U.S. patent application number 11/638615 was filed with the patent office on 2007-08-02 for methods for determining the prognosis for cancer patients using tucan.
This patent application is currently assigned to The Burnham Institute. Invention is credited to John C. Reed.
Application Number | 20070178502 11/638615 |
Document ID | / |
Family ID | 38322529 |
Filed Date | 2007-08-02 |
United States Patent
Application |
20070178502 |
Kind Code |
A1 |
Reed; John C. |
August 2, 2007 |
Methods for determining the prognosis for cancer patients using
TUCAN
Abstract
The invention provides methods for determining a prognosis for
survival for a cancer patient. One method involves (a) measuring a
level of a TUCAN in a neoplastic cell-containing sample from the
cancer patient, and (b) comparing the level of TUCAN in the sample
to a reference level of TUCAN, wherein a low level of TUCAN in the
sample correlates with increased survival of the patient. Another
method involves (a) measuring a level of TUCAN in a neoplastic
cell-containing sample from the cancer patient, and (b) classifying
the patient as belonging to either a first or second group of
patients, wherein the first group of patients having low levels of
TUCAN is classified as having an increased likelihood of survival
compared to the second group of patients having high levels of
TUCAN.
Inventors: |
Reed; John C.; (Rancho Santa
Fe, CA) |
Correspondence
Address: |
MCDERMOTT, WILL & EMERY
4370 LA JOLLA VILLAGE DRIVE, SUITE 700
SAN DIEGO
CA
92122
US
|
Assignee: |
The Burnham Institute
La Jolla
CA
|
Family ID: |
38322529 |
Appl. No.: |
11/638615 |
Filed: |
December 12, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10141618 |
May 7, 2002 |
7163801 |
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11638615 |
Dec 12, 2006 |
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09388221 |
Sep 1, 1999 |
6818750 |
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10141618 |
May 7, 2002 |
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60356934 |
Feb 12, 2002 |
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60289233 |
May 7, 2001 |
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Current U.S.
Class: |
435/6.12 ;
435/7.23 |
Current CPC
Class: |
A01K 2217/05 20130101;
C12Q 2600/158 20130101; G01N 33/57484 20130101; C12Q 2600/118
20130101; A61K 38/00 20130101; G01N 33/57419 20130101; C12Q 1/6886
20130101; G01N 2800/52 20130101; G01N 2333/96466 20130101; C07K
2319/00 20130101; A61K 2039/505 20130101; G01N 2510/00 20130101;
C07K 14/4747 20130101 |
Class at
Publication: |
435/006 ;
435/007.23 |
International
Class: |
C12Q 1/68 20060101
C12Q001/68; G01N 33/574 20060101 G01N033/574 |
Goverment Interests
[0002] This invention was made with government support under grant
numbers AG15402, CA69381 and NS36821, awarded by the National
Institutes of Health. The United States Government has certain
rights in this invention.
Claims
1. A method for determining a prognosis for survival for a cancer
patient, comprising: (a) measuring a level of a TUCAN in a
neoplastic cell-containing sample from said cancer patient, and (b)
comparing the level of TUCAN in said sample to a reference level of
TUCAN, wherein a low level of TUCAN in said sample correlates with
increased survival of said patient.
2. The method of claim 1, wherein said survival is overall
survival.
3. The method of claim 1, wherein said survival is disease-free
survival.
4. The method of claim 1, wherein said cancer patient has a cancer
selected from the group consisting of: colon cancer,
gastrointestinal cancer, breast cancer, ovarian cancer, lung
cancer, leukemia, CNS cancer, melanoma, prostate cancer, and renal
cancer.
5. The method of claim 1, wherein said sample is colon tumor
tissue.
6. The method of claim 1, wherein said sample is a fluid selected
from the group consisting of blood, serum, urine, semen and
stool.
7-8. (canceled)
9. The method of claim 1, wherein a level of a TUCAN nucleic acid
is measured.
10. The method of claim 1, wherein said patient has an early stage
of cancer.
11. The method of claim 1, wherein said level of TUCAN is used to
determine if said patient is at risk for relapse.
12. The method of claim 1, wherein said level of TUCAN is used to
determine a proper course of treatment for said patient.
13. A method of determining a prognosis for survival for a cancer
patient, comprising: (a) measuring levels of TUCAN and one or more
biomarkers selected from the group consisting of cIAP2, Apaf1,
Bcl-2 and Smac in a neoplastic cell-containing sample from said
cancer patient, and (b) comparing the level of TUCAN and the one or
more selected biomarkers in said sample to a reference level of
TUCAN and said one more selected biomarkers, wherein a low level of
TUCAN and a high level of any of Apaf1, Bcl-2 or Smac, or a low
level of TUCAN and a low level of cIAP2, in said sample correlate
with increased survival of said patient.
14. The method of claim 13, wherein said survival is overall
survival.
15. The method of claim 13, wherein said survival is disease-free
survival.
16. The method of claim 13, wherein cIAP2 is a selected
biomarker.
17. The method of claim 13, wherein Apaf1 is a selected
biomarker.
18. The method of claim 13, wherein Bcl-2 is a selected
biomarker.
19. The method of claim 13 wherein Smac is a selected
biomarker.
20. The method of claim 13, wherein said cancer patient has a
cancer selected from the group consisting of: colon cancer,
gastrointestinal cancer, breast cancer, ovarian cancer, lung
cancer, leukemia, CNS cancer, melanoma, prostate cancer, and renal
cancer.
21. The method of claim 13, wherein said sample is colon tumor
tissue.
22. The method of claim 13, wherein said sample is a fluid selected
from the group consisting of blood, serum, semen, urine, and
stool.
23-24. (canceled)
25. The method of claim 13, wherein a level of TUCAN or a biomarker
nucleic acid is measured.
26. The method of claim 13, wherein said patient has an early stage
of cancer.
27. The method of claim 13, wherein the levels of TUCAN and one or
more biomarkers are used to determine if said patient is at risk
for relapse.
28. The method of claim 13, wherein the levels of TUCAN and one or
more biomarkers are used to determine a proper course of treatment
for said patient.
29. The method of claim 13, further comprising selecting two or
more biomarkers from the group consisting of cIAP2, Apaf1, Bcl-2
and Smac.
30. A method for monitoring the effectiveness of a course of
treatment for a patient with cancer, comprising: (a) determining a
level of a TUCAN in a neoplastic cell-containing sample from a
cancer patient prior to treatment, and (b) determining the level of
TUCAN in a neoplastic cell-containing sample from said patient
after treatment, whereby comparison of said TUCAN level prior to
treatment with the TUCAN level after treatment indicates the
effectiveness of said treatment.
31. The method of claim 30, wherein said cancer patient has a
cancer selected from the group consisting of: colon cancer,
gastrointestinal cancer, breast cancer, ovarian cancer, lung
cancer, leukemia, CNS cancer, melanoma, prostate cancer, and renal
cancer.
32. The method of claim 30, wherein said sample is colon tumor
tissue.
33. The method of claim 30, wherein said sample is a fluid selected
from the group consisting of blood, serum, urine, semen and
stool.
34-35. (canceled)
36. The method of claim 30, wherein a level of a TUCAN nucleic acid
is measured.
37. The method of claim 30, wherein said patient has an early stage
of cancer.
38. The method of claim 30, further comprising determining a level
of a biomarker selected from the group consisting of cIAP2, Apaf1,
Smac and Bcl-2 in said neoplastic cell-containing sample from said
cancer patient prior to and after treatment, wherein the levels of
the selected biomarker and TUCAN prior to treatment are compared
with the levels of the selected biomarker and TUCAN after treatment
to indicate the effectiveness of said treatment.
39. A method of determining a prognosis for survival for a cancer
patient, comprising: (a) measuring a level of TUCAN in a neoplastic
cell-containing sample from said cancer patient, and (b)
classifying said patient as belonging to either a first or second
group of patients, wherein said first group of patients having low
levels of TUCAN is classified as having an increased likelihood of
survival compared to said second group of patients having high
levels of TUCAN.
40. The method of claim 39, wherein said survival is overall
survival.
41. The method of claim 39, wherein said survival is disease-free
survival.
42. The method of claim 39, wherein said cancer patient has a
cancer selected from the group consisting of: colon cancer,
gastrointestinal cancer, breast cancer, ovarian cancer, lung
cancer, leukemia, brain cancer, melanoma, prostate cancer, and
renal cancer.
43. The method of claim 39, wherein said sample is colon tumor
tissue.
44. The method of claim 39, wherein said sample is a fluid selected
from the group consisting of blood, serum, urine, semen and
stool.
45-46. (canceled)
47. The method of claim 39, wherein a level of TUCAN nucleic acid
is measured.
48. The method of claim 39, wherein said patient has an early stage
of cancer.
49. The method of claim 39, further comprising: (a) determining a
level of cIAP2 said neoplastic cell-containing sample from said
cancer patient, and (b) classifying said patient as belonging to
either a first or second group of patient, wherein said first group
of patients having low levels of TUCAN and low levels of cIAP2 is
classified as having increased likelihood of survival compared to
said second group of patients having high levels of TUCAN and high
levels of cIAP2.
50. The method of claim 39, further comprising: (a) determining a
level of a biomarker selected from the group consisting of Apaf1,
Smac and Bcl-2 in said neoplastic cell-containing sample from said
cancer patient, and (b) classifying said patient as belonging to
either a first or second group of patient, wherein said first group
of patients having low levels of TUCAN and high levels of any of
Apaf1, Smac or Bcl-2 is classified as having increased likelihood
of survival compared to said second group of patients having high
levels of TUCAN and low levels of any of Apaf1, Smac or Bcl-2.
Description
[0001] This application is a divisional of U.S. patent application
Ser. No. 10/141,618, filed May 7, 2002, which is a
continuation-in-part of U.S. patent application Ser. No.
09/388,221, filed Sep. 1, 1999, and claims the benefit of U.S.
Provisional Application No. 60/356,934, filed Feb. 12, 2002, and
U.S. Provisional Application No. 60/289,233, filed May 7, 2001,
each of which is incorporated herein by reference.
BACKGROUND OF THE INVENTION
[0003] This invention relates generally to cancer and, more
specifically, to biomarkers that can be used to diagnose or
prognose cancer.
[0004] Cancer remains a major public health problem that profoundly
affects the more than 1 million people diagnosed each year, as well
as their families and friends. As our Nation's population grows and
ages, more people will get cancer. The use of screening tests to
detect cancers early often leads to more effective treatment with
fewer side effects. Patients whose cancers are found early also are
less likely to die from these cancers than are those whose cancers
are not found until symptoms appear.
[0005] One type of cancer screening test involves the detection of
a biomarker, such as a tumor marker, in a fluid or tissue obtained
from a patient. Tumor markers are substances produced by cancer
cells that are not typically produced by normal cells. These
substances generally can be detected in the body fluids or tissues
of patients with cancer. Unfortunately, some tumor markers also can
be detected in significant amounts in the body fluids or tissues of
people who do not have cancer, making certain markers less reliable
for diagnosis. Nevertheless, tumor markers remain an important tool
for diagnosing cancer.
[0006] Another important use for tumor markers is for monitoring
patients being treated for advanced cancer. Measuring tumor markers
for this purpose can be less invasive, less time-consuming, as well
as less expensive, than repeating chest x-rays, computed tomography
(CT) scans, bone scans, or other complicated tests, to determine if
a therapy is reducing the cancer.
[0007] A further important use for tumor markers is for determining
a prognosis of survival of a cancer patient. Such prognostic
methods can be used to identify surgically treated patients likely
to experience cancer recurrence so that they can be offered
additional therapeutic options. Biomarkers useful for prognosis of
survival also can be especially effective for determining the risk
of metastasis in patients who demonstrate no measurable metastasis
at the time of examination or surgery. Knowledge of the likelihood
of metastasis in a cancer patient can be an important factor in
selecting a treatment option. For example, a cancer patient likely
to experience metastasis may be advantageously treated using a
modality that is particularly aggressive.
[0008] Thus, there exists a need for identification of biomarkers
that can be used as diagnostic and prognostic indicators for
cancer. The present invention satisfies this need and provides
related advantages as well.
SUMMARY OF THE INVENTION
[0009] The invention provides methods for determining a prognosis
for survival for a cancer patient. One method involves (a)
measuring a level of a TUCAN in a neoplastic cell-containing sample
from the cancer patient, and (b) comparing the level of TUCAN in
the sample to a reference level of TUCAN, wherein a lower level of
TUCAN in the sample correlates with increased survival of the
patient.
[0010] Another method for determining a prognosis for survival for
a cancer patient involves (a) measuring levels of TUCAN and one or
more biomarkers selected from the group consisting of cIAP2, Apaf1,
Bcl-2 and Smac in a neoplastic cell-containing sample from the
cancer patient, and (b) comparing the level of TUCAN and the one or
more selected biomarkers in the sample to a reference level of
TUCAN and the one or more selected biomarkers, wherein a low level
of TUCAN and a high level of any of Apaf1, Bcl-2 or Smac, or a low
level of TUCAN and a low level of cIAP2, in said sample correlate
with increased survival of said patient.
[0011] A further method of determining a prognosis for survival for
a cancer patient involves (a) measuring a level of TUCAN in a
neoplastic cell-containing sample from the cancer patient, and (b)
classifying the patient as belonging to either a first or second
group of patients, wherein the first group of patients having low
levels of TUCAN is classified as having an increased likelihood of
survival than the second group of patients having high levels of
TUCAN.
[0012] The invention also provides a method for monitoring the
effectiveness of a course of treatment for a patient with cancer.
The method involves (a) determining a level of a TUCAN in a
neoplastic cell-containing sample from the cancer patient prior to
treatment, and (b) determining the level of TUCAN in a neoplastic
cell-containing sample from the patient after treatment, whereby
comparison of the TUCAN level prior to treatment with the TUCAN
level after treatment indicates the effectiveness of the
treatment.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] FIGS. 1A-1F show examples of immunohistochemical detection
of IAP-family proteins, Apaf1 and TUCAN in normal and malignant
colon tissues. FIG. 1A shows a colon cancer microarray slide
stained for cIAP2 (.times.5 magnification). Examples of normal
colonic epithelium immunostaining are presented for cIAP1 (FIG. 1B;
.times.100), Survivin (FIG. 1D; .times.150), Smac (FIG. 1E;
.times.150), AIF (FIG. 1G; .times.150), and Tucan (FIG. 1K;
.times.20). Immunostaining results in regions of invasive cancer
are shown for Smac (FIG. 1F; .times.400), AIF (FIG. 1H;
.times.250), Apaf1 (FIG. 1I, J; .times.200), TUCAN (FIG. 1L
.times.20; M .times.400), and Bcl-2 (FIG. 1N; .times.150). Examples
of malignant and the adjacent normal colonic epithelium are
presented for cIAP2 (FIG. 1C; .times.40), p53 (FIG. 10; .times.150)
and MIB-1 (FIG. 1P; .times.400).
[0014] FIGS. 2A and 2B show comparisons of immunoscores for normal
and malignant colon tissues.
[0015] FIGS. 3A-3F show the specificity of antibodies and
expression of IAPs, Apaf1 and TUCAN protein in colon carcinoma by
immunoblotting. FIG. 3A shows immunoblot analysis of the indicated
in vitro translated proteins using polyclonal XIAP antiserum. FIG.
3B shows immunoblot analysis of recombinant IAP-family proteins and
lysates from normal tissues lacking Survivin mRNA and protein
versus tumor cell lines which express Survivin protein using
anti-Survivin antiserum. FIG. 3C shows immunoblot analysis of
GST-Smac recombinant protein using anti-Smac antiserum. FIG. 3D
shows immunoblot analysis of Jurkat cells transfected as indicated
using anti AIF antiserum. FIG. 3E shows immunoblot analysis of
detergent lysates of five frozen colon cancer specimens which were
identified as having sufficient amounts of both adjacent normal (N)
and tumor (T) tissue for immunoblot analysis using antibodies
specific for IAPs, Apaf1, and other proteins. FIG. 3F shows
densitometry analysis of the immunoblots shown in FIG. 3E.
[0016] FIG. 4 shows correlations of biomarker immunostaining data
with disease-free (left panels, labeled "DFS") and overall survival
(right panels, labeled "OS") for colon carcinoma patients.
[0017] FIGS. 5A-5D show correlations of biomarkers and their
combinations with disease-free (FIGS. 5A and 5B) and overall (FIGS.
5C and 5D) survival for colon carcinoma patients. FIGS. 5A and 5B
illustrate a combination of biomarkers (FIG. 5A, low cIAP2 and high
Apaf1; FIG. 5B, low cIAP2 and low TUCAN) with positive impact on
disease-free survival. The two combinations of markers with an
adverse effect on survival are presented in FIG. 5C (low Apaf1 and
high TUCAN) and FIG. 5D (low Bcl-2 and high cIAP2).
[0018] FIGS. 6A and 6B show expression of TUCAN in several tumor
cell lines. FIG. 6A shows immunoblot analysis of representative
human tumor cell lines from the NCI panel of 60 human tumor cell
lines using an antiserum specific for TUCAN. FIG. 6B shows
immunoblot analysis using TUCAN antiserum showing the levels of
endogenous TUCAN protein in some of these cancer cell lines
compared with HEK293T and Jurkat cells transfected with TUCAN.
[0019] FIGS. 7A-7G show immunohistochemical analysis of TUCAN
expression in colorectal cancer.
[0020] FIGS. 8A-8C show that TUCAN binds selectively to
pro-caspase-9 and to itself. FIGS. 8A-8C show representative
results from co-immunoprecipitation experiments performed using
TUCAN containing either Flag or Myc epitope tags. FIG. 8A shows
that TUCAN co-immunoprecipitated with pro-caspase-9 but not the
CARD-containing protein Apaf1. TUCAN also did not associate
non-specifically with pro-caspase-8 and -10. FIG. 8B shows that
pro-caspase-9 co-immunoprecipitated with full-length TUCAN and the
CARD only fragment of TUCAN (residues 345-431) but not the
.DELTA.CARD fragment of TUCAN lacking the CARD (residues 1-337).
FIG. 8C shows self-association of TUCAN using HA and Myc-tagged
proteins. Full-length TUCAN interacted with full-length TUCAN and
the CARD-only fragment but not the .DELTA.CARD fragment.
DETAILED DESCRIPTION OF THE INVENTION
[0021] This invention relates to the finding that expression of the
CARD domain containing protein, TUCAN (Tumor Up-regulated
CARD-containing Antagonist of Caspase Nine), formerly known as
CARD-X in PCT publication WO 01/16170, can be used to effectively
predict clinical outcome for patients with cancer, either
independently, or in combination with other biomarkers.
[0022] The prognostic methods of the invention are useful for
determining if a patient is at risk for relapse. Cancer relapse is
a concern relating to a variety of types of cancer. For example, of
patients undergoing complete surgical removal of colon cancer,
25-40% of patients with stage II colon carcinoma and about 50% of
patients with stage III colon carcinoma experience cancer
recurrence.
[0023] One explanation for cancer recurrence is that patients with
relatively early stage disease (for example, stage II or stage III)
already have small amounts of cancer spread outside the affected
organ that were not removed by surgery. These cancer cells,
referred to as micrometastases, cannot typically be detected with
currently available tests. The prognostic methods of the invention
can be used to identify surgically treated patients likely to
experience cancer recurrence so that they can be offered additional
therapeutic options, including preoperative or postoperative
adjuncts such as chemotherapy, radiation, biological modifiers and
other suitable therapies. The methods are especially effective for
determining the risk of metastasis in patients who demonstrate no
measurable metastasis at the time of examination or surgery.
[0024] The prognostic methods of the invention also are useful for
determining a proper course of treatment for a patient having
cancer. A course of treatment refers to the therapeutic measures
taken for a patient after diagnosis or after treatment for cancer.
For example, a determination of the likelihood for cancer
recurrence, spread, or patient survival, can assist in determining
whether a more conservative or more radical approach to therapy
should be taken, or whether treatment modalities should be
combined. For example, when cancer recurrence is likely, it can be
advantageous to precede or follow surgical treatment with
chemotherapy, radiation, immunotherapy, biological modifier
therapy, gene therapy, vaccines, and the like, or adjust the span
of time during which the patient is treated.
[0025] As disclosed herein in Examples II and VIII, elevated levels
of TUCAN were found in 49 and 64% of colon tumor specimens
examined, respectively. Univariate analysis was used to determine
significant correlations between longer disease-free survival (DFS)
and low expression of TUCAN (p=0.0004). As shown in Example IV, 78%
(39/50) of patients whose tumors contained low levels of TUCAN
remained alive and disease-free during the time covered by this
study, compared to only 44% (21/48) of those with high expression
of this protein. Example VIII also indicates that TUCAN
immunostaining was significantly higher among patients who died of
colon cancer, as compared to patients who remained alive.
[0026] As shown in Example IV, at a median follow-up of 5 years,
49% of patients with high expression of TUCAN had relapse or died
of colon cancer, and only 19% had recurrence and 4% died of disease
in a group of patients whose tumors expressed low levels of this
protein. Multivariate analysis indicated that the presence of high
TUCAN increased risk of death from colon cancer 17-fold (p=000004).
Therefore, a high level of TUCAN in a sample from a patient with
cancer correlates with increased likelihood of tumor metastasis and
reduced survival. Similarly, a low level of TUCAN in a sample from
a patient with cancer correlates with decreased likelihood of tumor
metastasis and increased likelihood of survival.
[0027] Also disclosed herein is the observation that the
combination of low levels of cIAP2 and low levels of TUCAN
identified a subgroup of early-stage colon cancer patients with
very favorable outcome. Approximately one-third of patients in a
cohort of 92 patients had a combination of low cIAP2 and low TUCAN
(33/92 [36%]). Among these 33 patients, 32 (97%) remained alive and
30 (91%) disease-free during the time covered by this study, as
opposed to 56% and 44% for other categories of patients. Similarly,
in a cohort of 81 patients, 17 had a combination of high Apaf1 and
low TUCAN. All (17) patients featuring high expression of Apaf1 and
low TUCAN were alive and relapse-free at the end of the survey,
compared to only 65% (53/81) alive and 53% (43/81) recurrence-free
for those who were not characterized by this feature. Therefore, a
high level of TUCAN combined with a high level of cIAP2 or a low
level of Apaf1 in a sample from a patient with cancer correlates
with increased likelihood of tumor metastasis and reduced
likelihood of survival, whereas a low level of TUCAN combined with
a low level of cIAP2 or a high level of Apaf1 in a sample from a
patient with cancer correlates with reduced likelihood of tumor
metastasis and increased likelihood of survival.
[0028] Based on these results, the invention provides methods for
diagnosing neoplastic conditions, prognosing survival of patients
suffering from cancer, and determining a stage of cancer using
TUCAN as a biomarker. TUCAN can be used alone or in combination
with other prognostic indicators as a specific biomarker for
prognosing survival of patients suffering from cancer.
[0029] As disclosed herein, elevated levels of
[0030] Apaf1, Survivin, XIAP, cIAP1, and cIAP2 were found in 38%,
54%, 74%, 61% and 35% of colon tumor specimens, respectively.
Univariate analysis was used to determine significant correlations
between longer disease-free survival (DFS) and low expression of
cIAP2 (p=0.0002), .beta.-Catenin (p=0.04), mutant p53 protein
(p=0.03), or high levels of Apaf1 (p=0.00008), Bcl-2 (p=0.005), and
SMAC (p=0.03) (see FIG. 4a). Thus, 78% (39/50) of patients whose
tumors contained low levels of TUCAN remained alive and
disease-free during the time covered by this study, compared to
only 44% (21/48) of those with high expression of this protein.
Similarly, 74% (45/61) of low cIAP2 expressors were cancer-free at
the time of last survey compared to only 36% (12/33) of those with
high cIAP2 levels. At a median follow-up of 5 years, 60% of
patients with high cIAP2 levels relapsed and 46% died of colon
cancer, whereas in a low-cIAP2 group there were 20% relapses and
18% colon cancer-related deaths.
[0031] As further disclosed herein, high levels of Apaf1 were
associated with longer survival, with 33/38 (87%) of colon cancer
patients remaining disease-free compared to only 28/62 (45%) of
those with low Apaf1 expression. In contrast, 43% of patients with
low Apaf1 relapsed and 35% died of colon cancer, while only 14% had
a cancer recurrence or died in a high-Apaf1 cohort. Low Bcl-2
levels also were associated with poor overall survival. Of 18
patients with low expression of this protein, 11 (61%) died of
colon cancer, compared with 24% of patients who died in the
high-Bcl-2 group (18/76). Similarly, patients whose tumors
contained low Apaf1 staining had worse overall survival compared
with those who overexpressed Bcl-2 (FIG. 1N). Multivariate analysis
indicated that high Apaf1 and Bcl-2 expression was associated with
a decreased relative risk of dying of colon cancer by 75% (p=0.004)
and 82% (p=0.00006). Therefore, a decreased level of Apaf1 or Bcl-2
in a sample from a patient with colon cancer correlates positively
with increased chance of tumor metastasis and reduced survival.
[0032] Also disclosed herein is the observation that the
combination of low levels of cIAP2 and high levels of Apaf1
identified a subgroup of early-stage colon cancer patients with
very favorable outcome. Roughly one-quarter (25/94 [27%]) of the
tumors analyzed contained both low cIAP2 and high Apaf1. Among
these 25 patients, all 25 remained alive and free of disease after
surgery at the time of last survey (median follow-up 5 years).
Thus, the median 5 yr disease-free and overall survival rate for
this group of patients was 100%, compared to only 50% and 64% for
other categories of patients, respectively. Therefore, an increased
level of cIAP2 and decreased level of Apaf1 in a sample from a
patient with colon cancer correlates with increased chance of tumor
metastasis and reduced survival.
[0033] As used herein, the term "level" refers to mean the amount,
accumulation or rate of a biomarker molecule, such as TUCAN. A
level can be represented, for example, by the amount or synthesis
rate of messenger RNA (mRNA) encoded by a gene, the amount or
synthesis rate of polypeptide corresponding to a given amino acid
sequence encoded by a gene, or the amount or synthesis rate of a
biochemical form of a molecule accumulated in a cell, including,
for example, the amount of particular post-synthetic modifications
of a molecule such as a polypeptide, nucleic acid or small
molecule. The term can be used to refer to an absolute amount of a
molecule in a sample or to a relative amount of the molecule,
including amounts determined under steady-state or non-steady-state
conditions. The expression level of a molecule can be determined
relative to a control molecule in a sample.
[0034] When used in reference to TUCAN mRNA or polypeptide, the
term level refers to the extent, amount or rate of synthesis of the
nucleic acid sequence shown as SEQ ID NO:1 or the TUCAN polypeptide
shown as SEQ ID NO:2, or substantially the same nucleotide or amino
acid sequences. The nucleic acid sequence and amino acid sequence
of TUCAN, formerly referenced as CARD-X, are also described in PCT
publication WO 01/16170, which is incorporated herein by reference.
When used in reference to cIAP2 mRNA or polypeptide expression, the
term level refers to the extent, amount or rate of synthesis of the
nucleic acid sequence shown as SEQ ID NO:5 or the CIAP2 polypeptide
shown as SEQ ID NO:6, or substantially the same nucleotide or amino
acid sequences. When used in reference to .beta.-catenin mRNA or
polypeptide, the term level refers to the extent, amount or rate of
synthesis of the nucleic acid sequence shown as SEQ ID NO:7 or the
.beta.-catenin polypeptide shown as SEQ ID NO:8, or substantially
the same nucleotide or amino acid sequences. When used in reference
to Apaf1 mRNA or polypeptide, the term level refers to the extent,
amount or rate of synthesis of the nucleic acid sequence shown as
SEQ ID NO:9 or the Apaf1 polypeptide shown as SEQ ID NO:10, or
substantially the same nucleotide or amino acid sequences. When
used in reference to Bcl-2 mRNA or polypeptide, the term level
refers to the extent, amount or rate of synthesis of the nucleic
acid sequence shown as SEQ ID NO:11 or the Bcl-2 polypeptide shown
as SEQ ID NO:12, or substantially the same nucleotide or amino acid
sequences. When used in reference to Smac mRNA or polypeptide, the
term level refers to the extent, amount or rate of synthesis of the
nucleic acid sequence shown as SEQ ID NO:13 or the Smac polypeptide
shown as SEQ ID NO:14, or substantially the same nucleotide or
amino acid sequences. A level of these and other biomarkers of
cancer, including XIAP, cIAP1, Survivin, Bcl-XL, Bax, BAG1, mutant
p53, p53 and MIB-1, can be a gene expression level or a polypeptide
expression level.
[0035] An amino acid sequence that has substantially the same amino
acid sequence as a reference amino acid sequence contains a
considerable degree of sequence identity or similarity, such as at
least 70%, 80%, got, 95%, 98%, or 100% sequence identity or
similarity, to a reference amino acid sequence. Such changes, gaps
and insertions can be naturally occurring mutations, or can result
from processing a sample containing the polypeptide. A nucleotide
sequence that is substantially the same as a reference nucleotide
sequences contains a considerable degree of sequence identity or
similarity, such as at least 70%, 80%, 90%, 95%, 98%, or 100%
sequence identity or similarity, to the reference nucleotide
sequence. Such differences can be due to genetic differences
between individuals, such as mutations and polymorphisms of a gene.
Differences between nucleotide and amino acid sequences can be
determined using available algorithms and programs such as the
Smith-Waterman algorithm and the BLAST homology search program
(Altschul et al., J. Mol. Biol. 215:403-410 (1990)).
[0036] A gene expression level of a molecule is intended to mean
the amount, accumulation or rate of synthesis of a biomarker gene.
The gene expression level can be represented by, for example, the
amount or transcription rate of hnRNA or mRNA encoded by a gene. A
gene expression level similarly refers to an absolute or relative
amount or a synthesis rate determined, for example, under
steady-state or non-steady-state conditions.
[0037] A polypeptide expression level is intended to mean the
amount, accumulation or rate of synthesis of a biomarker
polypeptide. The polypeptide expression level can be represented
by, for example, the amount or rate of synthesis of the
polypeptide, a precursor form or a post-translationally modified
form of the polypeptide. Various biochemical forms of a polypeptide
resulting from post-synthetic modifications can be present in cell
contained in a sample. Such modifications include
post-translational modifications, proteolysis, and formation of
macromolecular complexes. Post-translational modifications of
polypeptides include, for example, phosphorylation, lipidation,
prenylation, sulfation, hydroxylation, acetylation, addition of
carbohydrate, addition of prosthetic groups or cofactors, formation
of disulfide bonds and the like. In addition, it is understood that
fragments of a polypeptide are included within the definition of a
polypeptide expression level. Fragments can include, for example,
amino terminal, carboxyl terminal, or internal deletions of a full
length polypeptide. Accumulation or synthesis rate with or without
such modifications is included with in the meaning of the term.
Similarly, a polypeptide expression level also refers to an
absolute amount or a synthesis rate of the polypeptide determined,
for example, under steady-state or non-steady-state conditions.
[0038] As used herein, the term "reference level" refers to a
control level of expression of a biomarker used to evaluate a test
level of expression of a biomarker in a neoplastic cell-containing
sample of a patient. For example, when the level of TUCAN in the
neoplastic cells of a patient are higher than the reference level
of TUCAN, the cells will be considered to have a high level of
expression, or overproduction, of TUCAN. Conversely, when the level
of TUCAN in the neoplastic cells of a patient are lower than the
reference level, the cells will be considered to have a low level
of expression, or underproduction, of TUCAN.
[0039] The reference level can be determined by a plurality of
methods, provided that the resulting reference level accurately
provides a level of a biomarker above which exists a first group of
patients having a different probability of survival than that of a
second group of patients having levels of the biomarker below the
reference level. The reference level can be determined by, for
example, measuring the level of expression of a biomarker in
non-tumorous cancer cells from the same tissue as the tissue of the
neoplastic cells to be tested. The reference level can also be a
level of a biomarker of in vitro cultured cells which can be
manipulated to simulate tumor cells, or can be manipulated in any
other manner which yields expression levels which accurately
determine the reference level.
[0040] The reference level can also be determined by comparison of
the level of a biomarker, such as TUCAN, in populations of patients
having the same cancer. This can be accomplished, for example, by
histogram analysis, in which an entire cohort of patients are
graphically presented, wherein a first axis represents the level of
the biomarker, and a second axis represents the number of patients
in the cohort whose neoplastic cells express the biomarker at a
given level. Two or more separate groups of patients can be
determined by identification of subsets populations of the cohort
which have the same or similar levels of the biomarker.
Determination of the reference level can then be made based on a
level which best distinguishes these separate groups. A reference
level also can represent the levels of two or more markers. Two or
more markers can be represented, for example, by a ratio of values
for levels of each biomarker.
[0041] The reference level can be a single number, equally
applicable to every patient, or the reference level can vary,
according to specific subpopulations of patients. For example,
older men might have a different reference level than younger men
for the same cancer, and women might have a different reference
level than men for the same cancer. Furthermore, the reference
level can be some level determined for each patient individually.
For example, the reference level might be a certain ratio of a
biomarker in the neoplastic cells of a patient relative to the
biomarker levels in non-tumor cells within the same patient. Thus
the reference level for each patient can be proscribed by a
reference ratio of one or more biomarkers, such as TUCAN, wherein
the reference ratio can be determined by any of the methods for
determining the reference levels described herein.
[0042] As used herein, the term "neoplastic cell" refers to any
cell that is transformed such that it proliferates without normal
homeostatic growth control. Such cells can result in a benign or
malignant lesion of proliferating cells. Such a lesion can be
located in a variety of tissues and organs of the body. Table 1,
below, provides a list of exemplary types of cancers from which a
neoplastic cell can be derived.
[0043] As used herein, the term "cancer" is intended to mean a
class of diseases characterized by the uncontrolled growth of
aberrant cells, including all known cancers, and neoplastic
conditions, whether characterized as malignant, benign, soft tissue
or solid tumor. Specific cancers include digestive and
gastrointestinal cancers, such as anal cancer, bile duct cancer,
gastrointestinal carcinoid tumor, colon cancer, esophageal cancer,
gallbladder cancer, liver cancer, pancreatic cancer, rectal cancer,
appendix cancer, small intestine cancer and stomach (gastric)
cancer; breast cancer; ovarian cancer; lung cancer; renal cancer;
CNS cancer; leukemia and melanoma. By exemplification, a list of
known cancers is provided below in Table 1. TABLE-US-00001 TABLE 1
Types of Cancer HEMATOPORETIC NEOPLASMS Lymphoid Neoplasms Myeloid
Neoplasms Histiocytoses Precursor B lymphoblastic leukemia/lymphoma
(ALL) Precursor T lymphoblastic leukemia/lymphoma (ALL) Chronic
lymphocytic leukemia/small lymphocytic lymphoma (SLL)
Lymphoplasmacytic lymphoma Mantle cell lymphoma Follicular lymphoma
Marginal zone lymphoma Hairy cell leukemia Plasmacytoma/plasma cell
myeloma Diffuse large B-cell lymphoma Burkitt lymphoma T-cell
chronic lymphocytic leukemia Large granular lymphocytic leukemia
Mycosis fungoids and sezary syndrome Peripheral T-cell lymphoma,
unspecified Angioimmunoblastic T-cell lymphoma Angiocentric
lymphoma (NK/T-cell lymphoma) Intestinal T-cell lymphoma Adult
T-cell leukemia/lymphoma Anaplastic large cell lymphoma Hodgkin
Diseases (HD) Acute myclogenous leukemia (AML) Myclodysplastic
syndromes Chronic Myclofroliferative Disorders Chronic Myclogenous
Leukemia (CML) Polycythemia Vera Essential Thrombocytosis
Myelofibrosis with Myeloid Metaplasia Hemangioma Lymphangioma
Glomangioma Kaposi Sarcoma Hemanioendothelioma Angiosarcoma
Hemangiopericytoma HEAD & NECK Basal Cell Carcinoma Squamous
Cell Carcinoma Ceruminoma Osteoma Nonchromaffin Paraganglioma
Acoustic Neurinoma Adenoid Cystic Carcinoma Mucoepidermoid
Carcinoma Malignant Mixed Tumors Adenocarcinoma Lymphoma
Fibrosarcoma Osteosarcoma Chondrosarcoma Melanoma Olfactory
Neuroblastoma Isolated Plasmocytoma Inverted Papillomas
Undifferentiated Carcinoma Mucoepidermoid Carcinoma Acinic Cell
Carcinoma Malignant Mixed Tumor Other Carcinomas Amenoblastoma
Odontoma THYMUS Malignant Thymoma Type I (Invasive thymoma) Type II
(Thymic carcinoma) Squamous cell carcinoma Lymph epithelioma THE
LUNG Squamous Cell Carcinoma Adenocarcinoma Bronchial derived
Acinar; papillary; solid Bronchioalveolar Small Cell Carcinoma Oat
Cell Intermediate Cell Large Cell Carcinoma Undifferentiated; giant
cell; clear cell Malignant Mesothelioma Sarcomotoid Type Epithelial
Type THE GASTROINTESTINAL TRACT Squamous Cell Carcinoma
Adenocarcinoma Carcinoid Malignant Melanoma Adenocarcinoma Gastric
Carcinoma Gastric Lymphoma Gastric Stromal Cell Tumors Lymphoma
Kaposi's Sarcoma Intestinal Stromal Cell Tumors Carcinids Malignant
Mesethelioma Non-mucin producing adenocarcinoma THE LIVER AND THE
BILIARY TRACT Hepatocellular Carcinoma Cholangiocarcinoma
Hepatoblastoma Angiosarcoma Fibrolameller Carcinoma Carcinoma of
the Gallbladder Adenocarcinoma Squamous Cell Carcinoma Papillary,
poorly differentiated THE PANCREAS Adenocarcinoma
Cystadenocarcinoma Insulinoma Gastrinoma Glucagonamoa THE KIDNEY
Renal Cell Carcinoma Nephroblastoma (Wilm's Tumor) THE LOWER
URINARY TRACT Urothelial Tumors Squamous Cell Carcinoma Mixed
Carcinoma Adenocarcinoma Small Cell Carcinoma Sarcoma THE MALE
GENITAL TRACT Squamous Cell CarcinomaSarcinoma Speretocytic
Sarcinoma Embyonal Carcinoma Choriocarcinoma Teratoma Leydig Cell
Tumor Sertoli Cell Tumor Lymphoma Adenocarcinoma Undifferentiated
Prostatic Carcinoma Ductal Transitional Carcinoma THE FEMALE
GENITAL TRACT Squamous Cell Carcinoma Basal Cell Carcinoma Melanoma
Fibrosarcoma Intaepithelial Carcinoma Adenocarcinoma Embryonal
Rhabdomysarcoma Large Cell Carcinoma Neuroendocrine or Oat Cell
Carcinoma Adenocarcinoma Adenosquamous Carcinoma Undifferentiated
Carcinoma Carcinoma Adenoacanthoma Sarcoma Carcinosarcoma
Leiomyosarcoma Endometrial Stromal Sarcoma Serous
Cystadenocarcinoma Mucinous Cystadenocarcinoma Endometrioid Tumors
Adenosarcoma Celioblastoma (Brenner Tumor) Clear Cell Carcinoma
Unclassified Carcinoma Granulosa-Theca Cell Tumor Sertoli-Leydig
Cell Tumor Disgerminoma Teratoma THE BREAST Phyllodes Tumor Sarcoma
Paget's Disease Carcinoma Insitu Carcinoma Invasive Carcinoma THE
ENDOCRINE SYSTEM Adenoma Carcinoma Meningnoma Cramiopharlingioma
Papillary Carcinoma Follicular Carcinoma Medullary Carcinoma
Anoplastic Carcinoma Adenoma Carcinoma Pheochromocytoma
Neuroblastome Paraganglioma Pineal Pineoblastoma Pineocytoma THE
SKIN Melanoma Squamous cell carcinoma Basal cell carcinoma Merkel
cell carcinoma Extramamary Paget's Disease Paget's Disease of the
nipple Kaposi's Sarcoma Cutaneous T-cell lymphoma BONES, JOINTS,
AND SOFT TISSUE TUMORS Multiple Myeloma Malignant Lymphoma
Chondrosacrcoma Mesenchymal Chondrosarcoma Osteosarcoma Ewing Tumor
(Ewing Sarcoma) Malignant Giant Cell Tumor Adamantinoma Malignant
Fibrous Histiocytoma Desmoplastc Fibroma Fibrosarcoma Chordoma
Hemangioendothelioma Memangispericytoma Liposarcoma Malignant
Fibrous
Histiocytoma Rhabdomysarcoms Leiomyosarcoma Angiosarcoma NERVOUS
SYSTEM Schwannoma Neurofibroma Malignant Periferal Nerve Sheath
Tumor Astrocytoma Fibrillary Astrocytoma Glioblastoma Multiforme
Brain Stem Glioma Pilocytic Astrocytoma Pleomorphic
Xanthorstrocytoma Oligodendroglioma Ependymoma Gangliocytoma
Cerebral Neuroblastoma Central Neurocytoma Dysembryoplastic
Neuroepithelial Tumor Medulloblastoma Malignant Meningioma Primary
Brain Lymphoma Primary Brain Germ Cell Tumor THE EYE Carcinoma
Squamous Cell Carcinoma Mucoepidermoid Carcinoma Melanoma
Retinoblastoma Glioma Meningioma THE HEART Myxoma Fibroma Lipoma
Papillary Fibroelastoma Rhasdoyoma Angiosarcoma Other Sarcoma
HISTIOCYTOSES Langerhans Cell Histiocytosis
[0044] As used herein, the term "specifically reactive" when used
in reference to an antibody refers to the discriminatory binding of
the antibody to the indicated target polypeptide. For such binding
to be discriminating, the antibody will not substantially cross
react with other polypeptides. Specific reactivity can include
binding properties such as binding specificity, binding affinity
and binding avidity. For example, an antibody can bind a target
polypeptide with a binding affinity (Kd) of about 10-.sup.4 M or
more, 10-.sup.6 M or more, 10-.sup.7 M or more, 10-.sup.8 M or
more, 10-.sup.9 M or more, or 10-.sup.10 M or more. Several methods
for detecting or measuring antibody binding are known in the art
and disclosed herein.
[0045] As used herein, the term "sample" is intended to mean any
biological fluid, cell, tissue, organ or portion thereof, that
includes or potentially includes a neoplastic cell, such as a cell
from the colon, rectum, breast, ovary, prostate, kidney, lung,
blood, brain or other organ or tissue that contains or is suspected
to contain a neoplastic cell. The term includes samples present in
an individual as well as samples obtained or derived from the
individual. For example, a sample can be a histologic section of a
specimen obtained by biopsy, or cells that are placed in or adapted
to tissue culture. A sample further can be a subcellular fraction
or extract, or a crude or substantially pure nucleic acid molecule
or protein preparation.
[0046] As used herein, the term "disease-free survival" refers to
the lack of tumor recurrence and/or spread and the fate of a
patient after diagnosis, for example, a patient who is alive
without tumor recurrence. The phrase "overall survival" refers to
the fate of the patient after diagnosis, regardless of whether the
patient has a recurrence of the tumor.
[0047] As used herein, the term "risk of recurrence" refers to the
probability of tumor recurrence or spread in a patient subsequent
to diagnosis of cancer, wherein the probability is determined
according to the process of the invention.
[0048] Tumor recurrence refers to further growth of neoplastic or
cancerous cells after diagnosis of cancer. Particularly, recurrence
can occur when further cancerous cell growth occurs in the
cancerous tissue. Tumor spread refers to dissemination of cancer
cells into local or distant tissues and organs, for example during
tumor metastasis. Tumor recurrence, in particular, metastasis, is a
significant cause of mortality among patients who have undergone
surgical treatment for cancer. Therefore, tumor recurrence or
spread is correlated with disease-free and overall patient
survival.
[0049] The invention relates to the use of TUCAN as a biomarker for
prognosing survival and monitoring the effectiveness of a treatment
for a cancer patient. TUCAN is a CARD domain-containing protein
that has a role in regulating apoptosis. Apoptosis is a physiologic
process that ensures homeostasis is maintained between cell
production and cell turnover in essentially all self-renewing
tissues. In addition to maintaining tissue homeostasis, apoptosis
also occurs in response to a variety of external stimuli, including
growth factor deprivation, alterations in calcium levels,
free-radicals, cytotoxic lymphokines, infection by some viruses,
radiation and most chemotherapeutic agents. Thus, apoptosis is an
inducible event that likely is subject to similar mechanisms of
regulation as occur, for example, in a metabolic pathway. In this
regard, dysregulation of apoptosis also can occur and is observed,
for example, in some types of cancer cells, which survive for a
longer time than corresponding normal cells, and in
neurodegenerative diseases where neurons die prematurely. In viral
infections, induction of apoptosis can figure prominently in the
pathophysiology of the disease process, because immune-based
eradication of viral infections depends on elimination of
virus-producing host cells by immune cell attack resulting in
apoptosis.
[0050] The principal effectors of apoptosis are a family of
intracellular proteases known as Caspases, representing an
abbreviation for Cysteine Aspartyl Proteases. Caspases are found as
inactive zymogens in essentially all animal cells. During
apoptosis, the caspases are activated by proteolytic processing at
specific aspartic acid residues, resulting in the production of
subunits that assemble into an active protease typically consisting
of a heterotetramer containing two large and two small subunits
(Thornberry and Lazebnik, Science 281:1312-1316 (1998)). The
phenomenon of apoptosis is produced directly or indirectly by the
activation of caspases in cells, resulting in the proteolytic
cleavage of specific substrate proteins.
[0051] TUCAN contains at least two protein domains, one of which is
a CARD (Caspase-Associated Recruitment Domain). CARDs are protein
interaction motifs found in the N-terminal prodomains of several
caspases and in apoptosis-regulatory proteins that either activate
or suppress activation of CARD-containing pro-caspases. In mammals,
eight CARD-carrying caspases have been identified, including
pro-caspases-1, 2, 4, 5, 9, 11, 12 and 13. To date, multiple
non-caspase CARD-containing proteins have been discovered and
functionally characterized, including Apaf1, Nod1 (CARD4), NAC
(DEPCAP), Raidd (CRADD), Cardiak (Rip2, RICK), BcllO (CIPER), ARC
(Nop30), Asc, CARD9, CARD10, CARD11, CARD14, cIAP1, cIAP2, and
CLAN. The CARD domains of many of these proteins are capable of
binding the CARD-containing prodomains of specific CARD-carrying
caspases, either facilitating or inhibiting protease
activation.
[0052] The CARD domain of TUCAN selectively binds to its own CARD
and to pro-Caspase-9 (see Example IX). In addition, the binding of
TUCAN to pro-caspase-9 has been shown to interfere with the ability
of pro-caspase-9 to interact with Apaf1. By inhibiting the
interaction between pro-caspase-9 and Apaf1, TUCAN inhibits
apoptosis signaling in the mitochondrial/cytochrome c pathway.
Consistent with this observation is that finding that
over-expression of TUCAN reduces apoptosis induced by stimuli that
are known to activate the mitochondrial pathway for
caspase-activation, including Bax, DNA-damaging drugs, and
staurosporine. In contrast, apoptosis induced via alternative
pathways, including GraB and Fas (TNF-family death receptor), is
not inhibited by TUCAN. Further, over-expression of TUCAN in cells
by stable or transient transfection inhibits apoptosis and caspase
activation induced by Apaf1/caspase-9-dependent stimuli, including
Bax, VP16, and Staurosporine, but not by
Apaf1/caspase-9-independent stimuli, Fas and Granzyme B. These
cellular functions of TUCAN indicate that it has an important role
in inhibiting mitochondrial signaling pathway-induced
apoptosis.
[0053] TUCAN also contains an N-terminal domain that shares
amino-acid similarity with a segment of the NAC protein, a
CARD-carrying regulator of the Apaf1 apoptosome Chu et al. J Biol
Chem 276:9239-9245 (2001) and Hlaing et al. J Biol Chem
276:9230-9238 (2001)). The TUCAN N-terminal domain contains several
candidate phosphorylation sites, including PKC (S/T-x-R/K) sites at
amino-acids 72, 286, 313, and 416, Casein kinase II (S/T-x-D/E)
sites at 289, 376, 398, 414, and 416 and MAP kinase/CDK (S/T-P)
sites at 187 and 289. The observed multiple forms of TUCAN
identified by their different mobilities in SDS-PAGE experiments
(see FIG. 6B, for example) could be differently phosphorylated
forms of TUCAN. TUCAN also contains a candidate caspase cleavage
site (DEED) at residues 243-246.
[0054] These and other molecular characteristics and cellular
functions of TUCAN are described, for example, in Pathan et al. J.
Biol. Chem. 276:32220-32229 (2001), the entirety of which is
incorporated herein by reference.
[0055] As disclosed herein in Example VII, relatively high levels
of TUCAN are found in several human cancer cell lines. Moreover, as
disclosed in Examples II and VIII, compared to normal colonic
mucosa, TUCAN immunostaining was pathologically elevated in roughly
two-thirds of early-stage colon cancers, indicating abnormal
over-expression of this anti-apoptotic protein in association with
malignant transformation. Studies of cells derived from
pro-caspase-9 knock-out mice have indicated that pro-caspase-9
functions as a tumor suppressor in a p53-dependent pathway (Soengas
et al. Science 284:156-159 (1999)). In view of the role of TUCAN in
regulating pro-caspase-9, over-expression of TUCAN can be
functionally equivalent to loss of pro-caspase-9, indicating that
elevated levels of TUCAN can promote tumor pathogenesis or
progression. As shown herein in Examples IV and VIII, colon cancer
patients whose tumors contained higher levels of TUCAN indeed were
more likely to die from their disease, based on retrospective
analysis using archival specimens.
[0056] Therefore, the invention provides a method for determining a
prognosis for survival for a cancer patient using TUCAN. The method
involves (a) measuring a level of a TUCAN in a neoplastic
cell-containing sample from the cancer patient, and (b) comparing
the level of TUCAN in the sample to a reference level of TUCAN,
wherein low levels of TUCAN in the sample correlate with increased
survival of the patient.
[0057] A level of TUCAN in a neoplastic cell-containing sample that
exceeds a determined basal level, or reference level, of TUCAN can
be a significant factor in tumor recurrence or spread. When tumor
cell determined reference levels are exceeded, the level of TUCAN
is characterized as high or overproduced. High or overproduced
TUCAN can be indicative of increased risk of tumor recurrence or
spread. Low or underproduced TUCAN can be indicative of decreased
risk or tumor recurrence or spread.
[0058] The methods of the invention for prognosing survival for a
cancer patient involve obtaining a sample from a patient and
measuring the level of one or more biomarkers, such as TUCAN. The
level of the biomarker, such as TUCAN, is used to determine the
prognosis for disease-free or overall survival of a cancer patient
based on the correlations provided herein. Such prognosis is
possible because the likelihood of tumor recurrence or spread
correlates with the level of TUCAN in a tumor cell. For example, as
shown in Examples VI and VIII, it has been found that when the
levels of TUCAN expression are low, the likelihood of cancer
recurrence is low. The level of TUCAN in a neoplastic-cell
containing sample from a patient can be used as the sole factor in
assessing disease status or can be used in addition to other
predictive methods.
[0059] TUCAN can be used to prognose survival or monitor the
effectiveness of a course of treatment for patients suffering from
a variety of types of cancer. As described in Example VII, TUCAN is
present in multiple different cancer cell types, including
leukemia, melanoma and breast, ovarian, lung, CNS, prostate and
renal cancers. Also as described above, a cellular function of
TUCAN is suppression of mitochondrial signaling pathway-induced
apoptosis. Mitochondrial signaling pathway-induced apoptosis is an
apoptotic mechanism that can occur in any cell type, and that can
become dysregulated or suppressed in any type cell, resulting in
transformation of a cell such that it proliferates without normal
homeostatic growth control. Therefore, a level of TUCAN can be
correlated with tumor recurrence or survival of a patient having
any type of cancer. Using the guidance provided herein and other
well-known methods, those skilled in the art will be able to
determine if a level of TUCAN in a particular tumor cell type
correlates with patient survival. Having determined a correlation
between a reference level of TUCAN and survival of a cancer
patient, those skilled in the art can practice the methods for
determining the prognosis for survival for a cancer patient and the
method for monitoring the effectiveness of a course of treatment
for a patient with cancer described herein.
[0060] In the methods of the invention, a sample can be, for
example, a cell or tissue obtained using a biopsy procedure or can
be a fluid sample containing cells, such as blood, serum, semen,
urine, or stool. Those skilled in the art will be able to determine
an appropriate sample, which will depend on cancer type, and an
appropriate method for obtaining a biopsy sample, if necessary.
When possible, it can be preferable to obtain a sample from a
patient using the least invasive collection means. For example,
obtaining a fluid sample from a patient, such as blood, saliva,
serum, semen, urine or stool, is less invasive than collecting a
tissue sample.
[0061] In one embodiment, a level of TUCAN can be determined by
measuring the amount of a TUCAN using a selective binding agent,
such as an antibody specifically reactive with a TUCAN polypeptide.
Other selective binding agents include polypeptides that bind to a
TUCAN polypeptide, such as a TUCAN polypeptide that contains the
TUCAN CARD domain (amino acids 345-431 (SEQ ID NO:3)), and a
caspase 9 polypeptide, the amino acid sequence of which (SEQ ID
NO:4) is referenced as P55211 in the Prosite database, or
modifications thereof that bind to a TUCAN polypeptide. Selective
binding of TUCAN to pro-caspase and to itself is described in
Example IX.
[0062] Essentially all modes of affinity binding assays are
applicable for use in determining a level of TUCAN, or another
biomarker polypeptide, such as cIAP2, Apaf1, Smac, .beta.-catenin,
Bcl-2 or p53, in a sample. Such methods are rapid, efficient and
sensitive. Moreover, affinity binding methods are simple and can be
modified to be performed under a variety of clinical settings and
conditions to suit a variety of particular needs. Affinity binding
assays that are known and can be used in the methods of the
invention include both soluble and solid phase formats. A specific
example of a soluble phase affinity binding assay is
immunoprecipitation using a biomarker selective antibody or other
binding agent. Solid phase formats are advantageous for the methods
of the invention since they are rapid and can be performed more
easily on multiple different samples simultaneously without losing
sensitivity or accuracy. Moreover, solid phase affinity binding
assays are further amenable to high throughput screening and
automation.
[0063] Specific examples of solid phase affinity binding assays
include immunohistochemical binding assays, immunoaffinity binding
assays such as an ELISA and radioimmune assay (RIA). Other solid
phase affinity binding assays are known to those skilled in the art
and are applicable to the methods of the invention. Although
affinity binding assays are generally formatted for use with an
antibody binding molecules that is selective for the analyte or
ligand of interest, essentially any binding agent can be
alternatively substituted for the selectively binding antibody.
Such binding agents include, for example, macromolecules such as
polypeptides, peptides, nucleic acid molecules, lipids and sugars
as well as small molecule compounds. Methods are known in the art
for identifying such molecules which bind selectively to a
particular analyte or ligand and include, for example, surface
display libraries and combinatorial libraries. Thus, for a molecule
other than an antibody to be used in an affinity binding assay, all
that is necessary is for the binding agent to exhibit selective
binding activity for a biomarker.
[0064] The various modes of affinity binding assays, such as
immunoaffinity binding assays, include, for example,
immunohistochemistry methods, solid phase ELISA and RIA as well as
modifications thereof. Such modifications thereof include, for
example, capture assays and sandwich assays as well as the use of
either mode in combination with a competition assay format. The
choice of which mode or format of immunoaffinity binding assay to
use will depend on the intent of the user. Such methods can be
found described in common laboratory manuals such as Harlow and
Lane, Using Antibodies: A Laboratory Manual, Cold Spring Harbor
Laboratory Press, New York (1999).
[0065] An antibody useful in the methods of the invention includes
a polyclonal and monoclonal antibody, as well as an antigen binding
fragment of such antibodies. Methods of preparing polyclonal or
monoclonal antibodies are well known to those skilled in the art
and are described in Example I and in Harlow and Lane, Antibodies:
A Laboratory Manual, Cold Spring Harbor Laboratory Press
(1988).
[0066] An antibody useful in the methods of the invention also
includes naturally occurring antibodies as well as non-naturally
occurring antibodies, including, for example, single chain
antibodies, chimeric, bifunctional and humanized antibodies, as
well as antigen-binding fragments thereof. Such non-naturally
occurring antibodies can be constructed using solid phase peptide
synthesis, can be produced recombinantly or can be obtained, for
example, by screening combinatorial libraries consisting of
variable heavy chains and variable light chains as described by
Huse et al. (Science 246:1275-1281 (1989)). These and other methods
of making, for example, chimeric, humanized, CDR-grafted, single
chain, and bifunctional antibodies are well known to those skilled
in the art (Winter and Harris, Immunol. Today 14:243-246 (1993);
Ward et al., Nature 341:544-546 (1989); Harlow and Lane, supra,
1988); Hilyard et al., Protein Engineering: A practical approach
(IRL Press 1992); Borrabeck, Antibody Engineering, 2d ed. (Oxford
University Press 1995)).
[0067] Formats employing affinity binding can be used in
conjunction with a variety of detection labels and systems known in
the art to quantitate amounts of biomarkers in the analyzed sample.
Detection systems include the detection of bound biomarker by both
direct and indirect means. Direct detection methods include
labeling of the biomarker-specifically reactive antibody or binding
agent. Indirect detection systems include, for example, the use of
labeled secondary antibodies and binding agents.
[0068] Secondary antibodies, labels and detection systems are well
known in the art and can be obtained commercially or by techniques
well known in the art. The detectable labels and systems employed
with the biomarker-selective binding agent should not impair
binding of the agent to the biomarker. Moreover, multiple antibody
and label systems can be employed for detecting the bound
biomarker-specifically reactive antibody to enhance the sensitivity
of the binding assay if desired.
[0069] Detectable labels can be essentially any label that can be
quantitated or measured by analytical methods. Such labels include,
for example, enzymes, radioisotopes, fluorochromes as well as
chemi- and bioluminescent compounds. Specific examples of enzyme
labels include horseradish peroxidase (HRP), alkaline phosphatase
(AP), .beta.-galactosidase, urease and luciferase.
[0070] A horseradish-peroxidase detection system can be used, for
example, with the chromogenic substrate tetramethylbenzidine (TMB),
which yields a soluble product in the presence of hydrogen peroxide
that is detectable by measuring absorbance at 450 nm. An alkaline
phosphatase detection system can be used with the chromogenic
substrate p-nitrophenyl phosphate, for example, which yields a
soluble product readily detectable by measuring absorbance at 405
nm. Similarly, a .beta.-galactosidase detection system can be used
with the chromogenic substrate
o-nitrophenyl-.beta.-D-galactopyranoside (ONPG), which yields a
soluble product detectable by measuring absorbance at 410 nm, or a
urease detection system can be used with a substrate such as
urea-bromocresol purple (Sigma Immunochemicals, St. Louis, Mo.).
Luciferin is the substrate compound for luciferase which emits
light following ATP-dependent oxidation.
[0071] Fluorochrome detection labels are rendered detectable
through the emission of light of ultraviolet or visible wavelength
after excitation by light or another energy source. DAPI,
fluorescein, Hoechst 33258, R-phycocyanin, B-phycoerythrin,
R-phycoerythrin, rhodamine, Texas red and lissamine are specific
examples of fluorochrome detection labels that can be utilized in
the affinity binding formats of the invention. A particularly
useful fluorochrome is fluorescein or rhodamine.
[0072] Chemiluminescent as well as bioluminescent detection labels
are convenient for sensitive, non-radioactive detection of a
biomarker and can be obtained commercially from various sources
such as Amersham Lifesciences, Inc. (Arlington Heights, Ill.).
[0073] Alternatively, radioisotopes can be used as detectable
labels in the methods of the invention. Iodine-125 is a specific
example of a radioisotope useful as a detectable label.
[0074] Signals from detectable labels can be analyzed, for example,
using a spectrophotometer to detect color from a chromogenic
substrate; a fluorometer to detect fluorescence in the presence of
light of a certain wavelength; or a radiation counter to detect
radiation, such as a gamma counter for detection of iodine-125. For
detection of an enzyme-linked secondary antibody, for example, a
quantitative analysis of the amount of bound agent can be made
using a spectrophotometer such as an EMAX Microplate Reader
(Molecular Devices, Menlo Park, Calif.) in accordance with the
manufacturer's instructions. If desired, the assays of the
invention can be automated or performed robotically, and the signal
from multiple samples can be detected simultaneously.
[0075] The prognostic formats of the present invention can be
forward, reverse or simultaneous as described in U.S. Pat. No.
4,376,110 and No. 4,778,751. Separation steps for the various assay
formats described herein, including the removal of unbound
secondary antibody, can be performed by methods known in the art
(Harlow and Lane, supra). For example, washing with a suitable
buffer can be followed by filtration, aspiration, vacuum or
magnetic separation as well as by centrifugation.
[0076] A binding agent selective for a biomarker also can be
utilized in imaging methods that are targeted at
biomarker--expressing neoplastic cells. These imaging techniques
will have utility in identification of residual neoplastic cells at
the primary site following standard treatments including, for
example, surgical resection of an organ of the gastrointestinal
system, such as the colon, and radiation therapy. In addition,
imaging techniques that detect neoplastic cells have utility in
detecting secondary sites of metastasis. The biomarker specific
binding agent can be radiolabeled with, for example, .sup.111indium
and infused intravenously as described by Kahn et al., Journal of
Urology 152:1952-1955 (1994). The binding agent selective for a
biomarker can be, for example, a monoclonal antibody specifically
reactive with TUCAN or another biomarker, such as cIAP2, Apaf1,
Smac, .beta.-catenin, Bcl-2 or p53. Imaging can be accomplished by,
for example, radioimmunoscintigraphy as described by Kahn et al.,
supra.
[0077] The level of TUCAN, or another biomarker, such as cIAP2,
Apaf1, Smac, .beta.-catenin, Bcl-2 or p53, also can be determined
by measuring the amount of a biomarker mRNA or DNA using a binding
agent selective for the biomarker, such as a nucleic acid probe.
The methods used to detect mRNA levels include detection of
hybridization or amplification of mRNA encoding the biomarker. This
detection can be carried out by analysis of mRNA either in vitro or
in situ using one of the methods known to one of ordinary skill in
the art as exemplified in the Current Protocols in Molecular
Biology (John Wiley & Sons, 1999); in U.S. Pat. No. 5,882,864;
and the like. A TUCAN mRNA, or other biomarker mRNA, detected will
be any RNA transcript of a TUCAN gene, or fragment thereof, or
cIAP2, Bcl-2, p53, .beta.-catenin, survivin or Apaf1 gene, or
fragment thereof.
[0078] There are numerous methods well known in the art for
detecting nucleic acid molecules by specific or selective
hybridization with a complementary probe. Briefly, for detection by
hybridization, a TUCAN nucleic acid probe complementary to a TUCAN
gene, having a detectable label is added to a neoplastic
cell-containing sample obtained from the individual having, or
suspected of having cancer under conditions which allow annealing
of the probe to TUCAN RNA. Methods for detecting TUCAN RNA in a
sample can include the use of, for example, RT-PCR. Conditions are
well known in the art for both solution and solid phase
hybridization procedures. Moreover, optimization of hybridization
conditions can be performed, if desired, by hybridization of an
aliquot of the sample at different temperatures, durations and in
different buffer conditions. Such procedures are routine and well
known to those skilled. Following annealing, the sample is washed
and the signal is measured and compared with a suitable control or
standard value. The magnitude of the hybridization signal is
directly proportional to the mRNA level of TUCAN. A level of TUCAN
mRNA in a neoplastic cell-containing sample is compared to a
suitable reference level for TUCAN mRNA. The levels of other
biomarker mRNA, such as cIAP2, Apaf1, Smac, .beta.-catenin, Bcl-2
or p53, can be similarly determined and compared to a suitable
reference level for the particular biomarker.
[0079] Other examples of methods include PCR and other
amplification methods such as RT-PCR, 5' or 3' RACE, RNase
protection, RNA blot, dot blot or other membrane-based
technologies, dip stick, pin, ELISA or two-dimensional arrays
immobilized onto a solid support. These methods can be performed
using either qualitative or quantitative measurements, all of which
are well known to those skilled in the art.
[0080] PCR or RT-PCR can be used with isolated RNA or crude cell
lysate preparations. PCR is advantageous when there is limiting
amounts of starting material. A further description of PCR methods
can be found in, for example, Dieffenbach, C. W., and Dveksler, G.
S., PCR Primer: A Laboratory Manual, Cold Spring Harbor Press,
Plainview, N.Y. (1995). Multisample formats such as microarrays
offer the advantage of analyzing numerous, different samples in a
single assay. In contrast, solid-phase dip stick-based methods
offer the advantage of being able to rapidly analyze a patient's
fluid sample for an immediate result.
[0081] Nucleic acid probes useful for measuring the expression
level of a biomarker, such as cIAP2, TUCAN, Apaf1, .beta.-catenin,
Bcl-2, or Smac by hybridization include, for example, probes
prepared using the nucleotide sequences provided herein. Nucleic
acid molecules corresponding to the entire cDNA sequences and
fragments thereof, including oligonucleotides corresponding to
cIAP2, TUCAN, Apaf1, .beta.-catenin, Bcl-2, or Smac nucleotide
sequences and which are capable of specifically or selectively
hybridizing to cIAP2, TUCAN, Apaf1, .beta.-catenin, Bcl-2, or Smac
RNA, are useful for hybridization methods.
[0082] A reference level is a level a biomarker, such as cIAP2,
TUCAN, Apaf1, Smac, .beta.-catenin, of Bcl-2, used to evaluate the
level of the biomarker in cancerous cells of a patient.
Specifically, when the level of a biomarker in the cancerous cells
of a patient are higher than the reference level, the cells will be
considered to have a high level of, or overproduction, of the
biomarker. Conversely, when the level of biomarker in the cancerous
cells of a patient are lower than the reference level, the cells
will be considered to have a low level of, or underproduction, of
the biomarker.
[0083] A high level of a biomarker, such as cIAP2, TUCAN, Apaf1,
Smac, .beta.-catenin, Bcl-2 or p53, or overproduction of a
biomarker gene is related to a level of the biomarker above a
determined basal level. Thus, a reference or basal level of a
biomarker, such as cIAP2, TUCAN, Apaf1, Smac, .beta.-catenin, Bcl-2
or p53, in a cancer cell is identified as a "cutoff" value, above
which there is a significant correlation between the presence of
the biomarker and increased or decreased tumor recurrence or
spread. Those of skill in the art will recognize that some "cutoff"
values are not sharp in that clinical correlations are still
significant over a range of values on either side of the cutoff;
however, it is possible to select an optimal cutoff value (for
example varying H-scores, and the like) of a level of a biomarker
for a cancer cell type. It is understood that improvements in
optimal cutoff values could be determined, depending on the
sophistication of statistical methods used and on the number and
source of samples used to determine reference or basal values.
[0084] Such overproduction is not typically calculated in terms of
absolute biomarker levels, but is determined using relative
measurements. These relative measurements are illustrated for
quantitation purposes with an internal standard; however, it will
be appreciated that other standards or methods of determination can
be used, such as comparison with external standards, biomarker
polypeptide measurements, biomarker mRNA measurements, absolute
values of protein, mRNA or DNA levels, and the like.
[0085] A reference level can also be determined by comparison of
biomarker levels in populations of patients having cancer, such as
patients having cancer of the same stage. This can be accomplished
by histogram analysis, in which the entire cohort of patients
tested are graphically presented, wherein a first axis represents
the level of a biomarker, and a second axis represents the number
of patients in the cohort whose tumor cells contain the biomarker
at a given level. Two or more separate groups of patients can be
determined by identification of subsets populations of the cohort
which have the same or similar levels of the biomarker.
Determination of the reference level can then be made based on a
biomarker level that best distinguishes these separate groups.
[0086] Verification that the reference level distinguishes the
likelihood of tumor recurrence or spread in cancer patients
expressing below-reference biomarker levels versus cancer patients
expressing above-reference biomarker levels can be carried out
using single variable or multi-variable analysis. These methods
determine the likelihood of a correlation between one or more
variables and a given outcome. In the specific case, the methods
will determine the likelihood of a correlation between a biomarker
levels (or biomarker level coupled with another variable) and
disease-free or overall survival of cancer patients. Any one of a
plurality of methods well known to those of ordinary skill in the
art for carrying out these analyses can be used. Examples of single
variable analysis is the Kaplan-Meir method or the log-rank test.
An example of multi-variable analysis is the Cox
proportional-hazards regression model (see, for example, Example
VI).
[0087] Population-based determination of reference levels, for
example, by histogram analysis can be carried out using a cohort of
patients sufficient in size in order to determine two or more
separate groups of patients having different biomarker levels.
Typically, such a cohort comprises at least 25 patients, such as at
least 50 patients, including at least 75 patients, and at least 100
patients. Similarly, verification of determined reference levels
can also comprise at least 25 patients, such as at least 50
patients, including at least 75 patients, and at least 100
patients.
[0088] The reference level can be a single number, equally
applicable to every patient, or the reference level can vary
according to specific subpopulations of patients. For example, men
might have a different reference level than women for the same
cancer. Furthermore, the reference level can be a level determined
for each patient individually. For example, the reference level
might be a certain ratio of a biomarker level in the tumor cells of
a patient relative to the biomarker level in non-tumor cells within
the same patient. Thus the reference level for each patient can be
proscribed by a reference ratio of biomarker levels, wherein the
reference ratio can be determined by any of the methods for
determining the reference levels described above.
[0089] Further, while a reference level can separate two groups of
patients, it is within the scope of the invention that numerous
reference values might exist which separate a plurality of
populations. For example, two reference values can separate a first
group of patients with high levels of a biomarker from a second
group of patients with intermediate levels the biomarker, and from
a third group of patients with low levels of the biomarker. The
number of different reference levels can be sufficient to proscribe
a curve, such as a continuous line, which describes the likelihood
of disease-free or overall survival in a patient as a function of
the biomarker level in that patient. Such a curve will constitute a
"continuous" biomarker level, where the likelihood of disease free
or overall survival in a patient is proportional to the biomarker
level in that patient. Two or more biomarker levels also can be
represented by such a curve.
[0090] The reference level can also represent the level of a
biomarker protein, such as cIAP2, TUCAN, Apaf1, Smac,
.beta.-catenin, Bcl-2 or p53, in one or more compartments of the
cell. Typically, the reference level will represent the level of
biomarker protein in (a) the whole cell, (b) the nucleus, or (c)
the cytosol. This level will be useful when cell
compartmentalization of the protein correlates with the risk of
tumor recurrence or spread of a certain cancer. Similarly, the
reference level can be a ratio of levels of biomarker protein in
the different compartments (for example, the ratio of nuclear
biomarker protein to whole cell biomarker protein, or the ratio of
nuclear to cytosolic biomarker protein).
[0091] The reference level of a biomarker, such as cIAP2, TUCAN,
Apaf1, or Smac, can further be used in conjunction with another
variable found to be a statistically significant indicator of the
likelihood of disease-free or overall survival for cancer. Such
indicators include the presence or levels of known cancer markers
(for example, colon cancer markers include sialosyl-TnCEA, CA19-9,
and LASA), or can be clinical or pathological indicators (for
example, age, tumor size, tumor histology, clinical stage, family
history and the like). For example, clinical stage of the cancer is
also a statistically significant indicator of disease-free or
overall survival, wherein the reference level of a biomarker can
vary according to the clinical stage of the cancer. For example,
the level of a biomarker, such as a low level of TUCAN, in
conjunction with clinical stage II of a cancer for a given patient,
together are indicators for increased likelihood of disease free or
overall survival. Hence, the reference level of a biomarker can
vary as a function of another statistically significant indicator
of disease-free or overall survival for cancer.
[0092] The levels of biomarkers, such as cIAP2, Apaf1, TUCAN, Bcl-2
and Smac, in a cancer cell can correlate with each other and with
other molecules because these molecules participate in common
dysregulated molecular pathways that contribute to the
hyperproliferative state of a cancer cell. Therefore a combination
of TUCAN with one or more additional biomarkers can be used in the
methods of the invention for determining a prognosis for survival
for a cancer patient. A second or additional biomarker can be, for
example, Apaf1, cIAP1, cIAP2, survivin, AIF, Bcl-2, Bcl-XL, Bax,
Bid, BAG1, p53, mutant p53, .beta.-catenin, MIB-1 or another
well-known tumor marker, such as the exemplary commercially
available tumor markers described below. Furthermore, the use of a
combination of TUCAN with one or more biomarkers can provide
increased prognostic significance or confidence in a prognostic
determination.
[0093] Therefore, the invention provides a method for determining a
prognosis for survival for a cancer patient that involves the use
of two or more biomarkers. The method is practiced by (a) measuring
the levels of TUCAN and one or more biomarkers selected from the
group consisting of cIAP2, Apaf1, Bcl-2 and Smac in a neoplastic
cell-containing sample from the cancer patient, and (b) comparing
the level of TUCAN and the one or more selected biomarkers in the
sample to a reference level of TUCAN and the biomarkers, wherein a
low level of TUCAN and a high level of any of Apaf1, Bcl-2 or Smac,
or a low level of TUCAN and a low level of cIAP2, in said sample
correlate with increased survival of said patient.
[0094] The methods of the invention can be practiced, for example,
by selecting a combination of TUCAN and one or more biomarkers for
which increased or decreased expression correlates with improved
survival, such as any of cIAP2, Apaf1, Bcl-2, Smac, or another
known or standard biomarker for cancer. The selected biomarker can
be a general diagnostic or prognostic marker useful for multiple
types of cancer, such as CA 125, CEA or LDH, or can be a
cancer-specific diagnostic or prognostic marker, such as a colon
cancer marker (for example, sialosyl-TnCEA, CA19-9, or LASA),
breast cancer marker (for example, CA 15-2. Her-2/neu and CA
27.29), ovarian cancer marker (for example, CA72-4), lung cancer
(for example, neuron-specific enolase (NSE) and tissue polypeptide
antigen (TPA)), prostate cancer (for example, PSA,
prostate-specific membrane antigen and prostatic acid phosphatase),
melanoma (for example, S-100 and TA-90), as well as other
biomarkers specific for other types of cancer. Those skilled in the
art will be able to select useful diagnostic or prognostic markers
for detection in combination with TUCAN. Similarly, three or more,
four or more or five or more or a multitude of biomarkers can be
used together for determining a prognosis for survival for a cancer
patient.
[0095] The use of two or more biomarkers can provide increased
confidence in prognostic outcome. For example, as disclosed herein,
combinations of low cIAP and low TUCAN, and high Apaf1 and low
TUCAN were correlated with increased disease-free survival (see
Example V). In particular, among 33 patients examined for levels of
cIAP and TUCAN in a neoplastic cell-containing sample, 97% of
patients having low cIAP and low TUCAN remained alive (91%
disease-fee), as opposed to 56% alive and 44% disease-free for
other categories of patients. In addition, among 17 patients
examined for levels of Apaf1 and TUCAN in a neoplastic
cell-containing sample, 100% of patients having high Apaf1 and low
TUCAN remained alive and disease-free, as opposed to 65% alive and
53% disease-free for other categories of patients. Those skilled in
the art will recognize that such correlations can be observed using
other combinations of biomarkers using methods described
herein.
[0096] Combinations of biomarkers useful in the prognostic methods
of the invention include, for example, cIAP2 and TUCAN, Apaf1 and
TUCAN, and a multiplicity of other combination of TUCAN with
biomarkers such as cIAP2, Apaf1, Bcl-2 and Smac and other
molecules, including AIF, Bcl-2, Bcl-XL, Bax, Bid, BAG1, p53,
mutant p53, .beta.-catenin, MIB-1 and a variety of other general
and tumor-specific biomarkers, such as commercially available
diagnostic markers described herein above. Such combinations can be
useful indicators of the metastatic state of a cancer cell because
elevated levels of these biomarkers was observed in a portion of
all cancer specimens evaluated (see Example II). Further, elevated
levels of various biomarkers correlated with another colon cancer
marker, Ki-67, and positive correlations between the expression of
biomarkers was observed, for example, between cIAP2 and TUCAN
(p=0.003) in patient populations.
[0097] The invention also provides a method for monitoring the
effectiveness of a course of treatment for a patient with cancer.
The method involves (a) determining the level of a TUCAN in a
neoplastic cell-containing sample from the cancer patient, and (b)
determining the level of TUCAN in a neoplastic cell-containing
sample from the patient after treatment, whereby comparison of the
TUCAN level prior to treatment with the biomarker level after
treatment indicates the effectiveness of the treatment.
[0098] As used in the context of a course of treatment,
"effectiveness" refers to the ability of the course of treatment to
decrease the risk of tumor recurrence or spread and therefore to
increase the likelihood of disease-free or overall survival of the
patient. This method will have particular utility when the level a
biomarker, such as cIAP, TUCAN, Apaf1 or Smac, in the tumor cells
of a patient is abnormal compared to the level of cIAP, TUCAN,
Apaf1 and Smac in the non-tumor cells of the patient. Comparison of
biomarker levels in a neoplastic cell-containing sample from a
patient before and after treatment will thereby serve to indicate
whether a biomarker level is returning to that of non-tumor cells,
implying a more effective course of treatment, or whether a
biomarker level is remaining abnormal or increasing in abnormality,
implying a less effective course of treatment. For example, an
increase in the level of Apaf1, Bcl-2 or Smac in a patient sample
after treatment indicates that treatment is effective because high
levels of Apaf1 or Smac correlate with a lower incidence of colon
cancer recurrence. Further, a low in the level of .beta.-catenin,
cIAP2 or TUCAN in a patient sample after treatment indicates that
treatment is effective because low levels of .beta.-catenin, cIAP2
or TUCAN correlate with a lower incidence of colon cancer
recurrence.
[0099] Patients having cancer can be classified according to
whether a high level of a particular biomarker, or a low level of
the biomarker, is measured in a neoplastic cell-containing sample
obtained from the patient. Determination of the prognosis for the
patient can be made by determining whether the group to which the
patient has been assigned correlates with a higher or lower
likelihood of disease-free or overall survival with respect to the
group to which the patient was not assigned.
[0100] Therefore, the invention also provides a method of
determining a prognosis for survival for a cancer patient that
involves patient classification. The method is practiced by (a)
measuring a level of TUCAN in a neoplastic cell-containing sample
from the cancer patient, and (b) classifying the patient as
belonging to either a first or second group of patients, wherein
the first group of patients having low levels of TUCAN is
classified as having an increased likelihood of survival compared
to the second group of patients having high levels of TUCAN.
[0101] A high level of TUCAN, or overproduction of TUCAN,
correlates with patients having an increased risk of tumor
recurrence or spread. Thus, patients belonging to a first group
having high levels of TUCAN are classified as having an increased
risk of tumor recurrence or spread compared to a second group of
patients having low levels TUCAN. Patients belonging to a first
group having low levels of TUCAN are classified as having increased
likelihood of survival compared to a second group of patients
having high levels of TUCAN.
[0102] The method of determining a prognosis for survival for a
cancer patient can be practiced using one or more additional
biomarkers. A variety of biomarkers, including known cancer markers
and the prognostic biomarkers disclosed herein, can be used in
combination with TUCAN to determine a prognosis for survival for a
cancer patient. In one embodiment, the method involves (a)
determining a level of cIAP2 the neoplastic cell-containing sample
from the cancer patient, and (b) classifying the patient as
belonging to either a first or second group of patient, wherein the
first group of patients having low levels of TUCAN and low levels
of cIAP2 is classified as having increased likelihood of survival
compared to the second group of patients having high levels of
TUCAN and high levels of cIAP2.
[0103] In another embodiment, the method involves (a) determining a
level of a biomarker selected from the group consisting of Apaf1,
Smac and Bcl-2 in the neoplastic cell-containing sample from the
cancer patient, and (b) classifying the patient as belonging to
either a first or second group of patient, wherein the first group
of patients having low levels of TUCAN and high levels of any of
Apaf1, Smac or Bcl-2 is classified as having increased likelihood
of survival compared to the second group of patients having high
levels of TUCAN and low levels of any of Apaf1, Smac or Bcl-2.
[0104] After the levels of one or more biomarker in patient sample
have been determined and compared to a reference level, the patient
is then classified into a group having a certain likelihood of
disease free or overall survival. Then the likelihood of
disease-free or overall survival for the patient is assessed based
on the likelihood of disease-free or overall survival for patients
in that group.
[0105] For example, a neoplastic cell containing sample from a
cancer patient can be determined to have high levels of Apaf1,
Bcl-2 or Smac relative to a reference level. This patient would
then be classified into a group of patients having high levels of
Apaf1, Bcl-2 or Smac. Because it has been discovered that there is
an increased likelihood of disease-free or overall survival for the
group of patients expressing high levels of Apaf1, Bcl-2 or Smac in
cancer cells (relative to those expressing low levels of Apaf1,
Bcl-2 or Smac in cancer cells), the specific cancer patient would
be considered to have an increased likelihood of disease free or
overall survival.
[0106] Conversely, a neoplastic cell containing sample from a
cancer patient can be determined to have high levels of cIAP2,
.beta.-catenin or TUCAN relative to a reference level. This patient
would then be classified into a group of patients having high
levels of cIAP2, .beta.-catenin or TUCAN. Because it has been
discovered that there is a decreased likelihood of disease-free or
overall survival for the group of patients expressing high levels
of cIAP2, .beta.-catenin or TUCAN in cancer cells (relative to
those expressing low levels of cIAP2, .beta.-catenin or TUCAN in
cancer cells), the specific cancer patient would be considered to
have an decreased likelihood of disease free or overall
survival.
[0107] The methods of the invention are applicable to determining
the susceptibility of an individual for developing cancer. The
methods are applicable to a variety of cancers, including
gastrointestinal, lung, colon, prostate, breast, ovarian, skin,
blood and kidney cancers. In particular, colon cancers develop from
premalignant precursor lesions known as adenomatous colon polyps.
Multiple epidemiological studies have demonstrated that once one
member of a family has developed an adenomatous colon polyp, his or
her siblings are at markedly elevated risk for developing both
colon adenomas and colon cancers. Those skilled in the art
understand that the method of the invention can be practiced as
described herein for neoplastic conditions, including colon
neoplastic conditions, such as adenomatous colon polyps, for
example, by collecting an appropriate biopsy sample.
[0108] The methods of the invention for determining a prognosis for
survival for a cancer patient are applicable to patients at any
stage of tumor progression, and further can be used to determine a
stage of tumor progress. A stage of a tumor refers to the degree of
progression of a tumor. Various stages of tumor development are
well known to those of skill in the art, as exemplified in Markman,
"Basic Cancer Medicine," Saunders, (ed. Zorab, R.) (1997). For
example, cancers can be staged into three general
stages--localized, regional spread, and distant spread. Cancers
also can be staged using the TNM system, which considers the extent
of direct spread within affected and nearby tissues, the extent of
spread to nearby lymph nodes, and the extent of spread to distant
organs. Based on these features, spread of cancers can be
summarized by assigning Roman numerals from 0 through IV. Those
skilled in the art can select an appropriate staging system for a
particular type of cancer.
[0109] In particular, colon cancer can be staged using the Dukes,
Astler-Coller and AJCC/TNM systems, which describe the spread of
the cancer in relation to the layers of the wall of the colon or
rectum, organs next to the colon and rectum, and other organs
farther away. Dukes stage A is equivalent to AJCC/TNM stage I and
Astler-Coller stage A, B1; Duke's stage B is equivalent to AJCC/TNM
stage II and Astler-Coller stage B2, B3. Dukes stage C is
equivalent to AJCC/TNM stage III and Astler-Coller stage C1, C2,
C3. AJCC/TNM stages of colorectal cancer are as follow: Stage 0:
the cancer has not grown beyond the inner layer (mucosa) of the
colon or rectum. This stage is also known as carcinoma in situ or
intramucosal carcinoma; Stage I: the cancer has grown through the
mucosa into the submucosa, or can also have grown into the
muscularis propria, but it has not spread outside the wall itself
into nearby tissue such as lymph nodes; Stage II: the cancer has
grown through the wall of the colon or rectum, into the outermost
layers and may have invaded other nearby tissues, but has not yet
spread to the nearby lymph nodes; Stage III: the cancer can be of
any size, but has spread to 3 or fewer nearby lymph nodes, or has
spread to 4 or more nodes but it has not spread to other parts of
the body; Stage IV: the cancer has spread to distant organs such as
the liver, lung, peritoneum or ovary.
[0110] Early stages of tumor development shall be understood to
refer to stages in tumor development in which the tumor has
detectably spread no further than the lymph nodes local to the
organ of the primary tumor. Typically, early stages will be
considered to be stages I and II.
[0111] The predictive value of the method of the invention will be
particularly effective in the case of patients in the early stages
of cancer. This is because the method of the invention is
advantageously effective in determining the risk of metastasis in
patients who demonstrate no measurable metastasis at the time of
examination. One of ordinary skill in the art would appreciate that
the prognostic indicators of survival for cancer patients suffering
from stage I cancer may be different from those for cancer patients
suffering from stage IV cancer. For example, prognosis for stage I
cancer patients may be oriented toward the likelihood of continued
growth and/or metastasis of the cancer, whereas prognosis for stage
IV cancer patients may be oriented toward the likely effectiveness
of therapeutic methods for treating the cancer.
[0112] A stage of cancer progression can be correlated with a level
of one or more biomarkers, such as a level of TUCAN, Apaf1 or an
IAP, such as cIAP2 or Smac. Therefore, a determination of a level
of a biomarker in a sample from a cancer patient can be used to
determine a stage of the tumor from which the sample was derived by
comparing the sample with a reference level of the biomarker
indicative of a particular stage of cancer.
[0113] The methods of the invention are applicable for use with a
variety of different types of samples isolated or obtained from an
individual having, or suspected of having a cancer or neoplastic
condition. For example, samples applicable for use in one or more
prognostic formats of the invention, include tissue and cell
samples. A tissue or cell sample can be obtained, for example, from
a fluid sample obtained from the patient, by biopsy or surgery. For
example, in the case of solid tumors which have not metastasized, a
tissue sample from the surgically removed tumor can be obtained and
prepared for testing by conventional techniques. In addition, a
sample can be removed from a patient, for example, using well-known
biopsy procedures. For example, in the case of colon cancer, to
obtain a sample of very small, raised polyps, a colonoscope can be
fitted with a snare to remove a polyp without damage to the wall of
the colon (polypectomy); or to obtain small, flatter polyps, a
biopsy forceps can be attached to a colonoscope to collect a small
sample of tissue.
[0114] As described below, and depending on the format of the
method, the tissue can be used whole or subjected to various
methods known in the art to disassociate the sample into smaller
pieces, cell aggregates or individual cells. Additionally, when
combined with amplification methods such as polymerase chain
reaction (PCR), a single cell sample is sufficient for use in
prognostic assays of the invention which employ hybridization
detection methods. Similarly, when measuring biomarker polypeptide
levels, amplification of the signal with enzymatic coupling or
photometric enhancement can be employed using only a few or a small
number of cells.
[0115] Whole tissue obtained from a biopsy or surgery is one
example of a neoplastic cell-containing sample. Tumor tissue cell
samples can be assayed employing any of the formats described
below. For example, the tumor tissue sample can be mounted and
hybridized in situ with biomarker nucleic acid probes. Similar
histological formats employing protein detection methods and in
situ activity assays also can be used to detect a biomarker
polypeptide in whole tissue tumor cell samples. Protein detection
methods include, for example, staining with a biomarker specific
antibody, as described herein, in Example II. Such histological
methods as well as others well known to those skilled in the art
are applicable for use in the prognostic methods of the invention
using whole tissue as the source of a neoplastic cell-containing
sample. Methods for preparing and mounting the samples are
similarly well known in the art.
[0116] Individual cells and cell aggregates from an individual
having, or suspected of having a neoplastic condition or cancer is
another example of a neoplastic cell-containing sample that can be
analyzed for increased or decreased expression of biomarker RNA or
polypeptide. The cells can be grown in culture and analyzed using
procedures such as those described above. Whole cell samples
expressing cell surface markers associated with biomarker
expression can be rapidly tested using fluorescent or magnetic
activated cell sorting (FACS or MACS) with labeled binding agents
selective for the surface marker or using binding agents selective
for specific cell populations, for example, and then determining a
level of a biomarker within this population. A level of a biomarker
can be determined using, for example, binding specifically reacting
agents for a biomarker or by hybridization to a biomarker specific
probe. Other methods for measuring the level of a biomarker in
whole cell samples are known in the art and are similarly
applicable in any of the prognostic formats described below.
[0117] The tissue or whole cell tumor cell sample obtained from an
individual also can be analyzed for increased or decreased
biomarker levels by lysing the cell and measuring the level of a
biomarker in the lysate, a fractionated portion thereof or a
purified component thereof using any of formats described herein.
For example, if a hybridization format is used, biomarker RNA can
be amplified directly from the lysate using PCR, or other
amplification procedures well known in the art such as RT-PCR, 5'
or 3' RACE to directly measure the level of a biomarker nucleic
acid molecules. RNA also can be isolated and probed directly such
as by solution hybridization or indirectly by hybridization to
immobilized RNA. Similarly, when determining a level of a biomarker
using polypeptide detection formats, lysates can be assayed
directly, or they can be further fractionated to enrich for a
biomarker. For example, an immunochemical method, such as
immunoblot analysis (see Example III) can be performed using a
neoplastic cell-containing sample. Numerous other methods
applicable for use with whole tumor cell samples are well known to
those skilled in the art and can accordingly be used in the methods
of the invention.
[0118] The tumor tissue or cell sample can be obtained directly
from the individual or, alternatively, it can be obtained from
other sources for testing. Similarly, a cell sample can be tested
when it is freshly isolated or it can be tested following short or
prolonged periods of cryopreservation without substantial loss in
accuracy or sensitivity. If the sample is to be tested following an
indeterminate period of time, it can be obtained and then
cryopreserved, or stored at 4.sup.o C for short periods of time,
for example. An advantage of the prognostic methods of the
invention is that they do not require histological analysis of the
sample. As such, the sample can be initially disaggregated, lysed,
fractionated or purified and the active component stored for later
diagnosis.
[0119] The prognostic methods of the invention are applicable for
use with a variety of different types of samples other than tumor
cell samples. For example, a biomarker polypeptide or fragment
thereof that is released into the extracellular space, including
circulatory fluids as well as other bodily fluids, can be used in
prognostic methods to detect a secreted polypeptide or fragment
related to a biomarker polypeptide. In such a case, the methods of
the invention are applicable with fluid samples collected from an
individual having, or suspected of having a neoplastic condition or
cancer.
[0120] Fluid samples, which can be measured for biomarker levels,
include, for example, blood, serum, lymph, urine and stool. Other
bodily fluids are known to those skilled in the art and are
similarly applicable for use as a sample in the prognostic methods
of the invention. One advantage of analyzing fluid samples is that
they are readily obtainable, in sufficient quantity, without
invasive procedures as required by biopsy and surgery. Analysis of
fluid samples such as blood, serum and urine will generally be in
the prognostic formats described herein which measure biomarker
polypeptide levels. As the biomarker related polypeptide is
circulating in a soluble form, the methods will be similar to those
which measure expression levels from cell lysates, fractionated
portions thereof or purified components.
[0121] Neoplastic conditions and cancer can be diagnosed, predicted
or prognosed by measuring a level of a biomarker in a neoplastic
cell-containing sample, circulating fluid or other bodily fluid
obtained from the individual. As described herein, levels of a
biomarker can be measured by a variety methods known in the
art.
[0122] One skilled in the art can readily determine an appropriate
assay system given the teachings and guidance provided herein and
choose a method based on measuring RNA or polypeptide.
Considerations such as the sample type, availability and amount
will also influence selection of a particular prognostic format.
For example, if the sample is a tumor cell sample and there is only
a small amount available, then prognostic formats which measure the
amount of biomarker RNA by, for example, PCR amplification, or
which measure biomarker polypeptide by, for example, FACS analysis
can be appropriate choices for determining the level of a
biomarker. Alternatively, if the sample is a blood sample and the
user is analyzing numerous different samples simultaneous, such as
in a clinical setting, then a multisample format, such as an Enzyme
Linked Immunoabsorbant Assay (ELISA), which measures the amount of
a biomarker polypeptide can be an appropriate choice for
determining the level of a biomarker. Additionally, biomarker
nucleic acid molecules released into bodily fluids from the
neoplastic or pathological cells can also be analyzed by, for
example, PCR or RT-PCR. Those skilled in the art will know, or can
determine which format is amenable for a particular application and
which methods or modifications known within the art are compatible
with a particular type of format.
[0123] Nucleic acid probes can be produced recombinantly or
chemically synthesized using methods well known in the art.
Additionally, hybridization probes can be labeled with a variety of
detectable labels including, for example, radioisotopes,
fluorescent tags, reporter enzymes, biotin and other ligands. Such
detectable labels can additionally be coupled with, for example,
calorimetric or photometric indicator substrate for
spectrophotometric detection. Methods for labeling and detecting
such probes are well known in the art and can be found described
in, for example, Sambrook et al., Molecular Cloning: A Laboratory
Manual, 2nd ed., Cold Spring Harbor Press, Plainview, N.Y. (1989),
and Ausubel et al., Current Protocols in Molecular Biology
(Supplement 47), John Wiley & Sons, New York (1999).
[0124] Nucleic acid probes useful for detecting a biomarker in a
sample can be hybridized under various stringency conditions
readily determined by one skilled in the art. Depending on the
particular assay, one skilled in the art can readily vary the
stringency conditions to optimize detection of a particular
biomarker in a particular sample type.
[0125] In general, the stability of a hybrid is a function of the
ion concentration and temperature. Typically, a hybridization
reaction is performed under conditions of lower stringency,
followed by washes of varying, but higher, stringency. Moderately
stringent hybridization refers to conditions that permit a nucleic
acid molecule such as a probe to bind a complementary nucleic acid
molecule. The hybridized nucleic acid molecules generally have at
least 60% identity, at least 75% identity, at least 85% identity;
or at least 90% identity. Moderately stringent conditions are
conditions equivalent to hybridization in 50% formamide, 5.times.
Denhart's solution, 5.times.SSPE, 0.2% SDS at 42.degree. C.,
followed by washing in 0.2.times.SSPE, 0.2% SDS, at 42.degree. C.
High stringency conditions can be provided, for example, by
hybridization in 50% formamide, 5.times. Denhart's solution,
5.times.SSPE, 0.2% SDS at 42.degree. C., followed by washing in
0.1.times.SSPE, and 0.1% SDS at 65.degree. C.
[0126] Low stringency hybridization refers to conditions equivalent
to hybridization in 10% formamide, 5.times. Denhart's solution,
6.times.SSPE, 0.2% SDS at 22.degree. C., followed by washing in
1.times.SSPE, 0.2% SDS, at 37.degree. C. Denhart's solution
contains 1% Ficoll, 1% polyvinylpyrolidone, and 1% bovine serum
albumin (BSA). 20.times.SSPE (sodium chloride, sodium phosphate,
ethylene diamide tetraacetic acid (EDTA)) contains 3M sodium
chloride, 0.2M sodium phosphate, and 0.025 M (EDTA). Other suitable
moderate stringency and high stringency hybridization buffers and
conditions are well known to those of skill in the art and are
described, for example, in Sambrook et al., Molecular Cloning: A
Laboratory Manual, 2nd ed., Cold Spring Harbor Press, Plainview,
N.Y. (1989); and Ausubel et al., supra, 1999). Nucleic acid
molecules encoding polypeptides hybridize under moderately
stringent or high stringency conditions to substantially the entire
sequence, or substantial portions, for example, typically at least
15-30 nucleotides of the nucleic acid sequences of cIAP2, TUCAN,
Apaf1, Bcl-2, Smac, .beta.-catenin or another biomarker.
[0127] The invention relates to the discovery that high or low
amounts of particular biomarkers, including cIAP2, TUCAN, Apaf1,
Bcl-2, .beta.-catenin and Smac are predictive of survival of
patients having cancer. The over-expression or under-expression of
these biomarkers can contribute to the genetic malfunction of
cancer cells that leads to uncontrolled proliferation. Therefore,
modulation of the level of a biomarker in a cancer cell to a level
consistent with a normal cell can be used to return a cancer cell
to a more normal proliferation state. In the case of over-expressed
biomarker genes, such as cIAP2, TUCAN and .beta.-catenin a variety
of strategies can be employed to reduce gene expression. For
example, inhibition of transcription or translation of cIAP2, TUCAN
and .beta.-catenin, or reduction in the amount of active cIAP2,
TUCAN and .beta.-catenin polypeptide, can be used to reduce the
levels of these biomarkers to a level representative of a normal
cell. In the case of under-expressed biomarker genes, such as
Apaf1, Bcl-2 and Smac, a variety of strategies can be employed to
increase gene expression. For example, introduction of Apaf1, Bcl-2
and Smac from an exogenous nucleic acid molecule, promotion of
transcription or translation of Apaf1, Bcl-2 or Smac, or promotion
in the amount of active Apaf1, Bcl-2 or Smac polypeptide, can be
used to increase the levels of these biomarkers to a level
representative of a normal cell.
[0128] Therefore, the invention additionally provides a method for
treating or reducing the progression of a neoplastic condition such
as cancer by reducing neoplastic cell proliferation. In one
embodiment, the method involves administering a nucleic acid
encoding Apaf1, Bcl-2 or Smac into a neoplastic cell and expressing
the Apaf1, Bcl-2 or Smac polypeptide in an amount effective to
reduce neoplastic cell proliferation. In another embodiment, the
method of reducing neoplastic cell proliferation involves
contacting a neoplastic cell with an effective amount of an agent
that, under sufficient conditions, increases the amount of Apaf1,
Bcl-2 or Smac in the cell.
[0129] Such an agent can increase the amount of a biomarker
directly or indirectly, for example, by increasing the amount of a
biomarker polypeptide in a cell, such as by stimulating increased
mRNA expression. Apaf1, Bcl-2 or Smac mRNA expression can be
increased, for example, by inducing or derepressing transcription
of Apaf1, Bcl-2 or Smac genes and by regulating the expression of a
cellular protein that acts as a transcription factor to regulate
gene expression. An agent can act to increase the amount of Apaf1,
Bcl-2 or Smac by increasing the stability of a Apaf1, Bcl-2 or Smac
mRNA or polypeptide, for example, by decreasing a cellular
degradation activity, such as a protease activity. Molecules that
mediate the regulation of Apaf1, Bcl-2 or Smac expression, such as
receptors and corresponding signal transduction molecules, can also
be targets of agents that increase the amount of Apaf1, Bcl-2 or
Smac in a cell. For example, a signal transduction pathway that
stimulates the expression of Apaf1, Bcl-2 or Smac can be modulated
to increase the level of Apaf1, Bcl-2 or Smac expression, for
example, by increasing the rate of Apaf1, Bcl-2 or Smac synthesis
or the length of time that gene expression remains active.
[0130] Conversely, a decrease in the amount of a biomarker in a
cell can be affected by inducing changes in biomarker
transcription, translation or protein stability opposite to those
described above. As such, in a further embodiment, the method of
reducing neoplastic cell proliferation involves contacting a
neoplastic cell with an effective amount of an agent that, under
sufficient conditions, decreases the amount of cIAP2,
.beta.-catenin or TUCAN in the cell.
[0131] The amount of a biomarker in a cell, such as cIAP2, TUCAN,
.beta.-catenin, Bcl-2, Apaf1 or Smac, can be modulated, for
example, by increasing expression of the biomarker from an
exogenous nucleic acid molecule, by introducing a biomarker
polypeptide or functional analog thereof into a cell, by
introducing inhibitor of a biomarker polypeptide into a cell, and
by modulating the expression or activity of a gene or protein
product that regulates the level of a biomarker in a cell. The
amount of a biomarker in a cell also can be modulated using an
antisense molecule to block transcription or translation of the
biomarker mRNA. Specifically, cells can be transformed with
sequences complementary to cIAP2, .beta.-catenin or TUCAN nucleic
acid molecules. Such methods are well known in the art, and sense
or antisense oligonucleotides or larger fragments, can be designed
from various locations along the coding or control regions of
sequences encoding biomarkers. Thus, antisense molecules can be
used to modulate biomarker activity, or to achieve regulation of
gene function.
[0132] Ribozymes, enzymatic RNA molecules, can also be used to
catalyze the specific cleavage of a biomarker mRNA, such as cIAP2,
.beta.-catenin or TUCAN. The mechanism of ribozyme action involves
sequence-specific hybridization of the ribozyme molecule to
complementary target biomarker RNA, followed by endonucleolytic
cleavage. Specific ribozyme cleavage sites within any potential RNA
target are identified by scanning the biomarker RNA for ribozyme
cleavage sites which include the following sequences: GUA, GUU, and
GUC. Once identified, short RNA sequences of between 15 and 20
ribonucleotides corresponding to the region of the target gene
containing the cleavage site can be evaluated for secondary
structural features which can render the oligonucleotide
inoperable. The suitability of candidate targets can also be
evaluated by testing accessibility to hybridization with
complementary oligonucleotides using ribonuclease protection
assays. Antisense molecules and ribozymes of the invention can be
prepared by any method known in the art for the synthesis of
nucleic acid molecules.
[0133] RNA interference (RNAi) can also be used to modulate the
amount of a biomarker mRNA, such as cIAP2, .beta.-catenin or TUCAN.
RNAi is a process of sequence-specific gene silencing by
post-transcriptional RNA degradation, which is initiated by
double-stranded RNA (dsRNA) homologous in sequence to the silenced
gene. A suitable double-stranded RNA (dsRNA) for RNAi contains
sense and antisense strands of about 21 contiguous nucleotides
corresponding to the gene to be targeted that form 19 RNA base
pairs, leaving overhangs of two nucleotides at each 3' end
(Elbashir et al., Nature 411:494-498 (2001); Bass, Nature
411:428-429 (2001); Zamore, Nat. Struct. Biol. 8:746-750 (2001)).
dsRNAs of about 25-30 nucleotides have also been used successfully
for RNAi (Karabinos et al., Proc. Natl. Acad. Sci. 98:7863-7868
(2001). dsRNA can be synthesized in vitro and introduced into a
cell by methods known in the art.
[0134] A variety of methods are known in the art for introducing a
nucleic acid molecule into a cell, including a cancer cell. Such
methods include microinjection, electroporation, lipofection,
calcium-phosphate mediated transfection, DEAE-Dextran-mediated
transfection, polybrene- or polylysine-mediated transfection, and
conjugation to an antibody, gramacidinS, artificial viral envelopes
or other intracellular carriers such as TAT. For example, cells can
be transformed by microinjection as described in Cibelli et al.,
Nat. Biotech. 16:642-646 (1998) or Lamb and Gearhart, Cur. Opin.
Gen. Dev. 5:342-348 (1995); by lipofection as described in Choi
(U.S. Pat. No. 6,069,010) or Lamb and Gearhart, Cur. Opin. Gen.
Dev. 5:342-348 (1995); by electroporation as described in Current
Protocols in Molecular Biology, John Wiley and Sons, pp
9.16.4-9.16.11 (2000) or Cibelli et al., Nat. Biotech. 16:642-646
(1998); or by fusion with yeast spheroplasts Lamb and Gearhart,
Cur. Opin. Gen. Dev. 5:342-348 (1995).
[0135] A nucleic acid encoding a biomarker polypeptide, such as
Apaf1, Bcl-2 or Smac, or other molecule useful for reducing
proliferation of a cancer cell, can be delivered into a mammalian
cell, either in vivo or in vitro using suitable vectors well-known
in the art. Suitable vectors for delivering a nucleic acid encoding
a biomarker polypeptide to a mammalian cell, include viral vectors
and non-viral vectors such as plasmid vectors. Such vectors are
useful for providing therapeutic amounts of a biomarker
polypeptide, such as Apaf1, Bcl-2 or Smac, as well as for
delivering antisense nucleic acid molecules and ribozymes.
[0136] Viral based systems provide the advantage of being able to
introduce relatively high levels of the heterologous nucleic acid
into a variety of cells. Suitable viral vectors for introducing a
nucleic acid encoding a biomarker polypeptide, such as Bcl-2, Smac
or Apaf1, into a mammalian cell are well known in the art. These
viral vectors include, for example, Herpes simplex virus vectors
(Geller et al., Science, 241:1667-1669 (1988)); vaccinia virus
vectors (Piccini et al., Meth. Enzymology, 153:545-563 (1987));
cytomegalovirus vectors (Mocarski et al., in Viral Vectors, Y.
Gluzman and S. H. Hughes, Eds., Cold Spring Harbor Laboratory, Cold
Spring Harbor, N.Y., 1988, pp. 78-84)); Moloney murine leukemia
virus vectors (Danos et al., Proc. Natl. Acad. Sci. USA,
85:6460-6464 (1988); Blaese et al., Science, 270:475-479 (1995);
Onodera et al., J. Virol., 72:1769-1774 (1998)); adenovirus vectors
(Berkner, Biotechniques, 6:616-626 (1988); Cotten et al., Proc.
Natl. Acad. Sci. USA, 89:6094-6098 (1992); Graham et al., Meth.
Mol. Biol., 7:109-127 (1991); Li et al., Human Gene Therapy,
4:403-409 (1993); Zabner et al., Nature Genetics, 6:75-83 (1994));
adeno-associated virus vectors (Goldman et al., Human Gene Therapy,
10:2261-2268 (1997); Greelish et al., Nature Med., 5:439-443
(1999); Wang et al., Proc. Natl. Acad. Sci. USA, 96:3906-3910
(1999); Snyder et al., Nature Med., 5:64-70 (1999); Herzog et al.,
Nature Med., 5:56-63 (1999)); retrovirus vectors (Donahue et al.,
Nature Med., 4:181-186 (1998); Shackleford et al., Proc. Natl.
Acad. Sci. USA, 85:9655-9659 (1988); U.S. Pat. Nos. 4,405,712,
4,650,764 and 5,252,479, and WIPO publications WO 92/07573, WO
90/06997, WO 89/05345, WO 92/05266 and WO 92/14829; and lentivirus
vectors (Kafri et al., Nature Genetics, 17:314-317 (1997)). It is
understood that both permanent and transient expression can be
useful in a method of the invention.
[0137] An Apaf1, Bcl-2 or Smac polypeptide-encoding recombinant
nucleic acid can be directed into a particular tissue or organ
system, for example, by vector targeting or tissue-restricted gene
expression. Therefore, a vector useful for therapeutic
administration of a nucleic acid encoding an Apaf1, Bcl-2 or Smac
polypeptide can contain a regulatory element that provides tissue
specific expression of the polypeptide. For example, a nucleic acid
sequence encoding a Apaf1, Bcl-2 or Smac polypeptide can be
operatively linked to a cell specific promoter.
[0138] Any of a variety of inducible promoters or enhancers can
also be included in a nucleic acid or vector of the invention to
allow control of expression of a Apaf1, Bcl-2 or Smac polypeptide,
or another molecule useful for modulating cell proliferation, such
as an antisense nucleic acid molecule or ribozyme, by added stimuli
or molecules. Such inducible systems, include, for example,
tetracycline inducible system (Gossen & Bizard, Proc. Natl.
Acad. Sci. USA, 89:5547-5551 (1992); Gossen et al., Science,
268:1766-1769 (1995); Clontech, Palo Alto, Calif.); metalothionein
promoter induced by heavy metals; insect steroid hormone responsive
to ecdysone or related steroids such as muristerone (No et al.,
Proc. Natl. Acad. Sci. USA, 93:3346-3351 (1996); Yao et al.,
Nature, 366:476-479 (1993); Invitrogen, Carlsbad, Calif.); mouse
mammary tumor virus (MMTV) induced by steroids such as
glucocorticoid and estrogen (Lee et al., Nature, 294:228-232
(1981); and heat shock promoters inducible by temperature
changes.
[0139] An inducible system particularly useful for therapeutic
administration utilizes an inducible promoter that can be regulated
to deliver a level of therapeutic product in response to a given
level of drug administered to an individual and to have little or
no expression of the therapeutic product in the absence of the
drug. One such system utilizes a Gal4 fusion that is inducible by
an antiprogestin such as mifepristone in a modified adenovirus
vector (Burien et al., Proc. Natl. Acad. Sci. USA, 96:355-360
(1999). The GENE SWITCH inducible expression system (U.S. Pat. Nos.
5,935,934 and 5,874,534) is an example of such a system. Other
inducible systems use the drug rapamycin to induce reconstitution
of a transcriptional activator containing rapamycin binding domains
of FKBP12 and FRAP in an adeno-associated virus vector (Ye et al.,
Science, 283:88-91 (1999)), use tetracycline to control
transcription (Baron Nucleic Acids Res. 25:2723-2729 (1997)) and
use synthetic dimerizers to regulate gene expression (Pollock et
al., Methods Enzymol. 306:263-281 (1999)). Such a regulatable
inducible system is advantageous because the level of expression of
the therapeutic product can be controlled by the amount of drug
administered to the individual or, if desired, expression of the
therapeutic product can be terminated by stopping administration of
the drug.
[0140] It is understood that modifications which do not
substantially affect the activity of the various embodiments of
this invention are also included within the definition of the
invention provided herein. Accordingly, the following examples are
intended to illustrate but not limit the present invention.
EXAMPLE I
Generation of Antibodies for Immunodetection of IAPs and Apaf1
[0141] This example shows preparation and characterization of
antibodies useful for detecting IAPs and Apaf1.
[0142] Antisera were raised against recombinant proteins and
synthetic peptides for immunodetection of Survivin, XIAP, Apaf1,
AIF and Smac. Prior to employing these antibodies for analysis of
cancers, the specificity of these antibodies for their intended
protein targets was confirmed by SDS-PAGE/immunoblot analysis.
Examples of data are provided in FIG. 3. FIG. 3A shows in vitro
translated Survivin, XIAP, cIAP1, cIAP2, NAIP, BRUCE, and
baculovirus Cp-IAP proteins were subjected to SDS-PAGE/immunoblot
analysis, using polyclonal XIAP antiserum (AR-27A). Incubation with
XIAP antiserum detected only XIAP in vitro translated protein.
Detergent lysates were prepared from various normal human tissues,
normalized for total protein content (50 ug), and subjected to
SDS-PAGE/immunoblot assay using antisera specific for Survivin (B),
Apaf1 (C), SMAC (D) or AIF (E); molecular weight markers are
indicated in kilo-Daltons (F). In addition, lysates from 5 matched
pairs of colon carcinoma (T) and normal colonic mucosa (N)
specimens were analyzed for total protein content (100 mg per lane)
and subjected to SDS-PAGE/immunoblot analysis, using the antisera
specific for c-IAP1, c-IAP2, XIAP, Survivin, Apaf-1, and TUCAN (G).
Antibody detection was accomplished by an ECL method. Immunoblot
data were quantified by scanning densitometry using Pro-Image
software system.
[0143] The anti-XIAP antiserum reacted specifically with the
expected .about.57 kDa XIAP protein, but not with other IAP-family
members including Survivin, cIAP1, cIAP2, NAIP, BRUCE, and
baculovirus Cp-IAP--which were all produced by in vitro
transcription and translation from cDNAs (FIG. 3A). Similarly,
monospecificity of the anti-Survivin antiserum was demonstrated by
SDS-PAGE/immunoblot analysis of recombinant IAP-family proteins and
lysates from normal tissues which lack Survivin mRNA and protein
versus tumor cell lines which express Survivin protein (FIG. 3B).
The anti-Smac antiserum displayed specific reactivity against
GST-Smac recombinant protein (FIG. 3C). The antibody detected
abundant amounts of Smac protein in RS11 and Jurkat cells, and
several human tissues, such as epidermis, brain and testis. Barely
detectable Smac levels in normal colon contrasted with relatively
high amount of this protein in a colon cancer lysate.
[0144] Polyclonal antisera for Survivin, Apaf1, XIAP and Smac were
generated in rabbits using recombinant protein immunogens. Survivin
(full-length protein) and Apaf1 (residues 264-282) were produced as
GST-fusion proteins from pGEX vectors using Escherichia coli BL21
(DE3) as the host strain. The protein purification method has been
described previously. An additional anti-Apaf-1 serum was generated
in rabbits using a synthetic peptide as the immunogen. A peptide
(NH2-CGPKYVVPVESSLGKEKGLE-amide (SEQ ID NO:15)) corresponding to
residues 264-282 of human (hu) Apaf-1, was synthesized with an
N-terminal cysteine appended to permit conjugation to
maleimide-activated carrier proteins KLH and OVA (Pierce, Inc.).
This peptide conjugate was used to generate a polyclonal antiserum
(AR-23) in rabbits. Affinity-purified His 6-tagged--XIAP BIR2
recombinant protein was produced using published methods and was
used as an immunogen to produce XIAP-specific antiserum (AR-27A).
An anti-AIF serum was produced in rabbits using a synthetic peptide
corresponding to residues 151-170 of human AIF. New Zealand white
female rabbits were injected subcutaneously with a mixture of 0.25
ml KLH-peptide (1 mg/ml), 0.25 ml OVA-peptide (1 mg/ml), or
recombinant protein (0.1-0.25 .mu.g protein per immunization) and
0.5 ml Freund's complete adjuvant (dose divided over 10 injections
sites) and then boosted 3 times at weekly intervals, followed by
another 3-20 boostings at monthly intervals with 0.25 mg each of
KLH-peptide, OVA-peptide, or recombinant protein immunogens in
Freund's incomplete adjuvant, collecting blood at 1-3 weeks after
each boosting to obtain immune serum. The generation of Bcl-2,
Bcl-XL, Bax, and TUCAN-specific antisera has been described.
Anti-c-IAP1 and c-IAP2 antibodies were obtained from Santa Cruz
Biotechnology Inc., CA and R&D Systems, Inc., .beta.-Catenin
Laboratories, and p53 clone DO-7, MIB-1, and BAG1 clone KS-6C8 from
DAKO.
EXAMPLE II
Immunohistochemical Analysis of IAPs and Other Biomarkers in Normal
Colonic Mucosa and Colon Cancer
[0145] This example shows immunohistochemical analysis of IAPs and
other biomarkers in a tissue microarray representing tissue samples
obtained from 102 individuals.
[0146] A tissue microarray was constructed using primary tumor
specimens derived from a relatively homogenous cohort of 102
patients presenting with stage II disease (Dukes' B stage) to a
single institution, and who were treated by surgical resection with
curative intent. Colon carcinoma specimens were obtained from
Department of Pathology, Yonsei University, College of Medicine,
Seoul, Korea. Samples were taken from primary tumors derived from
patients who presented between 1986 and 1996 with Dukes' B stage
[stage II disease, as defined by American Joint Committee on Cancer
and Union Internationale Contre le Cancer (AJCC/UICC) criteria].
Patients with Dukes' stage B2 (T3N0M0) constituted 91% of the
cohort, whereas 9% suffered from a Dukes'B3 (T4N0M0) cancer. All
patients were treated by surgical resection of the involved segment
of colon. No postoperative adjuvant chemotherapy was performed
initially in all cases. However, chemotherapy was administered for
some patients after relapse. Clinical data represent a median
follow up of 60 months.
[0147] To construct colon cancer microarrays, 2-5 cylinders of 1 mm
diameter tissue were taken from representative areas of archival
paraffin blocks containing 8% formalin-fixed tumor and arrayed into
a new recipient paraffin block with a custom-built precision
instrument (Beecher Instruments, Silver Spring, Md.). Serial
sections (4 m) were applied to 3-aminopropyl-triethoxysilane
(APES)-coated slides (Sigma).
[0148] Microarrays were immunostained using antisera specific for
the IAP family members Survivin, XIAP, cIAP1, and cIAP2 (FIG. 1A),
and other markers such as Apaf1, Smac, AIF, Bcl-2, Bcl-XL, Bax,
BAG1, .beta.-Catenin, MIB-1 and p53. Dewaxed tissue sections were
immunostained using a diaminobenzidine (DAB)-based detection method
as described in detail, employing the Envision-Plus-Horse Radish
Peroxidase (HRP) system (DAKO) using an automated immunostainer
(Dako Universal Staining System). Antisera specific for Survivin,
XIAP, Apaf1, TUCAN, AIF, Smac, Bax, and Bid were applied at 1:3000
to 10000 (v/v), for Bcl-2 and Bcl-XL at 1:2000 (v/v). The dilutions
of c-IAP1, c-IAP2 and .beta.-Catenin antibodies were 1:600 (v/v),
BAG1 and MIB-1 1:100, and p53 1:50. For all tissues examined, the
immunostaining procedure was performed in parallel using preimmune
serum to verify specificity of the results. Initial confirmations
of antibody specificity also included experiments in which
antiserum was preabsorbed with 5-10 g/ml of either synthetic
peptide immunogen or recombinant protein immunogen. The scoring of
tumor immunostaining was based on the percentage of immunopositive
cells (0-100) multiplied by staining intensity score (0/1/2/3),
yielding scores of 0-300. All immunostaining results were
quantified according the approximate percentage of immunopositive
cells (0-100%) and immunointensity on a 0-3 scale, and then an
immunoscore was calculated from the product of the percentage
immunopositivity and immunointensity (0-300).
[0149] Tissue sections were immunostained using various antisera,
as described above, followed by detection using a HRPase-based
method with diaminobenzidine colorimetric substrate (brown). Nuclei
were counterstained with hematoxylin (blue). Representative data
are shown in FIG. 1. FIG. 1A shows a colon cancer microarray slide
stained for cIAP2 (.times.5 magnification). Examples of normal
colonic epithelium immunostaining are presented for cIAP1 (B;
.times.100), Survivin (D; .times.150), Smac (E; .times.150), AIF
(G; .times.150), and Tucan (K; .times.20). Immunostaining results
in regions of invasive cancer are shown for Smac (F; .times.400),
AIF (H; .times.250), Apaf1 (I, J; .times.200), TUCAN (L .times.20;
M .times.400), and Bcl-2 (N; .times.150). Examples of malignant and
the adjacent normal colonic epithelium are presented for cIAP2 (C;
.times.40), p53 (O; .times.150) and MIB-1 (P; .times.400).
[0150] Several of the 102 tumor specimens on the array (.about.65%)
contained adjacent normal colonic mucosa (59-70), depending on the
particular slide), permitting side-by-side comparisons of
immunostaining results for normal versus malignant epithelium. In
addition, 4 specimens of normal colon derived from individuals who
were not diagnosed with colon cancer were stained separately.
Immunoreactivity for the cIAP1 and cIAP2 proteins was detected in
62/62 (100%) and 34/65 (52%) of normal colonic mucosa specimens
examined, respectively. The intensity of cIAP1 staining in
non-malignant epithelium progressively increased from the base of
the crypts to the luminal surface (FIG. 1B). In contrast, low cIAP2
immunoreactivity was more evenly distributed along the crypt-villus
axis, though a slight increase in immunointensity in the upper
regions of the villi was sometimes evident. XIAP was also expressed
in non-malignant colonic epithelium (63/63 [100%]) and was
distributed in a gradient similar to cIAP1, with XIAP
immunoreactivity highest in the upper portions of the villi. Low
intensity Survivin immunostaining was present in 60/62 (97%) of
specimens containing normal colonic epithelium. Survivin
immunoreactivity was predominantly nuclear in the crypt epithelial
cells, and became progressively stronger in intensity and
predominantly cytoplasmic towards the luminal surface along the
crypt-villus axis (FIG. 1D). Immunohistochemical analysis of Apaf1
in normal colonic mucosa revealed the presence of immunoreactivity
in 58/60 (97%) of specimens. Apaf1 immunoreactivity was present
predominantly in peri-nuclear and cytosolic locations in normal
colonic epithelial cells, with the intensity slightly increasing as
the cells migrated from the crypt bases to the upper regions of the
villi. Along with Apaf1, the intracellular concentration of Smac
protein increased towards the luminal surface in 58/62 (94%) of
normal colonic mucosa specimens (FIG. 1E). A relatively high mostly
granular cytosolic expression of AIF was uniformly distributed
along the colonic crypts in 100% of specimens (60/60) (FIG. 1G).
The specificity of these immunostaining results was confirmed by
control stainings performed using either preimmune serum or immune
antisera which had been preabsorbed with the relevant
immunogens.
[0151] Immunohistochemical analysis of tumor tissues on the
microarray revealed several examples of cancer-specific alterations
in the expression of these apoptosis-regulatory proteins. FIG. 1
shows some examples of the immunostaining results for tumor
specimens. The mean intensity of immunostaining was significantly
higher in the invasive cancer compared to normal colonic epithelium
for all investigated proteins (FIG. 1C, E-F, K-M, 0, P) with the
exception of Bcl-2, Bax, and AIF (FIG. 1G, H). Moreover, while
immunostaining results varied widely among specimens examined, the
immunoscores for a portion of the cancer specimens clustered into
groups displaying clear elevations in immunoreactivity when
compared to normal specimens (FIG. 2). For example, while all
normal colonic specimens had cIAP1 immunoscores of <200, 35 of
94 (37%) invasive cancer specimens had immunoscores of=200
(p<0.0001), thus suggesting that a subgroup of colon cancers
develops pathological elevations in the levels of this
anti-apoptotic protein. Similarly, cIAP2 immunoscores were <100
for normal colonic epithelium, in contrast to invasive cancers
where 25 of 94 (27%) had immunoscores of >100 (p<0.0001).
Likewise, all normal colonic epithelium samples possessed
immunoscores of <190 for XIAP, while 34 of 97 invasive cancers
(35%) had XIAP immunoscores of >190 (p<0.0001). Survivin
immunoscores for non-malignant epithelium were <190, compared to
invasive cancers where scores >190 were found for 33 of 100
(33%) of specimens (p<0.0001). For Apaf1, two clusters of
immunoscores emerged for both normal and malignant epithelium. Most
normal colonic specimens (50/60; 83%) had immunoscores <100. In
tumors, a group of specimens with similarly low immunoscores
(<100) was observed (64/102; 63%) (FIG. 1J) but an additional
group of cancers (38/102; 37%) was identified in which immunoscores
clustered above 100, ranging from 140-280 (FIG. 1I). These results
show that for all biomarkers examined, evidence of tumor-associated
upregulation of expression was observed in a portion of the cancer
specimens evaluated.
[0152] Elevated levels of cIAP2, Survivin, and .beta.-Catenin
correlated with high Ki-67 labeling index (p=0.006, p=0.005, and
p=<0.0001, respectively). Statistical analysis revealed a
significant correlation between the levels of Survivin and those of
XIAP and cIAP1 (p=0.01), or cIAP2 (p=0.008). Elevated levels of
survivin were associated with high expression of Bcl-2. A positive
correlation between the expression of cIAP2 and TUCAN (p=0.003)
agrees with an observed positive impact that a combination of low
levels of these proteins has on survival in our cohort of colon
carcinoma patients. However, an inverse correlation between TUCAN
and Bcl-2 or AIF, did not reach a statistical significance. No
significant association between cIAP2 and Apaf1 or Bcl-2 was found.
Bcl-2, which has implications of a good prognostic marker in our
cohort, correlates significantly with some pro-apoptotic proteins,
such as Apaf1 (p<0.0001), AIF (p=0.002) and Smac (p=0.008), but
also with an anti-apoptotic BAG1 protein which was found to predict
long-term survival in early-stage breast cancer (#7874). An
increased nuclear concentration of p53, which in 80% is related to
p53 point missense mutation correlated with increased expression of
Bcl-XL (p<0.0001).
EXAMPLE III
Immunoblot Analysis of IAPs and Apaf1 in Colon Carcinoma
[0153] This example shows immunoblot analysis of IAPs, Apaf1 and
other apoptosis-regulators in five frozen colon cancer
specimens.
[0154] To corroborate the immunohistochemistry data, five frozen
colon cancer specimens were identified that had sufficient amounts
of both adjacent normal (N) and tumor (T) tissue for immunoblot
analysis using antibodies specific for IAPs, Apaf1, and other
proteins. Detergent-lysates of these tissues specimens were
prepared and normalized for total protein content prior
SDS-PAGE/immunoblot analysis (FIG. 3E). Densitometry analysis was
also performed to quantify band intensities, and the results from
the loading control blot were used to normalize all data (FIG.
3F).
[0155] Colon cancer specimens (n=10) with high ratios of cancer
cells relative to stroma (>70%) were selected for immunoblotting
analysis. The protein lysates were prepared without additional
microdissection or fractionation. The tumor lysates and the samples
of the normal mucosa from the same patients were prepared using
modified RIPA buffer (50 mM Tris [pH 7.4], 150 mM NaCl, 0.25%
Na-deoxycholate, 1% NP40, 1 mM EDTA, 1 mM Na3VO4, 1 mM NaF, 1 mM
PMSF) containing complete protease inhibitor cocktail (SIGMA),
Pan-Caspase inhibitor z-Asp-2.6-dichlorobenzoyloxy-methylketone and
ZVAD-fmk, normalized for total protein content (100 ug) and
resolved by SDS-PAGE (12% and 15% gels). Protein quantification was
performed using the Bio-Rad Protein Assay Kit (Bio-Rad). Proteins
were transferred (overnight 150 mA, 4.degree. C.) to PVDF membranes
(Amersham Pharmacia). After blocking with 5% skim milk in TBST (50
mM Tris [pH 7.6], 150 mM NaCl, 0.05% Tween 20) at room temperature
for 2 hours, blots were incubated overnight with antisera specific
for particular IAP family members, Apaf1, and TUCAN, using
1:1,000-1:10,000 (v/v) dilutions at 4.degree. C. After incubation
with HRPase-conjugated secondary goat anti-rabbit (either Bio-Rad
or Santa Cruz) antibody at room temperature for 1 hr,
immunodetection was accomplished by an enhanced chemoluminescence
(ECL) method (Amersham), with exposure to x-ray film (Kodak/XAR).
Densitometry was performed to quantify the intensity of bands,
using Image-pro Plus software.
[0156] Higher levels of cIAP2, XIAP, Survivin, and Apaf1 were
detected in every specimen evaluated, compared to case-matched
normal tissue. Levels of cIAP1 protein, as well as the
anti-apoptotic protein TUCAN, were elevated in some tumor specimens
compared to normal, but not others. A nonspecific band obtained
during preblocking procedure with a secondary ECL antibody
(Biorad), served as a loading control.
[0157] The immunoblotting results confirmed the
immunohistochemistry observations described in Example II (FIG. 1
E, F). Higher levels of cIAP2, XIAP, Survivin, and Apaf1 were
detected in every specimen evaluated as compared to case-matched
normal tissue. Levels of cIAP1 and TUCAN were elevated in some
tumor specimens compared to normal, but not others.
EXAMPLE IV
Correlation of Protein Expression with Clinical Outcome
[0158] To analyze the relation of biomarkers with patient survival,
the comparisons of the immunoscores obtained for normal colonic
epithelium and colon cancers shown in FIG. 3 were used to set
logical cut-offs for dichotomization of data.
[0159] Clinical data were available for all patient specimens
included on the tissue microarray with respect to relapse and
overall survival, with a median follow-up of 5 years. Patients were
categorized as: (i) Alive without disease (A); (ii) Alive with
recurrent disease (R); or (iii) Dead (D). As shown in Table 2, no
significant differences in the immunoscores for cIAP1, XIAP, or
Survivin were observed when comparing the A, R, and D groups of
patients. cIAP2 immunostaining was significantly higher in colon
cancer patients who had either died of disease (D) or who had
relapsed after surgery (R) (p<0.0001). In contrast, immunoscores
for Apaf1 were significantly lower in the groups of patients who
had relapsed (R) or died (D), compared to patients who were alive
without disease (p<0.0001) (Table 2). An unpaired t-test method
was used for comparisons of XIAP, Survivin, cIAP1, cIAP2, and Apaf1
immunoscores in the A, R, and D groups of patients. P-values refer
to a comparison of group A with the combined groups R and D.
TABLE-US-00002 TABLE 2 Summary of immunostaining results for colon
cancer patients Patient Survivin cIAP1 cIAP2 Apaf1 Status Mean .+-.
SE Median Mean .+-. SE Median Mean .+-. SE Median Mean .+-. SE
Median Mean .+-. SE Mean A 168 .+-. 9 160 152 .+-. 10 160 166 .+-.
9 190 81 .+-. 9 70 132 .+-. 8 140 R 176 .+-. 22 170 125 .+-. 25 95
169 .+-. 23 180 162 .+-. 22 160 46 .+-. 20 50 D 177 .+-. 13 180 135
.+-. 13 120 174 .+-. 13 180 146 .+-. 13 130 77 .+-. 12 70 p-values
0.5 0.2 0.7 <.0001 <.0001 A vs R+D
[0160] To analyze the relation of biomarkers to patient survival by
another method, immunostaining data for these proteins were
dichotomized into high- versus low-expression groups. For this
purpose, the comparisons of the immunoscores obtained for normal
colonic epithelium and colon cancers shown in FIG. 2 were used to
set logical cut-offs for ichotomization of data. Immunoscores for
normal and malignant colon epithelium were depicted in a graphic
form in FIG. 2. Based on comparisons with normal colonic
epithelium, cutoffs for dichotomizing immunostaining data were
selected. The range of immunoscore for 95% of normal specimens
defined a group of tumors with low immunoscore for cIAP1, cIAP2,
XIAP, Survivin, Bcl-XL, and BAG1. Bimodal distribution of proteins
helped to identify cut-offs for Bax, Apaf1 and TUCAN. The
application of median immunoscores as cut-offs for Bcl-2, Bid, AIF,
Smac, and .beta.-catenin, increased accuracy in the
subcategorisation of tumors into low and high expressors. The
histograms for p53 and MIB-1 present the immunopercentage,
classifying cases >0% as high p53 expressors and=20% as those
expressing high levels of MIB.
[0161] Based on this method, high levels of Apaf1, TUCAN, Survivin,
XIAP, cIAP1, and cIAP2 were found in 38%, 49%, 54%, 74%, 61% and
35% tumor specimens, respectively. In univariate analysis,
significant correlations were observed in this cohort between
longer disease-free survival (DFS) and low expression of cIAP2
(p=0.0002), TUCAN (p=0.0004), .beta.-Catenin (p=0.04), mutant p53
protein (p=0.03), or high levels of Apaf1 (p=0.00008), Bcl-2
(p=0.005), and SMAC (p=0.03) (FIG. 4a). Thus, 78% (39/50) of
patients whose tumors contained low levels of TUCAN remained alive
and disease-free during the time covered by this study, compared to
only 44% (21/48) of those with high expression of this protein.
Similarly, 74% (45/61) of low cIAP2 expressors enjoyed colon
cancer-free life at the time of last survey compared to only 36%
(12/33) of those with high cIAP2 levels. In contrast, high levels
of Apaf1 were associated with longer survival in this cohort of
colon cancer patients, with 33/38 (87%) of patients remaining
disease-free compared to only 28/62 (45%) of those with low Apaf1
expression.
[0162] The most significant improvement of overall survival was
noticed in a group of patients whose colon carcinoma specimens
contained low levels of TUCAN (p<0.0001) (FIG. 4b). Among 50
patients expressing low TUCAN, only 4% (2/50) died, as opposed to
54% (26/48) of those presenting high levels of this protein.
Significant correlations were also observed between longer overall
survival and low cIAP2 (p=0.01) or low mutant p53 protein (p=0.03).
Low Bcl-2 levels were associated with poor overall survival. Of 18
patients with low expression of this protein, 11 (61%) died of
colon cancer, compared with 24% of patients who died in the
high-Bcl-2 group (18/76). Similarly, patients whose tumors
contained low Apaf1 staining had worse overall survival compared
with those who overexpressed Bcl-2 (FIG. 1N).
[0163] Elevated levels of Bcl-2 conferred a significant advantage
for both overall (p=0.0008) and disease-free survival (p=0.005). Of
76 patients whose tumors revealed high Bcl-2, 58 (76%) remained
alive and 50 (66%) relapse-free, compared to 39% and 33% of those
with low Bcl-2 levels. Independent of its anti-apoptotic function,
Bcl-2 can delay entry into the cell cycle and promote exit of cells
from the cycle. Thus, a positive effect of Bcl-2 on clinical
outcome may be linked to its cell cycle-inhibitory role.
[0164] FIG. 4 shows correlations of biomarkers immunostaining data
with disease-free (A) survival and overall survival (B) for colon
carcinoma patients. All biomarkers data and outcome measures were
entered into a database using STATISTICA software system
(StatSoft). The log rank test was used to for correlation of
immunoscore data with the patient survival. The Kaplan-Meier curves
illustrate correlations of the investigated biomarkers with
survival for this cohort of patients.
[0165] In summary, at a median follow-up of 5 years, 60% of
patients with high cIAP2 levels relapsed and 46% died of colon
cancer, whereas in a low-cIAP2 group there were 20% relapses and
18% colon cancer-related deaths. At the same time point, 49% of
patients with high expression of TUCAN had relapse or died of colon
cancer, and only 19% had recurrence and 4% died of disease in a
group of patients whose tumors expressed low levels of this
protein. In contrast, 43% of patients with low Apaf1 relapsed and
35% died of colon cancer, while only 14% had a cancer recurrence or
died in a high-Apaf1 cohort. Thus, these findings indicate that
higher levels of the anti-apoptotic protein cIAP2 and lower levels
of the pro-apoptotic protein Apaf1 are associated with adverse
outcome in patients with early-stage colon cancer. No significant
differences were noted in the age, or gender of the patients in the
high- versus low-expression groups for cIAP2, Apaf1, or TUCAN.
EXAMPLE V
Combined Analysis of cIAP2 and Apaf1 Expression Data
[0166] This example shows combined analysis of cIAP2 and Apaf1
expression data.
[0167] Since certain proteins had significant prognostic value, it
was determined whether combining two biomarkers could identify a
subgroup of patients with distinct survival characteristics.
Patients with two favorable variables (low cIAP2 and high Apaf1)
were compared with all other patients in this cohort.
[0168] FIG. 5 shows correlations of biomarkers and their
combinations with disease-free (A, B) survival and overall survival
(C, D) for colon carcinoma patients. Using the Kaplan-Meier curves,
panels A and B illustrate a combination of biomarkers [low cIAP2
and high Apaf1 (A); low cIAP2 and low TUCAN (B)] with positive
impact on disease-free survival. The two combinations of markers
with an adverse effect on survival are presented in panel C (low
Apaf1 and high TUCAN), and panel D (low Bcl-2 and high cIAP2).
[0169] Of the 94 patient samples successfully analyzed for cIAP2
and Apaf1, 25 (27%) had both a low cIAP2 and a high Apaf1
immunoscore. All (100%) of these patients with the combination of
low cIAP2 and high Apaf1 were alive and disease-free at 5 years
after diagnosis, compared to 52% disease-free or 64% alive of
others (p=0.00007 for OS; p<0.0001 for DFS) (FIG. 5A; DFS). At
the same time point, among patients with a combination of low cIAP2
and low TUCAN 97% were alive and 94% disease-free, compared to 59%
alive and 50% disease-free of others (p=0.00001) (FIG. 5B; DFS).
Thus, the combinations of cIAP2 and Apaf1 or cIAP2 and TUCAN
immunostaining data identify a subgroup of colon cancer patients
with distinct survival characteristics. However, when patients with
two adverse biomarkers (low Apaf1 and high TUCAN) were compared
with other patients, 34% of patients with this combination of
proteins and 90% of others were alive at 5 years after diagnosis
(p<0.0001) (FIG. 4C). The discrepancy was even larger at the end
of the survey, with 0% and 90% of those who remained alive,
respectively. When combination data were examined for another pair
of adverse biomarkers (cIAP2 high and Bcl-2 low), none of the
patients was alive in this group 5 years after surgery, but 75% of
others survived (p=004) (FIG. 4D). These results are in agreement
with an outcome of the LERS data analysis.
EXAMPLE VI
Multivariate Analysis Identifies cIAP2, Apaf1, TUCAN and Bcl-2 as
Independent Prognostic Indicators of Survival in Early-Stage Colon
Cancer
[0170] This example shows that multivariate analysis confirms that
cIAP2, Apaf1, TUCAN and Bcl-2 are independent prognostic indicators
of survival in early-stage colon cancer.
[0171] Multivariate Cox proportional hazards models were fitted to
assess whether elevated levels of biomarkers were associated with
disease-free survival (DFS) and overall survival (OS). The
variables were not stratified into T3N0M0 and T4N0M0 subgroups due
to a small number of patients involved in this study. In addition,
the data mining system LERS (Learning from Examples based on Rough
Sets) was employed to perform a multivariate analysis of
immunohistochemical staining data.
[0172] In this project, the algorithms LEM2 was determined to be
the most applicable to the data and therefore was employed for
multivariate analysis. The presence of high cIAP2 and high TUCAN
increased risk of death from colon cancer within this cohort of
patients 2.7-fold (p=0.01) and 17-fold ((p=000004), respectively.
High Apaf1 and Bcl-2 expression was associated with a decreased
relative risk of dying of colon cancer by 75% (p=0.004) and 82%
(p=0.00006).
[0173] When an association of protein levels with disease-free
survival was assessed by multivariate analysis, cIAP2 and TUCAN
maintained prognostic significance (p=0.000005, p=0.0005), with
high levels of these proteins increasing risk of recurrence 6-fold
and 3.4-fold, respectively. Also Apaf1 and Bcl-2 retained their
significant prognostic role (p=0.006, p=0.0004), decreasing the
hazard rate of colon cancer recurrence by approximately 75%.
Additionally, high levels of Smac decreased the risk of recurrence
by 63%. No role of Smac was evident for overall survival of
patients in this cohort. Taken together, these findings indicate
that immunostaining data for cIAP2, Apaf1, TUCAN, Bcl-2 and their
combination can have prognostic significance for patients with
early-stage colon cancer. Table 3 A-B shows multivariate analysis
of DFS (A) and OS (B) in stage II colon carcinoma patients using
backward stepwise Cox proportional hazards regression analysis to
assess whether elevated levels of biomarkers were associated with
disease-free survival or overall survival. TABLE-US-00003 TABLE 3
Multivariate analysis of DFS (A) and OS (B) in stage II colon
carcinoma patients HR BIOMARKER coeffifcient (95% CI) p A. DFS
cIAP2 1.79 5.96 0.000005 (2.78 - 12.8) Apaf1 - 1.27 0.28 0.006
(0.11 - 0.68) TUCAN 1.23 3.43 0.0005 (1.6 - 6.55) Bcl-2 - 1.37 0.25
0.007 (0.13 - 0.60) Smac - 1.00 0.37 0.007 (0.19 - 0.81) B. OS
cIAP2 0.98 2.66 0.01 (1.04 - 5.42) Apaf1 - 1.36 0.26 0.004 (0.10 -
0.65) TUCAN 2.84 17.19 0.000004 (5.12 - 57.48) Bcl-2 - 1.69 0.18
0.00006 (0.08 - 0.43)
EXAMPLE VII
Expression of TUCAN in Multiple Cancer Cell Lines
[0174] This example shows that TUCAN is expressed in several tumor
cell lines.
[0175] To determine the expression of TUCAN in cancers, the NCI
panel of 60 human tumor cell lines (Weinstein, et al. Science
17:343-349 (1997)) was analyzed by immuno-blotting using an
antiserum specific for TUCAN (FIG. 6A). Cell lines included in the
panel are shown in Table 4, below: TABLE-US-00004 TABLE 4 NCI panel
of 60 human tumor cell lines Cell Line Name Cell Type CCRF-CEM
Leukemia HL-60 (TB) Leukemia K-562 Leukemia MOLT-4 Leukemia
RPMI-8226 Leukemia SR Leukemia A549/ATCC Non-Small Cell Lung EKVX
Non-Small Cell Lung HOP-62 Non-Small Cell Lung HOP-92 Non-Small
Cell Lung NCI-H226 Non-Small Cell Lung NCI-H23 Non-Small Cell Lung
NCI-H322M Non-Small Cell Lung NCI-H460 Non-Small Cell Lung NCI-H522
Non-Small Cell Lung COLO 205 Colon HCC-2998 Colon HCT-116 Colon
HCT-15 Colon HT29 Colon KM12 Colon SW-620 Colon SF-268 CNS SF-295
CNS SF-539 CNS SNB-19 CNS SNB-75 CNS U251 CNS LOX IMVI Melanoma
MALME-3M Melanoma M14 Melanoma SK-MEL-2 Melanoma SK-MEL- 28
Melanoma SK-MEL-5 Melanoma UACC-257 Melanoma UACC-62 Melanoma
IGR-OV1 Ovarian OVCAR-3 Ovarian OVCAR-4 Ovarian OVCAR-5 Ovarian
OVCAR-8 Ovarian SK-OV-3 Ovarian 786-0 Renal A498 Renal ACHN Renal
CAKI-1 Renal RXF 393 Renal SN12C Renal TK-10 Renal UO-31 Renal PC-3
Prostate DU-145 Prostate MCF7 Breast NCI/ADR-RES Breast
MDA-MB-231/ATCC Breast HS 578T Breast MDA-MB-435 Breast MDA-N
Breast BT-549 Breast T-47D Breast
[0176] Lysates were normalized for total protein content prior to
analysis. Relative levels of TUCAN protein varied widely among the
tumor lines tested, with some cell lines containing especially
abundant levels of this protein (for example, MCF7 breast cancer
cells, OVCAR5 ovarian cancer cells, and NCI-H322M lung cancer
cells). TUCAN protein also was present in HL-60 leukemia cells,
SNB-19 CNS cancer cells, MDA-MB-231 breast cancer cells, IGROV1
ovarian cancer cells, NCI-H226 non-small cell lung cancer cells,
NCI-H23 non small cell lung cancer cells, M14 melanoma cells,
Du-145 prostate cancer cells, UO-31 renal cancer cells, and K562
leukemia cells. In some of these tumor lines, TUCAN migrated in
SDS-PAGE as a broad band or as an apparent doublet, indicating that
multiple forms of TUCAN protein can be present in cancer cells
(FIG. 6A).
[0177] The levels of endogenous TUCAN protein in some of these
cancer cell lines were compared with the transfected HEK293T and
Jurkat cells. The levels of plasmid-derived TUCAN produced in
transiently transfected HEK293T cells were comparable to the
endogenous levels of TUCAN found in MCF7 breast cancer cells (FIG.
6B). Levels of plasmid-derived TUCAN produced in the stably
transfected Jurkat cells were comparable in amount to endogenous
TUCAN measured in OVCAR5 ovarian and NCI-H322M lung cancer cell
lines.
[0178] In summary, TUCAN is expressed in a variety of tumor cell
lines, including cancer cells obtained from human breast, ovarian,
lung, CNS, leukemia, kidney, prostate, skin and colon tumors.
EXAMPLE VIII
Elevated TUCAN Expression in Colon Cancers Correlates with Reduced
Patient Survival
[0179] This example shows that TUCAN expression is elevated in
colon cancers and that TUCAN elevation correlates with reduced
colon cancer patient survival.
[0180] Using anti-TUCAN antibodies, the expression of TUCAN protein
was analyzed by immunohistochemical methods in a collection of 102
archival paraffin-embedded colon cancer specimens derived from
patients with uniform clinical stage (Duke's B; Stage II) and
treatment (surgery without adjuvant chemotherapy). A tissue
microarray was constructed so that all 102 tumor specimens could be
analyzed on a single glass slide, thus minimizing differences in
immuno-intensity due to technical artifacts (FIG. 7).
[0181] Normal human tissues for immunohistochemistry analysis were
obtained from biopsy and autopsy specimens, fixed in Bouin's
solution (Sigma), and embedded in paraffin. Colon carcinoma
specimens were obtained from Department of Pathology, Yonsei
University, College of Medicine, Seoul, Korea. Tissue samples
included 102 primary tumors derived from patients who presented
between 1986 and 1996 with stage II disease (Duke's B-stage), as
defined by American Joint Committee on Cancer and Union
Internationale Contre le Cancer (AJCC/UICC) criteria. All patients
were treated by surgical resection of the involved segment of
colon. No postoperative adjuvant chemotherapy was performed
initially in all cases. However, chemotherapy was administered for
some patients after relapse. Clinical data represent a median
follow up of 60 months.
[0182] To construct colon cancer microarrays, 2-5 cylinders of 1 mm
diameter tissue were taken from representative areas of archival
paraffin blocks containing 8% formalin-fixed tumor and arrayed into
a new recipient paraffin block with a custom-built precision
instrument (Beecher Instruments, Silver Spring, Md.). Serial
sections (4 um) were applied to 3-aminopropyltri-ethoxysilane
(APES)-coated slides (Sigma), as described in Rentrop et al.
Histochem J. 18:271-276 (1986).
[0183] For immunohistochemistry, dewaxed tissue sections were
immunostained using a diaminobenzidine (DAB)-based detection
method, employing the Envision-Plus-Horse Radish Peroxidase (HRP)
system (DAKO) using an automated immunostainer (Dako Universal
Staining System) (Krajewski et al. Proc. Natl. Acad. Sci. USA
96:5752-5757 (1999)). Anti-TUCAN antibody was applied at 1:5000
(v/v). Incubation with antiserum preabsorbed with 5 ug/ml of either
synthetic peptide (BUR215) or recombinant GST-CARD/TUCAN protein
(BUR206) immunogen was used to verify specificity of the results.
The scoring of tumor immunostaining was based on the percentage of
immunopositive cells (0-100) multiplied by staining intensity score
(0/1/2/3), yielding scores of 0-300.
[0184] Data were analyzed using the JMP Statistics software package
(SAS Institute). An unpaired t-test method and Pearson ChiSquare
test were used for correlation of TUCAN immunostaining data with
the patient survival.
[0185] Of the 102 tumor specimens arrayed, 66 contained adjacent
normal colonic epithelium in the same section, permitting
comparisons of the intensity of TUCAN immunostaining in tumor
versus normal cells. TUCAN immuno-intensity was stronger in the
invasive cancer cells compared to normal colonic epithelial cells
in 42 of 66 (64%) of these specimens, indicating that roughly
two-thirds of colon cancers have up-regulated levels of TUCAN
protein. TUCAN immunoreactivity was present diffusely through the
cytosol of these cells (FIG. 7). Control staining performed with
either preimmune serum or with anti-TUCAN antiserum that had been
preabsorbed with TUCAN immunogen confirmed that these results were
specific for anti-TUCAN.
[0186] Tumor immunostaining results were scored with respect to
immuno-intensity (ranked on a scale of 0-3), percentage
immunopositivity (0-100%), and immunoscore (which is the product of
immuno-intensity and immuno-percentage), and these data were
correlated with patient survival information. TUCAN immunostaining
was significantly higher among patients who died of their cancer
(n=31), compared to patients who remained alive without disease
(n=61) or alive with recurrent disease (n=10). A summary of TUCAN
immunostaining results is shown below in Table 5. TABLE-US-00005
TABLE 5 Summary of TUCAN Immunostaining Results Patient %
Immunopositivity Immunointensity Immunoscore Status n Mean .+-. SE
Median Mean .+-. SE Median Mean .+-. SE Median Alive 61 58 .+-. 3
60 1.4 .+-. 0.1 1 92 .+-. 9 80 without disease Alive with 10 54
.+-. 7 55 1.3 .+-. 0.2 1 73 .+-. 21 65 disease Dead from 31 90 .+-.
4 95 2.5 .+-. 0.1 3 224 .+-. 12 240 disease p-values 102 p <
.0001 p < .0001 p < .0001
[0187] In summary, TUCAN expression is abnormally elevated in a
substantial proportion of early-stage colon cancers. Furthermore,
elevated TUCAN expression correlates with reduced patient
survival.
EXAMPLE IX
TUCAN Binds Selectively to Pro-Caspase-9 and to Itself
[0188] This example shows that TUCAN binds selectively to
Pro-Caspase-9 and to itself. Since CARDS are known for their
ability to bind each other, TUCAN was tested for interactions with
the CARD-containing proteins pro-Caspase-1, pro-Caspase-2,
pro-Caspase-9, Apaf1, Nod1 (CARD4), CED4, NAC (DEFCAP), Cardiak
(RIP2), Raidd (CRADD), Bcl10 (CIPER; huE10), cIAP1, cIAP2, CLAN,
CARD9, and itself. Among these, TUCAN associated only with
pro-Caspase-9 and itself.
[0189] FIG. 8 shows representative results from
co-immunoprecipitation experiments performed using TUCAN containing
either Flag or Myc epitope tags. The TUCAN polypeptides were
expressed by transient transfection in HEK293T cells together with
epitope-tagged pro-caspase-9 or other proteins. An inactive mutant
of pro-caspase-9 in which the catalytic cysteine was substitute
with alanine (Cys287/Ala) was employed for these experiments to
avoid induction of apoptosis (Cardone et al. Science 282:1318-1321
(1998)). Cell lysates were prepared from transfected cells and
immunoprecipitations were performed using anti-Flag or anti-Myc
antibodies, followed by SDS-PAGE/immunoblot analysis.
Representative results are presented in FIG. 8A, which shows that
TUCAN co-immunoprecipitated with pro-Caspase-9 but not the
CARD-containing protein Apaf1. TUCAN also did not
co-immunoprecipitate with the CARD-containing proteins
pro-Caspase-1, pro-Caspase-2, Nod1, CED4, NAC, Cardiak, Raidd,
Bcl10, CLAN, CARD9, cIAP1, and cIAP2. Moreover, TUCAN did not
associate non-specifically with caspases, as co-immunoprecipitation
experiments did not reveal interactions with the DED-containing
caspases, pro-caspase-8 and -10 (FIG. 8A).
[0190] To determine the role of the CARD domain within TUCAN for
interactions with pro-Caspase-9, fragments of TUCAN were expressed.
The TUCAN fragments contained essentially only the CARD (residues
345-431) or lacked the CARD (residues 1-337) (.DELTA.CARD).
Pro-Caspase-9 co-immunoprecipitated with full-length TUCAN and the
CARD only fragment but not the .DELTA.CARD fragment of TUCAN (FIG.
8B). Thus, the CARD domain of TUCAN is necessary and sufficient for
association with pro-Caspase-9. Self-association of TUCAN was also
confirmed by co-immunoprecipitation experiments, using HA and
Myc-tagged proteins and contrasting the full-length, CARD-only, and
.DELTA.CARD proteins. Full-length TUCAN interacted with full-length
TUCAN and the CARD-only fragment but not the .DELTA.CARD fragment
(FIG. 8C). Thus, the CARD domain of TUCAN is necessary and
sufficient for self-association.
[0191] Throughout this application various publications have been
referenced within parentheses. The disclosures of these
publications in their entireties are hereby incorporated by
reference in this application in order to more fully describe the
state of the art to which this invention pertains.
[0192] Although the invention has been described with reference to
the disclosed embodiments, those skilled in the art will readily
appreciate that the specific experiments detailed are only
illustrative of the invention. It should be understood that various
modifications can be made without departing from the spirit of the
invention.
Sequence CWU 1
1
15 1 1487 DNA Homo sapiens CDS (1)...(1293) 1 atg atg aga cag agg
cag agc cat tat tgt tcc gtg ctg ttc ctg agt 48 Met Met Arg Gln Arg
Gln Ser His Tyr Cys Ser Val Leu Phe Leu Ser 1 5 10 15 gtc aac tat
ctg ggg ggg aca ttc cca gga gac att tgc tca gaa gag 96 Val Asn Tyr
Leu Gly Gly Thr Phe Pro Gly Asp Ile Cys Ser Glu Glu 20 25 30 aat
caa ata gtt tcc tct tat gct tct aaa gtc tgt ttt gag atc gaa 144 Asn
Gln Ile Val Ser Ser Tyr Ala Ser Lys Val Cys Phe Glu Ile Glu 35 40
45 gaa gat tat aaa aat cgt cag ttt ctg ggg cct gaa gga aat gtg gat
192 Glu Asp Tyr Lys Asn Arg Gln Phe Leu Gly Pro Glu Gly Asn Val Asp
50 55 60 gtt gag ttg att gat aag agc aca aac aga tac agc gtt tgg
ttc ccc 240 Val Glu Leu Ile Asp Lys Ser Thr Asn Arg Tyr Ser Val Trp
Phe Pro 65 70 75 80 act gct ggc tgg tat ctg tgg tca gcc aca ggc ctc
ggc ttc ctg gta 288 Thr Ala Gly Trp Tyr Leu Trp Ser Ala Thr Gly Leu
Gly Phe Leu Val 85 90 95 agg gat gag gtc aca gtg acg att gcg ttt
ggt tcc tgg agt cag cac 336 Arg Asp Glu Val Thr Val Thr Ile Ala Phe
Gly Ser Trp Ser Gln His 100 105 110 ctg gcc ctg gac ctg cag cac cat
gaa cag tgg ctg gtg ggc ggc ccc 384 Leu Ala Leu Asp Leu Gln His His
Glu Gln Trp Leu Val Gly Gly Pro 115 120 125 ttg ttt gat gtc act gca
gag cca gag gag gct gtc gcc gaa atc cac 432 Leu Phe Asp Val Thr Ala
Glu Pro Glu Glu Ala Val Ala Glu Ile His 130 135 140 ctc ccc cac ttc
atc tcc ctc caa ggt gag gtg gac gtc tcc tgg ttt 480 Leu Pro His Phe
Ile Ser Leu Gln Gly Glu Val Asp Val Ser Trp Phe 145 150 155 160 ctc
gtt gcc cat ttt aag aat gaa ggg atg gtc ctg gag cat cca gcc 528 Leu
Val Ala His Phe Lys Asn Glu Gly Met Val Leu Glu His Pro Ala 165 170
175 cgg gtg gag cct ttc tat gct gtc ctg gaa agc ccc agc ttc tct ctg
576 Arg Val Glu Pro Phe Tyr Ala Val Leu Glu Ser Pro Ser Phe Ser Leu
180 185 190 atg ggc atc ctg ctg cgg atc gcc agt ggg act cgc ctc tcc
atc ccc 624 Met Gly Ile Leu Leu Arg Ile Ala Ser Gly Thr Arg Leu Ser
Ile Pro 195 200 205 atc act tcc aac aca ttg atc tat tat cac ccc cac
ccc gaa gat att 672 Ile Thr Ser Asn Thr Leu Ile Tyr Tyr His Pro His
Pro Glu Asp Ile 210 215 220 aag ttc cac ttg tac ctt gtc ccc agc gac
gcc ttg cta aca aag gcg 720 Lys Phe His Leu Tyr Leu Val Pro Ser Asp
Ala Leu Leu Thr Lys Ala 225 230 235 240 ata gat gat gag gaa gat cgc
ttc cat ggt gtg cgc ctg cag act tcg 768 Ile Asp Asp Glu Glu Asp Arg
Phe His Gly Val Arg Leu Gln Thr Ser 245 250 255 ccc cca atg gaa ccc
ctg aac ttt ggt tcc agt tat att gtg tct aat 816 Pro Pro Met Glu Pro
Leu Asn Phe Gly Ser Ser Tyr Ile Val Ser Asn 260 265 270 tct gct aac
ctg aaa gta atg ccc aag gag ttg aaa ttg tcc tac agg 864 Ser Ala Asn
Leu Lys Val Met Pro Lys Glu Leu Lys Leu Ser Tyr Arg 275 280 285 agc
cct gga gaa att cag cac ttc tca aaa ttc tat gct ggg cag atg 912 Ser
Pro Gly Glu Ile Gln His Phe Ser Lys Phe Tyr Ala Gly Gln Met 290 295
300 aag gaa ccc att caa ctt gag att act gaa aaa aga cat ggg act ttg
960 Lys Glu Pro Ile Gln Leu Glu Ile Thr Glu Lys Arg His Gly Thr Leu
305 310 315 320 gtg tgg gat act gag gtg aag cca gtg gat ctc cag ctt
gta gct gca 1008 Val Trp Asp Thr Glu Val Lys Pro Val Asp Leu Gln
Leu Val Ala Ala 325 330 335 tca gcc cct cct cct ttc tca ggt gca gcc
ttt gtg aag gag aac cac 1056 Ser Ala Pro Pro Pro Phe Ser Gly Ala
Ala Phe Val Lys Glu Asn His 340 345 350 cgg caa ctc caa gcc agg atg
ggg gac ctg aaa ggg gtg ctc gat gat 1104 Arg Gln Leu Gln Ala Arg
Met Gly Asp Leu Lys Gly Val Leu Asp Asp 355 360 365 ctc cag gac aat
gag gtt ctt act gag aat gag aag gag ctg gtg gag 1152 Leu Gln Asp
Asn Glu Val Leu Thr Glu Asn Glu Lys Glu Leu Val Glu 370 375 380 cag
gaa aag aca cgg cag agc aag aat gag gcc ttg ctg agc atg gtg 1200
Gln Glu Lys Thr Arg Gln Ser Lys Asn Glu Ala Leu Leu Ser Met Val 385
390 395 400 gag aag aaa ggg gac ctg gcc ctg gac gtg ctc ttc aga agc
att agt 1248 Glu Lys Lys Gly Asp Leu Ala Leu Asp Val Leu Phe Arg
Ser Ile Ser 405 410 415 gaa agg gac cct tac ctc gtg tcc tat ctt aga
cag cag aat ttg 1293 Glu Arg Asp Pro Tyr Leu Val Ser Tyr Leu Arg
Gln Gln Asn Leu 420 425 430 taaaatgagt cagttaggta gtctggaaga
gagaatccag cgttctcatt ggaaatggat 1353 aaacagaaat gtgatcattg
atttcagtgt tcaagacaga agaagactgg gtaacatcta 1413 tcacacaggc
tttcaggaca gacttgtaac ctggcatgta cctattgact gtatcctcat 1473
gcattttcct caag 1487 2 431 PRT Homo sapiens 2 Met Met Arg Gln Arg
Gln Ser His Tyr Cys Ser Val Leu Phe Leu Ser 1 5 10 15 Val Asn Tyr
Leu Gly Gly Thr Phe Pro Gly Asp Ile Cys Ser Glu Glu 20 25 30 Asn
Gln Ile Val Ser Ser Tyr Ala Ser Lys Val Cys Phe Glu Ile Glu 35 40
45 Glu Asp Tyr Lys Asn Arg Gln Phe Leu Gly Pro Glu Gly Asn Val Asp
50 55 60 Val Glu Leu Ile Asp Lys Ser Thr Asn Arg Tyr Ser Val Trp
Phe Pro 65 70 75 80 Thr Ala Gly Trp Tyr Leu Trp Ser Ala Thr Gly Leu
Gly Phe Leu Val 85 90 95 Arg Asp Glu Val Thr Val Thr Ile Ala Phe
Gly Ser Trp Ser Gln His 100 105 110 Leu Ala Leu Asp Leu Gln His His
Glu Gln Trp Leu Val Gly Gly Pro 115 120 125 Leu Phe Asp Val Thr Ala
Glu Pro Glu Glu Ala Val Ala Glu Ile His 130 135 140 Leu Pro His Phe
Ile Ser Leu Gln Gly Glu Val Asp Val Ser Trp Phe 145 150 155 160 Leu
Val Ala His Phe Lys Asn Glu Gly Met Val Leu Glu His Pro Ala 165 170
175 Arg Val Glu Pro Phe Tyr Ala Val Leu Glu Ser Pro Ser Phe Ser Leu
180 185 190 Met Gly Ile Leu Leu Arg Ile Ala Ser Gly Thr Arg Leu Ser
Ile Pro 195 200 205 Ile Thr Ser Asn Thr Leu Ile Tyr Tyr His Pro His
Pro Glu Asp Ile 210 215 220 Lys Phe His Leu Tyr Leu Val Pro Ser Asp
Ala Leu Leu Thr Lys Ala 225 230 235 240 Ile Asp Asp Glu Glu Asp Arg
Phe His Gly Val Arg Leu Gln Thr Ser 245 250 255 Pro Pro Met Glu Pro
Leu Asn Phe Gly Ser Ser Tyr Ile Val Ser Asn 260 265 270 Ser Ala Asn
Leu Lys Val Met Pro Lys Glu Leu Lys Leu Ser Tyr Arg 275 280 285 Ser
Pro Gly Glu Ile Gln His Phe Ser Lys Phe Tyr Ala Gly Gln Met 290 295
300 Lys Glu Pro Ile Gln Leu Glu Ile Thr Glu Lys Arg His Gly Thr Leu
305 310 315 320 Val Trp Asp Thr Glu Val Lys Pro Val Asp Leu Gln Leu
Val Ala Ala 325 330 335 Ser Ala Pro Pro Pro Phe Ser Gly Ala Ala Phe
Val Lys Glu Asn His 340 345 350 Arg Gln Leu Gln Ala Arg Met Gly Asp
Leu Lys Gly Val Leu Asp Asp 355 360 365 Leu Gln Asp Asn Glu Val Leu
Thr Glu Asn Glu Lys Glu Leu Val Glu 370 375 380 Gln Glu Lys Thr Arg
Gln Ser Lys Asn Glu Ala Leu Leu Ser Met Val 385 390 395 400 Glu Lys
Lys Gly Asp Leu Ala Leu Asp Val Leu Phe Arg Ser Ile Ser 405 410 415
Glu Arg Asp Pro Tyr Leu Val Ser Tyr Leu Arg Gln Gln Asn Leu 420 425
430 3 87 PRT Homo sapiens 3 Ala Ala Phe Val Lys Glu Asn His Arg Gln
Leu Gln Ala Arg Met Gly 1 5 10 15 Asp Leu Lys Gly Val Leu Asp Asp
Leu Gln Asp Asn Glu Val Leu Thr 20 25 30 Glu Asn Glu Lys Glu Leu
Val Glu Gln Glu Lys Thr Arg Gln Ser Lys 35 40 45 Asn Glu Ala Leu
Leu Ser Met Val Glu Lys Lys Gly Asp Leu Ala Leu 50 55 60 Asp Val
Leu Phe Arg Ser Ile Ser Glu Arg Asp Pro Tyr Leu Val Ser 65 70 75 80
Tyr Leu Arg Gln Gln Asn Leu 85 4 416 PRT Homo sapiens 4 Met Asp Glu
Ala Asp Arg Arg Leu Leu Arg Arg Cys Arg Leu Arg Leu 1 5 10 15 Val
Glu Glu Leu Gln Val Asp Gln Leu Trp Asp Ala Leu Leu Ser Ser 20 25
30 Glu Leu Phe Arg Pro His Met Ile Glu Asp Ile Gln Arg Ala Gly Ser
35 40 45 Gly Ser Arg Arg Asp Gln Ala Arg Gln Leu Ile Ile Asp Leu
Glu Thr 50 55 60 Arg Gly Ser Gln Ala Leu Pro Leu Phe Ile Ser Cys
Leu Glu Asp Thr 65 70 75 80 Gly Gln Asp Met Leu Ala Ser Phe Leu Arg
Thr Asn Arg Gln Ala Ala 85 90 95 Lys Leu Ser Lys Pro Thr Leu Glu
Asn Leu Thr Pro Val Val Leu Arg 100 105 110 Pro Glu Ile Arg Lys Pro
Glu Val Leu Arg Pro Glu Thr Pro Arg Pro 115 120 125 Val Asp Ile Gly
Ser Gly Gly Phe Gly Asp Val Gly Ala Leu Glu Ser 130 135 140 Leu Arg
Gly Asn Ala Asp Leu Ala Tyr Ile Leu Ser Met Glu Pro Cys 145 150 155
160 Gly His Cys Leu Ile Ile Asn Asn Val Asn Phe Cys Arg Glu Ser Gly
165 170 175 Leu Arg Thr Arg Thr Gly Ser Asn Ile Asp Cys Glu Lys Leu
Arg Arg 180 185 190 Arg Phe Ser Ser Pro His Phe Met Val Glu Val Lys
Gly Asp Leu Thr 195 200 205 Ala Lys Lys Met Val Leu Ala Leu Leu Glu
Leu Ala Gln Gln Asp His 210 215 220 Gly Ala Leu Asp Cys Cys Val Val
Val Ile Leu Ser His Gly Cys Gln 225 230 235 240 Ala Ser His Leu Gln
Phe Pro Gly Ala Val Tyr Gly Thr Asp Gly Cys 245 250 255 Pro Val Ser
Val Glu Lys Ile Val Asn Ile Phe Asn Gly Thr Ser Cys 260 265 270 Pro
Ser Leu Gly Gly Lys Pro Lys Leu Phe Phe Ile Gln Ala Cys Gly 275 280
285 Gly Glu Gln Lys Asp His Gly Phe Glu Val Ala Ser Thr Ser Pro Glu
290 295 300 Asp Glu Ser Pro Gly Ser Asn Pro Glu Pro Asp Ala Thr Pro
Phe Gln 305 310 315 320 Glu Gly Leu Arg Thr Phe Asp Gln Leu Asp Ala
Ile Ser Ser Leu Pro 325 330 335 Thr Pro Ser Asp Ile Phe Val Ser Tyr
Ser Thr Phe Pro Gly Phe Val 340 345 350 Ser Trp Arg Asp Pro Lys Ser
Gly Ser Trp Tyr Val Glu Thr Leu Asp 355 360 365 Asp Ile Phe Glu Gln
Trp Ala His Ser Glu Asp Leu Gln Ser Leu Leu 370 375 380 Leu Arg Val
Ala Asn Ala Val Ser Val Lys Gly Ile Tyr Lys Gln Met 385 390 395 400
Pro Gly Cys Phe Asn Phe Leu Arg Lys Lys Leu Phe Phe Lys Thr Ser 405
410 415 5 3164 DNA Homo sapiens CDS (724)...(2538) 5 gaattcaaaa
tgtcttcagt tgtaaatctt accattattt tacgtacctc taagaaataa 60
aagtgcttct aattaaaata tgatgtcatt aattatgaaa tacttcttga taacagaagt
120 ttaaaatagc catcttagaa tcagtgaaat atggtaatgt attattttcc
tcctttgagt 180 taggtcttgt gctttttttt cctggccact aaatttcaca
atttccaaaa agcaaaataa 240 acatattctg aatatttttg ctgtgaaaca
cttgacagca gagctttcca ccatgaaaag 300 aagcttcatg agtcacacat
tacatctttg ggttgattga atgccactga aacattctag 360 tagcctggag
aagttgacct acctgtggag atgcctgcca ttaaatggca tcctgatggc 420
ttaatacaca tcactcttct gtgaagggtt ttaattttca acacagctta ctctgtagca
480 tcatgtttac attgtatgta taaagattat acaaaggtgc aattgtgtat
ttcttcctta 540 aaatgtatca gtataggatt tagaatctcc atgttgaaac
tctaaatgca tagaaataaa 600 aataataaaa aatttttcat tttggctttt
cagcctagta ttaaaactga taaaagcaaa 660 gccatgcaca aaactacctc
cctagagaaa ggctagtccc ttttcttccc cattcatttc 720 att atg aac ata gta
gaa aac agc ata ttc tta tca aat ttg atg aaa 768 Met Asn Ile Val Glu
Asn Ser Ile Phe Leu Ser Asn Leu Met Lys 1 5 10 15 agc gcc aac acg
ttt gaa ctg aaa tac gac ttg tca tgt gaa ctg tac 816 Ser Ala Asn Thr
Phe Glu Leu Lys Tyr Asp Leu Ser Cys Glu Leu Tyr 20 25 30 cga atg
tct acg tat tcc act ttt cct gct ggg gtc cct gtc tca gaa 864 Arg Met
Ser Thr Tyr Ser Thr Phe Pro Ala Gly Val Pro Val Ser Glu 35 40 45
agg agt ctt gct cgc gct ggt ttc tat tac act ggt gtg aat gac aag 912
Arg Ser Leu Ala Arg Ala Gly Phe Tyr Tyr Thr Gly Val Asn Asp Lys 50
55 60 gtc aaa tgc ttc tgt tgt ggc ctg atg ctg gat aac tgg aaa aga
gga 960 Val Lys Cys Phe Cys Cys Gly Leu Met Leu Asp Asn Trp Lys Arg
Gly 65 70 75 gac agt cct act gaa aag cat aaa aag ttg tat cct agc
tgc aga ttc 1008 Asp Ser Pro Thr Glu Lys His Lys Lys Leu Tyr Pro
Ser Cys Arg Phe 80 85 90 95 gtt cag agt cta aat tcc gtt aac aac ttg
gaa gct acc tct cag cct 1056 Val Gln Ser Leu Asn Ser Val Asn Asn
Leu Glu Ala Thr Ser Gln Pro 100 105 110 act ttt cct tct tca gta aca
aat tcc aca cac tca tta ctt ccg ggt 1104 Thr Phe Pro Ser Ser Val
Thr Asn Ser Thr His Ser Leu Leu Pro Gly 115 120 125 aca gaa aac agt
gga tat ttc cgt ggc tct tat tca aac tct cca tca 1152 Thr Glu Asn
Ser Gly Tyr Phe Arg Gly Ser Tyr Ser Asn Ser Pro Ser 130 135 140 aat
cct gta aac tcc aga gca aat caa gat ttt tct gcc ttg atg aga 1200
Asn Pro Val Asn Ser Arg Ala Asn Gln Asp Phe Ser Ala Leu Met Arg 145
150 155 agt tcc tac cac tgt gca atg aat aac gaa aat gcc aga tta ctt
act 1248 Ser Ser Tyr His Cys Ala Met Asn Asn Glu Asn Ala Arg Leu
Leu Thr 160 165 170 175 ttt cag aca tgg cca ttg act ttt ctg tcg cca
aca gat ctg gca aaa 1296 Phe Gln Thr Trp Pro Leu Thr Phe Leu Ser
Pro Thr Asp Leu Ala Lys 180 185 190 gca ggc ttt tac tac ata gga cct
gga gac aga gtg gct tgc ttt gcc 1344 Ala Gly Phe Tyr Tyr Ile Gly
Pro Gly Asp Arg Val Ala Cys Phe Ala 195 200 205 tgt ggt gga aaa ttg
agc aat tgg gaa ccg aag gat aat gct atg tca 1392 Cys Gly Gly Lys
Leu Ser Asn Trp Glu Pro Lys Asp Asn Ala Met Ser 210 215 220 gaa cac
ctg aga cat ttt ccc aaa tgc cca ttt ata gaa aat cag ctt 1440 Glu
His Leu Arg His Phe Pro Lys Cys Pro Phe Ile Glu Asn Gln Leu 225 230
235 caa gac act tca aga tac aca gtt tct aat ctg agc atg cag aca cat
1488 Gln Asp Thr Ser Arg Tyr Thr Val Ser Asn Leu Ser Met Gln Thr
His 240 245 250 255 gca gcc cgc ttt aaa aca ttc ttt aac tgg ccc tct
agt gtt cta gtt 1536 Ala Ala Arg Phe Lys Thr Phe Phe Asn Trp Pro
Ser Ser Val Leu Val 260 265 270 aat cct gag cag ctt gca agt gcg ggt
ttt tat tat gtg ggt aac agt 1584 Asn Pro Glu Gln Leu Ala Ser Ala
Gly Phe Tyr Tyr Val Gly Asn Ser 275 280 285 gat gat gtc aaa tgc ttt
tgc tgt gat ggt gga ctc agg tgt tgg gaa 1632 Asp Asp Val Lys Cys
Phe Cys Cys Asp Gly Gly Leu Arg Cys Trp Glu 290 295 300 tct gga gat
gat cca tgg gtt caa cat gcc aag tgg ttt cca agg tgt 1680 Ser Gly
Asp Asp Pro Trp Val Gln His Ala Lys Trp Phe Pro Arg Cys 305 310 315
gag tac ttg ata aga att aaa gga cag gag ttc atc cgt caa gtt caa
1728 Glu Tyr Leu Ile Arg Ile Lys Gly Gln Glu Phe Ile Arg Gln Val
Gln 320 325 330 335 gcc agt tac cct cat cta ctt gaa cag ctg cta tcc
aca tca gac agc 1776 Ala Ser Tyr Pro His Leu Leu Glu Gln Leu Leu
Ser Thr Ser Asp Ser 340 345 350 cca gga gat gaa aat gca gag tca tca
att atc cat ttt gaa cct gga 1824 Pro Gly Asp Glu Asn Ala Glu Ser
Ser Ile Ile His Phe Glu Pro Gly 355 360 365 gaa gac cat tca gaa gat
gca atc atg atg aat act cct gtg att aat 1872 Glu Asp His Ser Glu
Asp Ala Ile Met Met Asn Thr Pro Val Ile Asn 370 375 380 gct gcc gtg
gaa atg ggc ttt agt aga agc ctg gta aaa cag aca gtt 1920 Ala Ala
Val Glu Met Gly Phe Ser Arg Ser Leu Val Lys Gln Thr Val 385
390 395 cag aga aaa atc cta gca act gga gag aat tat aga cta gtc aat
gat 1968 Gln Arg Lys Ile Leu Ala Thr Gly Glu Asn Tyr Arg Leu Val
Asn Asp 400 405 410 415 ctt gtg tta gac tta ctc aat gca gaa gat gaa
ata agg gaa gag gag 2016 Leu Val Leu Asp Leu Leu Asn Ala Glu Asp
Glu Ile Arg Glu Glu Glu 420 425 430 aga gaa aga gca act gag gaa aaa
gaa tca aat gat tta tta tta atc 2064 Arg Glu Arg Ala Thr Glu Glu
Lys Glu Ser Asn Asp Leu Leu Leu Ile 435 440 445 cgg aag aat aga atg
gca ctt ttt caa cat ttg act tgt gta att cca 2112 Arg Lys Asn Arg
Met Ala Leu Phe Gln His Leu Thr Cys Val Ile Pro 450 455 460 atc ctg
gat agt cta cta act gcc gga att att aat gaa caa gaa cat 2160 Ile
Leu Asp Ser Leu Leu Thr Ala Gly Ile Ile Asn Glu Gln Glu His 465 470
475 gat gtt att aaa cag aag aca cag acg tct tta caa gca aga gaa ctg
2208 Asp Val Ile Lys Gln Lys Thr Gln Thr Ser Leu Gln Ala Arg Glu
Leu 480 485 490 495 att gat acg att tta gta aaa gga aat att gca gcc
act gta ttc aga 2256 Ile Asp Thr Ile Leu Val Lys Gly Asn Ile Ala
Ala Thr Val Phe Arg 500 505 510 aac tct ctg caa gaa gct gaa gct gtg
tta tat gag cat tta ttt gtg 2304 Asn Ser Leu Gln Glu Ala Glu Ala
Val Leu Tyr Glu His Leu Phe Val 515 520 525 caa cag gac ata aaa tat
att ccc aca gaa gat gtt tca gat cta cca 2352 Gln Gln Asp Ile Lys
Tyr Ile Pro Thr Glu Asp Val Ser Asp Leu Pro 530 535 540 gtg gaa gaa
caa ttg cgg aga cta caa gaa gaa aga aca tgt aaa gtg 2400 Val Glu
Glu Gln Leu Arg Arg Leu Gln Glu Glu Arg Thr Cys Lys Val 545 550 555
tgt atg gac aaa gaa gtg tcc ata gtg ttt att cct tgt ggt cat cta
2448 Cys Met Asp Lys Glu Val Ser Ile Val Phe Ile Pro Cys Gly His
Leu 560 565 570 575 gta gta tgc aaa gat tgt gct cct tct tta aga aag
tgt cct att tgt 2496 Val Val Cys Lys Asp Cys Ala Pro Ser Leu Arg
Lys Cys Pro Ile Cys 580 585 590 agg agt aca atc aag ggt aca gtt cgt
aca ttt ctt tca tga 2538 Arg Ser Thr Ile Lys Gly Thr Val Arg Thr
Phe Leu Ser * 595 600 agaagaacca aaacatcatc taaactttag aattaattta
ttaaatgtat tataacttta 2598 actttcatcc taatttggtt tccttaaaat
ttttatttat ttacaactca acaaacattg 2658 ttttgtgtaa catatttaat
atatgtatct aaaccatatg aacatatatt ttttagaaac 2718 taagagaatg
ataggctttt gttcttatga acgaaaaaga ggtagcacta caaacacaat 2778
attcaatcaa aatttcagca ttattgaaat tgtaagtgaa gtaaaactta agatatttga
2838 gttaaccttt aagaatttta aatattttgg cattgtacta ataccgggaa
catgaagcca 2898 ggtgtggtgg tatgtgcctg tagtcccagg ctgaggcaag
agaattactt gagcccagga 2958 gtttgaatcc atcctgggca gcatactgag
accctgcctt taaaaacaaa cagaacaaaa 3018 acaaaacacc agggacacat
ttctctgtct tttttgatca gtgtcctata catcgaaggt 3078 gtgcatatat
gttgaatgac attttaggga catggtgttt ttataaagaa ttctgtgaga 3138
aaaaatttaa taaaaccccc caaatt 3164 6 604 PRT Homo sapiens 6 Met Asn
Ile Val Glu Asn Ser Ile Phe Leu Ser Asn Leu Met Lys Ser 1 5 10 15
Ala Asn Thr Phe Glu Leu Lys Tyr Asp Leu Ser Cys Glu Leu Tyr Arg 20
25 30 Met Ser Thr Tyr Ser Thr Phe Pro Ala Gly Val Pro Val Ser Glu
Arg 35 40 45 Ser Leu Ala Arg Ala Gly Phe Tyr Tyr Thr Gly Val Asn
Asp Lys Val 50 55 60 Lys Cys Phe Cys Cys Gly Leu Met Leu Asp Asn
Trp Lys Arg Gly Asp 65 70 75 80 Ser Pro Thr Glu Lys His Lys Lys Leu
Tyr Pro Ser Cys Arg Phe Val 85 90 95 Gln Ser Leu Asn Ser Val Asn
Asn Leu Glu Ala Thr Ser Gln Pro Thr 100 105 110 Phe Pro Ser Ser Val
Thr Asn Ser Thr His Ser Leu Leu Pro Gly Thr 115 120 125 Glu Asn Ser
Gly Tyr Phe Arg Gly Ser Tyr Ser Asn Ser Pro Ser Asn 130 135 140 Pro
Val Asn Ser Arg Ala Asn Gln Asp Phe Ser Ala Leu Met Arg Ser 145 150
155 160 Ser Tyr His Cys Ala Met Asn Asn Glu Asn Ala Arg Leu Leu Thr
Phe 165 170 175 Gln Thr Trp Pro Leu Thr Phe Leu Ser Pro Thr Asp Leu
Ala Lys Ala 180 185 190 Gly Phe Tyr Tyr Ile Gly Pro Gly Asp Arg Val
Ala Cys Phe Ala Cys 195 200 205 Gly Gly Lys Leu Ser Asn Trp Glu Pro
Lys Asp Asn Ala Met Ser Glu 210 215 220 His Leu Arg His Phe Pro Lys
Cys Pro Phe Ile Glu Asn Gln Leu Gln 225 230 235 240 Asp Thr Ser Arg
Tyr Thr Val Ser Asn Leu Ser Met Gln Thr His Ala 245 250 255 Ala Arg
Phe Lys Thr Phe Phe Asn Trp Pro Ser Ser Val Leu Val Asn 260 265 270
Pro Glu Gln Leu Ala Ser Ala Gly Phe Tyr Tyr Val Gly Asn Ser Asp 275
280 285 Asp Val Lys Cys Phe Cys Cys Asp Gly Gly Leu Arg Cys Trp Glu
Ser 290 295 300 Gly Asp Asp Pro Trp Val Gln His Ala Lys Trp Phe Pro
Arg Cys Glu 305 310 315 320 Tyr Leu Ile Arg Ile Lys Gly Gln Glu Phe
Ile Arg Gln Val Gln Ala 325 330 335 Ser Tyr Pro His Leu Leu Glu Gln
Leu Leu Ser Thr Ser Asp Ser Pro 340 345 350 Gly Asp Glu Asn Ala Glu
Ser Ser Ile Ile His Phe Glu Pro Gly Glu 355 360 365 Asp His Ser Glu
Asp Ala Ile Met Met Asn Thr Pro Val Ile Asn Ala 370 375 380 Ala Val
Glu Met Gly Phe Ser Arg Ser Leu Val Lys Gln Thr Val Gln 385 390 395
400 Arg Lys Ile Leu Ala Thr Gly Glu Asn Tyr Arg Leu Val Asn Asp Leu
405 410 415 Val Leu Asp Leu Leu Asn Ala Glu Asp Glu Ile Arg Glu Glu
Glu Arg 420 425 430 Glu Arg Ala Thr Glu Glu Lys Glu Ser Asn Asp Leu
Leu Leu Ile Arg 435 440 445 Lys Asn Arg Met Ala Leu Phe Gln His Leu
Thr Cys Val Ile Pro Ile 450 455 460 Leu Asp Ser Leu Leu Thr Ala Gly
Ile Ile Asn Glu Gln Glu His Asp 465 470 475 480 Val Ile Lys Gln Lys
Thr Gln Thr Ser Leu Gln Ala Arg Glu Leu Ile 485 490 495 Asp Thr Ile
Leu Val Lys Gly Asn Ile Ala Ala Thr Val Phe Arg Asn 500 505 510 Ser
Leu Gln Glu Ala Glu Ala Val Leu Tyr Glu His Leu Phe Val Gln 515 520
525 Gln Asp Ile Lys Tyr Ile Pro Thr Glu Asp Val Ser Asp Leu Pro Val
530 535 540 Glu Glu Gln Leu Arg Arg Leu Gln Glu Glu Arg Thr Cys Lys
Val Cys 545 550 555 560 Met Asp Lys Glu Val Ser Ile Val Phe Ile Pro
Cys Gly His Leu Val 565 570 575 Val Cys Lys Asp Cys Ala Pro Ser Leu
Arg Lys Cys Pro Ile Cys Arg 580 585 590 Ser Thr Ile Lys Gly Thr Val
Arg Thr Phe Leu Ser 595 600 7 2585 DNA Homo sapiens CDS
(201)...(2546) 7 ggggcagcag cgttggcccg gccccgggag cggagagcga
ggggaggcgg agacggagga 60 aggtctgagg agcagcttca gtccccgccg
agccgccacc gcaggtcgag gacggtcgga 120 ctcccgcggc gggaggagcc
tgttcccctg agggtatttg aagtatacca tacaactgtt 180 ttgaaaatcc
agcgtggaca atg gct act caa gct gat ttg atg gag ttg gac 233 Met Ala
Thr Gln Ala Asp Leu Met Glu Leu Asp 1 5 10 atg gcc atg gaa cca gac
aga aaa gcg gct gtt agt cac tgg cag caa 281 Met Ala Met Glu Pro Asp
Arg Lys Ala Ala Val Ser His Trp Gln Gln 15 20 25 cag tct tac ctg
gac tct gga atc cat tct ggt gcc act acc aca gct 329 Gln Ser Tyr Leu
Asp Ser Gly Ile His Ser Gly Ala Thr Thr Thr Ala 30 35 40 cct tct
ctg agt ggt aaa ggc aat cct gag gaa gag gat gtg gat acc 377 Pro Ser
Leu Ser Gly Lys Gly Asn Pro Glu Glu Glu Asp Val Asp Thr 45 50 55
tcc caa gtc ctg tat gag tgg gaa cag gga ttt tct cag tcc ttc act 425
Ser Gln Val Leu Tyr Glu Trp Glu Gln Gly Phe Ser Gln Ser Phe Thr 60
65 70 75 caa gaa caa gta gct gat att gat gga cag tat gca atg act
cga gct 473 Gln Glu Gln Val Ala Asp Ile Asp Gly Gln Tyr Ala Met Thr
Arg Ala 80 85 90 cag agg gta cga gct gct atg ttc cct gag aca tta
gat gag ggc atg 521 Gln Arg Val Arg Ala Ala Met Phe Pro Glu Thr Leu
Asp Glu Gly Met 95 100 105 cag atc cca tct aca cag ttt gat gct gct
cat ccc act aat gtc cag 569 Gln Ile Pro Ser Thr Gln Phe Asp Ala Ala
His Pro Thr Asn Val Gln 110 115 120 cgt ttg gct gaa cca tca cag atg
ctg aaa cat gca gtt gta aac ttg 617 Arg Leu Ala Glu Pro Ser Gln Met
Leu Lys His Ala Val Val Asn Leu 125 130 135 att aac tat caa gat gat
gca gaa ctt gcc aca cgt gca atc cct gaa 665 Ile Asn Tyr Gln Asp Asp
Ala Glu Leu Ala Thr Arg Ala Ile Pro Glu 140 145 150 155 ctg aca aaa
ctg cta aat gac gag gac cag gtg gtg gtt aat aag gct 713 Leu Thr Lys
Leu Leu Asn Asp Glu Asp Gln Val Val Val Asn Lys Ala 160 165 170 gca
gtt atg gtc cat cag ctt tct aaa aag gaa gct tcc aga cac gct 761 Ala
Val Met Val His Gln Leu Ser Lys Lys Glu Ala Ser Arg His Ala 175 180
185 atc atg cgt tct cct cag atg gtg tct gct att gta cgt acc atg cag
809 Ile Met Arg Ser Pro Gln Met Val Ser Ala Ile Val Arg Thr Met Gln
190 195 200 aat aca aat gat gta gaa aca gct cgt tgt acc gct ggg acc
ttg cat 857 Asn Thr Asn Asp Val Glu Thr Ala Arg Cys Thr Ala Gly Thr
Leu His 205 210 215 aac ctt tcc cat cat cgt gag ggc tta ctg gcc atc
ttt aag tct gga 905 Asn Leu Ser His His Arg Glu Gly Leu Leu Ala Ile
Phe Lys Ser Gly 220 225 230 235 ggc att cct gcc ctg gtg aaa atg ctt
ggt tca cca gtg gat tct gtg 953 Gly Ile Pro Ala Leu Val Lys Met Leu
Gly Ser Pro Val Asp Ser Val 240 245 250 ttg ttt tat gcc att aca act
ctc cac aac ctt tta tta cat caa gaa 1001 Leu Phe Tyr Ala Ile Thr
Thr Leu His Asn Leu Leu Leu His Gln Glu 255 260 265 gga gct aaa atg
gca gtg cgt tta gct ggt ggg ctg cag aaa atg gtt 1049 Gly Ala Lys
Met Ala Val Arg Leu Ala Gly Gly Leu Gln Lys Met Val 270 275 280 gcc
ttg ctc aac aaa aca aat gtt aaa ttc ttg gct att acg aca gac 1097
Ala Leu Leu Asn Lys Thr Asn Val Lys Phe Leu Ala Ile Thr Thr Asp 285
290 295 tgc ctt caa att tta gct tat ggc aac caa gaa agc aag ctc atc
ata 1145 Cys Leu Gln Ile Leu Ala Tyr Gly Asn Gln Glu Ser Lys Leu
Ile Ile 300 305 310 315 ctg gct agt ggt gga ccc caa gct tta gta aat
ata atg agg acc tat 1193 Leu Ala Ser Gly Gly Pro Gln Ala Leu Val
Asn Ile Met Arg Thr Tyr 320 325 330 act tac gaa aaa cta ctg tgg acc
aca agc aga gtg ctg aag gtg cta 1241 Thr Tyr Glu Lys Leu Leu Trp
Thr Thr Ser Arg Val Leu Lys Val Leu 335 340 345 tct gtc tgc tct agt
aat aag ccg gct att gta gaa gct ggt gga atg 1289 Ser Val Cys Ser
Ser Asn Lys Pro Ala Ile Val Glu Ala Gly Gly Met 350 355 360 caa gct
tta gga ctt cac ctg aca gat cca agt caa cgt ctt gtt cag 1337 Gln
Ala Leu Gly Leu His Leu Thr Asp Pro Ser Gln Arg Leu Val Gln 365 370
375 aac tgt ctt tgg act ctc agg aat ctt tca gat gct gca act aaa cag
1385 Asn Cys Leu Trp Thr Leu Arg Asn Leu Ser Asp Ala Ala Thr Lys
Gln 380 385 390 395 gaa ggg atg gaa ggt ctc ctt ggg act ctt gtt cag
ctt ctg ggt tca 1433 Glu Gly Met Glu Gly Leu Leu Gly Thr Leu Val
Gln Leu Leu Gly Ser 400 405 410 gat gat ata aat gtg gtc acc tgt gca
gct gga att ctt tct aac ctc 1481 Asp Asp Ile Asn Val Val Thr Cys
Ala Ala Gly Ile Leu Ser Asn Leu 415 420 425 act tgc aat aat tat aag
aac aag atg atg gtc tgc caa gtg ggt ggt 1529 Thr Cys Asn Asn Tyr
Lys Asn Lys Met Met Val Cys Gln Val Gly Gly 430 435 440 ata gag gct
ctt gtg cgt act gtc ctt cgg gct ggt gac agg gaa gac 1577 Ile Glu
Ala Leu Val Arg Thr Val Leu Arg Ala Gly Asp Arg Glu Asp 445 450 455
atc act gag cct gcc atc tgt gct ctt cgt cat ctg acc agc cga cac
1625 Ile Thr Glu Pro Ala Ile Cys Ala Leu Arg His Leu Thr Ser Arg
His 460 465 470 475 caa gaa gca gag atg gcc cag aat gca gtt cgc ctt
cac tat gga cta 1673 Gln Glu Ala Glu Met Ala Gln Asn Ala Val Arg
Leu His Tyr Gly Leu 480 485 490 cca gtt gtg gtt aag ctc tta cac cca
cca tcc cac tgg cct ctg ata 1721 Pro Val Val Val Lys Leu Leu His
Pro Pro Ser His Trp Pro Leu Ile 495 500 505 aag gct act gtt gga ttg
att cga aat ctt gcc ctt tgt ccc gca aat 1769 Lys Ala Thr Val Gly
Leu Ile Arg Asn Leu Ala Leu Cys Pro Ala Asn 510 515 520 cat gca cct
ttg cgt gag cag ggt gcc att cca cga cta gtt cag ttg 1817 His Ala
Pro Leu Arg Glu Gln Gly Ala Ile Pro Arg Leu Val Gln Leu 525 530 535
ctt gtt cgt gca cat cag gat acc cag cgc cgt acg tcc atg ggt ggg
1865 Leu Val Arg Ala His Gln Asp Thr Gln Arg Arg Thr Ser Met Gly
Gly 540 545 550 555 aca cag cag caa ttt gtg gag ggg gtc cgc atg gaa
gaa ata gtt gaa 1913 Thr Gln Gln Gln Phe Val Glu Gly Val Arg Met
Glu Glu Ile Val Glu 560 565 570 ggt tgt acc gga gcc ctt cac atc cta
gct cgg gat gtt cac aac cga 1961 Gly Cys Thr Gly Ala Leu His Ile
Leu Ala Arg Asp Val His Asn Arg 575 580 585 att gtt atc aga gga cta
aat acc att cca ttg ttt gtg cag ctg ctt 2009 Ile Val Ile Arg Gly
Leu Asn Thr Ile Pro Leu Phe Val Gln Leu Leu 590 595 600 tat tct ccc
att gaa aac atc caa aga gta gct gca ggg gtc ctc tgt 2057 Tyr Ser
Pro Ile Glu Asn Ile Gln Arg Val Ala Ala Gly Val Leu Cys 605 610 615
gaa ctt gct cag gac aag gaa gct gca gaa gct att gaa gct gag gga
2105 Glu Leu Ala Gln Asp Lys Glu Ala Ala Glu Ala Ile Glu Ala Glu
Gly 620 625 630 635 gcc aca gct cct ctg aca gag tta ctt cac tct agg
aat gaa ggt gtg 2153 Ala Thr Ala Pro Leu Thr Glu Leu Leu His Ser
Arg Asn Glu Gly Val 640 645 650 gcg aca tat gca gct gct gtt ttg ttc
cga atg tct gag gac aag cca 2201 Ala Thr Tyr Ala Ala Ala Val Leu
Phe Arg Met Ser Glu Asp Lys Pro 655 660 665 caa gat tac aag aaa cgg
ctt tca gtt gag ctg acc agc tct ctc ttc 2249 Gln Asp Tyr Lys Lys
Arg Leu Ser Val Glu Leu Thr Ser Ser Leu Phe 670 675 680 aga aca gag
cca atg gct tgg aat gag act gct gat ctt gga ctt gat 2297 Arg Thr
Glu Pro Met Ala Trp Asn Glu Thr Ala Asp Leu Gly Leu Asp 685 690 695
att ggt gcc cag gga gaa ccc ctt gga tat cgc cag gat gat cct agc
2345 Ile Gly Ala Gln Gly Glu Pro Leu Gly Tyr Arg Gln Asp Asp Pro
Ser 700 705 710 715 tat cgt tct ttt cac tct ggt gga tat ggc cag gat
gcc ttg ggt atg 2393 Tyr Arg Ser Phe His Ser Gly Gly Tyr Gly Gln
Asp Ala Leu Gly Met 720 725 730 gac ccc atg atg gaa cat gag atg ggt
ggc cac cac cct ggt gct gac 2441 Asp Pro Met Met Glu His Glu Met
Gly Gly His His Pro Gly Ala Asp 735 740 745 tat cca gtt gat ggg ctg
cca gat ctg ggg cat gcc cag gac ctc atg 2489 Tyr Pro Val Asp Gly
Leu Pro Asp Leu Gly His Ala Gln Asp Leu Met 750 755 760 gat ggg ctg
cct cca ggt gac agc aat cag ctg gcc tgg ttt gat act 2537 Asp Gly
Leu Pro Pro Gly Asp Ser Asn Gln Leu Ala Trp Phe Asp Thr 765 770 775
gac ctg taa atcatccttt aggagtaaca atacaaatgg attttgccc 2585 Asp Leu
* 780 8 781 PRT Homo sapiens 8 Met Ala Thr Gln Ala Asp Leu Met Glu
Leu Asp Met Ala Met Glu Pro 1 5 10 15 Asp Arg Lys Ala Ala Val Ser
His Trp Gln Gln Gln Ser Tyr Leu Asp 20 25 30 Ser Gly Ile His Ser
Gly Ala Thr Thr Thr Ala Pro Ser Leu Ser Gly 35 40 45 Lys Gly Asn
Pro Glu Glu Glu Asp Val Asp Thr Ser Gln Val Leu Tyr 50 55 60 Glu
Trp Glu Gln Gly Phe Ser Gln Ser Phe Thr Gln Glu Gln Val Ala 65 70
75 80 Asp Ile Asp Gly Gln Tyr Ala Met Thr
Arg Ala Gln Arg Val Arg Ala 85 90 95 Ala Met Phe Pro Glu Thr Leu
Asp Glu Gly Met Gln Ile Pro Ser Thr 100 105 110 Gln Phe Asp Ala Ala
His Pro Thr Asn Val Gln Arg Leu Ala Glu Pro 115 120 125 Ser Gln Met
Leu Lys His Ala Val Val Asn Leu Ile Asn Tyr Gln Asp 130 135 140 Asp
Ala Glu Leu Ala Thr Arg Ala Ile Pro Glu Leu Thr Lys Leu Leu 145 150
155 160 Asn Asp Glu Asp Gln Val Val Val Asn Lys Ala Ala Val Met Val
His 165 170 175 Gln Leu Ser Lys Lys Glu Ala Ser Arg His Ala Ile Met
Arg Ser Pro 180 185 190 Gln Met Val Ser Ala Ile Val Arg Thr Met Gln
Asn Thr Asn Asp Val 195 200 205 Glu Thr Ala Arg Cys Thr Ala Gly Thr
Leu His Asn Leu Ser His His 210 215 220 Arg Glu Gly Leu Leu Ala Ile
Phe Lys Ser Gly Gly Ile Pro Ala Leu 225 230 235 240 Val Lys Met Leu
Gly Ser Pro Val Asp Ser Val Leu Phe Tyr Ala Ile 245 250 255 Thr Thr
Leu His Asn Leu Leu Leu His Gln Glu Gly Ala Lys Met Ala 260 265 270
Val Arg Leu Ala Gly Gly Leu Gln Lys Met Val Ala Leu Leu Asn Lys 275
280 285 Thr Asn Val Lys Phe Leu Ala Ile Thr Thr Asp Cys Leu Gln Ile
Leu 290 295 300 Ala Tyr Gly Asn Gln Glu Ser Lys Leu Ile Ile Leu Ala
Ser Gly Gly 305 310 315 320 Pro Gln Ala Leu Val Asn Ile Met Arg Thr
Tyr Thr Tyr Glu Lys Leu 325 330 335 Leu Trp Thr Thr Ser Arg Val Leu
Lys Val Leu Ser Val Cys Ser Ser 340 345 350 Asn Lys Pro Ala Ile Val
Glu Ala Gly Gly Met Gln Ala Leu Gly Leu 355 360 365 His Leu Thr Asp
Pro Ser Gln Arg Leu Val Gln Asn Cys Leu Trp Thr 370 375 380 Leu Arg
Asn Leu Ser Asp Ala Ala Thr Lys Gln Glu Gly Met Glu Gly 385 390 395
400 Leu Leu Gly Thr Leu Val Gln Leu Leu Gly Ser Asp Asp Ile Asn Val
405 410 415 Val Thr Cys Ala Ala Gly Ile Leu Ser Asn Leu Thr Cys Asn
Asn Tyr 420 425 430 Lys Asn Lys Met Met Val Cys Gln Val Gly Gly Ile
Glu Ala Leu Val 435 440 445 Arg Thr Val Leu Arg Ala Gly Asp Arg Glu
Asp Ile Thr Glu Pro Ala 450 455 460 Ile Cys Ala Leu Arg His Leu Thr
Ser Arg His Gln Glu Ala Glu Met 465 470 475 480 Ala Gln Asn Ala Val
Arg Leu His Tyr Gly Leu Pro Val Val Val Lys 485 490 495 Leu Leu His
Pro Pro Ser His Trp Pro Leu Ile Lys Ala Thr Val Gly 500 505 510 Leu
Ile Arg Asn Leu Ala Leu Cys Pro Ala Asn His Ala Pro Leu Arg 515 520
525 Glu Gln Gly Ala Ile Pro Arg Leu Val Gln Leu Leu Val Arg Ala His
530 535 540 Gln Asp Thr Gln Arg Arg Thr Ser Met Gly Gly Thr Gln Gln
Gln Phe 545 550 555 560 Val Glu Gly Val Arg Met Glu Glu Ile Val Glu
Gly Cys Thr Gly Ala 565 570 575 Leu His Ile Leu Ala Arg Asp Val His
Asn Arg Ile Val Ile Arg Gly 580 585 590 Leu Asn Thr Ile Pro Leu Phe
Val Gln Leu Leu Tyr Ser Pro Ile Glu 595 600 605 Asn Ile Gln Arg Val
Ala Ala Gly Val Leu Cys Glu Leu Ala Gln Asp 610 615 620 Lys Glu Ala
Ala Glu Ala Ile Glu Ala Glu Gly Ala Thr Ala Pro Leu 625 630 635 640
Thr Glu Leu Leu His Ser Arg Asn Glu Gly Val Ala Thr Tyr Ala Ala 645
650 655 Ala Val Leu Phe Arg Met Ser Glu Asp Lys Pro Gln Asp Tyr Lys
Lys 660 665 670 Arg Leu Ser Val Glu Leu Thr Ser Ser Leu Phe Arg Thr
Glu Pro Met 675 680 685 Ala Trp Asn Glu Thr Ala Asp Leu Gly Leu Asp
Ile Gly Ala Gln Gly 690 695 700 Glu Pro Leu Gly Tyr Arg Gln Asp Asp
Pro Ser Tyr Arg Ser Phe His 705 710 715 720 Ser Gly Gly Tyr Gly Gln
Asp Ala Leu Gly Met Asp Pro Met Met Glu 725 730 735 His Glu Met Gly
Gly His His Pro Gly Ala Asp Tyr Pro Val Asp Gly 740 745 750 Leu Pro
Asp Leu Gly His Ala Gln Asp Leu Met Asp Gly Leu Pro Pro 755 760 765
Gly Asp Ser Asn Gln Leu Ala Trp Phe Asp Thr Asp Leu 770 775 780 9
7042 DNA Homo sapiens CDS (578)...(4162) 9 aagaagaggt agcgagtgga
cgtgactgct ctatcccggg caaaagggat agaaccagag 60 gtggggagtc
tgggcagtcg gcgacccgcg aagacttgag gtgccgcagc ggcatccgga 120
gtagcgccgg gctccctccg gggtgcagcc gccgtcgggg gaagggcgcc acaggccggg
180 aagacctcct ccctttgtgt ccagtagtgg ggtccaccgg agggcggccc
gtgggccggg 240 cctcaccgcg gcgctccggg actgtggggt caggctgcgt
tgggtggacg cccacctcgc 300 caaccttcgg aggtccctgg gggtcttcgt
gcgccccggg gctgcagaga tccaggggag 360 gcgcctgtga ggcccggacc
tgccccgggg cgaagggtat gtggcgagac agagccctgc 420 acccctaatt
cccggtggaa aactcctgtt gccgtttccc tccaccggcc tggagtctcc 480
cagtcttgtc ccggcagtgc cgccctcccc actaagacct aggcgcaaag gcttggctca
540 tggttgacag ctcagagaga gaaagatctg agggaag atg gat gca aaa gct
cga 595 Met Asp Ala Lys Ala Arg 1 5 aat tgt ttg ctt caa cat aga gaa
gct ctg gaa aag gac atc aag aca 643 Asn Cys Leu Leu Gln His Arg Glu
Ala Leu Glu Lys Asp Ile Lys Thr 10 15 20 tcc tac atc atg gat cac
atg att agt gat gga ttt tta aca ata tca 691 Ser Tyr Ile Met Asp His
Met Ile Ser Asp Gly Phe Leu Thr Ile Ser 25 30 35 gaa gag gaa aaa
gta aga aat gag ccc act caa cag caa aga gca gct 739 Glu Glu Glu Lys
Val Arg Asn Glu Pro Thr Gln Gln Gln Arg Ala Ala 40 45 50 atg ctg
att aaa atg ata ctt aaa aaa gat aat gat tcc tac gta tca 787 Met Leu
Ile Lys Met Ile Leu Lys Lys Asp Asn Asp Ser Tyr Val Ser 55 60 65 70
ttc tac aat gct cta cta cat gaa gga tat aaa gat ctt gct gcc ctt 835
Phe Tyr Asn Ala Leu Leu His Glu Gly Tyr Lys Asp Leu Ala Ala Leu 75
80 85 ctc cat gat ggc att cct gtt gtc tct tct tcc agt gta agg aca
gtc 883 Leu His Asp Gly Ile Pro Val Val Ser Ser Ser Ser Val Arg Thr
Val 90 95 100 ctg tgt gaa ggt gga gta cca cag agg cca gtt gtt ttt
gtc aca agg 931 Leu Cys Glu Gly Gly Val Pro Gln Arg Pro Val Val Phe
Val Thr Arg 105 110 115 aag aag ctg gtg aat gca att cag cag aag ctc
tcc aaa ttg aaa ggt 979 Lys Lys Leu Val Asn Ala Ile Gln Gln Lys Leu
Ser Lys Leu Lys Gly 120 125 130 gaa cca gga tgg gtc acc ata cat gga
atg gca ggc tgt ggg aag tct 1027 Glu Pro Gly Trp Val Thr Ile His
Gly Met Ala Gly Cys Gly Lys Ser 135 140 145 150 gta tta gct gca gaa
gct gtt aga gat cat tcc ctt tta gaa ggt tgt 1075 Val Leu Ala Ala
Glu Ala Val Arg Asp His Ser Leu Leu Glu Gly Cys 155 160 165 ttc cca
ggg gga gtg cat tgg gtt tca gtt ggg aaa caa gac aaa tct 1123 Phe
Pro Gly Gly Val His Trp Val Ser Val Gly Lys Gln Asp Lys Ser 170 175
180 ggg ctt ctg atg aaa ctg cag aat ctt tgc aca cgg ttg gat cag gat
1171 Gly Leu Leu Met Lys Leu Gln Asn Leu Cys Thr Arg Leu Asp Gln
Asp 185 190 195 gag agt ttt tcc cag agg ctt cca ctt aat att gaa gag
gct aaa gac 1219 Glu Ser Phe Ser Gln Arg Leu Pro Leu Asn Ile Glu
Glu Ala Lys Asp 200 205 210 cgt ctc cgc att ctg atg ctt cgc aaa cac
cca agg tct ctc ttg atc 1267 Arg Leu Arg Ile Leu Met Leu Arg Lys
His Pro Arg Ser Leu Leu Ile 215 220 225 230 ttg gat gat gtt tgg gac
tct tgg gtg ttg aaa gct ttt gac agt cag 1315 Leu Asp Asp Val Trp
Asp Ser Trp Val Leu Lys Ala Phe Asp Ser Gln 235 240 245 tgt cag att
ctt ctt aca acc aga gac aag agt gtt aca gat tca gta 1363 Cys Gln
Ile Leu Leu Thr Thr Arg Asp Lys Ser Val Thr Asp Ser Val 250 255 260
atg ggt cct aaa tat gta gtc cct gtg gag agt tcc tta gga aag gaa
1411 Met Gly Pro Lys Tyr Val Val Pro Val Glu Ser Ser Leu Gly Lys
Glu 265 270 275 aaa gga ctt gaa att tta tcc ctt ttt gtt aat atg aag
aag gca gat 1459 Lys Gly Leu Glu Ile Leu Ser Leu Phe Val Asn Met
Lys Lys Ala Asp 280 285 290 ttg cca gaa caa gct cat agt att ata aaa
gaa tgt aaa ggc tct ccc 1507 Leu Pro Glu Gln Ala His Ser Ile Ile
Lys Glu Cys Lys Gly Ser Pro 295 300 305 310 ctt gta gta tct tta att
ggt gca ctt tta cgt gat ttt ccc aat cgc 1555 Leu Val Val Ser Leu
Ile Gly Ala Leu Leu Arg Asp Phe Pro Asn Arg 315 320 325 tgg gag tac
tac ctc aaa cag ctt cag aat aag cag ttt aag aga ata 1603 Trp Glu
Tyr Tyr Leu Lys Gln Leu Gln Asn Lys Gln Phe Lys Arg Ile 330 335 340
agg aaa tct tcg tct tat gat tat gag gct cta gat gaa gcc atg tct
1651 Arg Lys Ser Ser Ser Tyr Asp Tyr Glu Ala Leu Asp Glu Ala Met
Ser 345 350 355 ata agt gtt gaa atg ctc aga gaa gac atc aaa gat tat
tac aca gat 1699 Ile Ser Val Glu Met Leu Arg Glu Asp Ile Lys Asp
Tyr Tyr Thr Asp 360 365 370 ctt tcc atc ctt cag aag gac gtt aag gtg
cct aca aag gtg tta tgt 1747 Leu Ser Ile Leu Gln Lys Asp Val Lys
Val Pro Thr Lys Val Leu Cys 375 380 385 390 att ctc tgg gac atg gaa
act gaa gaa gtt gaa gac ata ctg cag gag 1795 Ile Leu Trp Asp Met
Glu Thr Glu Glu Val Glu Asp Ile Leu Gln Glu 395 400 405 ttt gta aat
aag tct ctt tta ttc tgt gat cgg aat gga aag tcg ttt 1843 Phe Val
Asn Lys Ser Leu Leu Phe Cys Asp Arg Asn Gly Lys Ser Phe 410 415 420
cgt tat tat tta cat gat ctt caa gta gat ttt ctt aca gag aag aat
1891 Arg Tyr Tyr Leu His Asp Leu Gln Val Asp Phe Leu Thr Glu Lys
Asn 425 430 435 tgc agc cag ctt cag gat cta cat aag aag ata atc act
cag ttt cag 1939 Cys Ser Gln Leu Gln Asp Leu His Lys Lys Ile Ile
Thr Gln Phe Gln 440 445 450 aga tat cac cag ccg cat act ctt tca cca
gat cag gaa gac tgt atg 1987 Arg Tyr His Gln Pro His Thr Leu Ser
Pro Asp Gln Glu Asp Cys Met 455 460 465 470 tat tgg tac aac ttt ctg
gcc tat cac atg gcc agt gcc aag atg cac 2035 Tyr Trp Tyr Asn Phe
Leu Ala Tyr His Met Ala Ser Ala Lys Met His 475 480 485 aag gaa ctt
tgt gct tta atg ttt tcc ctg gat tgg att aaa gca aaa 2083 Lys Glu
Leu Cys Ala Leu Met Phe Ser Leu Asp Trp Ile Lys Ala Lys 490 495 500
aca gaa ctt gta ggc cct gct cat ctg att cat gaa ttt gtg gaa tac
2131 Thr Glu Leu Val Gly Pro Ala His Leu Ile His Glu Phe Val Glu
Tyr 505 510 515 aga cat ata cta gat gaa aag gat tgt gca gtc agt gag
aat ttt cag 2179 Arg His Ile Leu Asp Glu Lys Asp Cys Ala Val Ser
Glu Asn Phe Gln 520 525 530 gag ttt tta tct tta aat gga cac ctt ctt
gga cga cag cca ttt cct 2227 Glu Phe Leu Ser Leu Asn Gly His Leu
Leu Gly Arg Gln Pro Phe Pro 535 540 545 550 aat att gta caa ctg ggt
ctc tgt gag ccg gaa act tca gaa gtt tat 2275 Asn Ile Val Gln Leu
Gly Leu Cys Glu Pro Glu Thr Ser Glu Val Tyr 555 560 565 cag caa gct
aag ctg cag gcc aag cag gag gtc gat aat gga atg ctt 2323 Gln Gln
Ala Lys Leu Gln Ala Lys Gln Glu Val Asp Asn Gly Met Leu 570 575 580
tac ctg gaa tgg ata aac aaa aaa aac atc acg aat ctt tcc cgc tta
2371 Tyr Leu Glu Trp Ile Asn Lys Lys Asn Ile Thr Asn Leu Ser Arg
Leu 585 590 595 gtt gtc cgc ccc cac aca gat gct gtt tac cat gcc tgc
ttt tct gag 2419 Val Val Arg Pro His Thr Asp Ala Val Tyr His Ala
Cys Phe Ser Glu 600 605 610 gat ggt cag aga ata gct tct tgt gga gct
gat aaa acc tta cag gtg 2467 Asp Gly Gln Arg Ile Ala Ser Cys Gly
Ala Asp Lys Thr Leu Gln Val 615 620 625 630 ttc aaa gct gaa aca gga
gag aaa ctt cta gaa atc aag gct cat gag 2515 Phe Lys Ala Glu Thr
Gly Glu Lys Leu Leu Glu Ile Lys Ala His Glu 635 640 645 gat gaa gtg
ctt tgt tgt gca ttc tct aca gat gac aga ttt ata gca 2563 Asp Glu
Val Leu Cys Cys Ala Phe Ser Thr Asp Asp Arg Phe Ile Ala 650 655 660
acc tgc tca gtg gat aaa aaa gtg aag att tgg aat tct atg act ggg
2611 Thr Cys Ser Val Asp Lys Lys Val Lys Ile Trp Asn Ser Met Thr
Gly 665 670 675 gaa cta gta cac acc tat gat gag cac tca gag caa gtc
aat tgc tgc 2659 Glu Leu Val His Thr Tyr Asp Glu His Ser Glu Gln
Val Asn Cys Cys 680 685 690 cat ttc acc aac agt agt cat cat ctt ctc
tta gcc act ggg tca agt 2707 His Phe Thr Asn Ser Ser His His Leu
Leu Leu Ala Thr Gly Ser Ser 695 700 705 710 gac tgc ttc ctc aaa ctt
tgg gat ttg aat caa aaa gaa tgt cga aat 2755 Asp Cys Phe Leu Lys
Leu Trp Asp Leu Asn Gln Lys Glu Cys Arg Asn 715 720 725 acc atg ttt
ggt cat aca aat tca gtc aat cac tgc aga ttt tca cca 2803 Thr Met
Phe Gly His Thr Asn Ser Val Asn His Cys Arg Phe Ser Pro 730 735 740
gat gat aag ctt ttg gct agt tgt tca gct gat gga acc tta aag ctt
2851 Asp Asp Lys Leu Leu Ala Ser Cys Ser Ala Asp Gly Thr Leu Lys
Leu 745 750 755 tgg gat gcg aca tca gca aat gag agg aaa agc att aat
gtg aaa cag 2899 Trp Asp Ala Thr Ser Ala Asn Glu Arg Lys Ser Ile
Asn Val Lys Gln 760 765 770 ttc ttc cta aat ttg gag gac cct caa gag
gat atg gaa gtg ata gtg 2947 Phe Phe Leu Asn Leu Glu Asp Pro Gln
Glu Asp Met Glu Val Ile Val 775 780 785 790 aag tgt tgt tcg tgg tct
gct gat ggt gca agg ata atg gtg gca gca 2995 Lys Cys Cys Ser Trp
Ser Ala Asp Gly Ala Arg Ile Met Val Ala Ala 795 800 805 aaa aat aaa
atc ttt ttg tgg aat aca gac tca cgt tca aag gtg gct 3043 Lys Asn
Lys Ile Phe Leu Trp Asn Thr Asp Ser Arg Ser Lys Val Ala 810 815 820
gat tgc aga gga cat tta agt tgg gtt cat ggt gtg atg ttt tct cct
3091 Asp Cys Arg Gly His Leu Ser Trp Val His Gly Val Met Phe Ser
Pro 825 830 835 gat gga tca tca ttt ttg aca tct tct gat gac cag aca
atc agg ctc 3139 Asp Gly Ser Ser Phe Leu Thr Ser Ser Asp Asp Gln
Thr Ile Arg Leu 840 845 850 tgg gag aca aag aaa gta tgt aag aac tct
gct gta atg tta aag caa 3187 Trp Glu Thr Lys Lys Val Cys Lys Asn
Ser Ala Val Met Leu Lys Gln 855 860 865 870 gaa gta gat gtt gtg ttt
caa gaa aat gaa gtg atg gtc ctt gca gtt 3235 Glu Val Asp Val Val
Phe Gln Glu Asn Glu Val Met Val Leu Ala Val 875 880 885 gac cat ata
aga cgt ctg caa ctc att aat gga aga aca ggt cag att 3283 Asp His
Ile Arg Arg Leu Gln Leu Ile Asn Gly Arg Thr Gly Gln Ile 890 895 900
gat tat ctg act gaa gct caa gtt agc tgc tgt tgc tta agt cca cat
3331 Asp Tyr Leu Thr Glu Ala Gln Val Ser Cys Cys Cys Leu Ser Pro
His 905 910 915 ctt cag tac att gca ttt gga gat gaa aat gga gcc att
gag att tta 3379 Leu Gln Tyr Ile Ala Phe Gly Asp Glu Asn Gly Ala
Ile Glu Ile Leu 920 925 930 gaa ctt gta aac aat aga atc ttc cag tcc
agg ttt cag cac aag aaa 3427 Glu Leu Val Asn Asn Arg Ile Phe Gln
Ser Arg Phe Gln His Lys Lys 935 940 945 950 act gta tgg cac atc cag
ttc aca gcc gat gag aag act ctt att tca 3475 Thr Val Trp His Ile
Gln Phe Thr Ala Asp Glu Lys Thr Leu Ile Ser 955 960 965 agt tct gat
gat gct gaa att cag gta tgg aat tgg caa ttg gac aaa 3523 Ser Ser
Asp Asp Ala Glu Ile Gln Val Trp Asn Trp Gln Leu Asp Lys 970 975 980
tgt atc ttt cta cga ggc cat cag gaa aca gtg aaa gac ttt aga ctc
3571 Cys Ile Phe Leu Arg Gly His Gln Glu Thr Val Lys Asp Phe Arg
Leu 985 990 995 ttg aaa aat tca aga ctg ctt tct tgg tca ttt gat gga
aca gtg aag 3619 Leu Lys Asn Ser Arg Leu Leu Ser Trp Ser Phe Asp
Gly Thr Val Lys 1000 1005 1010 gta tgg aat att att act gga aat aaa
gaa aaa gac ttt gtc tgt cac 3667 Val
Trp Asn Ile Ile Thr Gly Asn Lys Glu Lys Asp Phe Val Cys His 1015
1020 1025 1030 cag ggt aca gta ctt tct tgt gac att tct cac gat gct
acc aag ttt 3715 Gln Gly Thr Val Leu Ser Cys Asp Ile Ser His Asp
Ala Thr Lys Phe 1035 1040 1045 tca tct acc tct gct gac aag act gca
aag atc tgg agt ttt gat ctc 3763 Ser Ser Thr Ser Ala Asp Lys Thr
Ala Lys Ile Trp Ser Phe Asp Leu 1050 1055 1060 ctt ttg cca ctt cat
gaa ttg agg ggc cac aac ggc tgt gtg cgc tgc 3811 Leu Leu Pro Leu
His Glu Leu Arg Gly His Asn Gly Cys Val Arg Cys 1065 1070 1075 tct
gcc ttc tct gtg gac agt acc ctg ctg gca acg gga gat gac aat 3859
Ser Ala Phe Ser Val Asp Ser Thr Leu Leu Ala Thr Gly Asp Asp Asn
1080 1085 1090 gga gaa atc agg ata tgg aat gtc tca aac ggt gag ctt
ctt cat ttg 3907 Gly Glu Ile Arg Ile Trp Asn Val Ser Asn Gly Glu
Leu Leu His Leu 1095 1100 1105 1110 tgt gct ccg ctt tca gaa gaa gga
gct gct acc cat gga ggc tgg gtg 3955 Cys Ala Pro Leu Ser Glu Glu
Gly Ala Ala Thr His Gly Gly Trp Val 1115 1120 1125 act gac ctt tgc
ttt tct cca gat ggc aaa atg ctt atc tct gct gga 4003 Thr Asp Leu
Cys Phe Ser Pro Asp Gly Lys Met Leu Ile Ser Ala Gly 1130 1135 1140
gga tat att aag tgg tgg aac gtt gtc act ggg gaa tcc tca cag acc
4051 Gly Tyr Ile Lys Trp Trp Asn Val Val Thr Gly Glu Ser Ser Gln
Thr 1145 1150 1155 ttc tac aca aat gga acc aat ctt aag aaa ata cac
gtg tcc cct gac 4099 Phe Tyr Thr Asn Gly Thr Asn Leu Lys Lys Ile
His Val Ser Pro Asp 1160 1165 1170 ttc aaa aca tat gtg act gtg gat
aat ctt ggt att tta tat att tta 4147 Phe Lys Thr Tyr Val Thr Val
Asp Asn Leu Gly Ile Leu Tyr Ile Leu 1175 1180 1185 1190 cag act tta
gaa taa aatagttaag cattaatgta gttgaacttt ttaaattttt 4202 Gln Thr
Leu Glu * gaattggaaa aaaattctaa tgaaaccctg atatcaactt tttataaagc
tcttaattgt 4262 tgtgcagtat tgcattcatt acaaaagtgt ttgtggttgg
atgaataata ttaatgtagc 4322 tttttcccaa atgaacatac ctttaatctt
gtttttcatg atcatcatta acagtttgtc 4382 cttaggatgc aaatgaaaat
gtgaatacat accttgttgt actgttggta aaattctgtc 4442 ttgatgcatt
caaaatggtt gacataatta atgagaagaa tttggaagaa attggtattt 4502
taatactgtc tgtatttatt actgttatgc aggctgtgcc tcagggtagc agtggcctgc
4562 tttttgaacc acacttaccc caagggggtt ttgttctcct aaatacaatc
ttagaggttt 4622 tttgcactct ttaaatttgc tttaaaaata ttgtgtctgt
gtgcatagtc tgcagcattt 4682 cctttaattg actcaataag tgagtcttgg
atttagcagg cccccccacc tttttttttt 4742 gtttttggag acagagtctt
gctttgttgc caggctggag tgcagtggcg cgatctcggc 4802 tcaccacaat
cgctgcctcc tgggttcaag caattctcct gcctcagcct cccgagtagc 4862
tgggactaca ggtgtgcgca catgccaggc taatttttgt atttttagta gagacggggt
4922 ttcaccatgt tggccgggat ggtctcgatc tcttgacctc atgatctacc
cgccttggcc 4982 tcccaaagtg ctgagattac aggcgtgagc caccgtgcct
ggccaggccc cttctctttt 5042 aatggagaca gggtcttgca ctatcaccca
ggctggagtg cagtggcata atcatacctc 5102 attgcagcct cagactcctg
ggttcaagca atcctcctgc ctcagcctcc caagtagctg 5162 agactgcagg
cacgagccac cacacccagc taatttttaa gttttcttgt agagacaggg 5222
tctcactatg ttgtctaggc tggtcttgaa ctcttggcct caagtaatcc tcctgcctca
5282 gcctcccaaa gtgttgggat tgcagatatg agccactggc ctggccttca
gcagttcttt 5342 ttgtgaagta aaacttgtat gttggaaaga gtagatttta
ttggtctacc cttttctcac 5402 tgtagctgct ggcagccctg tgccatatct
ggactctagt tgtcagtatc tgagttggac 5462 actattcctg ctccctcttg
tttcttacat atcagacttc ttacttgaat gaaacctgat 5522 ctttcctaat
cctcactttt ttctttttta aaaagcagtt tctccactgc taaatgttag 5582
tcattgaggt ggggccaatt ttaatcataa gccttaataa gatttttcta agaaatgtga
5642 aatagaacaa ttttcatcta attccattta cttttagatg aatggcattg
tgaatgccat 5702 tcttttaatg aatttcaaga gaattctctg gttttctgtg
taattccaga tgagtcactg 5762 taactctaga agattaacct tccagccaac
ctattttcct ttcccttgtc tctctcatcc 5822 tcttttcctt ccttctttcc
tttctcttct tttatctcca aggttaatca ggaaaaatag 5882 cttttgacag
gggaaaaaac tcaataacta gctatttttg acctcctgat caggaacttt 5942
agttgaagcg taaatctaaa gaaacatttt ctctgaaata tattattaag ggcaatggag
6002 ataaattaat agtagatgtg gttcccagaa aatataatca aaattcaaag
attttttttg 6062 tttctgtaac tggaactaaa tcaaatgatt actagtgtta
atagtagata acttgttttt 6122 attgttggtg catattagta taactgtggg
gtaggtcggg gagagggtaa gggaatagat 6182 cactcagatg tattttagat
aagctattta gcctttgatg gaatcataaa tacagtgaat 6242 acaatccttt
gcattgttaa ggaggttttt tgtttttaaa tggtgggtca aggagctagt 6302
ttacaggctt actgtgattt aagcaaatgt gaaaagtgaa accttaattt tatcaaaaga
6362 aatttctgta aatggtatgt ctccttagaa tacccaaatc ataattttat
ttgtacacac 6422 tgttaggggc tcatctcatg taggcagagt ataaagtatt
accttttgga attaaaagcc 6482 actgactgtt ataaagtata acaacacaca
tcaggtttta aaaagccttg aatggccctt 6542 gtcttaaaaa gaaattagga
gccaggtgcg gtggcacgtg cctgtagtcc cagctccttg 6602 ggaggctgag
acaggaggat tccttgagcc ctggagtttg agtccagcct gggtgacata 6662
gcaagaccct gtcttaaaag aaaaatggga agaaagacaa ggtaacatga agaaagaaga
6722 gatacctagt atgatggagc tgcaaatttc atggcagttc atgcagtcgg
tcaagaggag 6782 gattttgttt tgtagtttgc agatgagcat ttctaaagca
ttttcccttg ctgtattttt 6842 ttgtattata aattacattg gacttcatat
atataatttt tttttacatt atatgtctct 6902 tgtatgtttt gaaactcttg
tatttatgat atagcttata tgattttttt gccttggtat 6962 acattttaaa
atatgaattt aaaaaatttt tgtaaaaata aaattcacaa aattgttttg 7022
aaaaacaaaa aaaaaaaaaa 7042 10 1194 PRT Homo sapiens 10 Met Asp Ala
Lys Ala Arg Asn Cys Leu Leu Gln His Arg Glu Ala Leu 1 5 10 15 Glu
Lys Asp Ile Lys Thr Ser Tyr Ile Met Asp His Met Ile Ser Asp 20 25
30 Gly Phe Leu Thr Ile Ser Glu Glu Glu Lys Val Arg Asn Glu Pro Thr
35 40 45 Gln Gln Gln Arg Ala Ala Met Leu Ile Lys Met Ile Leu Lys
Lys Asp 50 55 60 Asn Asp Ser Tyr Val Ser Phe Tyr Asn Ala Leu Leu
His Glu Gly Tyr 65 70 75 80 Lys Asp Leu Ala Ala Leu Leu His Asp Gly
Ile Pro Val Val Ser Ser 85 90 95 Ser Ser Val Arg Thr Val Leu Cys
Glu Gly Gly Val Pro Gln Arg Pro 100 105 110 Val Val Phe Val Thr Arg
Lys Lys Leu Val Asn Ala Ile Gln Gln Lys 115 120 125 Leu Ser Lys Leu
Lys Gly Glu Pro Gly Trp Val Thr Ile His Gly Met 130 135 140 Ala Gly
Cys Gly Lys Ser Val Leu Ala Ala Glu Ala Val Arg Asp His 145 150 155
160 Ser Leu Leu Glu Gly Cys Phe Pro Gly Gly Val His Trp Val Ser Val
165 170 175 Gly Lys Gln Asp Lys Ser Gly Leu Leu Met Lys Leu Gln Asn
Leu Cys 180 185 190 Thr Arg Leu Asp Gln Asp Glu Ser Phe Ser Gln Arg
Leu Pro Leu Asn 195 200 205 Ile Glu Glu Ala Lys Asp Arg Leu Arg Ile
Leu Met Leu Arg Lys His 210 215 220 Pro Arg Ser Leu Leu Ile Leu Asp
Asp Val Trp Asp Ser Trp Val Leu 225 230 235 240 Lys Ala Phe Asp Ser
Gln Cys Gln Ile Leu Leu Thr Thr Arg Asp Lys 245 250 255 Ser Val Thr
Asp Ser Val Met Gly Pro Lys Tyr Val Val Pro Val Glu 260 265 270 Ser
Ser Leu Gly Lys Glu Lys Gly Leu Glu Ile Leu Ser Leu Phe Val 275 280
285 Asn Met Lys Lys Ala Asp Leu Pro Glu Gln Ala His Ser Ile Ile Lys
290 295 300 Glu Cys Lys Gly Ser Pro Leu Val Val Ser Leu Ile Gly Ala
Leu Leu 305 310 315 320 Arg Asp Phe Pro Asn Arg Trp Glu Tyr Tyr Leu
Lys Gln Leu Gln Asn 325 330 335 Lys Gln Phe Lys Arg Ile Arg Lys Ser
Ser Ser Tyr Asp Tyr Glu Ala 340 345 350 Leu Asp Glu Ala Met Ser Ile
Ser Val Glu Met Leu Arg Glu Asp Ile 355 360 365 Lys Asp Tyr Tyr Thr
Asp Leu Ser Ile Leu Gln Lys Asp Val Lys Val 370 375 380 Pro Thr Lys
Val Leu Cys Ile Leu Trp Asp Met Glu Thr Glu Glu Val 385 390 395 400
Glu Asp Ile Leu Gln Glu Phe Val Asn Lys Ser Leu Leu Phe Cys Asp 405
410 415 Arg Asn Gly Lys Ser Phe Arg Tyr Tyr Leu His Asp Leu Gln Val
Asp 420 425 430 Phe Leu Thr Glu Lys Asn Cys Ser Gln Leu Gln Asp Leu
His Lys Lys 435 440 445 Ile Ile Thr Gln Phe Gln Arg Tyr His Gln Pro
His Thr Leu Ser Pro 450 455 460 Asp Gln Glu Asp Cys Met Tyr Trp Tyr
Asn Phe Leu Ala Tyr His Met 465 470 475 480 Ala Ser Ala Lys Met His
Lys Glu Leu Cys Ala Leu Met Phe Ser Leu 485 490 495 Asp Trp Ile Lys
Ala Lys Thr Glu Leu Val Gly Pro Ala His Leu Ile 500 505 510 His Glu
Phe Val Glu Tyr Arg His Ile Leu Asp Glu Lys Asp Cys Ala 515 520 525
Val Ser Glu Asn Phe Gln Glu Phe Leu Ser Leu Asn Gly His Leu Leu 530
535 540 Gly Arg Gln Pro Phe Pro Asn Ile Val Gln Leu Gly Leu Cys Glu
Pro 545 550 555 560 Glu Thr Ser Glu Val Tyr Gln Gln Ala Lys Leu Gln
Ala Lys Gln Glu 565 570 575 Val Asp Asn Gly Met Leu Tyr Leu Glu Trp
Ile Asn Lys Lys Asn Ile 580 585 590 Thr Asn Leu Ser Arg Leu Val Val
Arg Pro His Thr Asp Ala Val Tyr 595 600 605 His Ala Cys Phe Ser Glu
Asp Gly Gln Arg Ile Ala Ser Cys Gly Ala 610 615 620 Asp Lys Thr Leu
Gln Val Phe Lys Ala Glu Thr Gly Glu Lys Leu Leu 625 630 635 640 Glu
Ile Lys Ala His Glu Asp Glu Val Leu Cys Cys Ala Phe Ser Thr 645 650
655 Asp Asp Arg Phe Ile Ala Thr Cys Ser Val Asp Lys Lys Val Lys Ile
660 665 670 Trp Asn Ser Met Thr Gly Glu Leu Val His Thr Tyr Asp Glu
His Ser 675 680 685 Glu Gln Val Asn Cys Cys His Phe Thr Asn Ser Ser
His His Leu Leu 690 695 700 Leu Ala Thr Gly Ser Ser Asp Cys Phe Leu
Lys Leu Trp Asp Leu Asn 705 710 715 720 Gln Lys Glu Cys Arg Asn Thr
Met Phe Gly His Thr Asn Ser Val Asn 725 730 735 His Cys Arg Phe Ser
Pro Asp Asp Lys Leu Leu Ala Ser Cys Ser Ala 740 745 750 Asp Gly Thr
Leu Lys Leu Trp Asp Ala Thr Ser Ala Asn Glu Arg Lys 755 760 765 Ser
Ile Asn Val Lys Gln Phe Phe Leu Asn Leu Glu Asp Pro Gln Glu 770 775
780 Asp Met Glu Val Ile Val Lys Cys Cys Ser Trp Ser Ala Asp Gly Ala
785 790 795 800 Arg Ile Met Val Ala Ala Lys Asn Lys Ile Phe Leu Trp
Asn Thr Asp 805 810 815 Ser Arg Ser Lys Val Ala Asp Cys Arg Gly His
Leu Ser Trp Val His 820 825 830 Gly Val Met Phe Ser Pro Asp Gly Ser
Ser Phe Leu Thr Ser Ser Asp 835 840 845 Asp Gln Thr Ile Arg Leu Trp
Glu Thr Lys Lys Val Cys Lys Asn Ser 850 855 860 Ala Val Met Leu Lys
Gln Glu Val Asp Val Val Phe Gln Glu Asn Glu 865 870 875 880 Val Met
Val Leu Ala Val Asp His Ile Arg Arg Leu Gln Leu Ile Asn 885 890 895
Gly Arg Thr Gly Gln Ile Asp Tyr Leu Thr Glu Ala Gln Val Ser Cys 900
905 910 Cys Cys Leu Ser Pro His Leu Gln Tyr Ile Ala Phe Gly Asp Glu
Asn 915 920 925 Gly Ala Ile Glu Ile Leu Glu Leu Val Asn Asn Arg Ile
Phe Gln Ser 930 935 940 Arg Phe Gln His Lys Lys Thr Val Trp His Ile
Gln Phe Thr Ala Asp 945 950 955 960 Glu Lys Thr Leu Ile Ser Ser Ser
Asp Asp Ala Glu Ile Gln Val Trp 965 970 975 Asn Trp Gln Leu Asp Lys
Cys Ile Phe Leu Arg Gly His Gln Glu Thr 980 985 990 Val Lys Asp Phe
Arg Leu Leu Lys Asn Ser Arg Leu Leu Ser Trp Ser 995 1000 1005 Phe
Asp Gly Thr Val Lys Val Trp Asn Ile Ile Thr Gly Asn Lys Glu 1010
1015 1020 Lys Asp Phe Val Cys His Gln Gly Thr Val Leu Ser Cys Asp
Ile Ser 1025 1030 1035 1040 His Asp Ala Thr Lys Phe Ser Ser Thr Ser
Ala Asp Lys Thr Ala Lys 1045 1050 1055 Ile Trp Ser Phe Asp Leu Leu
Leu Pro Leu His Glu Leu Arg Gly His 1060 1065 1070 Asn Gly Cys Val
Arg Cys Ser Ala Phe Ser Val Asp Ser Thr Leu Leu 1075 1080 1085 Ala
Thr Gly Asp Asp Asn Gly Glu Ile Arg Ile Trp Asn Val Ser Asn 1090
1095 1100 Gly Glu Leu Leu His Leu Cys Ala Pro Leu Ser Glu Glu Gly
Ala Ala 1105 1110 1115 1120 Thr His Gly Gly Trp Val Thr Asp Leu Cys
Phe Ser Pro Asp Gly Lys 1125 1130 1135 Met Leu Ile Ser Ala Gly Gly
Tyr Ile Lys Trp Trp Asn Val Val Thr 1140 1145 1150 Gly Glu Ser Ser
Gln Thr Phe Tyr Thr Asn Gly Thr Asn Leu Lys Lys 1155 1160 1165 Ile
His Val Ser Pro Asp Phe Lys Thr Tyr Val Thr Val Asp Asn Leu 1170
1175 1180 Gly Ile Leu Tyr Ile Leu Gln Thr Leu Glu 1185 1190 11 5086
DNA Homo sapiens CDS (1459)...(2178) 11 gcgcccgccc ctccgcgccg
cctgcccgcc cgcccgccgc gctcccgccc gccgctctcc 60 gtggccccgc
cgcgctgccg ccgccgccgc tgccagcgaa ggtgccgggg ctccgggccc 120
tccctgccgg cggccgtcag cgctcggagc gaactgcgcg acgggaggtc cgggaggcga
180 ccgtagtcgc gccgccgcgc aggaccagga ggaggagaaa gggtgcgcag
cccggaggcg 240 gggtgcgccg gtggggtgca gcggaagagg gggtccaggg
gggagaactt cgtagcagtc 300 atccttttta ggaaaagagg gaaaaaataa
aaccctcccc caccacctcc ttctccccac 360 ccctcgccgc accacacaca
gcgcgggctt ctagcgctcg gcaccggcgg gccaggcgcg 420 tcctgccttc
atttatccag cagcttttcg gaaaatgcat ttgctgttcg gagtttaatc 480
agaagacgat tcctgcctcc gtccccggct ccttcatcgt cccatctccc ctgtctctct
540 cctggggagg cgtgaagcgg tcccgtggat agagattcat gcctgtgtcc
gcgcgtgtgt 600 gcgcgcgtat aaattgccga gaaggggaaa acatcacagg
acttctgcga ataccggact 660 gaaaattgta attcatctgc cgccgccgct
gccaaaaaaa aactcgagct cttgagatct 720 ccggttggga ttcctgcgga
ttgacatttc tgtgaagcag aagtctggga atcgatctgg 780 aaatcctcct
aatttttact ccctctcccc ccgactcctg attcattggg aagtttcaaa 840
tcagctataa ctggagagtg ctgaagattg atgggatcgt tgccttatgc atttgttttg
900 gttttacaaa aaggaaactt gacagaggat catgctgtac ttaaaaaata
caagtaagtc 960 tcgcacagga aattggttta atgtaacttt caatggaaac
ctttgagatt ttttacttaa 1020 agtgcattcg agtaaattta atttccaggc
agcttaatac attgttttta gccgtgttac 1080 ttgtagtgtg tatgccctgc
tttcactcag tgtgtacagg gaaacgcacc tgatttttta 1140 cttattagtt
tgttttttct ttaacctttc agcatcacag aggaagtaga ctgatattaa 1200
caatacttac taataataac gtgcctcatg aaataaagat ccgaaaggaa ttggaataaa
1260 aatttcctgc gtctcatgcc aagagggaaa caccagaatc aagtgttccg
cgtgattgaa 1320 gacaccccct cgtccaagaa tgcaaagcac atccaataaa
atagctggat tataactcct 1380 cttctttctc tgggggccgt ggggtgggag
ctggggcgag aggtgccgtt ggcccccgtt 1440 gcttttcctc tgggaagg atg gcg
cac gct ggg aga acg ggg tac gac aac 1491 Met Ala His Ala Gly Arg
Thr Gly Tyr Asp Asn 1 5 10 cgg gag ata gtg atg aag tac atc cat tat
aag ctg tcg cag agg ggc 1539 Arg Glu Ile Val Met Lys Tyr Ile His
Tyr Lys Leu Ser Gln Arg Gly 15 20 25 tac gag tgg gat gcg gga gat
gtg ggc gcc gcg ccc ccg ggg gcc gcc 1587 Tyr Glu Trp Asp Ala Gly
Asp Val Gly Ala Ala Pro Pro Gly Ala Ala 30 35 40 ccc gca ccg ggc
atc ttc tcc tcc cag ccc ggg cac acg ccc cat cca 1635 Pro Ala Pro
Gly Ile Phe Ser Ser Gln Pro Gly His Thr Pro His Pro 45 50 55 gcc
gca tcc cgc gac ccg gtc gcc agg acc tcg ccg ctg cag acc ccg 1683
Ala Ala Ser Arg Asp Pro Val Ala Arg Thr Ser Pro Leu Gln Thr Pro 60
65 70 75 gct gcc ccc ggc gcc gcc gcg ggg cct gcg ctc agc ccg gtg
cca cct 1731 Ala Ala Pro Gly Ala Ala Ala Gly Pro Ala Leu Ser Pro
Val Pro Pro 80 85 90 gtg gtc cac ctg gcc ctc cgc caa gcc ggc gac
gac ttc tcc cgc cgc 1779 Val Val His Leu Ala Leu Arg Gln Ala Gly
Asp Asp Phe Ser Arg Arg 95 100 105 tac cgc ggc gac ttc gcc gag atg
tcc agc cag ctg cac ctg acg ccc 1827 Tyr Arg Gly Asp Phe Ala Glu
Met Ser Ser Gln Leu His Leu Thr Pro 110 115 120 ttc acc gcg cgg gga
cgc ttt gcc acg gtg gtg gag gag ctc ttc agg 1875 Phe Thr Ala Arg
Gly Arg Phe Ala Thr Val Val Glu Glu Leu Phe Arg 125 130 135 gac ggg
gtg aac tgg ggg agg att gtg gcc ttc ttt gag ttc ggt ggg 1923 Asp
Gly Val Asn Trp Gly Arg Ile Val Ala Phe Phe Glu Phe Gly Gly
140 145 150 155 gtc atg tgt gtg gag agc gtc aac cgg gag atg tcg ccc
ctg gtg gac 1971 Val Met Cys Val Glu Ser Val Asn Arg Glu Met Ser
Pro Leu Val Asp 160 165 170 aac atc gcc ctg tgg atg act gag tac ctg
aac cgg cac ctg cac acc 2019 Asn Ile Ala Leu Trp Met Thr Glu Tyr
Leu Asn Arg His Leu His Thr 175 180 185 tgg atc cag gat aac gga ggc
tgg gat gcc ttt gtg gaa ctg tac ggc 2067 Trp Ile Gln Asp Asn Gly
Gly Trp Asp Ala Phe Val Glu Leu Tyr Gly 190 195 200 ccc agc atg cgg
cct ctg ttt gat ttc tcc tgg ctg tct ctg aag act 2115 Pro Ser Met
Arg Pro Leu Phe Asp Phe Ser Trp Leu Ser Leu Lys Thr 205 210 215 ctg
ctc agt ttg gcc ctg gtg gga gct tgc atc acc ctg ggt gcc tat 2163
Leu Leu Ser Leu Ala Leu Val Gly Ala Cys Ile Thr Leu Gly Ala Tyr 220
225 230 235 ctg agc cac aag tga agtcaacatg cctgccccaa acaaatatgc
aaaaggttca 2218 Leu Ser His Lys * ctaaagcagt agaaataata tgcattgtca
gtgatgtacc atgaaacaaa gctgcaggct 2278 gtttaagaaa aaataacaca
catataaaca tcacacacac agacagacac acacacacac 2338 aacaattaac
agtcttcagg caaaacgtcg aatcagctat ttactgccaa agggaaatat 2398
catttatttt ttacattatt aagaaaaaag atttatttat ttaagacagt cccatcaaaa
2458 ctccgtcttt ggaaatccga ccactaattg ccaaacaccg cttcgtgtgg
ctccacctgg 2518 atgttctgtg cctgtaaaca tagattcgct ttccatgttg
ttggccggat caccatctga 2578 agagcagacg gatggaaaaa ggacctgatc
attggggaag ctggctttct ggctgctgga 2638 ggctggggag aaggtgttca
ttcacttgca tttctttgcc ctgggggcgt gatattaaca 2698 gagggagggt
tcccgtgggg ggaagtccat gcctccctgg cctgaagaag agactctttg 2758
catatgactc acatgatgca tacctggtgg gaggaaaaga gttgggaact tcagatggac
2818 ctagtaccca ctgagatttc cacgccgaag gacagcgatg ggaaaaatgc
ccttaaatca 2878 taggaaagta tttttttaag ctaccaattg tgccgagaaa
agcattttag caatttatac 2938 aatatcatcc agtaccttaa accctgattg
tgtatattca tatattttgg atacgcaccc 2998 cccaactccc aatactggct
ctgtctgagt aagaaacaga atcctctgga acttgaggaa 3058 gtgaacattt
cggtgacttc cgatcaggaa ggctagagtt acccagagca tcaggccgcc 3118
acaagtgcct gcttttagga gaccgaagtc cgcagaacct acctgtgtcc cagcttggag
3178 gcctggtcct ggaactgagc cgggccctca ctggcctcct ccagggatga
tcaacagggt 3238 agtgtggtct ccgaatgtct ggaagctgat ggatggagct
cagaattcca ctgtcaagaa 3298 agagcagtag aggggtgtgg ctgggcctgt
caccctgggg ccctccaggt aggcccgttt 3358 tcacgtggag cataggagcc
acgacccttc ttaagacatg tatcactgta gagggaagga 3418 acagaggccc
tgggccttcc tatcagaagg acatggtgaa ggctgggaac gtgaggagag 3478
gcaatggcca cggcccattt tggctgtagc acatggcacg ttggctgtgt ggccttggcc
3538 acctgtgagt ttaaagcaag gctttaaatg actttggaga gggtcacaaa
tcctaaaaga 3598 agcattgaag tgaggtgtca tggattaatt gacccctgtc
tatggaatta catgtaaaac 3658 attatcttgt cactgtagtt tggttttatt
tgaaaacctg acaaaaaaaa agttccaggt 3718 gtggaatatg ggggttatct
gtacatcctg gggcattaaa aaaaaatcaa tggtggggaa 3778 ctataaagaa
gtaacaaaag aagtgacatc ttcagcaaat aaactaggaa attttttttt 3838
cttccagttt agaatcagcc ttgaaacatt gatggaataa ctctgtggca ttattgcatt
3898 atataccatt tatctgtatt aactttggaa tgtactctgt tcaatgttta
atgctgtggt 3958 tgatatttcg aaagctgctt taaaaaaata catgcatctc
agcgtttttt tgtttttaat 4018 tgtatttagt tatggcctat acactatttg
tgagcaaagg tgatcgtttt ctgtttgaga 4078 tttttatctc ttgattcttc
aaaagcattc tgagaaggtg agataagccc tgagtctcag 4138 ctacctaaga
aaaacctgga tgtcactggc cactgaggag ctttgtttca accaagtcat 4198
gtgcatttcc acgtcaacag aattgtttat tgtgacagtt atatctgttg tccctttgac
4258 cttgtttctt gaaggtttcc tcgtccctgg gcaattccgc atttaattca
tggtattcag 4318 gattacatgc atgtttggtt aaacccatga gattcattca
gttaaaaatc cagatggcga 4378 atgaccagca gattcaaatc tatggtggtt
tgacctttag agagttgctt tacgtggcct 4438 gtttcaacac agacccaccc
agagccctcc tgccctcctt ccgcgggggc tttctcatgg 4498 ctgtccttca
gggtcttcct gaaatgcagt ggtcgttacg ctccaccaag aaagcaggaa 4558
acctgtggta tgaagccaga cctccccggc gggcctcagg gaacagaatg atcagacctt
4618 tgaatgattc taatttttaa gcaaaatatt attttatgaa aggtttacat
tgtcaaagtg 4678 atgaatatgg aatatccaat cctgtgctgc tatcctgcca
aaatcatttt aatggagtca 4738 gtttgcagta tgctccacgt ggtaagatcc
tccaagctgc tttagaagta acaatgaaga 4798 acgtggacgt ttttaatata
aagcctgttt tgtcttttgt tgttgttcaa acgggattca 4858 cagagtattt
gaaaaatgta tatatattaa gaggtcacgg gggctaattg ctagctggct 4918
gccttttgct gtggggtttt gttacctggt tttaataaca gtaaatgtgc ccagcctctt
4978 ggccccagaa ctgtacagta ttgtggctgc acttgctcta agagtagttg
atgttgcatt 5038 ttccttattg ttaaaaacat gttagaagca atgaatgtat
ataaaagc 5086 12 239 PRT Homo sapiens 12 Met Ala His Ala Gly Arg
Thr Gly Tyr Asp Asn Arg Glu Ile Val Met 1 5 10 15 Lys Tyr Ile His
Tyr Lys Leu Ser Gln Arg Gly Tyr Glu Trp Asp Ala 20 25 30 Gly Asp
Val Gly Ala Ala Pro Pro Gly Ala Ala Pro Ala Pro Gly Ile 35 40 45
Phe Ser Ser Gln Pro Gly His Thr Pro His Pro Ala Ala Ser Arg Asp 50
55 60 Pro Val Ala Arg Thr Ser Pro Leu Gln Thr Pro Ala Ala Pro Gly
Ala 65 70 75 80 Ala Ala Gly Pro Ala Leu Ser Pro Val Pro Pro Val Val
His Leu Ala 85 90 95 Leu Arg Gln Ala Gly Asp Asp Phe Ser Arg Arg
Tyr Arg Gly Asp Phe 100 105 110 Ala Glu Met Ser Ser Gln Leu His Leu
Thr Pro Phe Thr Ala Arg Gly 115 120 125 Arg Phe Ala Thr Val Val Glu
Glu Leu Phe Arg Asp Gly Val Asn Trp 130 135 140 Gly Arg Ile Val Ala
Phe Phe Glu Phe Gly Gly Val Met Cys Val Glu 145 150 155 160 Ser Val
Asn Arg Glu Met Ser Pro Leu Val Asp Asn Ile Ala Leu Trp 165 170 175
Met Thr Glu Tyr Leu Asn Arg His Leu His Thr Trp Ile Gln Asp Asn 180
185 190 Gly Gly Trp Asp Ala Phe Val Glu Leu Tyr Gly Pro Ser Met Arg
Pro 195 200 205 Leu Phe Asp Phe Ser Trp Leu Ser Leu Lys Thr Leu Leu
Ser Leu Ala 210 215 220 Leu Val Gly Ala Cys Ile Thr Leu Gly Ala Tyr
Leu Ser His Lys 225 230 235 13 1358 DNA Homo sapiens CDS
(20)...(739) 13 ggcgtccgcg cgctgcaca atg gcg gct ctg aag agt tgg
ctg tcg cgc agc 52 Met Ala Ala Leu Lys Ser Trp Leu Ser Arg Ser 1 5
10 gta act tca ttc ttc agg tac aga cag tgt ttg tgt gtt cct gtt gtg
100 Val Thr Ser Phe Phe Arg Tyr Arg Gln Cys Leu Cys Val Pro Val Val
15 20 25 gct aac ttt aag aag cgg tgt ttc tca gaa ttg ata aga cca
tgg cac 148 Ala Asn Phe Lys Lys Arg Cys Phe Ser Glu Leu Ile Arg Pro
Trp His 30 35 40 aaa act gtg acg att ggc ttt gga gta acc ctg tgt
gcg gtt cct att 196 Lys Thr Val Thr Ile Gly Phe Gly Val Thr Leu Cys
Ala Val Pro Ile 45 50 55 gca cag aaa tca gag cct cat tcc ctt agt
agt gaa gca ttg atg agg 244 Ala Gln Lys Ser Glu Pro His Ser Leu Ser
Ser Glu Ala Leu Met Arg 60 65 70 75 aga gca gtg tct ttg gta aca gat
agc acc tct acc ttt ctc tct cag 292 Arg Ala Val Ser Leu Val Thr Asp
Ser Thr Ser Thr Phe Leu Ser Gln 80 85 90 acc aca tat gcg ttg att
gaa gct att act gaa tat act aag gct gtt 340 Thr Thr Tyr Ala Leu Ile
Glu Ala Ile Thr Glu Tyr Thr Lys Ala Val 95 100 105 tat acc tta act
tct ctt tac cga caa tat aca agt tta ctt ggg aaa 388 Tyr Thr Leu Thr
Ser Leu Tyr Arg Gln Tyr Thr Ser Leu Leu Gly Lys 110 115 120 atg aat
tca gag gag gaa gat gaa gtg tgg cag gtg atc ata gga gcc 436 Met Asn
Ser Glu Glu Glu Asp Glu Val Trp Gln Val Ile Ile Gly Ala 125 130 135
aga gct gag atg act tca aaa cac caa gag tac ttg aag ctg gaa acc 484
Arg Ala Glu Met Thr Ser Lys His Gln Glu Tyr Leu Lys Leu Glu Thr 140
145 150 155 act tgg atg act gca gtt ggt ctt tca gag atg gca gca gaa
gct gca 532 Thr Trp Met Thr Ala Val Gly Leu Ser Glu Met Ala Ala Glu
Ala Ala 160 165 170 tat caa act ggc gca gat cag gcc tct ata acc gcc
agg aat cac att 580 Tyr Gln Thr Gly Ala Asp Gln Ala Ser Ile Thr Ala
Arg Asn His Ile 175 180 185 cag ctg gtg aaa ctg cag gtg gaa gag gtg
cac cag ctc tcc cgg aaa 628 Gln Leu Val Lys Leu Gln Val Glu Glu Val
His Gln Leu Ser Arg Lys 190 195 200 gca gaa acc aag ctg gca gaa gca
cag ata gaa gag ctc cgt cag aaa 676 Ala Glu Thr Lys Leu Ala Glu Ala
Gln Ile Glu Glu Leu Arg Gln Lys 205 210 215 aca cag gag gaa ggg gag
gag cgg gct gag tcg gag cag gag gcc tac 724 Thr Gln Glu Glu Gly Glu
Glu Arg Ala Glu Ser Glu Gln Glu Ala Tyr 220 225 230 235 ctg cgt gag
gat tga gggcctgagc acactgccct gtctccccac tcagtgggga 779 Leu Arg Glu
Asp * aagcaggggc agatgccacc ctgcccaggg ttggcatgac tgtctgtgca
ccgagaagag 839 gcggcaggtc ctgccctggc caatcaggcg agacgccttt
gtgagctgtg agtgcctcct 899 gtggtctcag gcttgcgctg gacctggttc
ttagcccttg ggcactgcac cctgtttaac 959 atttcacccc actctgtaca
gctgctctta cccatttttt ttacctcaca cccaaagcat 1019 tttgcctacc
tgggtcagag agaggagtcc tttttgtcat gcccttaagt tcagcaactg 1079
tttaacctgt tttcagtctt atttacgtcg tcaaaaatga tttagtactt gttccctctg
1139 ttgggatgcc agttgtggca gggggagggg aacctgtcca gtttgtacga
tttctttgta 1199 tgtatttctg atgtgttctc tgatctgccc ccactgtcct
gtgaggacag ctgaggccaa 1259 ggagtgaaaa acctattact actaagagaa
ggggtgcaga gtgtttacct ggtgctctca 1319 acaggactta acatcaacag
gacttaacac agaaaaaaa 1358 14 239 PRT Homo sapiens 14 Met Ala Ala
Leu Lys Ser Trp Leu Ser Arg Ser Val Thr Ser Phe Phe 1 5 10 15 Arg
Tyr Arg Gln Cys Leu Cys Val Pro Val Val Ala Asn Phe Lys Lys 20 25
30 Arg Cys Phe Ser Glu Leu Ile Arg Pro Trp His Lys Thr Val Thr Ile
35 40 45 Gly Phe Gly Val Thr Leu Cys Ala Val Pro Ile Ala Gln Lys
Ser Glu 50 55 60 Pro His Ser Leu Ser Ser Glu Ala Leu Met Arg Arg
Ala Val Ser Leu 65 70 75 80 Val Thr Asp Ser Thr Ser Thr Phe Leu Ser
Gln Thr Thr Tyr Ala Leu 85 90 95 Ile Glu Ala Ile Thr Glu Tyr Thr
Lys Ala Val Tyr Thr Leu Thr Ser 100 105 110 Leu Tyr Arg Gln Tyr Thr
Ser Leu Leu Gly Lys Met Asn Ser Glu Glu 115 120 125 Glu Asp Glu Val
Trp Gln Val Ile Ile Gly Ala Arg Ala Glu Met Thr 130 135 140 Ser Lys
His Gln Glu Tyr Leu Lys Leu Glu Thr Thr Trp Met Thr Ala 145 150 155
160 Val Gly Leu Ser Glu Met Ala Ala Glu Ala Ala Tyr Gln Thr Gly Ala
165 170 175 Asp Gln Ala Ser Ile Thr Ala Arg Asn His Ile Gln Leu Val
Lys Leu 180 185 190 Gln Val Glu Glu Val His Gln Leu Ser Arg Lys Ala
Glu Thr Lys Leu 195 200 205 Ala Glu Ala Gln Ile Glu Glu Leu Arg Gln
Lys Thr Gln Glu Glu Gly 210 215 220 Glu Glu Arg Ala Glu Ser Glu Gln
Glu Ala Tyr Leu Arg Glu Asp 225 230 235 15 20 PRT Homo sapiens 15
Cys Gly Pro Lys Tyr Val Val Pro Val Glu Ser Ser Leu Gly Lys Glu 1 5
10 15 Lys Gly Leu Glu 20
* * * * *