoid cannabinoid mediators, phospholipids and their
derivatives such as phosphatidic acid (PA) and phosphatidylglycerol
(PG), platelet activating factor (PAF) and cardiolipins as well as
lysophospholipids such as lysophosphatidyl choline (LPC) and
various lysophosphatidic acids (LPA). Bioactive signaling lipid
mediators also include the sphingolipids such as sphingomyelin,
ceramide, ceramide-1-phosphate, sphingosine, sphingosylphosphoryl
choline, sphinganine, sphinganine-1-phosphate (Dihydro-S1P) and
sphingosine-1-phosphate. Sphingolipids and their derivatives
represent a group of extracellular and intracellular signaling
molecules with pleiotropic effects on important cellular processes.
Other examples of bioactive signaling lipids include
phosphatidylserine (PS), phosphatidylinositol (PI),
phosphatidylethanolamine (PEA), diacylglyceride (DG), sulfatides,
gangliosides, and cerebrosides.
D. Lysolipids
[0023] Lysophospholipids (LPLs), also known as lysolipids, are low
molecular weight (typically less than about 500 dalton) lipids that
contain a single hydrocarbon backbone and a polar head group
containing a phosphate group. Some lysolipids are bioactive
signaling lipids. Two particular examples of medically important
bioactive lysolipids are LPA (glycerol backbone) and S1P (sphingoid
backbone). The structures of selected LPAs, S1P, and dihydro S1P
are presented below. ##STR1## ##STR2##
[0024] LPA is not a single molecular entity but a collection of
endogenous structural variants with fatty acids of varied lengths
and degrees of saturation (Fujiwara et al (2005), J Biol Chem, vol.
280: 35038-35050). The structural backbone of the LPAs is derived
from glycerol-based phospholipids such as phosphatidylcholine (PC)
or phosphatidic acid (PA). In the case of lysosphingolipids such as
S1P, the fatty acid of the ceramide backbone is missing. The
structural backbone of S1P, dihydro S1P (DHS1P), and
sphingosylphosphorylcholine (SPC) is based on sphingosine, which is
derived from sphingomyelin.
[0025] LPA and S1P regulate various cellular signaling pathways by
binding to the same class of multiple transmembrane domain G
protein-coupled (GPCR) receptors (Chun J, Rosen H (2006), Current
Pharm Des, vol. 12: 161-171 and Moolenaar WH (1999), Experimental
Cell Research, vol. 253: 230-238). The S1P receptors are designated
as S1P.sub.1, S1P.sub.2, S1P.sub.3, S1P.sub.4 and S1P.sub.5
(formerly EDG-1, EDG-5/AGR16, EDG-3, EDG-6 and EDG-8) and the LPA
receptors designated as LPA.sub.1, LPA.sub.2, LPA.sub.3 (formerly,
EDG-2, EDG-4, and EDG-7). A fourth LPA receptor of this family has
been identified for LPA (LPA.sub.4), and other putative receptors
for these lysophospholipids have also been reported.
E. Sphingosine-1-phosphate
[0026] S1P is a mediator of cell proliferation and protects from
apoptosis through the activation of survival pathways (Maceyka et
al. (2002), BBA, vol 1585): 192-201 and Spiegel S. et al. (2003),
Nature Reviews Molecular Cell Biology, vol 4: 397-407). It has been
proposed that the balance between ceramide/sphingosine (CER/SPH)
levels and S1P provides a rheostat mechanism that decides whether a
cell is directed into the death pathway or is protected from
apoptosis. The key regulatory enzyme of the rheostat mechanism is
sphingosine kinase (SPHK) whose role is to convert the
death-promoting bioactive signaling lipids (CER/SPH) into the
growth-promoting S1P. S1P has two fates: S1P can be degraded by S1P
lyase, an enzyme that cleaves S1P to phosphoethanolamine and
hexadecanal, or, less common, hydrolyzed by S1P phosphatase to SPH.
S1P is abundantly generated and stored in platelets, which contain
high levels of SPHK and lacks the enzymes for S1P degradation. When
platelets are activated, S1P is secreted. In addition, other cell
types, for example, mast cells, are also believed to be capable of
secreting S1P. Once secreted, S1P is thought to be bound at high
concentrations on carrier proteins such as serum albumin and
lipoproteins. S1P is found in high concentrations in plasma, with
concentrations in the range of 0.5-5 uM having been reported.
Though primarily extracellular, intracellular actions of S1P have
also been suggested (see, eg, Spiegel S, Kolesnick R (2002),
Leukemia, vol. 16: 1596-602; Suomalainen, et al (2005), Am J
Pathol, vol. 166: 773-81).
[0027] Widespread expression of the cell surface S1P receptors
allows S1P to influence a diverse spectrum of cellular responses,
including proliferation, adhesion, contraction, motility,
morphogenesis, differentiation, and survival. This spectrum of
response appears to depend upon the overlapping or distinct
expression patterns of the S1P receptors within the cell and tissue
systems. In addition, crosstalk between S1P and growth factor
signaling pathways, including platelet-derived growth factor
(PDGF), vascular endothelial growth factor (VEGF), transforming
growth factor beta (TGF.beta.) and basic fibroblastic growth factor
(bFGF), have recently been demonstrated (see, e.g., Baudhuin, et al
(2004), FASEB J, vol. 18: 341-3). Because regulation of various
cellular processes involving S1P has particular impact on neuronal
signaling, vascular tone, wound healing, immune cell trafficking,
reproduction, and cardiovascular function, among others, it is
believed that alterations of endogenous levels of S1P within these
systems can have detrimental effects, eliciting several
pathophysiologic conditions, including cancer, heart failure,
ocular disease and infectious and autoimmune diseases. We propose
that a potentially effective strategy for treating CNV associated
with AMD is to reduce the biologically available extracellular
levels of S1P. The applicants have developed a murine monoclonal
antibody (SPHINGOMAB.TM., anti-S1P mAb) that is specific for S1P.
SPHINGOMAB represents the first successfully created monoclonal
antibody against a bioactive signaling sphingolipid target.
SPHINGOMAB acts as a molecular sponge to selectively absorb S1P
from the extracellular fluid, lowering the effective concentration
of S1P. It selectively binds and neutralizes S1P with picomolar
affinity in biologic matrices. We propose that SPHINGOMAB would
deprive fibroblasts, pericytes, and endothelial, inflammatory and
immune cells in the eye of important growth and survival factors
thus targeting the multiple maladaptive steps of AMD resulting in
the loss of photoreceptors and visual acuity. A therapeutic that
simultaneously targets multiple components of the choroidal
neovascular response has the potential to be a more potent
therapeutic than "single-target" therapeutics.
[0028] As used herein, "sphingosine-1-phosphate" or "S1P" refers to
sphingosine-1-phosphate [sphingene-1-phosphate;
D-erythro-sphingosine-1-phosphate; sphing-4-enine-1-phosphate;
(E,2S,3R)-2-amino-3-hydroxy-octadec-4-enoxy]phosphonic acid;
CAS
[0029] 26993-30-6] and its variants, S1P and DHS1P (dihydro
sphingosine-1-phosphate [sphinganine-1-phosphate;
[(2S,3R)-2-amino-3-hydroxy-octadecoxy]phosphonic acid;
D-Erythro-dihydro-D-sphingosine-1-phosphate;CAS 19794-97-9] and
sphingosylphosphorylcholine. "Variants" of S1P and LPA, as used
herein, includes analogs and derivatives of S1P and LPA,
respectively, which function similarly, or might be expected to
function similarly, to the parent molecule.
[0030] Growing evidence suggests that S1P could contribute to both
the early and late stages of maladaptive retinal remodeling
associated with exudative AMD. S1P has a pronounced non-VEGF
dependent pro-angiogenic effect. S1P also stimulates migration,
proliferation and survival of multiple cell types, including
fibroblasts, EC, pericytes and inflammatory cells--the same cells
that participate in the multiple maladaptive processes of exudative
AMD. S1P is linked to the production and activation of VEGF, bFGF,
PDGF and other growth factors (GFs) implicated in the pathogenesis
of exudative AMD. Finally, S1P may modulate the maturation of naive
vasculature, a process leading to a loss of sensitivity to
anti-angiogenic agents. Inhibiting the action of S1P could be an
effective therapeutic treatment for exudative AMD that may offer
significant advantages over exclusively anti-VEGF approaches or may
act synergistically with them to address the complex processes and
multiple steps that ultimately lead to AMD associated visual
loss.
[0031] There is growing evidence that S1P is an important mediator
of inflammatory events [Olivera and Rivera (2005), J Immunol,. vol
174: 1153-8]. Activated platelets, neutrophils, macrophages and
mast cells serve as rich sources of S1P after coagulation and
inflammatory events [Yatomi et al. (2000) Blood, vol 96: 3431-8].
Because these cells are important components in the inflammation
response and tissue loss, S1P may regulate these events via control
of inflammatory cell function [Tezel (2004), Trends Mol Med, vol
10: 417-20]. S1P released from mast cells is responsible for many
of the responses in experimental animal models of inflammation
[Jolly et al. (2004), J Exp Med,. vol 199: 959-70 and Jolly et al.
(2005), Blood, vol 105: 4736-42]. Neutralizing S1P with SPHINGOMAB
could provide an effective, novel means of limiting the deleterious
inflammatory response that exacerbates ocular tissue damage of CNV
associated with AMD.
[0032] Several lines of evidence suggest that S1P, and S1P's
complement of receptors, may play a major regulatory role in the
angiogenic process [Allende and Proia 2002), Biochim Biophys Acta,.
vol 1582: 222-7; Spiegel (1993), J. Lipid Med,.vol 8: 169-175 and
Argraves et al. (2004), J Biol Chem, vol 279: 50580-90]. First, S1P
stimulates DNA synthesis and chemotactic motility of local and bone
marrow-derived vascular EC to sites of vascularization, while
inducing differentiation of multicellular structures consistent
with early BV formation [Lee et al. (1999), Biochem Biophys Res
Commun, vol 264: 743-325 and Annabi, et al (2003), Exp Hematology,.
vol 31: 640-649]. Second, S1P stimulates the formation and
maintenance of vascular EC assembly and integrity by activating
both S1P.sub.1 and S1P.sub.3, and S1P-induced EC adherent junction
assembly [Paik et al. (2004), Genes Dev, vol 18: 2392-403 and Lee
et al. (1999), Cell, vol 99: 301-12]. Antisense oligonucleotides
against these S1P receptors diminish S1P-induced vascular EC
assembly and cell barrier integrity [English, et al. (1999), J
Hematother Stem Cell Res, vol 8: 627-34 and Lee et al. (2001), Mol
Cell, vol 8: 693-704]. Third, capillary tube formation induced by
S1P has been demonstrated to be a more potent pro-angiogenic
stimulus than bFGF or VEGF [Wang et al. (1999), J. Biol. Chem., vol
274: 35343-50 and Lee et al. (1999), Biochem Biophys Res Commun,
vol 264: 743-325]. Finally, it has been shown that S1P elicits a
synergic effect with VEGF, EGF, PDGF, bFGF and IL-8 to promote the
development of vascular networks in vivo [Wang et al. (1999), J
Biol. Chem., vol 274: 35343-50]. S1P trans-activates EGF and VEGF2
receptors [Tanimoto, Jin and Berk (2002), J Biol Chem, vol 277:
42997-3001] and VEGF up-regulates S1P receptors [Igarashi et al.
(2003), Proc Natl Acad Sci USA, vol 100: 10664-9]. Treatment of
vascular ECs with VEGF markedly induces the up-regulation of S1P1
expression and enhances S1P-mediated signaling pathways leading to
the activation of the endothelial isoform of nitric oxide synthase
(eNOS) [Lee et al. (2001), Mol Cell, vol 8: 693-704 and Tanimoto,
Jin and Berk (2002), J Biol Chem, vol 277: 42997-3001 and Igarashi
and Michel (2001), J Biol Chem, vol 276: 36281-8]. eNOS activity
plays a crucial role in different cellular responses and essential
vascular functions, including inhibition of apoptosis, inhibition
of platelet aggregation and angiogenesis [Kwon et al. (2001), J
Biol Chem, vol 276: 10627-33; Huang (2003), Curr Hypertens Rep, vol
5: 473-80; Dantas, Igarashi Michel (2003), Am J Physiol Heart Circ
Physiol, vol 284: H2045-52; Rkitake et al. (2002), Arterioscler
Thromb Vasc Biol, vol 22: 08-114 and Kimura and Esumi (2003), Acta
Biochim Pol, vol 50: 49-59]. Vascular structures resulting from the
exposure to both bFGF and S1P were more differentiated that those
obtained from the exposure to bFGF alone suggesting that S 1P may
be required for the full activity of bFGF and VEGF [English et al.
(2000), FASEB J, vol 14: 2255-65.].
[0033] Thus, SPHINGOMAB may mitigate aberrant BV growth by
neutralizing synergistic pro-angiogenic GFs and possibly S1P
produced in excess during metabolic stress from inflammatory cells
associated with CNV. SPHINGOMAB not only inhibits S1P-induced EC
migration/infiltration and BV formation, but it also neutralizes
bFGF and VEGF-induced vascularization through its effect on S1P.
SPHINGOMAB has a potential advantage over "single-target"
therapeutics because of its ability to neutralize S1P, which
results in neutralization of multiple GFs via the pleiotropic
effects of S1P.
[0034] Direct neutralization of S1P and an indirect neutralization
of VEGF and PDGF-B by SPHINGOMAB could prevent pericyte
recruitment, BV maturation and slow the development of resistance
to anti-angiogenic drugs. Targeting pericytes, in the effort to
extended or increase vulnerability to anti-angiogenic agents,
represents an attractive long-term approach in treating patients
presenting with active CNV lesions and could promote involution of
vascular complexes [Erber et al. (2004), FASEB J, vol 18:
338-40].
[0035] S1P aids in the organization of actin into cortical rings
and strengthens both intracellular and cell-matrix adherence
[McVerry and Garcia (2005), Cell Signal, vol 17: 131-9 and McVerry
and Garcia (2004), J Cell Biochem, vol 92: 1075-85]. These
structural changes correlate with decreased vascular permeability
[Hla (2004), Semin Cell Dev Biol, vol 15: 513-20]. It has been
demonstrated that blocking the function of S1P increased vascular
permeability in kidneys, the pulmonary system and tumors
[LaMontagne et al. (2006), Cancer Res, vol 66: 221-31; Sanchez et
al. (2003), J Biol Chem, vol 278: 47281-90 and Awad et al. (2006),
Am J Physiol Renal Physiol, vol 290: F1516-24]. Little is known
however, about the permeability effects of S1P in different organ
systems such as the brain and eye. Conduit ECs in the brain, and
likely the eye, form tighter, less permeable barriers to fluid and
solute than pulmonary artery ECs [Schnitzer et al. (1994), Biochem
Biophys Res Commun, vol 199: 11-19] and most likely than kidney and
tumors as well. Differential barrier functions have been attributed
to a significantly greater population of focal adhesion complexes
[Schnitzer et al. (1994), Biochem Biophys Res Commun, vol 199:
11-19]. In light of these differences, S1P-induced alterations in
ocular vascular permeability may be less influential.
[0036] VEGF and PDGF can compromise blood-retinal barrier (BRB)
integrity: SPHINGOMAB's ability to neutralize S1P trans-activation
of VEGF and PDGF could prove effective in mitigating macular edema
associated with AMD [Sanchez et al. (2003), J Biol Chem, vol 278:
47281-90; Saishin et al. (2003), J Cell Physiol, vol 195: 241-8 and
Vinores et al. (2000), Gen Pharmacol, vol 35: 233-9]. Transgenic
mice overexpressing VEGF demonstrate a BRB breakdown occurring in
the area of CNV similar to that seen in AMD and diabetic
retinopathies [Vinores et al. (2000), Adv Exp Med Biol, vol 476:
129-38]. Inhibitors of PDGF receptor kinase decreased leakage
caused by prostaglandin-induced breakdown of the BRB [Lindahl et
al. (1997), Science, vol 277: 242-5]. Finally, SPHINGOMAB mitigates
the effects of bFGF and VEGF in vivo as assayed in a murine
Matrigel plug model as described in the examples of this
application.
[0037] S1P and fibroblast proliferation and protection from cell
death: Fibroblasts respond to S1P treatment by an increase in DNA
synthesis; fibroblasts transfected with Sphingosine Kinase 1
(sphK1) exhibit increased cellular proliferation [Hammer et al.
(2004), J Cell Biochem, vol 91: 840-51]. Similar to the effects of
S1P on several other fibroblast types (Swiss 3T3, lung and
cardiac), S1P may stimulate ocular fibroblast proliferation (and
subsequent differentiation). Fibroblasts are directly protected
from apoptosis by addition of S1P, and apoptosis is enhanced by
inhibitors of sphK1 [Olivera et al. (1999), J Cell Biol, vol 147:
545-58]. S1P blocks cytochrome C release and subsequent caspase
activation [Olivera et al. (1999), J Cell Biol, vol 147: 545-58 and
Kang et al. (2004), Cell Death Differ, vol 11: 1287-98]. It is
established that sphK1 upregulates Akt, thereby regulating Bcl-2
family members [Limaye et al. (2005), Blood, vol 105: 3169-77] and
protecting fibroblasts from apoptosis.
[0038] S1P and fibroblast migration: S1P activates signaling
systems including Rho, resulting in the assembly of contractile
actin filaments controlled by Rho/Rac/Cdc42 system, and leading to
substantial effects on cellular migration [Radeff-Huang et al.
(2004), J Cell Biochem,. Vol 92: 949-66]. The activation of Rho and
Rho GTPases by S1P may be responsible for the migration of ocular
fibroblasts into the wound and thereby contribute to fibrosis.
[0039] S1P and fibroblast collagen expression: S1P promotes the
differentiation of quiescent fibroblasts to active myofibroblasts
which exhibit enhanced collagen expression during scar formation
[Urata et al. (2005), Kobe J Med Sci, vol 51: 17-27]. Concurrent
with the proliferation and migration of fibroblasts into the
scarring zone, myofibroblasts deposit a temporary granular network
consisting primarily of osteopontin and fibronectin [Sun and Weber
(2000), Cardiovasc Res, vol 46: 250-6]. As remodeling proceeds, the
temporary matrix is absorbed and a collagen network established
[Sun and Weber (2000), Cardiovasc Res, vol 46: 250-6]. We have
demonstrated that S1P promotes collagen production by
myofibroblasts. TGF.beta., a well-known fibrotic mediator, has been
shown to up-regulate several pro-fibrotic proteins, convert
fibroblasts to myofibroblasts and stimulate inflammatory protein
expression possibly through the action of S1P [Squires et al.
(2005); J Mol Cell Cardiol, vol 39: 699-707 and Butt, Laurent and
Bishop (1995), Eur J Cell Biol, vol 68: 330-5]. Up-regulation of
TIMP1, a signaling molecule implicated in TGF.beta.-stimulated
differentiation of fibroblasts to myofibroblasts, is blocked by
siRNA against sphK1 [Yamanaka et al J Biol Chem. 2004 Dec. 24;
279(52):53994-4001., suggesting that SPHINGOMAB could mitigate the
profibrotic effects of TGF.beta. as well as mitigating the
fibrogenic effects of S1P itself. Minimizing maladaptive scar
formation by neutralization of S1P could be beneficial and prevent
irreversible losses in visual acuity by limiting the extent of
sub-retinal fibrosis and subsequent photoreceptor damage.
F. Lysophosphatic Acids (LPA)
[0040] LPA have long been known as precursors of phospholipid
biosynthesis in both eukaryotic and prokaryotic cells, but LPA have
emerged only recently as signaling molecules that are rapidly
produced and released by activated cells, notably platelets, to
influence target cells by acting on specific cell-surface receptor
(see, eg, Moolenaar et al. (2004), BioEssays, vol. 26: 870-881 and
van Leewen et al. (2003), Biochem Soc Trans, vol 31: 1209-1212).
Besides being synthesized and processed to more complex
phospholipids in the endoplasmic reticulum, LPA can be generated
through the hydrolysis of pre-existing phospholipids following cell
activation; for example, the sn-2 position is commonly missing a
fatty acid residue due to de-acylation, leaving only the sn-3
hydroxyl esterified to a fatty acid. Moreover, a key enzyme in the
production of LPA, autotaxin (lysoPLD/NPP2), may be the product of
an oncogene, as many tumor types up-regulate autotaxin (Brindley
(2004), J Cell Biochem, vol. 92: 900-12). The concentrations of LPA
in human plasma and serum have been reported, including
determinations made using sensitive and specific LC/MS procedures
(Baker et al. (2001), Anal Biochem, vol 292: 287-295). For example,
in freshly prepared human serum allowed to sit at 25.degree. C. for
one hour, LPA concentrations have been estimated to be
approximately 1.2 .mu.M, with the LPA analogs 16:0, 18:1, 18:2, and
20:4 being the predominant species. Similarly, in freshly prepared
human plasma allowed to sit at 25.degree. C. for one hour, LPA
concentrations have been estimated to be approximately 0.7 .mu.M,
with 18:1 and 18:2 LPA being the predominant species.
[0041] LPA influence a wide range of biological responses,
including induction of cell proliferation, stimulation of cell
migration and neurite retraction, gap junction closure, and even
slime mold chemotaxis (Goetzl. et al. (2002), Scientific World
Journal, vol 2: 324-338). The body of knowledge about the biology
of LPA continues to grow as more and more cellular systems are
tested for LPA responsiveness. For instance, it is now known that,
in addition to stimulating cell growth and proliferation, LPA
promote cellular tension and cell-surface fibronectin binding,
which are important events in wound repair and regeneration
(Moolenaar et al. (2004), BioEssays, vol. 26: 870-881). Recently,
anti-apoptotic activity has also been ascribed to LPA, and it has
recently been reported that peroxisome proliferation receptor gamma
is a receptor/target for LPA (Simon et al. (2005), J Biol Chem, vol
280: 14656-14662).
[0042] Recently, the applicants have developed several monoclonal
antibodies against the LPAs. Like the anti-S1P antibody, the
anti-LPA antibodies can neutralize various LPAs and mitigate their
biologic and pharmacologic action. For application to ocular
disease and conditions, the anti-LPA antibodies would be expected
to act on the following processes for therapeutic benefit.
[0043] CNV and BV maturation: Autotaxin, a secreted
lysophospholipase D responsible for producing LPAs, is essential
for blood vessel formation during development [van Meeteren et al.
(2006), Mol Cell Biol, vol 26: 5015-22]. In addition, unsaturated
LPAs were identified as major contributors to the induction of
vascular smooth muscle cell dedifferentiation [Hayashi et al.
(2001), Circ Res, vol 89: 251-8].
[0044] Edema and vascular permeability: LPA induces plasma
exudation and histamine release in mice [Hashimoto et al. (2006), J
Pharmacol Sci, vol 100: 82-7].
[0045] Inflammation: LPA acts as inflammatory mediator in human
corneal epithelial cells [Zhang et al (2006), Am J Physiol, June
7]. LPA participates in corneal wound healing [Liliom K et al
(1998), Am. J. Physiol, vol 274: C1065-C1074] and stimulates the
release of ROS in lens tissue [Rao et al. (2004), Molecular
Visions, vol 10: 112-121]. LPA can also re-activate HSV-1 in rabbit
cornea [Martin et al. (1999), Molecular Visions, vol 5: 36-42}.
[0046] Fibrosis and scar formation: LPA inhibits TGF.beta.-mediated
stimulation of type I collagen mRNA stability via an ERK-dependent
pathway in dermal fibroblasts [Sato et al. (2004), Matrix Biol, vol
23: 353-61]. Moreover, LPA have some direct fibrogenic effects by
stimulating collagen gene expression and proliferation of
fibroblasts [Chen, et al. (2006) FEBS Lett. 580(19):4737-45.
3. Definitions.
[0047] Before describing the instant invention in detail, several
terms used in the context of the present invention will be defined.
In addition to these terms, others are defined elsewhere in the
specification, as necessary. Unless otherwise expressly defined
herein, terms of art used in this specification will have their
art-recognized meanings.
[0048] An "immune-derived moiety" refers to any polyclonal or
monoclonal antibody or antibody fragment, variant, or
derivative.
[0049] An "anti-S1P antibody" or an "immune-derived moiety reactive
against S1P" refers to any antibody or antibody-derived molecule
that binds S1P.
[0050] An "anti-LPA antibody" or an "immune-derived moiety reactive
against LPA" refers to any antibody or antibody-derived molecule
that binds to all or one or more of the LPAs.
[0051] A "bioactive lipid" refers to a lipid signaling molecule. In
general, a bioactive lipid does not reside in a biological membrane
when it exerts its signaling effects, which is to say that while
such a lipid species may exist at some point in a biological
membrane (for example, a cell membrane, a membrane of a cell
organelle, etc.), when associated with a biological membrane it is
not a "bioactive lipid" but is instead a "structural lipid"
molecule. Bioactive lipids are distinguished from structural lipids
(e.g., membrane-bound phospholipids) in that they mediate
extracellular and/or intracellular signaling and thus are involved
in controlling the function of many types of cells by modulating
differentiation, migration, proliferation, secretion, survival, and
other processes. In vivo, bioactive lipids can be found in
extracellular fluids, where they can be complexed with other
molecules, for example serum proteins such as albumin and
lipoproteins, or in "free" form, i.e., not complexed with another
molecule species. As extracellular mediators, some bioactive lipids
alter cell signaling by activating membrane-bound ion channels or
G-protein coupled receptors that, in turn, activate complex
signaling systems that result in changes in cell function or
survival. As intracellular mediators, bioactive lipids can exert
their actions by directly interacting with intracellular components
such as enzymes and ion channels. Representative examples of
bioactive lipids include LPA and S1P.
[0052] The term "therapeutic agent" means an agent to mitigate
angiogenesis and/or neovascularization, e.g., CNV and BV
maturation; edema, vascular permeability and fibrosis, fibrogenesis
and scarring associated with, or part of the underlying pathology
of, ocular diseases and conditions.
[0053] The term "combination therapy" refers to a therapeutic
regimen that involves the provision of at least two distinct
therapies to achieve an indicated therapeutic effect. For example,
a combination therapy may involve the administration of two or more
chemically distinct active ingredients, for example, an anti-LPA
antibody and an anti-S 1P antibody. Alternatively, a combination
therapy may involve the administration of an immune-derived moiety
reactive against a bioactive lipid and the administration of one or
more other chemotherapeutic agents. Combination therapy may,
alternatively, involve administration of an anti-lipid antibody
together with the delivery of another treatment, such as radiation
therapy and/or surgery. Further, a combination therapy may involve
administration of an anti-lipid antibody together with one or more
other biological agents (e.g.,anti-VEGF, TGFP, PDG.beta., or bFGF
agent), chemotherapeutic agents and another treatment such as
radiation and/or surgery. In the context of combination therapy
using two or more chemically distinct active ingredients, it is
understood that the active ingredients may be administered as part
of the same composition or as different compositions. When
administered as separate compositions, the compositions comprising
the different active ingredients may be administered at the same or
different times, by the same or different routes, using the same of
different dosing regimens, all as the particular context requires
and as determined by the attending physician. Similarly, when one
or more anti-lipid antibody species, for example, an anti-LPA
antibody, alone or in conjunction with one or more chemotherapeutic
agents are combined with, for example, radiation and/or surgery,
the drug(s) may be delivered before or after surgery or radiation
treatment.
[0054] "Monotherapy" refers to a treatment regimen based on the
delivery of one therapeutically effective compound, whether
administered as a single dose or several doses over time.
[0055] A "patentable" composition, process, machine, or article of
manufacture according to the invention means that the subject
matter satisfies all statutory requirements for patentability at
the time the analysis is performed. For example, with regard to
novelty, non-obviousness, or the like, if later investigation
reveals that one or more claims encompass one or more embodiments
that would negate novelty, non-obviousness, etc., the claim(s),
being limited by definition to "patentable" embodiments,
specifically exclude the unpatentable embodiment(s). Also, the
claims appended hereto are to be interpreted both to provide the
broadest reasonable scope, as well as to preserve their validity.
Furthermore, the claims are to be interpreted in a way that (1)
preserves their validity and (2) provides the broadest reasonable
interpretation under the circumstances, if one or more of the
statutory requirements for patentability are amended or if the
standards change for assessing whether a particular statutory
requirement for patentability is satisfied from the time this
application is filed or issues as a patent to a time the validity
of one or more of the appended claims is questioned.
[0056] The term "pharmaceutically acceptable salt" refers to salts
which retain the biological effectiveness and properties of the
agents and compounds of this invention and which are not
biologically or otherwise undesirable. In many cases, the agents
and compounds of this invention are capable of forming acid and/or
base salts by virtue of the presence of charged groups, for
example, charged amino and/or carboxyl groups or groups similar
thereto. Pharmaceutically acceptable acid addition salts may be
prepared from inorganic and organic acids, while pharmaceutically
acceptable base addition salts can be prepared from inorganic and
organic bases. For a review of pharmaceutically acceptable salts
(see Berge, et al. (1977) J. Pharm. Sci., vol. 66, 1-19).
[0057] The terms "separated," "purified," "isolated," and the like
mean that one or more components of a sample contained in a
sample-holding vessel are or have been physically removed from, or
diluted in the presence of, one or more other sample components
present in the vessel. Sample components that may be removed or
diluted during a separating or purifying step include, chemical
reaction products, unreacted chemicals, proteins, carbohydrates,
lipids, and unbound molecules.
[0058] The term "species" is used herein in various contexts, e.g.,
a particular species of chemotherapeutic agent. In each context,
the term refers to a population of molecules, chemically
indistinguishable from each other, of the sort referred in the
particular context.
[0059] "Specifically associate" and "specific association" and the
like refer to a specific, non-random interaction between two
molecules, which interaction depends on the presence of structural,
hydrophobic/hydrophilic, and/or electrostatic features that allow
appropriate chemical or molecular interactions between the
molecules.
[0060] Herein, "stable" refers to an interaction between two
molecules (eg, binding of an anti-LPA or anti-S1P antibody to its
target bioactive lipid) that is sufficiently strong such that the
molecules can be maintained for the desired purpose or
manipulation.
[0061] A "subject" or "patient" refers to an animal in which
treatment can be effected by molecules of the invention. The animal
may have, be at risk for, or be believed to have or be at risk for
a disease or condition that can be treated by compositions and/or
methods of the present invention. Animals that can be treated in
accordance with the invention include vertebrates, with mammals
such as bovine, canine, equine, feline, ovine, porcine, and primate
(including humans and non-human primates) animals being
particularly preferred examples.
[0062] A "therapeutically effective amount" (or "effective amount")
refers to an amount of an active ingredient, e.g., an agent
according to the invention, sufficient to effect treatment when
administered to a subject or patient. Accordingly, what constitutes
a therapeutically effective amount of a composition according to
the invention may be readily determined by one of ordinary skill in
the art. In the context of ocular therapy, a "therapeutically
effective amount" is one that produces an objectively measured
change in one or more parameters associated with treatment of the
ocular disease or condition including an increase or decrease in
the expression of one or more genes correlated with the ocular
disease or condition, induction of apoptosis or other cell death
pathways, clinical improvement in symptoms, a decrease in aberrant
neovascularization or in inflammation, etc. Of course, the
therapeutically effective amount will vary depending upon the
particular subject and condition being treated, the weight and age
of the subject, the severity of the disease condition, the
particular compound chosen, the dosing regimen to be followed,
timing of administration, the manner of administration and the
like, all of which can readily be determined by one of ordinary
skill in the art. It will be appreciated that in the context of
combination therapy, what constitutes a therapeutically effective
amount of a particular active ingredient may differ from what
constitutes a therapeutically effective amount of the active
ingredient when administered as a monotherapy (ie., a therapeutic
regimen that employs only one chemical entity as the active
ingredient).
[0063] The term "treatment" or "treating" of a disease or disorder
includes preventing or protecting against the disease or disorder
(that is, causing the clinical symptoms not to develop); inhibiting
the disease or disorder (i.e., arresting or suppressing the
development of clinical symptoms; and/or relieving the disease or
disorder (i.e., causing the regression of clinical symptoms). As
will be appreciated, it is not always possible to distinguish
between "preventing" and "suppressing" a disease or disorder since
the ultimate inductive event or events may be unknown or latent.
Accordingly, the term "prophylaxis" will be understood to
constitute a type of "treatment" that encompasses both "preventing"
and "suppressing." The term "treatment" thus includes
"prophylaxis".
[0064] The term "therapeutic regimen" means any treatment of a
disease or disorder using chemotherapeutic drugs, radiation
therapy, surgery, gene therapy, DNA vaccines and therapy,
antisense-based therapies including siRNA therapy, anti-angiogenic
therapy, immunotherapy, bone marrow transplants, aptamers and other
biologics such as antibodies and antibody variants, receptor decoys
and other protein-based therapeutics.
SUMMARY OF THE INVENTION
[0065] In accordance with the present invention, methods are
provided for treating ocular diseases or conditions through
administration of a pharmaceutical composition comprising an
immune-derived moiety (e.g, an antibody) reactive against a
bioactive lipid, in order to decrease the effective concentration
so that the bioactive lipid is inhibited in whole or in part from
eliciting its undesired effects. In some embodiments, the
immune-derived moiety is a monoclonal antibody or fragment, variant
or derivative thereof. In some embodiments, the immune-derived
moiety is reactive against a lysolipid, such as S1P or LPA. Methods
are also provided for decreasing or preventing aberrant
fibrogenesis, fibrosis or scarring; inflammation; or aberrant
neovascularization; modulating surgical and traumatic wound healing
responses of the eye; or for attenuating an ocular immune response.
Further provided are methods for decreasing the effective ocular
concentration or activity of bioactive lipid. Also provided are
methods of treating scleroderma using an immune-derived moiety
reactive against a bioactive lipid, such as the lysolipids S1P or
LPA. Representative bioactive lipids include sphingolipids and
variants thereof such as sphingosine-1-phosphate (S1P),
sphingosine, sphingosylphosphorylcholine, dihydrosphingosine. Other
bioactive lysolipids include lysophosphatidic acids (LPAs) and
variants thereof.
[0066] Another aspect of the invention concerns pharmaceutical or
veterinary compositions, including those for ocular administration,
that comprise a carrier and an isolated immune-derived moiety, for
example, a monoclonal antibody or antibody fragment, variant, or
derivative, reactive against a bioactive lipid. Preferred carriers
include those that are pharmaceutically acceptable, particularly
when the composition is intended for therapeutic use in humans. For
non-human therapeutic applications (e.g., in the treatment of
companion animals, livestock, fish, or poultry), veterinarily
acceptable carriers may be employed.
[0067] Exemplary routes of administration of an immune-derived
moiety according to the invention, preferably as part of a
therapeutic composition, include systemic administration,
parenteral administration (e.g., via injection via an intravenous,
intramuscular, or subcutaneous route), transdermal, intradermal or
transmucosal delivery, intraocular or periocular injection, mucosal
or topical administration or by inhalation.
[0068] These and other aspects and embodiments of the invention are
discussed in greater detail in the sections that follow.
BRIEF DESCRIPTION OF THE DRAWINGS
[0069] This patent application contains at least one figure
executed in color. Copies of this patent application with color
drawing(s) will be provided upon request and payment of the
necessary fee.
[0070] FIG. 1: SPHINGOMAB reduced CNV and scar formation in ocular
lesions. Mice were treated with SPHINGOMAB or an isotype-matched
non-specific mAb. CNV lesions were induced by laser rupture of
Bruchs membrane. Shown are graphs and representative images of
lesions from each treatment group stained with rhodamine-conjugated
R. communis agglutinin I for vascularization (A) or Masson's
Trichrome for collagen scar formation (B). FIG. 1a shows that
SPHINGOMAB dramatically attenuates choroidal neovascularization 14
and 28 days after laser-induced rupture of Bruch's membrane. FIG.
1b shows that SPHINGOMAB significantly reduces fibrosis associated
with CNV lesion formation 28 days after laser-induced rupture of
Bruchs's membrane.
[0071] FIG. 2: S1P promotes neovascularization through induction of
HUVECs tube formation and migration and is reduced by SPHINGOMAB.
Panel A: Micrographs of HUVECs seeded on Matrigel and incubated for
6 hrs to evaluate tube formation. Panel B: HUVECs were treated with
1 .mu.M S1P.+-.SPHINGOMAB (1 .mu.g/ml) for 6 hrs in a Matrigel
invasion chamber. The number of cells that migrated to the Matrigel
membrane were counted in 5 independent fields.
[0072] FIG. 3. SPHINGOMAB neutralizes S1P-, VEGF- and bFGF-induced
neovascularization. A: Representative FITC-stained BVs from
sections of Matrigel plugs .+-.GFs. B: S1P stimulates EC
infiltration. C: Quantification of relative fluorescence from
Matrigel plugs stimulated with VEGF or bFGF as an indicator of
neovascularization. S1P, VEGF and bFGF's effects were inhibited
when mice were systemically treated with 1 or 25 mg/kg of
SPHINGOMAB.
[0073] FIG. 4. SPHINGOMAB neutralized S1P-stimulated scar
formation. Fibroblasts were serum-starved and then treated with 0,
0.1, 0.5 or 1 .mu.M S1P+/-1 .mu.g/mL SPHINGOMAB for 12-24 hrs. S1P
stimulated Swiss 3T3 fibroblast proliferation as measured by
3H-thymidine incorporation (A), murine cardiac fibroblast migration
in a scratch assay (B), collagen gene expression (relative
fluorescence) in isolated cardiac fibroblasts from transgenic mice
expressing collagen-GFP (C) and WI-38 cell differentiation into
myofibroblasts as measured by decreased cellular proliferation and
increased .alpha.-SMA expression (D); SPHINGOMAB neutralized each
of S1P's effects. SPHINGOMAB reduced perivascular fibrosis in vivo
in a murine model of a permanent myocardial infarction (E).
[0074] FIG. 5. S1P promotes transformation of ocular epithelial
cells and fibroblasts into contractile, scar tissue-producing
myofibroblasts. The effects of S1P on myofibroblast transformation
of several human ocular cell lines were examined. S1P was found to
stimulate production of .alpha.-Smooth muscle actin (.alpha.-SMA; a
myofibroblast marker) in human retinal pigmented epithelial cells
(FIG. 5A) and human conjunctiva fibroblasts (FIG. 5B). These data
demonstrate for the first time, that S1P is among the factors that
promote transformation of ocular epithelial cells and fibroblasts
into contractile, scar tissue-producing myofibroblasts. The effects
of S1P on expression of plasminogen activator inhibitor (PAI-1) in
human conjunctiva fibroblasts were also examined. Increased PAI-1
expression correlates with a decrease in the proteolytic
degradation of connective tissue and is upregulated in association
with several fibrotic diseases that involve increased scaning. As
shown in FIG. 5C, S1P stimulates the PAI-1 expression in a
dose-dependent manner.
[0075] FIG. 6. SPHINGOMAB reduced immune-cell wound infiltration in
vivo. Mice were subjected to MI, treated with saline or 25 mg/kg
SPHINGOMAB 48 hrs after surgery and then sacrificed on day 4.
SPHINGOMAB reduced macrophage (A) and mast cell (B) infiltration
into the wound. Data are represented as fold decrease of saline
treated values.
[0076] FIG. 7. SPHINGOMAB is highly specific for S1P. A graph based
on competitive ELISA demonstrates SPHINGOMAB's specificity for S1P
compared to other bioactive lipids. SPHINGOMAB demonstrated no
cross-reactivity to sphingosine (SPH), the immediate metabolic
precursor of S1P or lysophosphatidic acid (LPA), an important
extracellular signaling molecule that is structurally and
functionally similar to S1P. SPHINGOMAB did not recognize other
structurally similar lipids and metabolites, including
ceramide-1-phosphate (C1P), dihydrosphingosine (DH-SPH),
phosphatidyl serine (PS), phosphatidyl ethanolamine (PE), or
sphingomyelin (SM). SPHINGOMAB did cross react with
dihydrosphingosine-1-phosphate (DH-S1P) and, to a lesser extent,
sphingosylphoryl choline (SPC). The affinity (Kd) of SPHINGOMAB for
S1P is <100 pM, much higher than most therapeutic antibodies,
particularly other molecular sponges.
DETAILED DESCRIPTION OF THE INVENTION
1. Compounds
[0077] The term "immune-derived moiety," which includes antibodies
(Ab) or immunoglobulins (Ig), refers to any form of a peptide,
polypeptide derived from, modeled after or encoded by, an
immunoglobulin gene, or a fragment of such peptide or polypeptide
that is capable of binding an antigen or epitope [see, eg,
Immunobiology, 5th Edition, Janeway, Travers, Walport, Shlomchiked.
(editors), Garland Publishing (2001)]. In the present invention,
the antigen is a bioactive lipid molecule. Antibody molecules or
immunoglobulins are large glycoprotein molecules with a molecular
weight of approximately 150 kDa, usually composed of two different
kinds of polypeptide chain. One polypeptide chain, termed the
"heavy" chain (H) is approximately 50 kDa. The other polypeptide,
termed the "light" chain (L), is approximately 25 kDa. Each
immunoglobulin molecule usually consists of two heavy chains and
two light chains. The two heavy chains are linked to each other by
disulfide bonds, the number of which varies between the heavy
chains of different immunoglobulin isotypes. Each light chain is
linked to a heavy chain by one covalent disulfide bond. In any
given naturally occurring antibody molecule, the two heavy chains
and the two light chains are identical, harboring two identical
antigen-binding sites, and are thus said to be divalent, i.e.,
having the capacity to bind simultaneously to two identical
molecules.
[0078] The "light" chains of antibody molecules from any vertebrate
species can be assigned to one of two clearly distinct types, kappa
(k) and lambda (l), based on the amino acid sequences of their
constant domains. The ratio of the two types of light chain varies
from species to species. As a way of example, the average k to l
ratio is 20:1 in mice, whereas in humans it is 2:1 and in cattle it
is 1:20.
[0079] The "heavy" chains of antibody molecules from any vertebrate
species can be assigned to one of five clearly distinct types,
called isotypes, based on the amino acid sequences of their
constant domains. Some isotypes have several subtypes. The five
major classes of immunoglobulin are immunoglobulin M (IgM),
immunoglobulin D (IgD), immunoglobulin G (IgG), immunoglobulin A
(IgA), and immunoglobulin E (IgE). IgG is the most abundant isotype
and has several subclasses (IgG1, 2, 3, and 4 in humans). The Fc
fragment and hinge regions differ in antibodies of different
isotypes, thus determining their functional properties. However,
the overall organization of the domains is similar in all
isotypes.
[0080] The term "variable region" refers to the N-terminal portion
of the antibody molecule or a fragment thereof. In general, each of
the four chains has a variable (V) region in its amino terminal
portion, which contributes to the antigen-binding site, and a
constant (C) region, which determines the isotype. The light chains
are bound to the heavy chains by many noncovalent interactions and
by disulfide bonds and the V regions of the heavy and light chains
pair in each arm of antibody molecule to generate two identical
antigen-binding sites. Some amino acid residues are believed to
form an interface between the light- and heavy-chain variable
domains [see Kabat et al. (1991), Sequences of Proteins of
Immunological Interest, Fifth Edition, National Institute of
Health, Bethesda, Md. and Clothia et al. (1985), J. Mol. Biol, vol
186: 651].
[0081] Of note, variability is not uniformly distributed throughout
the variable domains of antibodies, but is concentrated in three
segments called "complementarity-determining regions" (CDRs) or
"hypervariable regions" both in the light-chain and the heavy-chain
variable domains. The more highly conserved portions of variable
domains are called the "framework region" (FR). The variable
domains of native heavy and light chains each comprise four FR
regions connected by three CDRs. The CDRs in each chain are held
together in close proximity by the FR regions and, with the CDRs
from the other chains, form the antigen-binding site of antibodies
[see Kabat et al. (1991), Sequences of Proteins of Immunological
Interest, Fifth Edition, National Institute of Health, Bethesda,
Md.]. Collectively, the 6 CDRs contribute to the binding properties
of the antibody molecule for the antigen. However, even a single
variable domain (or half of an Fv, comprising only three CDRs
specific for an antigen) has the ability to recognize and bind
antigen [see Pluckthun (1994), in The Pharmacology of Monoclonal
Antibodies, vol. 113, Rosenburg and Moore eds., Springer-Verlag,
New York, pp. 269-315].
[0082] The term "constant domain" refers to the C-terminal region
of an antibody heavy or light chain. Generally, the constant
domains are not directly involved in the binding properties of an
antibody molecule to an antigen, but exhibit various effector
functions, such as participation of the antibody in
antibody-dependent cellular toxicity. Here, "effector functions"
refer to the different physiological effects of antibodies (e.g.,
opsonization, cell lysis, mast cell, basophil and eosinophil
degranulation, and other processes) mediated by the recruitment of
immune cells by the molecular interaction between the Fc domain and
proteins of the immune system. The isotype of the heavy chain
determines the functional properties of the antibody. Their
distinctive functional properties are conferred by the
carboxy-terminal portions of the heavy chains, where they are not
associated with light chains.
[0083] As used herein, "antibody fragment" refers to a portion of
an intact antibody that includes the antigen binding site or
variable regions of an intact antibody, wherein the portion can be
free of the constant heavy chain domains (e.g., CH2, CH3, and CH4)
of the Fc region of the intact antibody. Alternatively, portions of
the constant heavy chain domains (e.g., CH2, CH3, and CH4) can be
included in the "antibody fragment". Examples of antibody fragments
are those that retain antigen-binding and include Fab, Fab',
F(ab')2, Fd, and Fv fragments; diabodies; triabodies; single-chain
antibody molecules (sc-Fv); minibodies, nanobodies, and
multispecific antibodies formed from antibody fragments. By way of
example, a Fab fragment also contains the constant domain of a
light chain and the first constant domain (CH1) of a heavy
chain.
[0084] The term "variant" refers to an amino acid sequence which
differs from the native amino acid sequence of an antibody by at
least one amino acid residue or modification. A native or parent or
wild-type amino acid sequence refers to the amino acid sequence of
an antibody found in nature. "Variant" of the antibody molecule
includes, but is not limited to, changes within a variable region
or a constant region of a light chain and/or a heavy chain,
including the hypervariable or CDR region, the Fc region, the Fab
region, the CH.sub.1 domain, the CH.sub.2 domain, the CH.sub.3
domain, and the hinge region.
[0085] The term "specific" refers to the selective binding of an
antibody to its target epitope. Antibody molecules can be tested
for specificity of binding by comparing binding of the antibody to
the desired antigen to binding of the antibody to unrelated antigen
or analogue antigen or antigen mixture under a given set of
conditions. Preferably, an antibody according to the invention will
lack significant binding to unrelated antigens, or even analogs of
the target antigen. Here, the term "antigen" refers to a molecule
that is recognized and bound by an antibody molecule or
immune-derived moiety that binds to the antigen. The specific
portion of an antigen that is bound by an antibody is termed the
"epitope." A "hapten" refers to a small molecule that can, under
most circumstances, elicit an immune response (i.e., act as an
antigen) only when attached to a carrier molecule, for example, a
protein, polyethylene glycol (PEG), colloidal gold, silicone beads,
and the like. The carrier may be one that also does not elicit an
immune response by itself.
[0086] The term "antibody" is used in the broadest sense, and
encompasses monoclonal, polyclonal, multispecific (e.g.,
bispecific, wherein each arm of the antibody is reactive with a
different epitope or the same or different antigen), minibody,
heteroconjugate, diabody, triabody, chimeric, and synthetic
antibodies, as well as antibody fragments that specifically bind an
antigen with a desired binding property and/or biological
activity.
[0087] The term "monoclonal antibody" (mAb) refers to an antibody,
or population of like antibodies, obtained from a population of
substantially homogeneous antibodies, and is not to be construed as
requiring production of the antibody by any particular method. For
example, monoclonal antibodies can be made by the hybridoma method
first described by Kohler and Milstein (1975), Nature, vol 256:
495-497, or by recombinant DNA methods.
[0088] The term "chimeric" antibody (or immunoglobulin) refers to a
molecule comprising a heavy and/or light chain which is identical
with or homologous to corresponding sequences in antibodies derived
from a particular species or belonging to a particular antibody
class or subclass, while the remainder of the chain(s) is identical
with or homologous to corresponding sequences in antibodies derived
from another species or belonging to another antibody class or
subclass, as well as fragments of such antibodies, so long as they
exhibit the desired biological activity [Cabilly et al. (1984),
infra; Morrison etal., Proc. Natl. Acad. Sci. U.S.A. 81:6851].
[0089] The term "humanized antibody" refers to forms of antibodies
that contain sequences from non-human (eg, murine) antibodies as
well as human antibodies. A humanized antibody can include
conservative amino acid substitutions or non-natural residues from
the same or different species that do not significantly alter its
binding and/or biologic activity. Such antibodies are chimeric
antibodies that contain minimal sequence derived from non-human
immunoglobulins. For the most part, humanized antibodies are human
immunoglobulins (recipient antibody) in which residues from a
complementary-determining region (CDR) of the recipient are
replaced by residues from a CDR of a non-human species (donor
antibody) such as mouse, rat, camel, bovine, goat, or rabbit having
the desired properties. Furthermore, humanized antibodies can
comprise residues that are found neither in the recipient antibody
nor in the imported CDR or framework sequences. These modifications
are made to further refine and maximize antibody performance. Thus,
in general, a humanized antibody will comprise all of at least one,
and in one aspect two, variable domains, in which all or all of the
hypervariable loops correspond to those of a non-human
immunoglobulin and all or substantially all of the FR regions are
those of a human immunoglobulin sequence. The humanized antibody
optionally also will comprise at least a portion of an
immunoglobulin constant region (Fc), or that of a human
immunoglobulin. See, e.g., Cabilly et al., U.S. Pat. No. 4,816,567;
Cabilly et al., European Patent No. 0,125,023 B1; Boss et al., U.S.
Pat. No. 4,816,397; Boss et al., European Patent No. 0,120,694 B1;
Neuberger, M. S. et al., WO 86/01533; Neuberger, M. S. et al.,
European Patent No. 0,194,276 B1; Winter, U.S. Pat. No. 5,225,539;
Winter, European Patent No. 0,239,400 B1; Padlan, E. A. et al.,
European Patent Application No. 0,519,596 A1; Queen et al. (1989)
Proc. Nat'l Acad. Sci. USA, vol 86:10029-10033).
[0090] The term "bispecific antibody" can refer to an antibody, or
a monoclonal antibody, having binding properties for at least two
different epitopes. In one embodiment, the epitopes are from the
same antigen. In another embodiment, the epitopes are from two
different antigens. Methods for making bispecific antibodies are
known in the art. For example, bispecific antibodies can be
produced recombinantly using the co-expression of two
immunoglobulin heavy chain/light chain pairs. Alternatively,
bispecific antibodies can be prepared using chemical linkage.
Bispecific antibodies include bispecific antibody fragments.
[0091] The term "heteroconjugate antibody" can refer to two
covalently joined antibodies. Such antibodies can be prepared using
known methods in synthetic protein chemistry, including using
crosslinking agents. As used herein, the term "conjugate" refers to
molecules formed by the covalent attachment of one or more antibody
fragment(s) or binding moieties to one or more polymer
molecule(s).
[0092] The term "biologically active" refers to an antibody or
antibody fragment that is capable of binding the desired epitope
and in some way exerting a biologic effect. Biological effects
include, but are not limited to, the modulation of a growth signal,
the modulation of an anti-apoptotic signal, the modulation of an
apoptotic signal, the modulation of the effector function cascade,
and modulation of other ligand interactions.
[0093] The term "recombinant DNA" refers to nucleic acids and gene
products expressed therefrom that have been engineered, created, or
modified by man. "Recombinant" polypeptides or proteins are
polypeptides or proteins produced by recombinant DNA techniques,
for example, from cells transformed by an exogenous DNA construct
encoding the desired polypeptide or protein. "Synthetic"
polypeptides or proteins are those prepared by chemical
synthesis.
[0094] The term "expression cassette" refers to a nucleotide
molecule capable of affecting expression of a structural gene
(i.e., a protein coding sequence, such as an antibody of the
invention) in a host compatible with such sequences. Expression
cassettes include at least a promoter operably linked with the
polypeptide-coding sequence, and, optionally, with other sequences,
e.g., transcription termination signals. Additional regulatory
elements necessary or helpful in effecting expression may also be
used, e.g., enhancers. Thus, expression cassettes include plasmids,
expression vectors, recombinant viruses, any form of recombinant
"naked DNA" vector, and the like.
2. Applications
[0095] The invention is drawn to compositions and methods for
treating or preventing ocular diseases and conditions, using one or
more therapeutic agents that alter the activity or concentration of
one or more undesired bioactive lipids, or precursors or
metabolites thereof. The therapeutic methods and compositions of
the invention act by changing the effective concentration, i.e.,
the absolute, relative, effective and/or available concentration
and/or activities, of certain undesired bioactive lipids. Lowering
the effective concentration of the bioactive lipid may be said to
"neutralize" the target lipid or its undesired effects, including
downstream effects. Here, "undesired" refers to a bioactive lipid
that is unwanted due to its involvement in a disease process, for
example, as a signaling molecule, or to an unwanted amount of a
bioactive lipid which contributes to disease when present in
excess.
[0096] Without wishing to be bound by any particular theory, it is
believed that inappropriate concentrations of lipids such as S1P
and/or LPA, and/or their metabolites or downstream effectors, may
cause or contribute to the development of various ocular diseases
and disorders. As such, the compositions and methods can be used to
treat these ocular diseases and disorders, particularly by
decreasing the effective in vivo concentration of a particular
target lipid, for example, S1P and/or LPA. In particular, it is
believed that the compositions and methods of the invention are
useful in treating ocular diseases characterized, at least in part,
by aberrant neovascularization, angiogenesis, fibrogenesis,
fibrosis, scarring, inflammation, and immune response.
[0097] Examples of several classes of ocular diseases that may be
treated in accordance with the invention are described below. It
will be appreciated that many disease and conditions are
characterized, at least in part, by multiple pathological processes
(for example, both pathological neovascularization and scarring)
and that the classifications provided herein are for descriptive
convenience and do not limit the invention.
Ischemic Retinopathies Associated with Pathologic
Neovascularization and Diseases Characterized by Epiretinal and or
Subretinal Membrane Formation
[0098] Ischemic retinopathies (IR) are a diverse group of disorders
characterized by a compromised retinal blood flow. Examples of IR
include diabetic retinopathy (DR), retinopathy of prematurity
(ROP), sickle cell retinopathy and retinal venous occlusive
disease. All of these disorders can be associated with a VEGF
driven proliferation of pathological retinal neovascularization
which can ultimately lead to intraocular hemorrhaging, epi-retinal
membrane formation and tractional retinal detachment. Idiopathic
epi-retinal membranes (ERMs), also called macular pucker or
cellophane retinopathy, can cause a reduction in vision secondary
to distortion of the retinal architecture. These membranes
sometimes recur despite surgical removal and are sometimes
associated with retinal ischemia. VEGF and its receptors are
localized to ERMs. The presence of VEGF in membranes associated
with proliferative diabetic retinopathy, proliferative
vitreoretinopathy and macular pucker further suggests that this
cytokine plays an important role in angiogenesis in ischemic
retinal disease and in membrane growth in proliferative
vitreoretinal disorders. In addition VEGF receptors, VEGFR1 and
VEGFR2 are also identified on cells in ERMs. These data show that
VEGF may be an autocrine and/or paracrine stimulator that may
contribute to the progression of vascular and avascular ERMs. PDGF
and its receptors [Robbins et al. (1994), Invest Ophthalmol Vis
Sci; vol 35: 3649-3663] has been described in eyes with
proliferative retinal diseases [Cassidy et al. (1998), Br J
Ophthamol; vol 82: 181-85 and Freyberger et al. (2000), Exp Clin
Endocrinol Diabetes, vol 108: 106-109]. These findings suggest that
PDGF ligands and receptors are widespread in proliferative retinal
membranes of different origin and suggest that autocrine and
paracrine stimulation with PDGF may be involved in ERM
pathogenesis. Transforming growth factor-.beta. (TGF-.beta.) is
involved in the formation of ERMs [Pournaras et al. (1998), Klin
Monatsbl Augenheilkd, vol 212: 356-358] as demonstrated by TGF
staining and immunoreactivity. In addition, TGF-.beta. receptor II
is expressed in myofibroblasts of ERM of diabetic and PVR
membranes. These results suggest that TGF-.beta., produced in
multiple cell types in retina and ERMs, is an attractive target for
the treatment of PVR, diabetic and secondary ERMs. Interleukin-6
(IL-6) has been reported to be increased in human vitreous in
proliferative diabetic retinopathy (PDR) [La Heij et al. (2002), Am
J Ophthal, 134: 367-375] and in one study 100% of the diabetic ERMs
studied expressed IL-6 protein [Yamamoto et al. (2001) Am J
Ophthal, vol 132: 369-377].
[0099] Exogenous administration of basic fibroblastic growth factor
(bFGF) has been shown to induce endothelial proliferation and VEGF
expression [Stavri et al. (1995), Circulation, vol 92: 11-14].
Consistent with these observations, bFGF concentration is increased
in vitreous samples from patients with PDR [Sivalingam et al.
(1990), Arch Ophthalmol, vol 108: 869-872 and Boulton et al.
(1997), Br J Ophthalmol, vol 81: 228-233]. bFGF is also involved in
the formation of ERMs [Hueber et al. (1996), Int. Ophthalmol, vol
20: 345-350] demonstrated bFGF in 8 out of 10 PDR membranes
studied. Moreover, these workers found positive staining for the
corresponding receptor, FGFR1. Immunoreactivity for bFGF has also
been demonstrated in nonvascular idiopathic ERMs. These results
implicate bFGF in the formation of both vascular and avascular
ERMs. [Harada et al. (2006), Prog in Retinal and Eye Res, vol 25;
149-164]. Elevated bFGF has also been detected in the serum of
patients with ROP (Becerril et al. (2005), Ophthalmology, vol 112,
2238].
[0100] Given the known pleotropic effects of S1P and its
interactions with VEGF, bFGF, PDGF, TGF-.beta. and IL-6, it is
believed that an agent that binds, antagonizes, inhibits the
effects or the production of S1P will be effective at suppressing
pathologic retinal neovascularization in ischemic retinopathies and
posterior segment diseases characterized by vascular or avascular
ERM formation. Other ocular conditions characterized, at least in
part, by aberrant neovascularization or angiogenesis includc
age-related macular degeneration, corneal graft rejection,
neovascular glaucoma, contact lens overwear, infections of the
cornea, including herpes simplex, herpes zoster and protozoan
infection, pterygium, infectious uveitis, chronic retinal
detachment, laser injury, sickle cell retinopathy, venous occlusive
disease, choroidal neovascularization, retinal angiomatous
proliferation, and idiopathic polypoidal choroidal
vasculopathy.
Proliferative Vitreoretinopathy (PVR)
[0101] PVR is observed after spontaneous rhegmatogenous retinal
detachment and after traumatic retinal detachment. It is a major
cause of failed retinal detachment surgery. It is characterized by
the growth and contraction of cellular membranes on both sides of
the retina, on the posterior vitreous surface and the vitreous
base. This excessive scar tissue development in the eye may lead to
the development of tractional retinal detachment, and therefore
treatments directed at the prevention or inhibition of
proliferative vitreoretinopathy (PVR) are a logical principle of
management of retinal detachment. Histopathologically PVR is
characterized by excessive collagen production, contraction and
cellular proliferation [Michels, Retinal Detachment 2nd Edition.
Wilkinsin CP, Rice TA Eds, Complicated types of retinal detachment,
pp 641-771, Mosby St Louis 1997]. Cellular types identified in PVR
membranes include mainly retinal pigmented epithelial cells,
fibroblasts, macrophages and vascular endothelial cells [Jerdan JA
et al. (1989), Ophthalmology, vol 96: 801-10 and Vidinova et al.
(2005), Klin Monatsbl Augenheilkd; vol 222:568-571]. The
pathophysiology of this excessive scarring reaction appears to be
mediated by a number of cytokines including platelet derived growth
factor (PDGF), transforming growth factor (TGF) beta, basic
fibroblastic growth factor (bFGF), interleukin -6 (IL)-6 and
interleukin-8 (IL)-8 [Nagineni et al. (2005), J Cell Physiol, vol
203: 35-43; La Heij et al (2002), Am J Ophthalmol, 134: 367-75;
Planck et al. (1992), Curr Eye Res; vol 11: 1031-9; Canataroglu et
al. (2005) Ocul Immunol Inflamm; vol 13: 375-81 and Andrews et al.
(1999) Ophthalmol Vis Sci; vol 40: 2683-9]. Inhibition of these
cytokines may help prevent the development of PVR if given in a
timely fashion or limit its severity [Akiyama et al (2006), J Cell
Physiol, vol 207:407-12 and Zheng Y et al (2003), Jpn J
Ophthalmolm, vol 47:158-65].
[0102] Sphingosine-1-Phosphate (S1P) is a bioactive lysolipid with
pleotrophic effects. It is pro-angiogenic, pro inflammatory
(stimulates the recruitment of macrophages and mast cells) and
pro-fibrotic (stimulates scar formation). S1P generally stimulates
cells to proliferate and migrate and is anti-apoptotic. S1P
achieves these biologically diverse functions through its
interactions with numerous cytokines and growth factors. Inhibition
of S1P via a monoclonal antibody (SPHINGOMAB) has been demonstrated
to block the functions of vascular endothelial growth factor
(VEGF), bFGF, IL-6 and IL-8 [Visentin B et al. (2006), Cancer Cell,
vol 9: 1-14]. Binding of S1P to the S1P.sub.1 receptor can also
increase PDGF production; therefore an agent that binds S1P would
also be expected to diminish PDGF production [Milstien and Spiegel
(2006), Cancer Cell, vol 9:148-150]. As shown in the Examples
below, it has now been demonstrated that in vitro S1P transforms
human RPE cells into a myofibroblast-like phenotype similar to the
type seen in PVR. Given the pathophysiology that ultimately results
in the excessive scarring seen in PVR and the known effects of S1P
on these same key mediators, it is believed that an agent that
binds, antagonizes, or inhibits the effects or the production of
S1P will be effective at eliminating or minimizing the development
of PVR and its severely damaging effects on the eye.
Uveitis
[0103] Uveitis is an inflammatory disorder of the uveal tract of
the eye. It can affect the front (anterior) or back (posterior) of
the eye or both. It can be idiopathic or infectious in etiology and
can be vision-threatening. Idiopathic uveitis has been associated
with increased CD4+ expression in the anterior chamber. [Calder et
al. (1999), Invest Ophthalmol Vis Sci, vol 40: 2019-24]. Data also
suggests a pathologic role of the T lymphocyte and its
chemoattractant IP-10 in the pathogenesis of uveitis [Abu El-Asrar
(2004), Am J Ophthalmol, vol 138: 401-11]. Other chemokines in
acute anterior uveitis include macrophage inflammatory proteins,
monocyte chemoattractant protein-1 and IL-8. These cytokines
probably play a critical role in leukocyte recruitment in acute
anterior uveitis. [Verma et al. (1997), Curr Eye Res; vol 16;
1202-8]. Given the profound and pleiotropic effects of the S1P
signaling cascade, it is believed that SPHINGOMAB and other immune
moieties that reduce the effective concentration of bioactive lipid
would serve as an effective method of reducing or modulating the
intraocular inflammation associated with uveitis.
Refractive Surgery
[0104] The corneal wound healing response is of particular
relevance for refractive surgical procedures since it is a major
determinant of safety and efficacy. These procedures are performed
for the treatment of myopia, hyperopia and astigmatism. Laser in
situ keratomileusis (LASIK) and photorefractive keratectomy (PRK)
are the most common refractive procedures however others have been
developed in an attempt to overcome complications. These
complications include overcorrection, undercorrection, regression
and stromal opacification among others. A number of common
complications are related to the healing response and have their
roots in the biologic response to surgery. One of the greatest
challenges in corneal biology is to promote tissue repair via
regeneration rather than fibrosis. It is believed that the choice
between regeneration and fibrosis lies in the control of fibroblast
activation. [Stramer et al (2003), Invest Ophthalmol Vis Sci; vol
44: 4237-4246 and Fini (1999) Prog Retin Eye Res, vol 18: 529-551].
Cells called myofibroblasts may appear in the subepithelial stroma
1-2 weeks after surgery or injury. Myofibroblasts are presumably
derived from keratocytes under the influence of TGF-.beta. [Jester
et al (2003) Exp Eye Res, vol 77: 581-592]. Corneal haze and
stromal scarring are characterized by reduced corneal transparency
and may be associated with fibroblast and myofibroblast generation.
In situ and in vitro studies have suggested that TGF-.beta. and
PDGF are important in stimulating myofibroblast differentiation
[Folger et al. (2001), Invest Ophthalmol Vis Sci; 42: 2534-2541].
Haze can be noted in the central interface after LASIK under
certain circumstances. These include diffuse lamellar keratitis,
donut-shaped flaps, and retention of epithelial debris at the
interface. It is likely that each of these is associated with
increased access of TGF-.beta. from epithelial cells to the
activated keratocytes. [Netto et al. (2005), Cornea, vol 24:
509-522]. Regression is most likely due to heightened
epithelial-stromal wound healing interactions such as increased
production of epithelium modulating growth factors by corneal
fibroblasts and or myofibroblasts [Netto et al. (2005), Cornea, vol
24: 509-522]. Inhibition of TGF-.beta. binding to receptors with
topical anti-TGF-.beta. antibody has been shown to reduce haze
induced by PRK [Jester et al. (1997), Cornea, vol 16: 177-187].
Given the known effects of anti-bioactive lipid antibody on the
fibrotic process and TGF-.beta., we believe that it may aid in
treating some of the complications of refractive surgery such as
haze, stromal scarring and regression.
Modulation of Glaucoma Filtration Surgery
[0105] Glaucoma is classically thought of a disease whereby
elevated intraocular pressure causes damage to the optic nerve and
ultimately compromises the visual field and or the visual acuity.
Other forms of glaucoma exist where optic nerve damage can occur in
the setting of normal pressure or so called "normal tension
glaucoma". For many patients medications are able to control their
disease, but for others glaucoma filtration surgery is needed
whereby a fistula is surgically created in the eye to allow fluid
to drain. This can be accomplished via trabeculectomy, the
implantation of a medical device or other methods of surgical
intervention. Glaucoma filtration surgery fails due to a wound
healing process characterized by the proliferation of fibroblasts
and ultimately scarring. Anti-metabolites such as 5-fluorouracil
and mitomycin C can reduce subsequent scarring; however, even with
the use of these drugs long term follow up shows that surgical
failure is still a serious clinical problem. [Mutsch and Grehn
(2000), Graefes Arch Clin Exp Ophthalmol; vol 238: 884-91 and
Fontana et al. (2006), Ophthalmology, vol 113: 930-936]. Studies of
human Tenon's capsule fibroblasts demonstrate that they have the
capacity to synthesize bFGF and PDGF and TGF-.beta. and that these
growth factors are implicated in the tissue repair process after
glaucoma filtration surgery that contributes to the failure of the
procedure. [Trpathi et al. (1996), Exp Eye Res, vol 63: 339-46].
Additional studies have also implicated these growth factors in the
post filtration wound response [Denk et al. (2003), Curr Eye Res;
vol 27: 35-44] concluded that different isoforms of PDGF are major
stimulators of proliferation of Tenon's capsule fibroblasts after
glaucoma filtration surgery while TGF-.beta. is essential for the
transformation of Tenon's capsule fibroblasts into myofibroblasts.
We have demonstrated that S1P is present in human Tenon's
capsule/conjunctival fibroblasts and that S1P is strongly expressed
in the wound healing response. S1P also stimulates the profibrotic
function of multiple fibroblast cell types and the transformation
into the myofibroblast phenotype and collagen production. Given the
specific pleotropic effects of S1P and its known interactions with
bFGF, PDGF and TGF-beta, it is believed that an agent that binds,
antagonizes, inhibits the effects or the production of S1P, or
perhaps other bioactive lipids such as LPA, will be effective at
modulating the wound healing and/or fibrotic response that leads to
failure of glaucoma surgery and will be an effective therapeutic
method of enhancing successful surgical outcomes. It is envisioned
that the agent could be administered, e.g., via intravitreal or
subconjunctival injection or topically.
Corneal Transplantation
[0106] Corneal transplantation (penetrating keratoplasty (PK)) is
the most successful tissue transplantation procedure in humans. Yet
of the 47,000 corneal transplants performed annually in the United
States, corneal allograft rejection is still the leading cause of
corneal graft failure. [Ing JJ et al. (1998), Ophthalmology, vol
105: 1855-1865]. Currently, we do not sufficiently have the ability
to avert allograft rejection although immunosuppression and
immunomodulation may be a promising approach. Recently it has been
discovered that CD4(+) T cells function as directly as effector
cells and not helper cells in the rejection of corneal allografts.
[Hegde S et al. (2005), Transplantation, vol 79: 23-31]. Murine
studies have shown increased numbers of neutrophils, macrophage and
mast cells in the stroma of corneas undergoing rejection.
Macrophages were the main infiltrating cell type followed by
T-cells, mast cells and neutrophils. The early chemokine expression
in high risk corneal transplantation was the mouse homologue of
IL-8 (macrophage inflammatory protein-2) and monocyte chemotactic
protein-1 (MCP-1) [Yamagami S et al. (2005), Mol Vis, vol 11,
632-40].
[0107] FTY720 (FTY) is a novel immunosuppressive drug that acts by
altering lymphocyte trafficking; resulting in peripheral blood
lymphopenia and increased lymphocyte counts in lymph nodes. FTY
mediates its immune-modulating effects by binding to some of the
S1P receptors expressed on lymphocytes. [Bohler T et al. (2005),
Transplantation, vol 79: 492-5]. The drug is administered orally
and a single oral dose reduced peripheral lymphocyte counts by
30-70%. FTY reduced T-cell subset, CD4(+) cells more than CD8(+)
cells. [Bohler et al. (2004), Nephrol Dial Transplant, vol 19:
702-13]. FTY treated mice showed a significant prolongation of
orthotopic corneal-graft survival when administered orally. [Zhang
et al. (2003), Transplantation, vol 76: 1511-3]. FTY oral treatment
also significantly delayed rejection and decreased its severity in
a rat-to-mouse model of corneal xenotransplantation [Sedlakova et
al. (2005), Transplantation, vol 79, 297-303]. Given the known
pathogenesis of allograft rejection combined with the data
suggesting that modulating the effects of the S1P signaling can
improve corneal graft survival, it is believed that immune moieties
that decrease the effective concentration of bioactive lipids,
e.g., SPHINGOMAB, will also be useful in treatment of immunologic
conditions such as allograft rejection, for example by attenuating
the immune response, and thus will likely improve corneal graft
survival after PK. The drug may also have the added advantage that
in addition to systemic administration, local administration, e.g.,
via topical periocular or intraocular delivery, may be
possible.
[0108] Other ocular diseases with an inflammatory or immune
component include chronic vitritis, infections, including herpes
simplex, herpes zoster and protozoan infections, and ocular
histoplasmosis.
Anterior Segment Diseases Characterized by Scarring
[0109] Treatment with an antibody targeted to bioactive lipid also
is believed to benefit several conditions characterized by scarring
of the anterior portion of the eye. These include the
following:
Trauma
[0110] The cornea, as the most anterior structure of the eye, is
exposed to various hazards ranging from airborne debris to blunt
trauma that can result in mechanical trauma. The cornea and
anterior surface of the eye can also be exposed to other forms of
trauma from surgery, and chemical, such as acid and alkali,
injuries. The results of these types of injuries can be devastating
often leading to corneal and conjunctival scarring symblephera
formation. In addition corneal neovascularization may ensue.
Neutrophils accumulate, their release of leukotrienes, and the
presence of interleukin-1 and interleukin-6, serves to recruit
successive waves of inflammatory cells [Sotozono et al. (1997),
Curr Eye Res, vol 19: 670-676] infiltrate the cornea and release
proteolytic enzymes which lead to further damage and break down of
corneal tissue and a corneal melt. In addition corneal and
conjunctival fibroblasts become activated and invade and leading to
collagen deposition and fibrosis. The undesirable effects of
excessive inflammation and scarring are promoted by TGF-.beta..
[Saika S et al. (2006), Am J Pathol vol 168, 1848-60]. This process
leads to loss of corneal transparency and impaired vision. Reduced
inflammation, including decreased neutrophil infiltrates and
reduced fibrosis resulted in faster and more complete healing in a
murine model of alkali burned corneas [Ueno et al. (2005),
Ophthalmol Vis Sci, vol 46: 4097-106].
Ocular Cicatricial Pemphigoid (OCP)
[0111] OCP is a chronic cicatrizing (scar-forming) autoimmune
disease that primarily affects the conjunctiva. The disease is
invariably progressive and the prognosis is quite poor. In its
final stages conjunctival scarring and the associated keratopathy
lead to bilateral blindness. Histologically the conjunctiva shows
submucosal scarring and chronic inflammation in which mast cell
participation is surprisingly great.[Yao L et al. (2003), Ocul
Immunol Inflamm, vol 11: 211-222]. Autoantigens lead to the
formation of autoantibodies. The binding of the autoantibody to the
autoantigen sets in motion a complex series of events with
infiltration of T lymphocytes where CD4 (helper) cells far
outnumber CD8 (suppressor) cells. Macrophage and mast cell
infiltration also ensue as well as the release of proinflammatory
and profibrotic cytokines. Cytokine induced conjunctival fibroblast
proliferation and activation results, with resultant subepithelial
fibrosis (see examples hereinbelow). Studies have shown a role of
TGF-.beta. and IL-1 in conjunctival fibrosis in patients with OCP
[Razzaque MS et al. (2004), Invest Ophthalmol Vis Sci, vol 45:
1174-81].
Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis
(TEN)
[0112] SJS and TEN are life-threatening adverse reactions to
medications. The ocular sequelae of these two related conditions
can be severe and inyolve pathologic changes of the bulbar and
palpebral conjunctiva, eyelids and cornea. Drugs and infections are
the most common precipitating factors. Chronic eye findings include
scarring, symblepharon formation, and cicatrisation of the
conjunctiva as a result of the initial inflammatory process. This
leads to entropion formation, trichiasis and instability of the
tear film. Breakdown of the ocular surface leads to corneal
scarring, neovascularization, and in severe cases keratinization.
As in OCP subepithelial fibrosis of the conjunctiva occurs. A
vigorous autoimmune lymphocyte response to a drug or infection is
believed to play a role in development of SJS/TEN. [Harilaos et al.
(2005), Erythema Multiforme, Stevens Johnson Syndrome, and Toxic
Epidermal Necrolysis, in Cornea 2.sup.nd edition. Krachmer, Mannis,
Holland eds.Elesevier Mosby Philadelphia]. The infiltrating cell
population in SJS includes macrophages, CD4 positive T cells, and
CD8 positive T cells. This cell population is similar to those seen
in chemical injury. [Kawasaki et al. (2000), J Ophthalmol, vol 84:
1191-3].
Pterygium
[0113] Clinically a pterygium appears as a fleshy, vascular mass
that occurs in the interpalpebral fissure. The body of the
pterygium is a fleshy fibrovascular mass. Active pterygium are
characterized by marked vascular engorgement and progressive
growth. They are firmly adherent to the globe. In advanced cases
the pterygium encroaches onto the cornea and may cause visual loss
secondary to loss of corneal transparency within the visual axis or
irregular astigmatism. Symptomatically, patients may experience
foreign body sensation, tearing and blurred vision. Histopathology
demonstrates hyalinization of the subepithelial connective tissue
of the substantia propria, increased number of fibroblasts and
increased mast cells. [Butrus et al. (1995), Am J Ophthalmol, vol
119: 236-237]. Management of pterygium remains problematic.
Surgical excision is often performed however recurrence rates are
high. (Krag et al. (1992), Acta Ophthalmol, vol 70: 530]. In order
to help lower the recurrence rate of pterygium, various
pharmacologic adjuvants have been employed such as Mitomycin-C and
daunorubicin. Although these may be helpful, long term data are
limited and they can be associated with scleral thinning and
corneal melt. Dougherty et al. and Lee et al. [Dougherty et al.
(1996), Cornea, vol 15: 537-540 and Lee et al. (2001), Cornea, vol
20: 238-42] were the first to demonstrate that VEGF may play an
important role in the development of pterygium and to identify VEGF
and nitric oxide in the epithelium of pterygium. These workers
hypothesized that these as well as other cytokines are responsible
for the fibrovascular ingrowth characteristic of pterygium. The
presence of basic FGF and TGF-beta 1 in both primary and recurrent
pterygium has been demonstrated [Kira et al. (1998), Graefes Arch
Clin Exp Ophthalmol, vol 236: 702-8] and published morphometric and
immunohistochemical evidence further supports the notion that
angiogenesis may play a role in the formation of pterygium
[Marcovich et al (2002), Curr Eye Res, vol 25:17-22]. Other studies
have implicated IL-6 and IL-8 as well as VEGF as mediators that may
be relevant to pterygium development [Di Girolamo et al. (2006),
Invest Ophthalmol Vis Sci, vol 47: 2430-7]. An effective agent
against pterygium formation and growth may diminish the need for
surgical intervention or reduce recurrence rates.
[0114] Other ocular diseases and conditions with a fibrogenesis,
fibrosis or scarring component include AMD, diabetic retinopathy,
retinopathy of prematurity, sickle cell retinopathy, ischemic
retinopathy, retinal venous occlusive disease and contact lens
overwear.
[0115] In summary, excessive scarring is an underlying component of
the pathophysiology of many ocular and non-ocular diseases and
conditions. Bioactive lipids like S1P and LPAs play a role in this
process and an antibody-related treatment to diminish the
concentrations of these agents will likely lead to therapeutic
benefit to patients receiving the treatment. In one embodiment,
inhibitors of bioactive lipids, particularly monoclonal antibodies
directed against S1P and/or LPA, are believed to be useful in
modulating surgical and traumatic wound healing responses.
Anti-S1P and anti-LPA Antibodies for the Treatment of
Scleroderma
[0116] The compositions and methods of the invention will be useful
in treating disorders and diseases characterized, at least in part,
by aberrant neovascularization, angiogenesis, fibrogenesis,
fibrosis, scarring, inflammation, and immune response. One such
disease is scleroderma, which is also referred to as systemic
sclerosis.
[0117] Scleroderma is an autoimmune disease that causes scarring or
thickening of the skin, and sometimes involves other areas of the
body, including the lungs, heart, and/or kidneys. Scleroderma is
characterized by the formation of scar tissue (fibrosis) in the
skin and organs of the body, which can lead to thickening and
firmness of involved areas, with consequent reduction in function.
Today, about 300,000 Americans have scleroderma, according to the
Scleroderma Foundation. One-third or less of those affected have
widespread disease, while the remaining two-thirds primarily have
skin symptoms. When the disease affects the lungs and causing
scarring, breathing can become restricted because the lungs can no
longer expand as they should. To measure breathing capability,
doctors use a device that assesses forced vital capacity (FVC). In
people with an FVC of less than 50 percent of the expected reading,
the 10-year mortality rate from scleroderma-related lung disease is
about 42 percent. One reason the mortality rate is so high is that
no effective treatment is currently available.
[0118] As described in the examples of this application, existing
evidence indicates that S1P and LPA are pro-fibrotic growth factors
that can contribute to fibroblast activation, proliferation, and
the resulting increased fibroblast activity associated with
maladaptive scarring and remodeling. Moreover, potential roles for
S1P and LPA in activity of skin and other types of fibroblasts have
been demonstrated. For example, it has been shown that LPA
stimulates the migration of murine skin fibroblasts (Hama, et al.,
J Biol Chem. 2004 Apr. 23; 279(17):17634-9), and human skin
fibroblasts express several S1P receptor subtypes (Zhang, et al.,
Blood. 1999 May 1; 93(9):2984-90). In addition to the many direct
effects of S1P on fibroblast activity, S1P also may have many
potential indirect effects on fibroblast activity. For example, S1P
may facilitate the action of other well-known pro-fibrotic factors,
such as TGF-.beta. and platelet derived growth factor (PDGF).
TGF-.beta. is one of the most widely studied and recognized
contributors to fibrosis (Desmouliere, et al., J Cell Biol 122:
103-111, 1993). TGF-.beta. upregulates SphK1 expression and
activity leading to increased expression of tissue inhibitors of
metalloproteinases 1 (TIMP-1), a protein that inhibits ECM
degradation (Yamanaka, et al., J Biol Chem 279: 53994-54001, 2004).
Increased expression of TIMP-1 is linked to interstitial fibrosis
and diastolic dysfunction in heart failure patients (Heymans, et
al., Am J Pathol 166: 15-25, 2005). Conversely, S1P stimulates
expression and release of TGF-.beta. (Norata, et al., Circulation
111: 2805-2811, 2005). There is also distinct evidence of crosstalk
between S1P and PDGF. S1P directly stimulates expression of PDGF
(Usui, et al., J Biol Chem 279: 12300-12311, 2004). In addition,
the S1P.sub.1 receptor and the PDGF receptor bind one another and
their association is necessary for PDGF activation of downstream
signaling which contributes to proliferation and migration of
various cell types (Long, et al., Prostaglandins Other Lipid Mediat
80: 74-80, 2006; Baudhuin et al., Faseb J 18: 341-343, 2004). As
such, the effects of TGF-.beta. and PDGF on fibrosis may be due in
part to crosstalk with the S1P signaling pathway. As such, the
compositions and methods of the invention can be used to treat
scleroderma, particularly by decreasing the effective in vivo
concentration of a particular target lipid, for example, S1P and/or
LPA.
[0119] Systemic scleroderma is thought to be exacerbated by
stimulatory autoantibodies against PDGF receptors (Baroni, et al.,
N Engl J Med. 2006 v354(25):2667-76), and PDGF receptors are
up-regulated in scleroderma fibroblasts in response to TGF-.beta.
(Yamakage, et al., J Exp Med. 1992 May 1; 175(5): 1227-34). Because
of the substantial cross-talk among the S1P, PDGF and TGF-.beta.
signaling systems, blocking S1P bioactivity with and anti-S1P agent
(e.g., an anti-S1P mAb) could indirectly mitigate the pro-sclerotic
effects of PDGF and TGF-.beta.. Moreover, treatment with such an
anti-S1P agent could benefit scleroderma patients by mitigating the
direct effects of S1P on skin and other forms of fibroblasts that
contribute to disease progression.
3. Methods of Administration
[0120] The treatment for diseases and conditions such as the
examples given above can be administered by various routes
employing different formulations and devices. Suitable
pharmaceutically acceptable diluents, carriers, and excipients are
well known in the art. One skilled in the art will appreciate that
the amounts to be administered for any particular treatment
protocol can readily be determined. Suitable amounts might be
expected to fall within the range of 10 .mu.g/dose to 10 g/dose,
preferably within 10 mg/dose to 1 g/dose.
[0121] Drug substances may be administered by techniques known in
the art, including but not limited to systemic, subcutaneous,
intradermal, mucosal, including by inhalation, and topical
administration. The mucosa refers to the epithelial tissue that
lines the internal cavities of the body. For example, the mucosa
comprises the alimentary canal, including the mouth, esophagus,
stomach, intestines, and anus; the respiratory tract, including the
nasal passages, trachea, bronchi, and lungs; and the genitalia. For
the purpose of this specification, the mucosa will also include the
external surface of the eye, i.e. the cornea and conjunctiva. Local
administration (as opposed to systemic administration) may be
advantageous because this approach can limit potential systemic
side effects, but still allow therapeutic effect.
[0122] Pharmaceutical compositions used in the present invention
include, but are not limited to, solutions, emulsions, and
liposome-containing formulations. These compositions may be
generated from a variety of components that include, but are not
limited to, preformed liquids, self-emulsifying solids and
self-emulsifying semisolids.
[0123] The pharmaceutical formulations used in the present
invention may be prepared according to conventional techniques well
known in the pharmaceutical industry. Such techniques include the
step of bringing into association the active ingredients with the
pharmaceutical carrier(s) or excipient(s). Preferred carriers
include those that are pharmaceutically acceptable, particularly
when the composition is intended for therapeutic use in humans. For
non-human therapeutic applications (e.g., in the treatment of
companion animals, livestock, fish, or poultry), veterinarily
acceptable carriers may be employed. In general the formulations
are prepared by uniformly and intimately bringing into association
the active ingredients with liquid carriers or finely divided solid
carriers or both, and then, if necessary, shaping the product.
[0124] The compositions of the present invention may be formulated
into any of many possible dosage forms such as, but not limited to,
tablets, capsules, liquid syrups, soft gels, suppositories, and
enemas. The compositions of the present invention may also be
formulated as suspensions in aqueous, non-aqueous or mixed media.
Aqueous suspensions may further contain substances which increase
the viscosity of the suspension including, for example, sodium
carboxymethylcellulose, sorbitol and/or dextran. The suspension may
also contain stabilizers.
[0125] In one embodiment the pharmaceutical compositions may be
formulated and used as foams. Pharmaceutical foams include
formulations such as, but not limited to, emulsions,
microemulsions, creams, jellies and liposomes.
[0126] While basically similar in nature these formulations vary in
the components and the consistency of the final product. The
know-how on the preparation of such compositions and formulations
is generally known to those skilled in the pharmaceutical and
formulation arts and may be applied to the formulation of the
compositions of the present invention.
[0127] In one embodiment, an immune-derived moiety can be delivered
to the eye via, for example, topical drops or ointment, periocular
injection, intracamerally into the anterior chamber or vitreous,
via an implanted depot, or systemically by injection or oral
administration. The quantity of antibody used can be readily
determined by one skilled in the art.
[0128] The traditional approaches to delivering therapeutics to the
eye include topical application, redistribution into the eye
following systemic administration or direct intraocular/periocular
injections [Sultana et al. (2006), Current Drug Delivery, vol 3:
207-217; Ghate and Edelhauser (2006), Expert Opinion, vol 3:
275-287 and Kaur and Kanwar (2002), Drug Develop Industrial
Pharmacy, vol 28: 473-493]. Anti-S1P, anti-LPA or other
anti-bioactive lipid antibody therapeutics would likely be used
with any of these approaches although all have certain perceived
advantages and disadvantages. Topical drops are convenient, but
wash away primarily because of nasolacrimal drainage often
delivering less than 5% of the applied drug into the anterior
section of the eye and an even smaller fraction of that dose to the
posterior segment of the globe. Besides drops, sprays afford
another mode for topical administration. A third mode is ophthalmic
ointments or emulsions can be used to prolong the contact time of
the formulation with the ocular surface although blurring of vision
and matting of the eyelids can be troublesome. Such topical
approaches are still preferable, since systemic administration of
therapeutics to treat ocular disorders exposes the whole body to
the potential toxicity of the drug.
[0129] Treatment of the posterior segment of the eye is medically
important because age-related macular degeneration, diabetic
retinopathy, posterior uveitis, and glaucoma are the leading causes
of vision loss in the United States and other developed countries.
[Myles et al. (2005), Adv Drug Deliv Rev; 57: 2063-79]. The most
efficient mode of drug delivery to the posterior segment is
intravitreal injection through the pars plana. However, direct
injections require a skilled medical practitioner to effect the
delivery and can cause treatment-limiting anxiety in many patients.
Periocular injections, an approach that includes subconjunctival,
retrobulbar, peribulbar and posterior subtenon injections, are
somewhat less invasive than intravitreal injections. Repeated and
long-term intravitreal injections may cause complications, such as
vitreous hemorrhage, retinal detachment, or endophthalmitis.
[0130] The anti-bioactive lipid antibody treatment might also be
administered using one of the newer ocular delivery systems
[Sultana et al. (2006), Current Drug Delivery, vol 3: 207-217 and
Ghate and Edelhauser (2006), Expert Opinion, vol 3: 275-287],
including sustained or controlled release systems, such as (a)
ocular inserts (soluble, erodible, non-erodible or hydrogel-based),
corneal shields, eg, collagen-based bandage and contact lenses that
provide controlled delivery of drug to the eye, (b) in situ gelling
systems that provide ease of administration as drops that get
converted to.gel form in the eye, thereby providing some sustained
effect of drug in the eye, (c) vesicular systems such as liposomes,
niosomes/discomes, etc., that offers advantages of targeted
delivery, bio-compatibility and freedom from blurring of vision,
(d) mucoadhesive systems that provide better retention in the eye,
(e) prodrugs (f) penetration enhancers, (g) lyophilized carrier
systems, (h) particulates, (i) submicron emulsions, (j)
iontophoresis, (k) dendrimers, (l) microspheres including
bioadhesive microspheres, (m) nanospheres and other nanoparticles,
(n) collasomes and (o) drug delivery systems that combine one or
more of the above stated systems to provide an additive, or even
synergistic, beneficial effect. Most of these approaches target the
anterior segment of the eye and may be beneficial for treating
anterior segment disease. However, one or more of these approaches
still may be useful affecting bioactive lipid concentrations in the
posterior region of the eye because the relatively low molecular
weights of the lipids will likely permit considerable movement of
the lipid within the eye. In addition, the antibody introduced in
the anterior region of the eye may be able to migrate throughout
the eye especially if it is manufactured in a lower weight antibody
variant such as a Fab fragment. Sustained drug delivery systems for
the posterior segment such as those approved or under development
(see references, supra) could also be employed.
[0131] As previously mentioned, the treatment of disease of the
posterior retina, choroids, and macula is medically very important.
In this regard, transscleral iontophoresis [Eljarrat-Binstock and
Domb (2006), Control Release, 110: 479-89] is an important advance
and may offer an effective way to deliver antibodies to the
posterior segment of the eye.
[0132] Various excipients might also be added to the formulated
antibody to improve performance of the therapy, make the therapy
more convenient or to clearly ensure that the formulated antibody
is used only for its intended, approved purpose. Examples of
excipients include chemicals to control pH, antimicrobial agents,
preservatives to prevent loss of antibody potency, dyes to identify
the formulation for ocular use only, solubilizing agents to
increase the concentration of antibody in the formulation,
penetration enhancers and the use of agents to adjust isotonicity
and/or viscosity. Inhibitors of, e.g., proteases, could be added to
prolong the half life of the antibody. In one embodiment, the
antibody is delivered to the eye by intravitreal injection in a
solution comprising phosphate-buffered saline at a suitable pH for
the eye.
[0133] The antibody might also be chemically modified to yield a
pro-drug that is administered in one of the formulations or devices
previously described above. The active form of the antibody is then
released by action of an endogenous enzyme. Possible ocular enzymes
to be considered in this application are the various cytochrome
p450s, aldehyde reductases, ketone reductases, esterases or
N-acetyl-.beta.-glucosamidases. Other chemical modifications to the
antibody could increase its molecular weight, and as a result,
increase the residence time of the antibody in the eye. An example
of such a chemical modification is pegylation [Harris and Chess
(2003), Nat Rev Drug Discov; 2: 214-21], a process that can be
general or specific for a functional group such as disulfide
[Shaunak et al. (2006), Nat Chem Biol; 2:312-3] or a thiol [Doherty
et al. (2005), Bioconjug Chem; 16: 1291-8].
EXAMPLES
[0134] The invention will be further described by reference to the
following detailed examples. These Examples are in no way to be
considered to limit the scope of the invention.
[0135] For the data described below, in vitro studies were
performed in triplicate and repeated at least three times, and in
vivo studies were performed in at least 5 mice. In all studies,
statistical analysis was performed using Students T-test or ANOVA
using GraphPad software. Where applicable, data are presented as
the mean.+-.SEM with * representing p.ltoreq.0.05.
Example 1
SPHINGOMAB Significantly Reduced CNV and Scar Formation in a Murine
Model of CNV
[0136] Female C57BL6/J mice were subjected to laser-induced rupture
of Bruch's membrane and administered either 0.5 .mu.g of Sphingomab
or an isotype-matched non-specific (NS) antibody diluted in 2 .mu.l
of physiological saline. Mice were sacrificed 14 and 28 days after
laser rupture.
[0137] To induce CNV lesions, the pupils were dilated with
ophthalmic tropicamide (0.5%) and phenylephrine (2.5%). A coverslip
was placed on the eye. An Oculight GL 532 nm (Iridex Corporation,
Mountain View, Calif.) coupled to a slit lamp set to deliver a 100
msec pulse at 150 mW with a 50 .mu.m spot size was used to rupture
Bruch's membrane in three quadrants of the right eye located
approximately 50 .mu.m from the optic disc at relative 9, 12 and 3
o'clock positions. The left eye served as an uninjured control in
all cases. Any lesion not associated with a vapor bubble or lesions
that became confluent were excluded from analysis.
[0138] To measure CNV lesion size, choroidal flatmounts of the
sclera-choroid-RPE complex were prepared and stained for
vasculature (R. communis agglutinin I; red) and pericytes (CD140b;
green). Digital images were captured using an epifluorescence Zeiss
Axioplan 2 with RGB Spot high-resolution digital camera and laser
scanning confocal microscope (BioRad MRC 1024, BioRad Corporation,
Temecula, Calif.). For volumetric analysis, a z-series capture was
used and the sum of lesion area throughout the z-series was
multiplied by the z thickness (4 .mu.m) to obtain the lesion
volume.
[0139] To assess collagen deposition, the sclera-choroid-RPE
complex was stained with Masson's Trichrome. The sclera-choroid-RPE
complex was embedded in paraffin and then serially sectioned at a
thickness of 6 microns. Approximately 30 sections per lesion were
evaluated. Quantitation of the volume of collagen deposition was
calculated in the same manner as described for CNV lesion
volume.
[0140] Captured digital images are evaluated morphometrically using
ImageJ software (Research Services Branch, National Institutes of
Health, Bethesda, Md.). FIG. 1A shows that SPHINGOMAB dramatically
attenuates choroidal neovascularization 14 and 28 days after
laser-induced rupture of Bruch's membrane. FIG. 1B shows that
SPHINGOMAB significantly reduces fibrosis associated with CNV
lesion formation 28 days after laser-induced rupture of Bruch's
membrane.
Example 2
SPHINGOMAB Inhibits Neovascularization Through Multiple Mechanisms
Including Inhibition of Endothelial Cell Migration and Tube
Formation
[0141] S1P promotes the migration of human umbilical vein
endothelial cells (HUVECs) and, in Matrigel and other assays, the
formation of de novo BV formation in vitro [112]; SPHINGOMAB can
neutralize these effects of S1P. Experiments were performed as
described by Visentin et al. (Cancer Cell 2006 March;9(3):225-38).
Data in FIG. 2A suggest that HUVECs seeded onto GF-reduced Matrigel
formed multiple capillary-like structures in the presence of S1P
and failed to form capillary-like structures in the absence of S1P
or when co-incubated with SPHINGOMAB and S1P. Data in FIG. 2B
demonstrate the potent ability of 0.1-1 .mu.M S1P to stimulate
HUVEC migration 2-2.5 fold over non-treated HUVECs, or HUVECs
co-incubated with SPHINGOMAB in a Matrigel chemoinvasion assay.
Combined, these studies demonstrate that SPHINGOMAB can efficiently
mitigate the pro-angiogenic effects of S1P on ECs.
Example 3
SPHINGOMAB Inhibits Neovascularization Through Multiple Mechanisms
Including Mitigation of the Effects of S1P, VEGF and bFGF in
vivo
[0142] Based on in vivo studies showing that SiP increased
endothelial capillary growth into subcutaneously implanted Matrigel
plugs[54], we speculated that SPHINGOMAB could reduce de novo BV
formation in vivo. To investigate this, we employed the in vivo
Matrigel Plug assay for neovascularization. In one set of
experiments, Matrigel was supplemented with either 1 .mu.M S1P, 0.5
.mu.g/mL bFGF or 1 .mu.g/mL VEGF and then injected I.P. into mice
(n=4). After 10 days, the mice were heparinized and injected with
the fluorescent lectin, Isolectin B4-FITC, which binds to adhesion
molecules expressed by vascular EC that form the growing BVs. The
plugs were then excised, frozen in OCT, sectioned and viewed for
FITC-stained BVs. Data in FIG. 3A suggest that S1P is a more potent
stimulator of neovascularization in vivo than bFGF or VEGF[Lee, et
al., (1999), Biochem Biophys Res Commun,. vol 264: 743-50], as
evidenced by the vast amount of FITC-stained BVs in the plugs
containing S1P compared to the plugs containing bFGF or VEGF.
[0143] Sections of the plugs were then stained with hemotoxyln
& eosin for evaluation of EC infiltration (FIG. 3B). The
infiltration of ECs is a critical step in neo-vascularization.
Plugs containing S1P had a 3-fold increase of EC infiltration in
comparison to the Matrigel only plugs. Cell infiltration is
presumed to be ECs although we recognize that other cell types such
as immune cells may also be stained. Mice systemically administered
SPHINGOMAB every 48 hrs (initiated 1 day prior to plug
implantation), demonstrated a reduced amount of EC infiltration
even when S1P was added to the Matrigel plugs. These results
demonstrate the ability of SPHINGOMAB to inhibit EC infiltration in
vivo.
[0144] Endogenous S1P from the blood and surrounding tissue could
supply a wound with pro-angiogenic stimuli. The ability of
SPHINGOMAB to reduce endogenous S1P in a wound was investigated.
Optimally stimulated plugs (Matrigel supplemented with 0.5 .mu.g/mL
bFGF or 10 mg/mL VEGF) were implanted into mice. Mice received i.p.
injections of 25 mg/kg SPHINGOMAB or saline every 48 hrs starting 1
day prior to Matrigel implantation. Each treatment group (Matrigel,
Matrigel plus GF or Matrigel plus GF and administered SPHINGOMAB)
consisted of a minimum of 6 mice. After 10 days, the mice were
treated with heparin, injected with Isolectin B4-FITC, the plugs
excised, embedded in OCT freezing medium and sectioned.
Micro-vascular density was qualitatively accessed by lectin-FITC
stained vessels as shown in FIG. 3C. BV staining was sporadic in
control (untreated) plugs, whereas the plugs containing bFGF or
VEGF demonstrated significant evidence of vascularization. The
plugs from mice treated with the SPHINGOMAB demonstrated a
significant reduction in BV formation compared to the bFGF or VEGF
plugs from saline-treated mice. Quantification of stained vessels
revealed a 5 to 8.5-fold decrease in neovascularization of VEGF- or
bFGF-containing plugs, respectively, from animals treated with
SPHINGOMAB in comparison to saline-treated animals (FIG. 3C). This
evaluation further demonstrates the ability of endogenous serum and
tissue S1P to enhance micro-vascularization as well as the ability
of SPHINGOMAB to neutralize endogenous S1P's pro-angiogenic
effects.
Example 4
SPHINGOMAB Inhibits Scar Formation in vivo
[0145] S1P makes profound contributions to wound healing by
activating fibroblast migration, proliferation and collagen
production; SPHINGOMAB neutralizes these effects. Several studies
using multiple types of fibroblasts confirm S1P's ability to
promote wound healing: 1) S1P increased Swiss-3T3 fibroblast
proliferation as measured by .sup.3H-thymidine incorporation using
standard methods (FIG. 4A); 2) S1P promoted the migration of
cardiac fibroblasts in a standard scratch wound healing assay.
(FIG. 4B); 3) S1P promoted collagen expression by cardiac
fibroblasts isolated from transgenic mice possessing the collagen
1a GFP reporter, as indicated by immunofluorescence microscopy
(FIG. 4C); and 4) S1P induced the differentiation of WI-38 lung
fibroblasts into myofibroblasts, cells that are active in scar
remodeling, as indicated by increased expression of myofibroblast
marker protein, .alpha.-smooth muscle actin, using immunoblot
analysis (FIG. 4D). In each of these assays, SPHINGOMAB neutralized
S1P's. It is anticipated that ocular fibroblasts would respond
similarly to S1P and SPHINGOMAB. Similarities between
cardiovascular disease and neovascular lesions of AMD, including
scar remodeling and subsequent, maladaptive fibrous tissue
formation, have been noted; [Vine et al. (2005), Ophthalmology,.
vol 112: 2076-80 and Seddon and Chen (2004), Int Ophthalmol Clin,.
vol 44: 17-39]; thus it is believed that SPHINGOMAB would have
effects on ocular neovascularization and scarring similar to those
it has demonstrated in cardiovascular systems. Studies at Lpath
evaluated the efficacy of SPHINGOMAB to reduce cardiac scar
formation after permanent myocardial infarction (MI) via ligation
of the left descending coronary artery in mice. Systemic
administration of 25 mg/kg SPHINGOMAB or saline was initiated 48
hrs after surgery. Antibody administration at 48 hrs was chosen to
allow normal, reparative scar formation to occur during the early
remodeling phase and permit beneficial, S1P-stimulated angiogenesis
immediately after the MI. Two weeks after the infarct, mice were
sacrificed and fibrosis was accessed by Masson's trichrome staining
of the cardiac tissue. Animals receiving SPHINGOMAB treatments
exhibited almost complete abrogation of perivascular fibrosis (FIG.
4E). As a control for any non-specific wound-healing responses,
sham animals underwent thoracotomy without coronary artery
ligation.
Example 5
S1P Promotes Transformation of Ocular Epithelial Cells and
Fibroblasts Into Contractile, Scar Tissue-producing
Myofibroblasts
[0146] Pathological tissue fibrosis (scar formation) is a primary,
contributing factor in a number of ocular disorders, including:
age-related macular degeneration, diabetic retinopathy, retinopathy
of prematurity, proliferative vitreoretinopathy and consequences of
glaucoma surgery.
[0147] In many of these disorders, circulating growth factors and
chemokines promote the transformation of normal ocular cells into
fibrocontractile, scar tissue-producing cells that have been termed
"myofibroblasts". Normally, myofibroblasts are responsible for
tissue repair as part of the wound healing response following
injury. However altered number and function of myofibroblasts are
implicated in diseases characterized by pathological scar tissue
formation in the liver, skin, lung, kidney, heart and eyes. In the
eye, transformation of retinal pigmented epithelial (RPE) cells to
a myofibroblast phenotype is linked to formation of
fibro-contractile membranes which cause retinal detachment and
subsequent vision impairment. In addition, myofibroblast
transformation of ocular fibroblasts can result in abnormal scar
tissue production after eye injury leading to subsequent vision
loss. Although many of the circulating protein factors in the eye
that promote myofibroblast formation have been identified, nothing
is known regarding the role of lysolipids such as S1P in this
process. Therefore, we examined the effects of S1P on myofibroblast
transformation of several human ocular cell lines. As shown in FIG.
5, S1P stimulates production of .alpha.-Smooth muscle actin
(.alpha.-SMA; a myofibroblast marker) in human retinal pigmented
epithelial cells (FIG. 5A) and human conjunctiva fibroblasts (FIG.
5B). These data demonstrate for the first time, that S1P is among
the milieu of circulating chemical factors that promote
transformation of ocular epithelial cells and fibroblasts into
contractile, scar tissue-producing myofibroblasts which may
contribute to retinal detachment, ocular fibrosis and subsequent
vision impairment.
[0148] In these experiments, the ability of S1P to promote a-SMA
expression differed in a concentration dependent manner between the
retinal pigmented epithelial cells and conjunctiva fibroblasts. As
shown, a significant increase in .alpha.-SMA expression was
observed at the 0.001 .mu.M concentration in the epithelial cells
which then decreased to basal levels at the 10 .mu.M concentration.
In contrast, a significant increase in .alpha.-SMA expression was
observed only at the 10 .mu.M concentration in the conjunctiva
fibroblasts. This difference is believed to result from increased
S1P receptor expression in the epithelial cells compared to the
fibroblasts. We hypothesize that, due to increased S1P receptor
expression levels, retinal pigmented epithelial cells are likely
more sensitive to S1P at low concentrations. In contrast, at high
S1P levels the receptors become sensitized or possibly even
internalized leading to decreased stimulation by S1P.
[0149] Collagen is one of the primary structural proteins that
supports all tissues in the body and is one of the main components
of scar tissue. In the non-pathological setting, total collagen
content within tissue is maintained via a balance between collagen
production by fibroblasts and degradation by certain enzymes. A
number of disorders that involve increased levels of scar tissue
result, in part, from physiological and molecular processes that
inhibit degradation of collagen that is need for scar formation. We
hypothesized that the ability of S1P to promote scar tissue
formation may result from its ability to inhibit collagen
degradation, thereby leading to net increases in scar tissue within
organs. Therefore, we examined the effects of S1P on expression of
plasminogen activator inhibitor (PAI-1) in human conjunctiva
fibroblasts. Increased PAI-1 expression correlates with a decrease
in the proteolytic degradation of connective tissue and is
upregulated in association with several fibrotic diseases that
involve increased scarring. As shown in FIG. 5C, S1P stimulates the
PAI-1 expression in a dose-dependent manner. These data suggest
that, may also promote scar tissue formation by stimulating the
expression of proteins that inhibit its degradation, suggesting
that S1P functions through multiple mechanistic pathways to promote
and maintain pathological scarring associated with ocular
diseases.
Example 6
SPHINGOMAB Inhibits Inflammatory and Immune Cell Infiltration
[0150] Inflammation is the first response in the remodeling
process[7]. It is triggered both by ischemia and by cellular damage
and results in up-regulation of cytokine expression which
stimulates the migration of macrophages and neutrophils to the
injured area for phagocytosis of dead cells and to further
up-regulate the inflammatory response [Jordan et al.(1999),
Cardiovasc Res,. vol 43: 860-78]. Mast cells are also important
cellular mediators of the inflammatory response. S1P released from
mast cells is responsible for many of the adverse responses seen in
experimental animal models of inflammation [Jolly et al (2004), J
Exp Med,. vol 199: 959-70 and Jolly et al (2005), Blood,. vol 105:
4736-42].
[0151] Based upon the similarities of immune and inflammatory
responses in CNV and CVD, the efficacy of SPHINGOMAB to mitigate
immune cell infiltration into a wound was evaluated in a murine
infarct model as an indication of SPHINGOMAB's potential effects in
mitigating these damages during AMD [Vine et al. (2005),
Ophthalmology,. vol 112: 2076-80 and Seddon and Chen (2004), Int
Ophthalmol Clin,. vol 44: 17-39]. Four days post-MI, macrophage and
mast cell infiltration was evaluated using MAC-1 and MCG35
antibodies, respectively, within the area at risk. SPHINGOMAB
dramatically attenuated the density of inflammatory macrophages
(FIG. 6A) and mast cells (FIG. 6B) suggesting that SPHINGOMAB may
neutralize immune and inflammatory damages during AMD.
Example 7
SPHINGOMAB is Highly Specific for S1P
[0152] A competitive ELISA demonstrates SPHINGOMAB's specificity
for S1P compared to other bioactive lipids. SPHINGOMAB demonstrated
no cross-reactivity to sphingosine (SPH), the immediate metabolic
precursor of S1P or lysophosphatidic acid (LPA), an important
extracellular signaling molecule that is structurally and
functionally similar to S1P. SPHINGOMAB did not recognize other
structurally similar lipids and metabolites, including
ceramide-1-phosphate (C1P), dihydrosphingosine (DH-SPH),
phosphatidyl serine (PS), phosphatidyl ethanolamine (PE), or
sphingomyelin (SM). SPHINGOMAB did cross react with
dihydrosphingosine-1-phosphate (DH-S1P) and, to a lesser extent,
sphingosylphoryl choline (SPC) FIG. 7).
Example 8
Development of Anti-LPA mAbs
[0153] The overall objective of these experiments is to generate
and develop mAbs specific to LPA to develop an antibody-based
therapy for the treatment of LPA related diseases, in particular
those diseases which may involve excessive fibrosis. For example,
LPA may have some direct fibrogenic effects by stimulating collagen
gene expression and proliferation of fibroblasts [Chen, et al.
(2006) FEBS Lett. 580(19):4737-45]. Thus, an anti-LPA mAb may be
useful in the treatment of fibrosis and diseases characterized by
excessive fibroblast activity. These diseases include but are not
limited to various ocular disorders, cardiac remodeling and heart
failure and scleroderma. Antibodies directed against the bioactive
lipid, LPA, that demonstrate good performance characteristics both
in in vitro assays and in vivo would be highly useful in
therapeutic and diagnostic applications.
[0154] In order to generate monoclonal antibodies (mAbs) against
LPA, 80 mice were immunized with a derivative of Lysophosphatidic
acid (LPA, 1-acyl-2-lyso-sn-glycero-3-phosphate). The presence of
anti-LPA antibodies was determined by analyzing the sera of the
immunized mice by ELISA at 3 time points after immunization. The
immune response varied greatly between individual mice, both with
respect to time of antibody response and levels attained. Overall,
a significant immunological response (titer>125,000) was
observed in at least half of the mice. Five mice with the highest
antibody titer were selected to initiate hybridoma cell line
development. After the initial screening of over 2000 hybridoma
cells generated from these 5 fusions, a total of 29 anti-LPA
secreting hybridoma cell lines exhibited binding to LPA. Of these
clones, 24 were further subcloned and characterized in a panel of
ELISA assays. From the 14 clones that remained positive, six clones
were chosen for further characterization. The isotype of the mAb
was IgG1 for most of the antibodies.
[0155] In an initial screen, all the mAbs were compared for their
binding properties to 12:0 LPA and S1P. Out of 26 mAbs, 5 clones
cross-reacted with S1P. Eight anti-LPA mAbs with superior binding
to 12:0 and 18:0 LPA were further characterized for their
specificity and binding properties.
[0156] The mAbs from 6 individual cell lines were fully
characterized for their specificity by competition ELISA using a
series of analogues and for their potency in a panel of in vitro
assays (Table 1). The majority of the mAbs exhibited specificity
for LPA isoforms. The antibody affinity was estimated to be in the
picomolar range. Further testing in animal models will determine
whether these mAbs may provide the basis for promising therapies
for LPA related diseases.
[0157] Using surface plasmon resonance, the affinities and kinetics
were measured for 6 mAbs (Table 2). All six mAbs bound LPA with
similar K.sub.D values (ranging from 0.34 to 3.8 pM) and similar
kinetic parameters. For many of these interactions, the k.sub.d was
fixed at 1.times.10.sup.-6 s.sup.-1 in the fitting program as the
complexes dissociated very slowly. Table 1 also depicts the binding
of these 6 mAbs to 18:0 and 12:0 LPA bound to the wells of the
ELISA plate at increasing concentrations. The concentration of mAb
representing 50% of effective concentration (EC.sub.50) and the
maximal binding (MB) was determined using 18:0 and 12:0 LPA as
coating antigen. The EC.sub.50 values were generally lower for 18:0
LPA. It is noted that mAb B3 showed a higher binding preference to
18:0 LPA than to 12:0 LPA compared to the other mAbs.
[0158] The specificity of the anti-LPA mAbs was evaluated by
determining the binding to a set of LPA variants and related
biolipids such as distearoyl-phosphatidic acid,
lysophosphatidylcholine, S1P, ceramide and ceramide-1-phosphate.
The IC.sub.50 and cross-reactivity of the 6 selected mAbs plus two
additional mAbs (504B58-3F8 and 504B104) directed against different
LPA-related compounds are summarized in Table 3. All mAbs
discriminated between 12:0 (lauroyl), 14:0 (myristoyl), 16:0
(palmitoyl), 18:1 (oleoyl), 18:2 (linoleoyl) and 20:4
(arachidonoyl) LPAs (Table 3), while none of them demonstrated
cross-reactivity to distearoyl PA and LPC, the immediate metabolic
precursor of LPA. Furthermore, the inhibition effect of other
lipids tested such as S1P, ceramide and ceramide-1-phosphate were
negligible. These findings clearly show that the anti-LPA mAbs did
not recognize such structurally similar lipids including the
precursor lipids, demonstrating the high specificity of the
antibodies to lysophosphatidic acids. The rank order for EC.sub.50
was for the unsaturated 18:2>18:1>20:4 and for the saturated
lipids 14:0>16:0>18:0.
[0159] Interestingly, competition with 18:1 LPA revealed a
different behavior for the 6 mAbs. Amongst the 6 mAbs, 504B3
exhibited the lowest IC.sub.50 (50% inhibition of binding). Direct
binding of mAb 504B3 to immobilized 18:1 LPA was effectively
blocked in presence of added 18:1 LPA with IC.sub.50 values of 287
nM. Surprisingly, none of the IC.sub.50 values were close to their
respective Kd values for binding to LPA. The IC.sub.50 value was at
least 100-fold higher than their Kd (nM range vs pM range). 5 mAbs
exhibited specificity to 18:1 LPA as shown in the competition
assay. 18:1 LPA did not compete with mAb 63 bound to immobilized
18:1 LPA, yet it bound LPA with Kd values in the picomolar range.
Thus, while all six mAbs bound with similar affinities to LPA, five
out of six mAbs exhibited effective and specific binding to 18:1
LPA. TABLE-US-00001 TABLE 1 Direct binding kinetics. B3 B7 B58
B58-3F8 B104 D22-1 A63-1 B3A6-1 LPA-C12 HMC (nM) 2.420 0.413 0.554
0.463 0.559 1.307 0.280 0.344 Max (OD450) 0.809 1.395 1.352 1.404
1.402 0.449 1.269 1.316 LPA-C18 HMC (nM) 1.067 0.274 0.245 0.187
0.313 0.176 0.298 0.469 Max (OD450) 1.264 0.973 0.847 1.000 1.016
0.353 1.302 1.027 Increasing amounts of mAbs (up to 40 ng/100 .mu.l
reaction mix) were tested for binding to 12:0 LPA or 18:0 LPA (0.1
.mu.M) as coating antigen. EC.sub.50: effective antibody
concentration that gives 50% of the maximum binding. MB: maximal
binding (expressed as OD450).
[0160] TABLE-US-00002 TABLE 2 Binding affinity of the anti-LPA
mouse mAbs. Antibody Molecules k.sub.a (M.sup.-1 s.sup.-1) k.sub.d
(s.sup.-1) K.sub.D (pM) A63 4.4 .+-. 1.0 .times. 10.sup.5 1 .times.
10.sup.-6 2.3 .+-. 0.5 B3 7.0 .+-. 1.5 .times. 10.sup.5 1 .times.
10.sup.-6 1.4 .+-. 0.3 B7 6.2 .+-. 0.1 .times. 10.sup.5 1 .times.
10.sup.-6 1.6 .+-. 0.1 D22 3.0 .+-. 0.9 .times. 10.sup.4 1 .times.
10.sup.-6 33 .+-. 10 B3A6 1.2 .+-. 0.9 .times. 10.sup.6 1.9 .+-.
0.4 .times. 10.sup.-5 16 .+-. 1.2 B58 2.9 .+-. 1.6 .times. 10.sup.6
1 .times. 10.sup.-6 0.34 .+-. 0.019 LPA was immobilized to the
sensor chip at densities ranging 150 resonance units. Dilutions of
each mAb were passed over the immobilized LPA and kinetic constants
were obtained by nonlinear regression of association/dissociation
phases. # Errors are given as the standard deviation using at least
three determinations in duplicate run. Apparent affinities were
determined by K.sub.D = k.sub.a/k.sub.d. k.sub.a = Association rate
constant in M.sup.-1s.sup.-1 k.sub.d = Dissociation rate constant
in s.sup.-1
[0161] TABLE-US-00003 TABLE 3 Competition of LPA binding and
activity. 14:0 LPA 16:0 LPA 18:1 LPA 18:2 LPA 20:4 LPA IC.sub.50 MI
IC.sub.50 MI IC.sub.50 MI IC.sub.50 MI IC.sub.50 MI uM % uM % uM %
uM % uM % 504B3 0.02 72.3 0.05 70.3 0.287 83 0.064 72.5 0.02 67.1
504B7 0.105 61.3 0.483 62.9 >2.0 100 1.487 100 0.161 67 504B58
0.179 66.7 3.061 >100 1.606 72.8 1.278 94.6 0.22 63.6 504B58-3F8
0.26 63.9 5.698 >100 1.5 79.3 1.240 92.6 0.304 79.8 504B104 0.32
23.1 1.557 26.5 28.648 >100 1.591 36 0.32 20.1 504D22-1 0.164
34.9 0.543 31 1.489 47.7 0.331 31.4 0.164 29.5 504A63-1 1.147 31.9
5.994 45.7 -- -- -- -- 0.119 14.5 504B3A6-1 0.108 59.9 1.151 81.1
1.897 87.6 -- -- 0.131 44.9 18:0 LPA was captured on ELISA plates.
Each competitor lipid (up to 10 .mu.M) was serially diluted in BSA
(1 mg/ml)-PBS and then incubated with the mAbs (3 nM). Mixtures
were then transferred to LPA coated wells and the amount of bound
antibody was measured with a secondary antibody. Data was
normalized to maximum signal (A.sub.450) and is expressed as
percent inhibition. Assay were performed in triplicate for
parameter analysis. IC.sub.50: Half maximum inhibition
concentration MI: Maximum inhibition (% of binding in the absence
of inhibitor) --: not estimated because of a weak inhibition
Materials and Methods Biolipid Reagents:
[0162] All biolipids were purchased from Avanti Polar Lipids with
identity confirmed by HPLC and mass spectrometry. LPA derivatives
were synthesized at the Department of Chemistry (San Diego State
University). All other reagents were purchased from Fisher unless
otherwise stated. [0163] DLPC:
1-Palmytoyl-2-myristoyl-sn-glycero-3-phosphocholine. [0164] DASA:
1,2-Distearoyl-sn-glycero-3-phosphate; [0165] 14:0 LPA:
1-Myristoyl-2-hydroxy-sn-glycero-3-phosphate [0166] 16:0 LPA:
1-Plmytoyl-2-hydroxy-sn-glycero-3-phosphate [0167] 18:0 LPA:
1-Stearoyl-2-hydroxy-sn-glycero-3-phosphate [0168] 18:1 LPA:
1-Oleoyl-2-hydroxy-sn-glycero-3-phosphate [0169] 18:2 LPA:
1-Linoleoyl-2-hydroxy-sn-glycero-3-phosphate [0170] 20:4 LPA:
1-Arachidonoyl-2-hydroxy-sn-glycero-3-phosphate [0171] S1P:
D-erythro-sphingosine-1-phosphate Quantitative ELISAs:
[0172] Microtiter ELISA plates (Costar, Cat No. 3361) were coated
with rabbit anti-mouse IgG, F(ab').sub.2 fragment specific antibody
(Jackson, 315-005-047) diluteu in 1M Carbonate Buffer (pH 9.5) at
37.degree. C. for 1 h. Plates were washed with PBS and blocked with
PBS/BSA/Tween-20 for 1 hr at 37.degree. C. For the primary
incubation, dilutions of non-specific mouse IgG or human .IgG,
whole molecule (used for calibration curve) and samples to be
measured were added to the wells. Plates were washed and incubated
with 100 .mu.l per well of HRP conjugated goat anti-mouse (H+L)
diluted 1:40,000 (Jackson, cat No 115-035-146) for 1 hr at
37.degree. C. After washing, the enzymatic reaction was detected
with tetramethylbenzidine (Sigma, cat No T0440) and stopped by
adding 1 M H.sub.2SO.sub.4. The optical density (OD) was measured
at 450 nm using a Thermo Multiskan EX. Raw data were transferred to
GraphPad software for analysis.
Direct ELISA:
[0173] Microtiter ELISA plates (Costar, Cat No. 3361) were coated
with LPA-BSA diluted in 1M Carbonate Buffer (pH 9.5) at 37.degree.
C. for 1 h. Plates were washed with PBS (137 mM NaCl, 2.68 mM KCl,
10.1 mM Na.sub.2HPO.sub.4, 1.76 mM KH.sub.2PO.sub.4; pH 7.4) and
blocked with PBS/BSA/Tween-20 for 1 h at room temperature or
overnight at 4.degree. C. The samples to be tested were diluted at
0.4 .mu.g/mL, 0.2 .mu.g/mL, 0.1 .mu.g/mL, 0.05 .mu.g/mL, 0.0125
.mu.g/mL, and 0 .mu.g/mL and 100 .mu.l added to each well. Plates
were washed and incubated with 100 .mu.l per well of HRP conjugated
goat anti-mouse (1:20,000 dilution) (Jackson, cat No 115-035-003)
for 1 h at room temperature. After washing, the enzymatic reaction
was detected with tetramethylbenzidine (Sigma, cat No T0440) and
stopped by adding 1 M H.sub.2SO.sub.4. The optical density (OD) was
measured at 450 nm using a Thermo Multiskan EX. Raw data were
transferred to GraphPad software for analysis.
Competition Assays:
[0174] The specificity of mAbs was tested in ELISA assays.
Microtiter plates ELISA plates (Costar, Cat No. 3361) were coated
with 18:0 LPA-BSA diluted in 1M Carbonate Buffer (pH 9.5) at
37.degree. C. for 1 h. Plates were washed with PBS (137 mM NaCl,
2.68 mM KCl, 10.1 mM Na.sub.2HPO.sub.4, 1.76 mM KH.sub.2PO.sub.4;
pH 7.4) and blocked with PBS/BSA/Tween-20 at 37.degree. C. for 1 h
or overnight at room temperature. For the primary incubation 0.4
.mu.g/mL anti-LPA mAb and designated amounts of (14:0, 16:0, 18:0,
18:1, 18:2 and 20:4) LPA, DSPA, 18:1 LPC (lysophosphatidylcholine),
S1P, ceramide and ceramide-1-phosphate were added to wells of the
ELISA plates and incubated at 37.degree. C. for 1 h. Plates were
washed and incubated with 100 .mu.l per well of HRP conjugated goat
anti-mouse (1:20,000 dilution) (Jackson, cat No 115-035-003) or HRP
conjugated goat anti-human(H+L) diluted 1:50,000 (Jackson, cat
No109-035-003) at 37.degree. C. for 1 h. After washing, the
enzymatic reaction was detected with tetramethylbenzidine and
stopped by adding 1 M H.sub.2SO.sub.4. The optical density (OD) was
measured at 450 nm using a Thermo Multiskan EX. Raw data were
transferred to GraphPad software for analysis. not estimated
because of a weak inhibition
Antibody Purification:
[0175] Monoclonal antibodies were purified from culture
supernatants by passing culture supernatants over protein A/G
columns (Pierce, Cat.No 53133) at 0,.5 mL/min. Mobile phases
consisted of IX Pierce IgG binding Buffer (Cat.No 21001) and 0.1 M
glycine pH 2.7 (Pierce, Elution Buffer, Cat.No 21004). Antibody
collections in 0.1 M glycine were diluted 10% (v/v) with 1 M
Phosphate Buffer, pH 8.0, to neutralize the pH. IgG.sub.1
collections were pooled and dialyzed exhaustively against 1.times.
PBS (Pierce Slide-A-Lyzer Cassette, 3,500 MWCO, Cat. No 66382).
Eluates were concentrated using Centricon YM-3(10,000 MWCO Amicon
Cat. No 4203) by centrifugation for 1 h at 2,500 rcf. The antibody
concentration was determined by quantitative ELISA as described
above using a commercial myeloma IgG.sub.1 stock solution as a
standard. Heavy chain types of mAbs were determined by ELISA using
Monoclonal Antibody Isotyping Kit (Sigma, ISO-2).
Example 9
Humanized Anti-S1P Monoclonal Antibody--SPHINGOMAB
[0176] This example describes a particularly preferred humanized
monoclonal antibody specifically reactive with S1P. Construction,
synthesis, purification, and testing of this antibody, termed
LT1009, is described in commonly owned, co-pending, concurrently
filed U.S. patent application Ser. No. __/______ [attorney docket
no. LPT-3010-PV, entitled "Compositions and Methods for Binding
Sphingosine-1-Phosphate], which is hereby incorporated by reference
in its entirety for all purposes. As compared to the murine
anti-S1P antibody from which LT1009 was derived, the humanized form
exhibits an S1P binding affinity in the picomolar range, as well as
and superior stability and in vivo efficacy.
[0177] As with naturally occurring antibodies, LT1009 includes
three complementarity determining regions (each a "CDR") in each of
the two light chain polypeptides and each of the two heavy chain
polypeptides that comprise each antibody molecule. The amino acid
sequences for each of these six CDRs is provided immediately below
("VL" designates the variable region of the immunoglobulin light
chain, whereas "VH" designates the variable region of the
immunoglobulin heavy chain): TABLE-US-00004 CDR1 VL: ITTTDIDDDMN
[SEQ ID NO: 1] CDR2 VL: EGNILRP [SEQ ID NO: 2] CDR3 VL: LQSDNLPFT
[SEQ ID NO: 3] CDR1 VH: DHTIH [SEQ ID NO: 4] CDR3 VH: GGFYGSTIWFDF
[SEQ ID NO: 5] CDR2 VH: AISPRHDITKYNEMFRG [SEQ ID NO: 6]
The nucleotide and amino acid sequences for the heavy and light
chain polypeptides of LT1009 are listed immediately below:
[0178] LT1009 HC nucleotide sequence [SEQ ID NO: 7]: TABLE-US-00005
1 aagcttgccg ccaccatgga atggagctgg gtgttcctgt tctttctgtc 51
cgtgaccaca ggcgtgcatt ctgaggtgca gctggtgcag tctggagcag 101
aggtgaaaaa gcccggggag tctctgaaga tctcctgtca gagttttgga 151
tacatcttta tcgaccatac tattcactgg atgcgccaga tgcccgggca 201
aggcctggag tggatggggg ctatttctcc cagacatgat attactaaat 251
acaatgagat gttcaggggc caggtcacca tctcagccga caagtccagc 301
agcaccgcct acttgcagtg gagcagcctg aaggcctcgg acaccgccat 351
gtatttctgt gcgagagggg ggttctacgg tagtactatc tggtttgact 401
tttggggcca agggacaatg gtcaccgtct cttcagcctc caccaagggc 451
ccatcggtct tccccctggc accctcctcc aagagcacct ctgggggcac 501
agcggccctg ggctgcctgg tcaaggacta cttccccgaa ccggtgacgg 551
tgtcgtggaa ctcaggcgcc ctgaccagcg gcgtgcacac cttcccggct 601
gtcctacagt cctcaggact ctactccctc agcagcgtgg tgaccgtgcc 651
ctccagcagc ttgggcaccc agacctacat ctgcaacgtg aatcacaagc 701
ccagcaacac caaggtggac aagagagttg gtgagaggcc agcacaggga 751
gggagggtgt ctgctggaag ccaggctcag cgctcctgcc tggacgcatc 801
ccggctatgc agtcccagtc cagggcagca aggcaggccc cgtctgcctc 851
ttcacccgga ggcctctgcc cgccccactc atgctcaggg agagggtctt 901
ctggcttttt ccccaggctc tgggcaggca caggctaggt gcccctaacc 951
caggccctgc acacaaaggg gcaggtgctg ggctcagacc tgccaagagc 1001
catatccggg aggaccctgc ccctgaccta agcccacccc aaaggccaaa 1051
ctctccactc cctcagctcg gacaccttct ctcctcccag attccagtaa 1101
ctcccaatct tctctctgca gagcccaaat cttgtgacaa aactcacaca 1151
tgcccaccgt gcccaggtaa gccagcccag gcctcgccct ccagctcaag 1201
gcgggacagg tgccctagag tagcctgcat ccagggacag gccccagccg 1251
ggtgctgaca cgtccacctc catctcttcc tcagcacctg aactcctggg 1301
gggaccgtca gtcttcctct tccccccaaa acccaaggac accctcatga 1351
tctcccggac ccctgaggtc acatgcgtgg tggtggacgt gagccacgaa 1401
gaccctgagg tcaagttcaa ctggtacgtg gacggcgtgg aggtgcataa 1451
tgccaagaca aagccgcggg aggagcagta caacagcacg taccgtgtgg 1501
tcagcgtcct caccgtcctg caccaggact ggctgaatgg caaggagtac 1551
aagtgcaagg tctccaacaa agccctccca gcccccatcg agaaaaccat 1601
ctccaaagcc aaaggtggga cccgtggggt gcgagggcca catggacaga 1651
ggccggctcg gcccaccctc tgccctgaga gtgaccgctg taccaacctc 1701
tgtccctaca gggcagcccc gagaaccaca ggtgtacacc ctgcccccat 1751
cccgggagga gatgaccaag aaccaggtca gcctgacctg cctggtcaaa 1801
ggcttctatc ccagcgacat cgccgtggag tgggagagca atgggcagcc 1851
ggagaacaac tacaagacca cgcctcccgt gctggactcc gacggctcct 1901
tcttcctcta tagcaagctc accgtggaca agagcaggtg gcagcagggg 1951
aacgtcttct catgctccgt gatgcatgag gctctgcaca accactacac 2001
gcagaagagc ctctccctgt ctccgggtaa atag
[0179] LT1009 HC amino acid sequence [SEQ ID NO: 8]: TABLE-US-00006
1 mewswvflff lsvttgvhse vqlvqsgaev kkpgeslkis cqsfgyifid 51
htihwmrqmp gqglewmgai sprhditkyn emfrgqvtis adkssstayl 101
qwsslkasdt amyfcarggf ygstiwfdfw gqgtmvtvss astkgpsvfp 151
lapsskstsg gtaalgclvk dvfpepvtvs wnsgaltsgv htfpavlqss 201
glyslssvvt vpssslgtqt yicnvnhkps ntkvdkrvap ellggpsvfl 251
fppkpkdtlm isrtpevtcv vvdvshedpe vkfnwyvdgv evhnaktkpr 301
eeqynstyrv vsvltvlhqd wlngkeykck vsnkalpapi ektiskakgq 351
prepqvytlp psreemtknq vsltclvkgf ypsdiavewe sngqpennyk 401
ttppvldsdg sfflyskltv dksrwqqgnv fscsvmheal hnhytqksls 451
lspgk
[0180] LT1009 LC nucleotide sequence [SEQ ID NO: 9]: TABLE-US-00007
1 aagcttgccg ccaccatgtc tgtgcctacc caggtgctgg gactgctgct 51
gctgtggctg acagacgccc gctgtgaaac gacagtgacg cagtctccat 101
ccttcctgtc tgcatctgta ggagacagag tcaccatcac ttgcataacc 151
accactgata ttgatgatga tatgaactgg ttccagcagg aaccagggaa 201
agcccctaag ctcctgatct ccgaaggcaa tattcttcgt cctggggtcc 251
catcaagatt cagcagcagt ggatatggca cagatttcac tctcaccatc 301
agcaaattgc agcctgaaga ttttgcaact tattactgtt tgcagagtga 351
taacttacca ttcactttcg gccaagggac caagctggag atcaaacgta 401
cggtggctgc accatctgtc ttcatcttcc cgccatctga tgagcagttg 451
aaatctggaa ctgcctctgt tgtgtgcctg ctgaataact tctatcccag 501
agaggccaaa gtacagtgga aggtggataa cgccctccaa tcgggtaact 551
cccaggagag tgtcacagag caggacagca aggacagcac ctacagcctc 601
agcagcaccc tgacgctgag caaagcagac tacgagaaac acaaagtcta 651
cgcctgcgaa gtcacccatc agggcctgag ctcgcccgtc acaaagagct 701
tcaacagggg agagtgttag
[0181] LT1009 LC amino acid sequence [SEQ ID NO: 10]:
TABLE-US-00008 1 msvptqvlgl lllwltdarc ettvtqspsf lsasvgdrvt
itcitttdid 51 ddmnwfqqep gkapkllise gnilrpgvps rfsssgygtd
ftltisklqp 101 edfatyyclq sdnlpftfgq gtkleikrtv aapsvfifpp
sdeqlksgta 151 svvcllnnfy preakvqwkv dnalqsgnsq esvteqdskd
styslsstlt 201 lskadyekhk vyacevthqg lsspvtksfn rgec
[0182]
Sequence CWU 1
1
10 1 11 PRT Artificial Sequence Description of Artificial Sequence
Artificial Humanized Mouse Antibody 1 Ile Thr Thr Thr Asp Ile Asp
Asp Asp Met Asn 1 5 10 2 7 PRT Artificial Sequence Description of
Artificial Sequence Artificial Humanized Mouse Antibody 2 Glu Gly
Asn Ile Leu Arg Pro 1 5 3 9 PRT Artificial Sequence Description of
Artificial Sequence Artificial Humanized Mouse Antibody 3 Leu Gln
Ser Asp Asn Leu Pro Phe Thr 1 5 4 5 PRT Artificial Sequence
Description of Artificial Sequence Artificial Humanized Mouse
Antibody 4 Asp His Thr Ile His 1 5 5 12 PRT Artificial Sequence
Description of Artificial Sequence Artificial Humanized Mouse
Antibody 5 Gly Gly Phe Tyr Gly Ser Thr Ile Trp Phe Asp Phe 1 5 10 6
17 PRT Artificial Sequence Description of Artificial Sequence
Artificial Humanized Mouse Antibody 6 Ala Ile Ser Pro Arg His Asp
Ile Thr Lys Tyr Asn Glu Met Phe Arg 1 5 10 15 Gly 7 2034 DNA
Artificial Sequence Description of Artificial Sequence Artificial
Humanized Mouse Antibody 7 aagcttgccg ccaccatgga atggagctgg
gtgttcctgt tctttctgtc cgtgaccaca 60 ggcgtgcatt ctgaggtgca
gctggtgcag tctggagcag aggtgaaaaa gcccggggag 120 tctctgaaga
tctcctgtca gagttttgga tacatcttta tcgaccatac tattcactgg 180
atgcgccaga tgcccgggca aggcctggag tggatggggg ctatttctcc cagacatgat
240 attactaaat acaatgagat gttcaggggc caggtcacca tctcagccga
caagtccagc 300 agcaccgcct acttgcagtg gagcagcctg aaggcctcgg
acaccgccat gtatttctgt 360 gcgagagggg ggttctacgg tagtactatc
tggtttgact tttggggcca agggacaatg 420 gtcaccgtct cttcagcctc
caccaagggc ccatcggtct tccccctggc accctcctcc 480 aagagcacct
ctgggggcac agcggccctg ggctgcctgg tcaaggacta cttccccgaa 540
ccggtgacgg tgtcgtggaa ctcaggcgcc ctgaccagcg gcgtgcacac cttcccggct
600 gtcctacagt cctcaggact ctactccctc agcagcgtgg tgaccgtgcc
ctccagcagc 660 ttgggcaccc agacctacat ctgcaacgtg aatcacaagc
ccagcaacac caaggtggac 720 aagagagttg gtgagaggcc agcacaggga
gggagggtgt ctgctggaag ccaggctcag 780 cgctcctgcc tggacgcatc
ccggctatgc agtcccagtc cagggcagca aggcaggccc 840 cgtctgcctc
ttcacccgga ggcctctgcc cgccccactc atgctcaggg agagggtctt 900
ctggcttttt ccccaggctc tgggcaggca caggctaggt gcccctaacc caggccctgc
960 acacaaaggg gcaggtgctg ggctcagacc tgccaagagc catatccggg
aggaccctgc 1020 ccctgaccta agcccacccc aaaggccaaa ctctccactc
cctcagctcg gacaccttct 1080 ctcctcccag attccagtaa ctcccaatct
tctctctgca gagcccaaat cttgtgacaa 1140 aactcacaca tgcccaccgt
gcccaggtaa gccagcccag gcctcgccct ccagctcaag 1200 gcgggacagg
tgccctagag tagcctgcat ccagggacag gccccagccg ggtgctgaca 1260
cgtccacctc catctcttcc tcagcacctg aactcctggg gggaccgtca gtcttcctct
1320 tccccccaaa acccaaggac accctcatga tctcccggac ccctgaggtc
acatgcgtgg 1380 tggtggacgt gagccacgaa gaccctgagg tcaagttcaa
ctggtacgtg gacggcgtgg 1440 aggtgcataa tgccaagaca aagccgcggg
aggagcagta caacagcacg taccgtgtgg 1500 tcagcgtcct caccgtcctg
caccaggact ggctgaatgg caaggagtac aagtgcaagg 1560 tctccaacaa
agccctccca gcccccatcg agaaaaccat ctccaaagcc aaaggtggga 1620
cccgtggggt gcgagggcca catggacaga ggccggctcg gcccaccctc tgccctgaga
1680 gtgaccgctg taccaacctc tgtccctaca gggcagcccc gagaaccaca
ggtgtacacc 1740 ctgcccccat cccgggagga gatgaccaag aaccaggtca
gcctgacctg cctggtcaaa 1800 ggcttctatc ccagcgacat cgccgtggag
tgggagagca atgggcagcc ggagaacaac 1860 tacaagacca cgcctcccgt
gctggactcc gacggctcct tcttcctcta tagcaagctc 1920 accgtggaca
agagcaggtg gcagcagggg aacgtcttct catgctccgt gatgcatgag 1980
gctctgcaca accactacac gcagaagagc ctctccctgt ctccgggtaa atag 2034 8
455 PRT Artificial Sequence Description of Artificial Sequence
Artificial Humanized Mouse Antibody 8 Met Glu Trp Ser Trp Val Phe
Leu Phe Phe Leu Ser Val Thr Thr Gly 1 5 10 15 Val His Ser Glu Val
Gln Leu Val Gln Ser Gly Ala Glu Val Lys Lys 20 25 30 Pro Gly Glu
Ser Leu Lys Ile Ser Cys Gln Ser Phe Gly Tyr Ile Phe 35 40 45 Ile
Asp His Thr Ile His Trp Met Arg Gln Met Pro Gly Gln Gly Leu 50 55
60 Glu Trp Met Gly Ala Ile Ser Pro Arg His Asp Ile Thr Lys Tyr Asn
65 70 75 80 Glu Met Phe Arg Gly Gln Val Thr Ile Ser Ala Asp Lys Ser
Ser Ser 85 90 95 Thr Ala Tyr Leu Gln Trp Ser Ser Leu Lys Ala Ser
Asp Thr Ala Met 100 105 110 Tyr Phe Cys Ala Arg Gly Gly Phe Tyr Gly
Ser Thr Ile Trp Phe Asp 115 120 125 Phe Trp Gly Gln Gly Thr Met Val
Thr Val Ser Ser Ala Ser Thr Lys 130 135 140 Gly Pro Ser Val Phe Pro
Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly 145 150 155 160 Gly Thr Ala
Ala Leu Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro 165 170 175 Val
Thr Val Ser Trp Asn Ser Gly Ala Leu Thr Ser Gly Val His Thr 180 185
190 Phe Pro Ala Val Leu Gln Ser Ser Gly Leu Tyr Ser Leu Ser Ser Val
195 200 205 Val Thr Val Pro Ser Ser Ser Leu Gly Thr Gln Thr Tyr Ile
Cys Asn 210 215 220 Val Asn His Lys Pro Ser Asn Thr Lys Val Asp Lys
Arg Val Ala Pro 225 230 235 240 Glu Leu Leu Gly Gly Pro Ser Val Phe
Leu Phe Pro Pro Lys Pro Lys 245 250 255 Asp Thr Leu Met Ile Ser Arg
Thr Pro Glu Val Thr Cys Val Val Val 260 265 270 Asp Val Ser His Glu
Asp Pro Glu Val Lys Phe Asn Trp Tyr Val Asp 275 280 285 Gly Val Glu
Val His Asn Ala Lys Thr Lys Pro Arg Glu Glu Gln Tyr 290 295 300 Asn
Ser Thr Tyr Arg Val Val Ser Val Leu Thr Val Leu His Gln Asp 305 310
315 320 Trp Leu Asn Gly Lys Glu Tyr Lys Cys Lys Val Ser Asn Lys Ala
Leu 325 330 335 Pro Ala Pro Ile Glu Lys Thr Ile Ser Lys Ala Lys Gly
Gln Pro Arg 340 345 350 Glu Pro Gln Val Tyr Thr Leu Pro Pro Ser Arg
Glu Glu Met Thr Lys 355 360 365 Asn Gln Val Ser Leu Thr Cys Leu Val
Lys Gly Phe Tyr Pro Ser Asp 370 375 380 Ile Ala Val Glu Trp Glu Ser
Asn Gly Gln Pro Glu Asn Asn Tyr Lys 385 390 395 400 Thr Thr Pro Pro
Val Leu Asp Ser Asp Gly Ser Phe Phe Leu Tyr Ser 405 410 415 Lys Leu
Thr Val Asp Lys Ser Arg Trp Gln Gln Gly Asn Val Phe Ser 420 425 430
Cys Ser Val Met His Glu Ala Leu His Asn His Tyr Thr Gln Lys Ser 435
440 445 Leu Ser Leu Ser Pro Gly Lys 450 455 9 720 DNA Artificial
Sequence Description of Artificial Sequence Artificial Humanized
Mouse Antibody 9 aagcttgccg ccaccatgtc tgtgcctacc caggtgctgg
gactgctgct gctgtggctg 60 acagacgccc gctgtgaaac gacagtgacg
cagtctccat ccttcctgtc tgcatctgta 120 ggagacagag tcaccatcac
ttgcataacc accactgata ttgatgatga tatgaactgg 180 ttccagcagg
aaccagggaa agcccctaag ctcctgatct ccgaaggcaa tattcttcgt 240
cctggggtcc catcaagatt cagcagcagt ggatatggca cagatttcac tctcaccatc
300 agcaaattgc agcctgaaga ttttgcaact tattactgtt tgcagagtga
taacttacca 360 ttcactttcg gccaagggac caagctggag atcaaacgta
cggtggctgc accatctgtc 420 ttcatcttcc cgccatctga tgagcagttg
aaatctggaa ctgcctctgt tgtgtgcctg 480 ctgaataact tctatcccag
agaggccaaa gtacagtgga aggtggataa cgccctccaa 540 tcgggtaact
cccaggagag tgtcacagag caggacagca aggacagcac ctacagcctc 600
agcagcaccc tgacgctgag caaagcagac tacgagaaac acaaagtcta cgcctgcgaa
660 gtcacccatc agggcctgag ctcgcccgtc acaaagagct tcaacagggg
agagtgttag 720 10 234 PRT Artificial Sequence Description of
Artificial Sequence Artificial Humanized Mouse Antibody 10 Met Ser
Val Pro Thr Gln Val Leu Gly Leu Leu Leu Leu Trp Leu Thr 1 5 10 15
Asp Ala Arg Cys Glu Thr Thr Val Thr Gln Ser Pro Ser Phe Leu Ser 20
25 30 Ala Ser Val Gly Asp Arg Val Thr Ile Thr Cys Ile Thr Thr Thr
Asp 35 40 45 Ile Asp Asp Asp Met Asn Trp Phe Gln Gln Glu Pro Gly
Lys Ala Pro 50 55 60 Lys Leu Leu Ile Ser Glu Gly Asn Ile Leu Arg
Pro Gly Val Pro Ser 65 70 75 80 Arg Phe Ser Ser Ser Gly Tyr Gly Thr
Asp Phe Thr Leu Thr Ile Ser 85 90 95 Lys Leu Gln Pro Glu Asp Phe
Ala Thr Tyr Tyr Cys Leu Gln Ser Asp 100 105 110 Asn Leu Pro Phe Thr
Phe Gly Gln Gly Thr Lys Leu Glu Ile Lys Arg 115 120 125 Thr Val Ala
Ala Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln 130 135 140 Leu
Lys Ser Gly Thr Ala Ser Val Val Cys Leu Leu Asn Asn Phe Tyr 145 150
155 160 Pro Arg Glu Ala Lys Val Gln Trp Lys Val Asp Asn Ala Leu Gln
Ser 165 170 175 Gly Asn Ser Gln Glu Ser Val Thr Glu Gln Asp Ser Lys
Asp Ser Thr 180 185 190 Tyr Ser Leu Ser Ser Thr Leu Thr Leu Ser Lys
Ala Asp Tyr Glu Lys 195 200 205 His Lys Val Tyr Ala Cys Glu Val Thr
His Gln Gly Leu Ser Ser Pro 210 215 220 Val Thr Lys Ser Phe Asn Arg
Gly Glu Cys 225 230
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