U.S. patent application number 13/641451 was filed with the patent office on 2013-05-09 for methods for treating metabolic disorders using fgf.
This patent application is currently assigned to Salk Institute for Biological Studies. The applicant listed for this patent is Michael Downes, Ronald M. Evans, Johan W. Jonker, Jaemyoung Suh. Invention is credited to Michael Downes, Ronald M. Evans, Johan W. Jonker, Jaemyoung Suh.
Application Number | 20130116171 13/641451 |
Document ID | / |
Family ID | 44799376 |
Filed Date | 2013-05-09 |
United States Patent
Application |
20130116171 |
Kind Code |
A1 |
Jonker; Johan W. ; et
al. |
May 9, 2013 |
METHODS FOR TREATING METABOLIC DISORDERS USING FGF
Abstract
The method provides methods and compositions for treating
metabolic disorders such as impaired glucose tolerance, elevated
blood glucose, insulin resistance, dyslipidaemia, obesity, and
fatty liver.
Inventors: |
Jonker; Johan W.; (Gronigen,
NL) ; Downes; Michael; (San Diego, CA) ;
Evans; Ronald M.; (La Jolla, CA) ; Suh;
Jaemyoung; (San Diego, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Jonker; Johan W.
Downes; Michael
Evans; Ronald M.
Suh; Jaemyoung |
Gronigen
San Diego
La Jolla
San Diego |
CA
CA
CA |
NL
US
US
US |
|
|
Assignee: |
Salk Institute for Biological
Studies
La Jolla
CA
|
Family ID: |
44799376 |
Appl. No.: |
13/641451 |
Filed: |
April 18, 2011 |
PCT Filed: |
April 18, 2011 |
PCT NO: |
PCT/US11/32848 |
371 Date: |
January 2, 2013 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61325253 |
Apr 16, 2010 |
|
|
|
61325261 |
Apr 16, 2010 |
|
|
|
61325255 |
Apr 16, 2010 |
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Current U.S.
Class: |
514/4.8 ;
514/6.8; 514/6.9; 514/9.1 |
Current CPC
Class: |
A61K 9/0019 20130101;
A61P 3/06 20180101; A61K 31/4439 20130101; A61K 45/06 20130101;
A61K 38/1825 20130101; A61K 47/61 20170801; A61P 3/04 20180101;
A61P 43/00 20180101; A61P 3/10 20180101; A61P 1/16 20180101; A61P
3/00 20180101; A61K 47/60 20170801; A61K 38/1825 20130101; A61K
2300/00 20130101 |
Class at
Publication: |
514/4.8 ;
514/9.1; 514/6.9; 514/6.8 |
International
Class: |
A61K 38/18 20060101
A61K038/18; A61K 45/06 20060101 A61K045/06 |
Goverment Interests
STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSORED
RESEARCH OR DEVELOPMENT
[0002] This invention was made with government support under award
number LT00305/2005-L from the Human Frontier Science Program
Organization (HFSPO) as well as grants awarded by the National
Institutes of Health (NIH) and the Howard Hughes Medical Institute
(HHMI). The Government has certain rights in the invention.
Claims
1. A pharmaceutical composition for treating a metabolic disorder
in an individual comprising an FGF-1 compound.
2. The composition of claim 1, wherein the FGF-1 compound is a
functional fragment of FGF-1.
3. The composition of claim 1, wherein the FGF-1 compound is a
functional analog of FGF-1.
4. The composition of claim 1, wherein the composition is
formulated for intravenous administration.
5. The composition of claim 1, wherein the composition is
formulated for subcutaneous administration.
6. The composition of claim 1, wherein the metabolic disorder is
selected from elevated blood glucose, impaired glucose tolerance,
insulin resistance, type II diabetes, obesity, elevated percent
body fat, and fatty liver disease.
7. The composition of claim 1, wherein the dose of the FGF-1
compound in the composition is equivalent to 0.01-1 mg FGF-1 per kg
body weight.
8. A method for treating a metabolic disorder in an individual,
comprising administering an FGF-1 compound to the individual,
thereby treating the metabolic disorder.
9. The method of claim 8, wherein the metabolic disorder is
selected from elevated blood glucose, impaired glucose tolerance,
insulin resistance, type II diabetes, obesity, elevated percent
body fat, and fatty liver disease.
10. The method of claim 8, wherein the metabolic disorder is
elevated percent body fat or obesity.
11. The method of claim 8, wherein the metabolic disorder is
selected from elevated blood glucose, impaired glucose tolerance,
and insulin resistance.
12. The method of claim 8, wherein the metabolic disorder is type
II diabetes.
13. The method of claim 8, wherein the metabolic disorder is fatty
liver disease.
14. The method of claim 8, wherein the FGF-1 compound is
administered intravenously.
15. The method of claim 8, wherein the FGF-1 compound is
administered subcutaneously.
16. The method of claim 8, wherein the FGF-1 compound is
administered in combination with an additional therapeutic
compound.
17. The method of claim 8, wherein the FGF-1 compound is a
functional fragment of FGF-1.
18. The method of claim 8, wherein the FGF-1 compound is a
functional analog of FGF-1.
19. The method of claim 8, wherein the FGF-1 compound is
administered at a dose equivalent to 0.01-1 mg FGF-1 per kg body
weight.
20. The method of claim 8, wherein the FGF-1 compound is
administered once per day or less.
Description
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] This application claims priority to U.S. Ser. No.
61/325,255; U.S. Ser. No. 61/325,261; and U.S. Ser. No. 61/325,253,
all filed Apr. 16, 2010, the disclosures of which are incorporated
herein by reference in their entireties.
BACKGROUND OF THE INVENTION
[0003] Metabolic disorders such as type 2 diabetes, obesity, and
all of the related complications, are leading causes of mortality.
These disorders are associated with the excessive nutritional
intake and lack of exercise of the Western lifestyle, and
increasingly that of the rest of the world. Type 2 diabetes is a
debilitating disease characterized by high-circulating blood
glucose, insulin, and corticosteroid levels. The incidence of type
2 diabetes is high and rising and is becoming a leading cause of
mortality, morbidity, and healthcare expenditure throughout the
world (Amos et al., Diabetic Med. 14:S1-85, 1997). Diabetes (and
insulin resistant conditions) result in elevated levels of glucose
in the blood. Prolonged high blood sugar may cause blood vessel and
nerve damage.
[0004] Various pharmacological approaches for the treatment of type
2 diabetes are available (Scheen et al., Diabetes Care,
22(9):1568-1577, 1999). One such approach is the use of
thiazolidinediones (TZDs), which represent a new class of oral
antidiabetic drugs that improve metabolic control in patients with
type 2 diabetes. TZDs (including rosiglitazone (Avandia.RTM.) and
pioglitazone (Actos.RTM.)) command a large share of the current
antidiabetic drug market. TZDs reduce insulin resistance in
adipose, muscle, and liver tissues (Oakes et al., Metabolism
46:935-942, (1997); Young et al. Diabetes 44:1087-1092, (1995);
Oakes et al., Diabetes 43:1203-1210, (1994); Smith et al., Diabetes
Obes Metab 2:363-372 (2000)). TZDs also lower the levels of free
fatty acid (FFA) and triglycerides.
[0005] TZDs administered alone or in combination with metformin
have glucose-lowering effects in patients with type 2 diabetes and
reduce plasma insulin concentrations (i.e., in hyperinsulinaemia)
(Aronoff et al., Diabetes Care 2000; 23: 1605-1611; Lebovitz et
al., J Clin Endocrinol Metab 2001; 86: 280-288; Phillips et al.
Diabetes Care 2001; 24: 308-315). Abnormalities in lipid levels can
also be treated (Day, Diabet Med 1999; 16: 179-192; Ogihara et al.
Am J Hypertens 1995; 8: 316-320), high blood pressure (Ogihara et
al. Am J Hypertens 1995; 8: 316-320) and impaired fibrinolysis
(Gottschling-et al. Diabetologia 2000; 43:377-383). However, there
are numerous side effects associated with the use of TZDs, such as
weight gain, liver toxicity, cardiovascular toxicity, upper
respiratory tract infection, headache, back pain, hyperglycemia,
fatigue, sinusitis, diarrhea, hypoglycemia, mild to moderate edema,
fluid retention, and anemia (Moller, Nature, 2001, 414: 821-827).
Accordingly, there is a need for improved therapeutic approaches to
metabolic disorders that have fewer adverse effects than the
available pharmaceutical approaches utilizing TZDs.
BRIEF SUMMARY OF THE INVENTION
[0006] Provided herein are compositions and methods for treating a
metabolic disorder in an individual using an FGF-1 compound. Thus,
in some embodiments, the invention provides pharmaceutical
compositions for treating a metabolic disorder comprising an FGF-1
compound. In some embodiments, the FGF-1 compound is a functional
fragment of FGF-1 (e.g., amino acids 1-140, 1-141, 14-135, etc.).
In some embodiments, the FGF-1 compound is a functional analog of
FGF-1. In some embodiments, the FGF-1 compound is a functional
variant of FGF-1. In some embodiments, the FGF-1 compound is an
expression vector comprising a sequence encoding the FGF-1
compound.
[0007] In some embodiments, the pharmaceutical composition is
formulated for intravenous administration. In some embodiments, the
pharmaceutical composition is formulated for subcutaneous or
intraperitoneal administration. In some embodiments, the
pharmaceutical composition is formulated for a dose of the FGF-1
compound equivalent to 0.01-1 mg FGF-1 per kg body weight of the
individual, e.g., equivalent to 0.05-0.1, 0.1-0.2, 0.1-0.4, 0.05,
0.1, 0.2, 0.3, 0.4. 0.5 or higher mg FGF-1 per kg body weight. In
some embodiments, the composition includes a second therapeutic
agent, e.g., a TZD.
[0008] In some embodiments, the metabolic disorder is selected from
the group consisting of elevated blood glucose (e.g., reduced
ability to normalize glucose), impaired glucose tolerance, insulin
resistance, type II diabetes, obesity, elevated percent body fat,
and fatty liver (hepatic steatosis). In some embodiments, the
metabolic disorder is obesity. In some embodiments, the individual
has a BMI of 25 or higher, e.g., 26, 28, 30 or greater than 30. In
some embodiments, the metabolic disorder is hepatic steatosis. In
some embodiments, the metabolic disorder is insulin resistance. In
some embodiments, the metabolic disorder is impaired glucose
tolerance.
[0009] In some embodiments, the invention provides methods of
making a medicament for use in treating a metabolic disorder
comprising an FGF-1 compound as described herein. Further provided
is use of an FGF-1 compound for treating a metabolic disorder in an
individual.
[0010] Also provided are methods of treating a metabolic disorder
in an individual (treating an individual with a metabolic disorder)
comprising administering an FGF-1 compound to the individual,
thereby treating the metabolic disorder. The metabolic disorder can
be selected from the group consisting of elevated blood glucose
(e.g., reduced ability to normalize glucose), impaired glucose
tolerance, insulin resistance, type II diabetes, obesity, elevated
percent body fat, and fatty liver (hepatic steatosis). In some
embodiments, the metabolic disorder is obesity. In some
embodiments, the individual has a BMI of 25 or higher, e.g., 26,
28, 30 or greater than 30. In some embodiments, the metabolic
disorder is hepatic steatosis.
[0011] In some embodiments, the metabolic disorder is insulin
resistance. In some embodiments, the metabolic disorder is impaired
glucose tolerance.
[0012] In some embodiments, the FGF-1 compound is a functional
fragment of FGF-1 (e.g., amino acids 1-140, 1-141, 14-135, etc.).
In some embodiments, the FGF-1 compound is a functional analog of
FGF-1. In some embodiments, the FGF-1 compound is a functional
variant of FGF-1. In some embodiments, the FGF-1 compound is an
expression vector comprising a sequence encoding the FGF-1
compound.
[0013] In some embodiments, the administering is intravenous. In
some embodiments, the administering is subcutaneous or
intraperitoneal. In some embodiments, the dose of the FGF-1
compound administered is equivalent to 0.01-1 mg FGF-1 per kg body
weight of the individual, e.g., equivalent to 0.05-0.1, 0.1-0.2,
0.1-0.4, 0.05, 0.1, 0.2, 0.3, 0.4. 0.5 or higher mg FGF-1 per kg
body weight. In some embodiments, the FGF-1 compound is
administered once per day or less, e.g., every second day, every
third day, every week, every other week, or less.
[0014] In some embodiments, the method further comprises
administering a second therapeutic agent to the individual. In some
embodiments, the second therapeutic agent is administered at the
same time (e.g., in the same composition) as the FGF-1 compound. In
some embodiments, the second therapeutic agent is administered at a
different time than the FGF-1 compound. In some embodiments, the
second therapeutic agent is another treatment for a metabolic
disorder (e.g., a TZD). In some embodiments, the second therapeutic
agent targets an associated symptom, e.g., pain or high blood
pressure.
[0015] Further provided are methods of inducing fatty liver in a
food animal, e.g., a bird, such as duck or goose. The methods
comprise inhibiting FGF-1 in a food animal. In some embodiments,
the method comprises administering an effective amount of an FGF-1
inhibitor to the food animal. In some embodiments, the FGF-1
inhibitor is an antisense compound specific for FGF-1, e.g., an
expression vector comprising a sequence encoding the antisense
compound. In some embodiments, the FGF-1 inhibitor is an antibody
(e.g., Shi et al. (2011) IUBMB Life 63:129). In some embodiments,
the FGF-1 inhibitor is an inhibitor of the FGF-1 signaling pathway,
e.g., a MAP kinase pathway inhibitor such as PD-098059, PD-161570,
PD-173074, SU5402, or SB203580. In some embodiments, the FGF-1
inhibitor is administered more than once, e.g., once/day, or with
food. In some embodiments, the FGF-1 inhibitor is administered in
combination with a high fat diet. In some embodiments, the method
comprises generating an FGF-1 knockout or genetically altered FGF-1
inactive food animal, and feeding the animal with a high fat
diet.
BRIEF DESCRIPTION OF THE DRAWINGS
[0016] FIG. 1. FGF-1 gene structure and expression. (A) The
expression of the FGF-1 gene is directed by three distinct
promoters driving the untranslated exons: 1A, 1B, and 1D (open
bars), spaced up to 70 kb apart. Alternative splicing of these
untranslated exons to the three coding exons (closed bars) of the
FGF-1 gene results in identical but differentially expressed FGF-1
polypeptides. This organization as shown for human and mouse is
evolutionary conserved. Tissue distribution mRNA in mice for (B)
FGF-1A, (C) FGF-1B, and (D) FGF-1D.
[0017] FIG. 2. FGF-1A is a direct transcriptional target of
PPAR.gamma.. Determination of NR-mediated transcriptional
regulation of (A) FGF-1A, (B) FGF-1B, and (C) FGF-1D using
luciferase reporter assays. (D) Conserved PPAR response element
(PPRE) within the proximal promoter of FGF-1A relative to the
transcription start site (TSS). The sequences are shown from the
indicated species, numbered SEQ ID NOs:1-9 from top to bottom. (E)
Alignment of the PPRE within the FGF-1A promoter of different
species. Underline indicates nucleotide variations between the
PPREs relative to human. (F) Species-specific response of the
FGF-1A promoter to PPAR.gamma. using luciferase reporter
assays.
[0018] FIG. 3. Transcriptional regulation of FGF-1A in vivo. Levels
of FGF-1A (A, D) and FGF21 (B, C, E, F) mRNA in WAT and liver of
wild-type mice (n=5). (A, B, and C): Fed or overnight fast, with or
without rosiglitazone (5 mg/kg for 3 days p.o.). (D, E, and F):
Fed, 2 weeks HFD, or overnight fast. (G) Levels of FGF-1 protein
and various components of the insulin signaling pathway in WAT of
wild-type mice on a normal chow diet vs. 3 months HFD (n=3).
[0019] FIG. 4. HFD-induced insulin resistance in FGF-1 KO mice. In
response to HFD diet, FGF-1 KO mice display (A) normal weight gain,
(B) reduced epididymal white adipose (eWAT) weight gain, and (C)
increased liver weight as compared to wild-type littermates
(n=6-7). FGF-1 KO mice display (D) normal glucose tolerance when
fed with control diet, but develop HFD-induced insulin resistance
as indicated by (E) decreased glucose tolerance and (F) increased
insulin tolerance after 6 mo HFD. (G) histology (H&E) of liver
(upper panels) and WAT (lower panels) of wild-type (left panels)
and FGF-1 KO (right panels) animals. Histological analysis of
6-month HFD-treated FGF-1 knockout and wild-type mice. FGF-1 KO
mice display (H) normal pancreatic islet morphology and
organization, (I) increased hepatic steatosis, and (J) normal
adipocyte size and morphology.
[0020] FIG. 5. HFD-induced loss of AKT signaling in WAT of FGF-1 KO
mice. Protein levels of FGF-1, AKT, GSK3b, ERK1/2, and actin in
liver, BAT, WAT, and muscle of HFD-treated (6 months) FGF-1 KO and
wild-type mice (n=3). FGF-1 was not detected in muscle.
[0021] FIG. 6. FGF-1 and rosiglitazone stimulation of Glutl
expression in 3T3-L1 adipocytes. 3T3-L1 adipocytes were treated
with FGF-1 (+=50 ng/ml, ++=100 ng/ml), rosiglitazone (1 .mu.M), or
in combination. (A) mRNA (top) and protein (bottom) levels of
Glucose Transporter 1 (Glutl); (B) mRNA (top) and protein (bottom)
levels of Glucose Transporter 4 (Glut4).
[0022] FIG. 7. FGF-1 injection studies in rodents. (A) Fed blood
glucose in ob/ob male mice treated with FGF-1 (0.5 mg/kg, s.c.),
rosiglitazone (TZD, 5 mg/kg, p.o.), or vehicle. FGF-1 was
administered once daily, and blood glucose levels were measured at
day 0 (basal levels before FGF-1 injection), day 3, and day 6, 1
hour after injection. The values (.+-.SE) shown are the average of
the measurements of 5 animals in a group; (B) Sustained glucose
lowering effects of FGF-1: Fed blood glucose levels in ob/ob mice
at indicated time points after the last FGF-1 injection at day 6.
(C-H): 72 hrs after the sixth dose, another dose was given and
effects of FGF-1 and TZD on (C) body weight, (D) total body fat,
(E) lean weight, (F) weight gain, (G) liver weight, and (H) heart
weight were determined.
[0023] FIG. 8. Dose response effect of FGF-1 (s.c., mg/kg) on blood
glucose levels of ob/ob mice. The maximum glucose lowering effects
of FGF-1 are reached at 0.5 mg/kg with an EC50=0.25 mg/kg.
[0024] FIG. 9. Effect of FGF-1 (s.c., 0.5 mg/kg) on blood glucose
levels of ob/ob mice. The results show that a single s.c. dose
reduces blood glucose for more than 2 days.
[0025] FIG. 10. Effect of intravenous FGF1 (0.2 mg/kg) on blood
glucose levels of ob/ob mice. IV administration of FGF1 has acute
glucose lowering effects, which last up to one week.
[0026] FIG. 11. Effect of chronic FGF-1 on blood glucose. FGF-1
treatment every third day results in completely normalized blood
glucose in ob/ob mice.
[0027] FIG. 12. Effect of chronic FGF1 on food intake. FGF-1
induces a reduced food intake during the first 1-2 weeks of chronic
administration, but after two weeks food intake returned to
normal.
[0028] FIG. 13. Effect of chronic FGF-1 on body weight. FGF-1
treatment resulted in a reduced weight gain during the first week
of chronic FGF1 administration. After one week, weight gain is
similar between control and FGF1-treated mice. This reduced weight
gain corresponds with reduced food intake, but is more durable.
Reduced weight gain is evident after food intake returns to
normal.
[0029] FIG. 14. Effect of chronic FGF-1 on total percent body fat.
FGF-1 treated mice display reduced increase in percent body
fat.
[0030] FIG. 15. Effect of chronic FGF-1 on percent lean mass. FGF-1
treated mice display increased lean mass as compared with control
mice, further indicating that the reduced weight is due to a
decrease in the percent body fat.
[0031] FIG. 16. Effect of chronic FGF-1 on glucose tolerance.
Untreated mice show impaired glucose tolerance. After 4 weeks of
FGF-1 administration, ob/ob mice display a more rapid and effective
capacity to clear glucose from the blood, indicating that FGF-1
enhances glucose tolerance.
[0032] FIG. 17. Effect of chronic FGF-1 on insulin tolerance. After
4 weeks of chronic FGF-1 administration, ob/ob mice display
increased insulin sensitivity. FGF-1 treated mice clear glucose
from the blood more effectively than untreated mice.
[0033] FIG. 18. Effect of chronic FGF-1 on serum lipids. Serum
levels of triglycerides, free fatty acids, and cholesterol are
similar between control and FGF-1 treated mice.
[0034] FIG. 19. Effect of chronic FGF-1 on hepatic steatosis.
H&E staining of liver of A) control and B) FGF 1-treated ob/ob
mice. Control mice show mixed micro and macro vesicular steatosis
with some periportal sparing. Steatosis affects most hepatocyes
(>70%). There is little if any inflammatory infiltrate in either
the portal tracts or lobules, which is typical liver histology for
an ob/ob mouse. In contrast, livers from FGF-1 treated mice display
clearing of fat in a periportal to mid zonal distribution.
Steatosis is dramatically reduced compared to control and is mainly
microvesicular. There is very little macrovesicular steatosis, and
little or no inflammation.
[0035] FIG. 20. Effect of chronic FGF-1 on hepatic glycogen. FGF-1
treated ice display increased levels of hepatic glycogen as
compared to control mice.
[0036] FIG. 21. PPAR.gamma. binds to the FGF-1 promoter region in
mature adipocytes. Chromatin was prepared from differentiated
3T3-L1 adipocytes and chromatin immunoprecipitation assays were
performed with either IgG antibodies (negative control) or
anti-PPAR.gamma. antibodies. Quantitative PCR demonstrates that
PPAR.gamma. specifically binds the FGF1 promoter region. 36b4 is a
negative control locus devoid of PPAR.gamma. binding sites.
[0037] FIG. 22. Assessment of delivery method on FGF-1 blood
glucose effects. Subcutaenous, intraperitoneal, and intravenous
delivery of FGF-1 (0.5 mg/kg) display similar efficacy in
normalizing blood glucose levels of ob/ob diabetic mice.
[0038] FIG. 23. Assessment of delivery method on duration of FGF-1
activity. Single subcutaneous (sc) or intravenous (iv) injection of
FGF-1 (0.5 mg/kg) in ob/ob mice. FGF-1 glucose normalizing effects
persist longer when administered iv as compared to sc.
[0039] FIG. 24. FGF-1 effects in db/db mice. Single subcutaneous
injection of FGF-1 (0.5 mg/kg) normalizes blood glucose in db/db
leptin receptor mutant diabetic mice. The db/db model is considered
to represent a less severe diabetes model than ob/ob. The results
indicate that FGF-1 is effective for treatment of less severe
metabolic disorders.
[0040] FIG. 25. FGF1 effects in DIO mice. Single subcutaneous
injection of FGF1 (0.5 mg/kg) normalizes blood glucose in
diet-induced obesity mice (C57BL/6). Again, the results indicate
that FGF-1 is effective for treatment of metabolic disorders
arising from a number of causes.
[0041] FIG. 26. Human recombinant FGF-1 is effective in mice.
Single subcutaneous injection of human FGF1 (0.5 mg/kg) normalizes
blood glucose in ob/ob mice.
[0042] FIG. 27. Comparison of FGF1, FGF2, FGF9, and FGF10 effects.
Single subcutaneous injection of FGFs (0.5 mg/kg) in ob/ob mice.
Only FGF1 has glucose normalizing effects.
DETAILED DESCRIPTION OF THE INVENTION
I. Introduction
[0043] Provided herein are methods and compositions useful for
treating metabolic disorders using FGF-1 and functional variants
thereof. The inventors have shown that FGF-1 has rapid and
long-lasting effects, including normalizing blood glucose,
increasing insulin sensitivity, reducing percent body fat and
overall body weight, increasing percent lean mass, and reducing
fatty liver (hepatic steatosis).
II. Definitions
[0044] The following abbreviations are used herein: [0045] FGF
fibroblast growth factor [0046] NHR nuclear hormone receptor [0047]
PPAR peroxisome proliferator-activated receptor [0048] PPRE PPAR
response element [0049] TSS transcription start site [0050] TZD
thiazolidinedione [0051] BAT brown adipose tissue [0052] WAT white
adipose tissue [0053] HFD high fat diet [0054] i.p. intraperitoneal
injection [0055] s.c. subcutaneous injection [0056] p.o. oral
administration [0057] i.v. intravenous injection
[0058] Unless defined otherwise, technical and scientific terms
used herein have the same meaning as commonly understood by a
person of ordinary skill in the art. See, e.g., Singleton et al.,
DICTIONARY OF MICROBIOLOGY AND MOLECULAR BIOLOGY 2nd ed., J. Wiley
& Sons (New York, N.Y. 1994); Sambrook et al., MOLECULAR
CLONING, A LABORATORY MANUAL, Cold Springs Harbor Press (Cold
Springs Harbor, N.Y. 1989). Any methods, devices and materials
similar or equivalent to those described herein can be used in the
practice of this invention. The following definitions are provided
to facilitate understanding of certain terms used frequently herein
and are not meant to limit the scope of the present disclosure.
[0059] The term FGF-1 compound refers to FGF-1 or a variant thereof
(FGF-1 fragment, FGF-1 portion, modified form of FGF-1, protein
having substantial identity to FGF-1, FGF-1 analog, etc.) that
retains at least one FGF-1 activity (e.g., at least 10%, 20%, 30%,
40%, 50%, 60%, 70%, 80% or higher percent activity compared to
FGF-1). Thus, FGF-1 compounds include functional FGF-1 fragments,
functional FGF-1 variants, and functional FGF-1 analogs. An example
of an FGF-1 compound that is substantially identical to FGF-1 is a
protein having at least 80%, 85%, 90%, 95%, 98%, 99%, or 100% amino
acid identity to FGF-1. In some embodiments, the FGF-1 compound
comprises a polypeptide having, e.g., 95%, 98%, 99% or higher %
identity to FGF-1, where the non-identities represent conservative
substitutions or additions or deletions that do not substantially
change the activity.
[0060] FGF-1 (or acidic FGF) is a secreted protein that binds
heparin (e.g., heparin sulfate) and FGF receptor family members 1
and 4. The human protein is 155 amino acids in length, and the
sequence is publically available at SwissProt accession number
PO.sub.5230.1. The term "FGF-1" refers to naturally-occurring,
isolated, recombinant, or synthetically-produced proteins. FGF-1
also includes allelic variants and species homologs.
[0061] FGF-1 activities include binding heparin, FGFR1, and FGFR4,
and increasing expression of GLUT1 and/or GLUT4. FGF-1 activities
also include (among others) reducing glucose levels, improving
glucose tolerance, and increasing insulin sensitivity in a diabetic
individual. Additional FGF-1 activities include reducing percent
body fat, fatty liver disease, and increasing percent lean mass in
an individual.
[0062] A functional FGF-1 fragment is a protein having less than
the full length sequence of FGF-1 but retaining at least 25, 50, or
80% activity of at least one FGF-1 activity (e.g., FGF-1 (14-135,
1-140, 13-135, 1-141, etc.). The functional FGF-1 fragment can have
an amino acid sequence of any length up to the full length FGF
polypeptide sequence, e.g., 50, 50-80, 50-100, 120-150, 100-150, or
more than 100 amino acids. In some embodiments, the functional FGF
fragment is at least 80%, 85%, 90%, 95%, 98%, or 100% identical to
FGF-1 over the covered portion of the full length sequence (e.g.,
over 50-150 amino acids). In some embodiments, the functional FGF-1
fragment has greater than 90%, e.g., 95%, 98%, 99% or higher %
identity to FGF-1 1-141. In some embodiments, the functional FGF-1
fragment has greater than 90%, e.g., 95%, 98%, 99% or higher %
identity to FGF-1 1-141, where the non-identities represent
conservative substitutions or additions or deletions that do not
substantially change the activity.
[0063] A functional FGF-1 analog is a modified or synthetic (e.g.,
peptidomimetic) form of FGF-1 that retains at least 25, 50, or 80%
activity of at least one FGF-1 activity. Examples of FGF-1 analogs
that retain heparin-binding activity are disclosed in
WO2006/093814. The FGF-1 analog can include non-naturally occurring
amino acids, or modified amino acids, e.g., that improve the
stability (in storage or in vivo) or pharmacological properties
(tissue profile, half-life, etc.) of the protein. The functional
FGF-1 analog can also be a functional FGF-1 variant, e.g., having
greater than 90%, e.g., 95%, 98%, 99% or higher % identity to
FGF-1. In some embodiments, the functional FGF-1 analog has at
least 95%, 98%, 99% or higher % identity to FGF-1, where the
non-identities represent conservative substitutions or additions or
deletions that do not substantially change the activity.
[0064] The term "recombinant" when used with reference, e.g., to a
cell, or nucleic acid, protein, or vector, indicates that the cell,
nucleic acid, protein or vector, has been modified by the
introduction of a heterologous nucleic acid or protein or the
alteration of a native nucleic acid or protein, or that the cell is
derived from a cell so modified. Thus, for example, recombinant
cells express genes that are not found within the native
(non-recombinant) form of the cell or express native genes that are
otherwise abnormally expressed, under expressed or not expressed at
all.
[0065] The term "heterologous" when used with reference to portions
of a nucleic acid indicates that the nucleic acid comprises two or
more subsequences that are not found in the same relationship to
each other in nature. For instance, the nucleic acid is typically
recombinantly produced, having two or more sequences from unrelated
genes arranged to make a new functional nucleic acid, e.g., a
promoter from one source and a coding region from another source.
Similarly, a heterologous protein indicates that the protein
comprises two or more subsequences that are not found in the same
relationship to each other in nature (e.g., a fusion protein).
[0066] "Nucleic acid" refers to deoxyribonucleotides or
ribonucleotides and polymers thereof in either single- or
double-stranded form, and complements thereof. The term
"polynucleotide" refers to a linear sequence of nucleotides. The
term "nucleotide" typically refers to a single unit of a
polynucleotide, i.e., a monomer. Nucleotides can be
ribonucleotides, deoxyribonucleotides, or modified versions
thereof. Examples of polynucleotides contemplated herein include
single and double stranded DNA, single and double stranded RNA
(including siRNA), and hybrid molecules having mixtures of single
and double stranded DNA and RNA.
[0067] The words "complementary" or "complementarity" refer to the
ability of a nucleic acid in a polynucleotide to form a base pair
with another nucleic acid in a second polynucleotide. For example,
the sequence A-G-T is complementary to the sequence T-C-A.
Complementarity may be partial, in which only some of the nucleic
acids match according to base pairing, or complete, where all the
nucleic acids match according to base pairing.
[0068] The words "protein", "peptide", and "polypeptide" are used
interchangeably to denote an amino acid polymer or a set of two or
more interacting or bound amino acid polymers. The terms apply to
amino acid polymers in which one or more amino acid residue is an
artificial chemical mimetic of a corresponding naturally occurring
amino acid, as well as to naturally occurring amino acid polymers,
those containing modified residues, and non-naturally occurring
amino acid polymer.
[0069] The term "amino acid" refers to naturally occurring and
synthetic amino acids, as well as amino acid analogs and amino acid
mimetics that function similarly to the naturally occurring amino
acids. Naturally occurring amino acids are those encoded by the
genetic code, as well as those amino acids that are later modified,
e.g., hydroxyproline, .gamma.-carboxyglutamate, and
O-phosphoserine. Amino acid analogs refers to compounds that have
the same basic chemical structure as a naturally occurring amino
acid, e.g., an .alpha. carbon that is bound to a hydrogen, a
carboxyl group, an amino group, and an R group, e.g., homoserine,
norleucine, methionine sulfoxide, methionine methyl sulfonium. Such
analogs may have modified R groups (e.g., norleucine) or modified
peptide backbones, but retain the same basic chemical structure as
a naturally occurring amino acid. Amino acid mimetics refers to
chemical compounds that have a structure that is different from the
general chemical structure of an amino acid, but that functions
similarly to a naturally occurring amino acid.
[0070] Amino acids may be referred to herein by either their
commonly known three letter symbols or by the one-letter symbols
recommended by the IUPAC-IUB Biochemical Nomenclature Commission.
Nucleotides, likewise, may be referred to by their commonly
accepted single-letter codes.
[0071] "Conservatively modified variants" applies to both amino
acid and nucleic acid sequences. With respect to particular nucleic
acid sequences, conservatively modified variants refers to those
nucleic acids which encode identical or essentially identical amino
acid sequences, or where the nucleic acid does not encode an amino
acid sequence, to essentially identical or associated, e.g.,
naturally contiguous, sequences. Because of the degeneracy of the
genetic code, a large number of functionally identical nucleic
acids encode most proteins. For instance, the codons GCA, GCC, GCG
and GCU all encode the amino acid alanine Thus, at every position
where an alanine is specified by a codon, the codon can be altered
to another of the corresponding codons described without altering
the encoded polypeptide. Such nucleic acid variations are "silent
variations," which are one species of conservatively modified
variations.
[0072] As to amino acid sequences, one of skill will recognize that
individual substitutions, deletions or additions to a nucleic acid,
peptide, polypeptide, or protein sequence which alters, adds or
deletes a single amino acid or a small percentage of amino acids in
the encoded sequence is a "conservatively modified variant" where
the alteration results in the substitution of an amino acid with a
chemically similar amino acid. Conservative substitution tables
providing functionally similar amino acids are well known in the
art. Such conservatively modified variants are in addition to and
do not exclude polymorphic variants, interspecies homologs, and
alleles of the invention. The following amino acids are typically
conservative substitutions for one another: 1) Alanine (A), Glycine
(G); 2) Aspartic acid (D), Glutamic acid (E); 3) Asparagine (N),
Glutamine (Q); 4) Arginine (R), Lysine (K); 5) Isoleucine (I),
Leucine (L), Methionine (M), Valine (V); 6) Phenylalanine (F),
Tyrosine (Y), Tryptophan (W); 7) Serine (S), Threonine (T); and 8)
Cysteine (C), Methionine (M) (see, e.g., Creighton, Proteins
(1984)).
[0073] The terms "identical" or percent "identity," in the context
of two or more nucleic acids, or two or more polypeptides, refer to
two or more sequences or subsequences that are the same or have a
specified percentage of nucleotides, or amino acids, that are the
same (i.e., about 60% identity, preferably 65%, 70%, 75%, 80%, 85%,
90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or higher
identity over a specified region, when compared and aligned for
maximum correspondence over a comparison window or designated
region) as measured using a BLAST or BLAST 2.0 sequence comparison
algorithms with default parameters described below, or by manual
alignment and visual inspection. See e.g., the NCBI web site at
ncbi.nlm.nih.gov/BLAST. Such sequences are then said to be
"substantially identical." This definition also refers to, or may
be applied to, the compliment of a nucleotide test sequence. The
definition also includes sequences that have deletions and/or
additions, as well as those that have substitutions. Algorithms can
account for gaps and the like. Identity generally exists over a
region that is at least about 25 amino acids or nucleotides in
length, or over a region that is 50-100 amino acids or nucleotides
in length.
[0074] The term "metabolic disorder" is used broadly herein to
refer to the conditions, diseases, and disorders associated with
insulin and/or glucose dysregulation. Metabolic disorders include
type 2 diabetes, insulin insensitivity, glucose intolerance,
elevated blood glucose levels, obesity, high percent body fat,
fatty liver, etc. One of skill will understand that metabolic
disorders are associated with and can result in a wide range of
other disorders, e.g., high blood pressure, heart disease, poor
circulation, etc., which can be ameliorated by addressing the
metabolic disorder according to the methods of the invention.
[0075] "Biopsy" or "biological sample from a patient" as used
herein refers to a sample obtained from a patient having, or
suspected of having, a metabolic disorder. In some embodiments, the
biopsy is a blood sample, which can be separated into blood
components (plasma, serum, white blood cells, red blood cells,
platelets, etc.). In some embodiments, the sample is a tissue
biopsy, such as needle biopsy, fine needle biopsy, surgical biopsy,
etc. Tissue samples can be obtained from adipose, muscle, liver,
etc.
[0076] A "biological sample" or "cellular sample" can be obtained
from a patient, e.g., a biopsy, from an animal, such as an animal
model, or from cultured cells, e.g., a cell line or cells removed
from a patient and grown in culture for observation. Biological
samples include tissues and bodily fluids, e.g., blood, blood
fractions, lymph, saliva, urine, feces, etc.
[0077] "Subject," "patient," "individual" and like terms are used
interchangeably and refer to, except where indicated, mammals such
as humans and non-human primates, as well as livestock and
companion animals. The term does not necessarily indicate that the
subject has been diagnosed with a metabolic disorder, but typically
refers to an individual under medical supervision. A patient can be
an individual that is seeking treatment, monitoring, adjustment or
modification of an existing therapeutic regimen, etc. The terms can
refer to an individual that has been diagnosed, is currently
following a therapeutic regimen, or is at risk of developing a
metabolic disorder, e.g., due to family history, sedentary
lifestyle, etc.
[0078] A "control" condition or sample refers to a sample that
serves as a reference, usually a known reference, for comparison to
a test condition or sample. For example, a test sample can
represent a patient sample, while a control can represent a sample
from an individual known to have a metabolic disorder, or from an
individual that is known to not have the disorder. In another
example, a test sample can be taken from a test condition, e.g., in
the presence of a test compound, and compared to samples from known
conditions, e.g., in the absence of the test compound (negative
control), or in the presence of a known compound (positive
control). A control can also represent an average value gathered
from a number of tests or results. One of skill in the art will
recognize that controls can be designed for assessment of any
number of parameters. For example, a control can be devised to
compare therapeutic benefit based on pharmacological data (e.g.,
half-life) or therapeutic measures (e.g., comparison of benefit
and/or side effects). One of skill in the art will understand which
controls are valuable in a given situation and be able to analyze
data based on comparisons to control values. Controls are also
valuable for determining the significance of data. For example, if
values for a given parameter are widely variant in controls,
variation in test samples will not be considered as
significant.
[0079] The terms "therapy," "treatment," and "amelioration" refer
to any reduction in the severity of symptoms. In the case of
treating metabolic disorders, the terms can refer to reducing blood
glucose, increasing insulin sensitivity, reducing body weight,
reducing percent body fat, increasing percent lean mass, reducing
side effects of associated therapies, etc. As used herein, the
terms "treat" and "prevent" are not intended to be absolute terms.
Treatment can refer to any delay in onset, amelioration of
symptoms, improvement in patient survival, increase in survival
time or rate, etc. The effect of treatment can be compared to an
individual or pool of individuals not receiving the treatment, or
to the same patient prior to treatment or at a different time
during treatment. In some aspects, the severity of disease is
reduced by at least 10%, as compared, e.g., to the individual
before administration or to a control individual not undergoing
treatment. In some aspects the severity of disease is reduced by at
least 25%, 50%, 75%, 80%, or 90%, or in some cases, no longer
detectable using standard diagnostic techniques.
[0080] The terms "effective amount," "effective dose,"
"therapeutically effective amount," etc. refer to that amount of
the therapeutic agent sufficient to ameliorate a disorder, as
described above. For example, for the given parameter, a
therapeutically effective amount will show an increase or decrease
of therapeutic effect at least 5%, 10%, 15%, 20%, 25%, 40%, 50%,
60%, 75%, 80%, 90%, or at least 100%. Therapeutic efficacy can also
be expressed as "-fold" increase or decrease. For example, a
therapeutically effective amount can have at least a 1.2-fold,
1.5-fold, 2-fold, 5-fold, or more effect over a control. In the
context of the present invention, the effective amount of an FGF-1
compound can vary depending on co-administration of other
therapeutics or metabolic profile of the individual (among other
factors such as age, severity of disease, etc.).
[0081] The term "diagnosis" refers to a relative probability a
subject has a given metabolic disorder. Symptoms and diagnostic
criteria are summarized below. Similarly, the term "prognosis"
refers to a relative probability that a certain future outcome may
occur in the subject. For example, in the context of the present
invention, prognosis can refer to the likelihood that an individual
will develop a metabolic disorder. Prognosis can also refer to the
likely severity of the disease (e.g., severity of symptoms, rate of
functional decline, survival, etc.). The terms are not intended to
be absolute, as will be appreciated by any one of skill in the
field of medical diagnostics.
III. Fibroblast Growth Factor (FGF)-1
[0082] Fibroblast growth factors (FGFs) are a family of distinct
polypeptide hormones that are widely expressed in developing and
adult tissues (Baird et al., Cancer Cells, 3:239-243, 1991). FGFs
play crucial roles in multiple physiological functions including
angiogenesis, development, mitogenesis, pattern formation, cellular
proliferation, cellular differentiation, metabolic regulation, and
repair of tissue injury (McKeehan et al., Prog. Nucleic Acid Res.
Mol. Biol. 59:135-176, 1998; Beenken and Mohammadi, 2009). The FGF
family now consists of at least twenty-three members, FGF-1 to
FGF-23 (Reuss et al., Cell Tissue Res. 313:139-157 (2003).
[0083] FGFs bind to FGF receptors (FGFRs), of which there are four
(FGFR1-4). The receptor binding specificity of each FGF is
distinct, and can also depend on the particular isoform of the
FGFR. For example FGFR1 has at least 3 isoforms that result in
different splice variants in the third Ig-like domain (Lui et al.
(2007) Cancer Res. 67:2712). FGF signaling is also determined by
the tissue specificity of the receptor and receptor isoform. FGF-1
can bind to all FGFRs, but is reported to be internalized only upon
binding to FGFR1 and FGFR4. A review of FGF--FGFR specificities can
be found, e.g., in Sorensen et al. (2006) J Cell Science
119:4332.
[0084] The polypeptide and coding sequences of FGF-1 are known for
a number of animals and publically available from the NCBI website.
FGF-1 compounds that can be used in the methods of the invention
include full length human FGF-1, species homologs thereof, and
functional fragments thereof. Additional FGF-1 compounds that can
be used include modified versions of FGF-1 (e.g., modified to
increase stability, e.g., PEGylated or including non-naturally
occurring amino acids), functional analogs of FGF-1, and functional
FGF-1 variants with substantial identity to FGF-1. Another FGF-1
compound that can be used in the present methods includes
expression vectors for stable or transient expression of FGF-1 in a
cell. FGF-1 compounds include those that retain at least one FGF-1
activity, e.g., binding heparin, FGFR1, and FGFR4, and increasing
expression of GLUT1 and/or GLUT4. FGF-1 acitivities include (among
others) reducing (normalizing) glucose levels, improving glucose
tolerance, and increasing insulin sensitivity in a diabetic
individual. Additional FGF-1 activities include reducing percent
body fat, fatty liver disease, and increasing percent lean mass in
an individual.
[0085] In some embodiments, the FGF-1 compound is a functional
FGF-1 variant, functional FGF-1 fragment, and/or functional FGF-1
analog. That is, the FGF-1 compound can be a functional FGF-1
fragment with variations and modified or non-naturally occurring
amino acids, as long as the FGF-1 compound retains at least one
FGF-1 activity. In some embodiments, the FGF-1 compound is
substantially identical to full length FGF-1 or a fragment thereof,
e.g., at least 95, 98, or 99% identical over the relevant length of
FGF-1, where the non-identities include conservative substitutions
or deletions or additions that do not affect the FGF-1 activity.
Examples of FGF-1 amino acids that are involved in FGF-1
activities, and thus less amenable to substitution or deletion,
include Tyr-15, Arg-35, Asn-92, Tyr-94, Lys-101, His-102, Trp-107,
Leu-133, and Leu-135. Also included are Lys-112, Lys-113, Lys-118,
Arg-122, and Lys-128, which are involved in heparin interactions.
The position of these residues is with reference to the 155 amino
acid human sequence, but can be determined for species
homologs.
[0086] In some embodiments, the FGF-1 compound comprises amino
acids 1-140 of FGF-1, or a sequence having at least 90% identity to
amino acids 1-140 of FGF-1 that retains at least one FGF-1
activity. In some embodiments, the FGF-1 activity is normalizing
blood glucose levels in an individual. In some embodiments, the
FGF-1 activity is reducing percent body fat in an individual. In
some embodiments, the FGF-1 activity is increasing insulin
sensitivity in an individual. In some embodiments, the FGF-1
activity is binding to FGFR1 or FGFR4. In some embodiments, the
FGF-1 activity is increasing expression of GLUT1.
[0087] The FGF-1 compound may be generated, isolated, and/or
purified by any means known in the art. For standard recombinant
methods, see Sambrook et al., Molecular Cloning: A Laboratory
Manual, Cold Spring Harbor Laboratory Press, NY (1989); Deutscher,
Methods in Enzymology 182: 83-9 (1990); Scopes, Protein
Purification: Principles and Practice, Springer-Verlag, NY
(1982).
[0088] The FGF-1 compound can be modified, e.g., to improve
stability or its pharmacological profile. Chemical modifications
include, e.g., adding chemical moieties, creating new bonds, and
removing chemical moieties. Modifications at amino acid side groups
include acylation of lysine 8-amino groups, N-alkylation of
arginine, histidine, or lysine, alkylation of glutamic or aspartic
carboxylic acid groups, and deamidation of glutamine or asparagine.
Modifications of the terminal amino group include the des-amino,
N-lower alkyl, N-di-lower alkyl, and N-acyl modifications.
Modifications of the terminal carboxy group include the amide,
lower alkyl amide, dialkyl amide, and lower alkyl ester
modifications.
[0089] Examples of compounds that can improve the pharmacological
profile of the FGF-1 compound include water soluble polymers, such
as PEG, PEG derivatives, polyalkylene glycol (PAG), polysialyic
acid, hydroxyethyl starch, peptides (e.g., Tat (from HIV), Ant
(from the Drosophila antennapedia homeotic protein), or poly-Arg),
and small molecules (e.g., lipophilic compounds such as cholesterol
or DAG).
[0090] In some embodiments, the FGF-1 is linked to a heparin
molecule, which can improve the stability of FGF-1, and prevent
interaction with heparin in vivo. Linking heparin to FGF-1 ensures
that more of the modified FGF-1 remains in circulation than it
would without the heparin modification.
[0091] The FGF-1 compound can be expressed recombinantly using
routine techniques in the field of recombinant genetics. Standard
techniques are used for cloning, DNA and RNA isolation,
amplification and purification. Generally enzymatic reactions
involving DNA ligase, DNA polymerase, restriction endonucleases and
the like are performed according to the manufacturer's
specifications. Basic texts disclosing the general methods of use
in this invention include Sambrook and Russell eds. (2001)
Molecular Cloning: A Laboratory Manual, 3rd edition; the series
Ausubel et al. eds. (2007 with updated through 2010) Current
Protocols in Molecular Biology, among others known in the art.
[0092] To obtain high level expression of a nucleic acid sequence,
such as the nucleic acid sequences encoding an FGF-1 compound, one
typically subclones a nucleic acid sequence that encodes a
polypeptide sequence of the invention into an expression vector
that is subsequently transfected into a suitable host cell. The
expression vector typically contains a strong promoter or a
promoter/enhancer to direct transcription, a
transcription/translation terminator, and for a nucleic acid
encoding a protein, a ribosome binding site for translational
initiation. The promoter is operably linked to the nucleic acid
sequence encoding a polypeptide of the invention or a subsequence
thereof.
[0093] The particular expression vector used to transport the
genetic information into the cell is not particularly critical. Any
of the conventional vectors used for expression in eukaryotic or
prokaryotic cells may be used. Standard bacterial expression
vectors include plasmids such as pBR322 based plasmids, pSKF,
pET23D, and fusion expression systems such as GST and LacZ. Epitope
tags can also be added to the recombinant polypeptides to provide
convenient methods of isolation, e.g., His tags. In some case,
enzymatic cleavage sequences (e.g., Met-(His)g-Ile-Glu-GLy-Arg
which form the Factor Xa cleavage site) are added to the
recombinant polypeptides. Bacterial expression systems for
expressing the polypeptides are available in, e.g., E. coli,
Bacillus sp., and Salmonella (Palva et al., Gene 22:229-235 (1983);
Mosbach et al., Nature 302:543-545 (1983). Kits for such expression
systems are commercially available. Eukaryotic expression systems
for mammalian cells, yeast, and insect cells are well known in the
art and are also commercially available.
[0094] Standard transfection methods can be used to produce cell
lines that express large quantities of polypeptides of the
invention, which are then purified using standard techniques (see,
e.g., Colley et al., J. Biol. Chem., 264:17619-17622 (1989); Guide
to Protein Purification, in Methods in Enzymology, vol. 182
(Deutscher, ed., 1990)). Transformation of cells is performed
according to standard techniques (see, e.g., Morrison, J. Bact.,
132:349-351 (1977); Clark-Curtiss & Curtiss, Methods in
Enzymology, 101:347-362 (Wu et al., eds, 1983). For example, any of
the well known procedures for introducing foreign nucleotide
sequences into host cells may be used. These include the use of
calcium phosphate transfection, polybrene, protoplast fusion,
electroporation, liposomes, microinjection, plasma vectors, and
viral vectors (see, e.g., Sambrook et al., supra).
[0095] FGF-1 can be purified to substantial purity by standard
techniques known in the art, including, for example, extraction and
purification from inclusion bodies, size differential filtration,
solubility fractionation (i.e., selective precipitation with such
substances as ammonium sulfate); column chromatography,
immunopurification methods, etc.
[0096] The FGF-1 compound can also be chemically synthesized using
known methods including, e.g., solid phase synthesis (see, e.g.,
Merrifield, J. Am. Chem. Soc., 85:2149-2154 (1963) and Abelson et
al., Methods in Enzymology, Volume 289: Solid-Phase Peptide
Synthesis (1st ed. 1997)). Polypeptide synthesis can be performed
using manual techniques or by automation. Automated synthesis can
be achieved, for example, using Applied Biosystems 431A Peptide
Synthesizer (Perkin Elmer). Alternatively, various fragments of the
polypeptide (and any modified amino acids) can be chemically
synthesized separately and then combined using chemical methods to
produce the full length polypeptide. The sequence and mass of the
polypeptides can be verified by GC mass spectroscopy. Once
synthesized, the polypeptides can be modified, for example, by
N-terminal acetyl- and C-terminal amide-groups as described above.
Synthesized polypeptides can be further isolated by HPLC to a
purity of at least about 80%, preferably 90%, and more preferably
95%.
[0097] The invention further provides methods of inhibiting FGF-1
to induce fatty liver in a food animal, e.g., a bird such as a
duck, goose, quail, etc. The inhibited expression or activity can
be 40%, 50%, 60%, 70%, 80%, 90% or less than that in a untreated or
wild type control. In certain instances, the inhibition is
1.5-fold, 2-fold, 3-fold, 4-fold, 5-fold, 10-fold, or more in
comparison to a control.
[0098] Typically, inhibition of FGF-1 is accompanied by a high fat
diet. In some cases, the method comprises generating a genetically
modified animal with defective FGF-1 activity (e.g., an FGF-1
knockout animal). In some embodiments, FGF-1 is inhibited by
administering an FGF-1 inhibitor to the animal. Typically, the
inhibitor is administered more than once, e.g., on a regular
schedule (daily, weekly, etc.) or with food.
[0099] The FGF-1 inhibitor can be an antisense compound. The term
"antisense" is used herein as a general term referring to RNA
targeting strategies for reducing gene expression. Antisense
includes RNAi, siRNA, shRNA, etc. Typically, the antisense sequence
is identical to the targeted sequence (or a fragment thereof), but
this is not necessary for effective reduction of expression. For
example, the antisense sequence can have 85, 90, 95, 98, or 99%
identity to the complement of a target RNA or fragment thereof. The
targeted fragment can be about 10, 20, 30, 40, 50, 10-50, 20-40,
20-100, 40-200 or more nucleotides in length.
[0100] The term "RNAi" refers to RNA interference strategies of
reducing expression of a targeted gene. RNAi technique employs
genetic constructs within which sense and anti-sense sequences are
placed in regions flanking an intron sequence in proper splicing
orientation with donor and acceptor splicing sites. Alternatively,
spacer sequences of various lengths can be employed to separate
self-complementary regions of sequence in the construct. During
processing of the gene construct transcript, intron sequences are
spliced-out, allowing sense and anti-sense sequences, as well as
splice junction sequences, to bind forming double-stranded RNA.
Select ribonucleases then bind to and cleave the double-stranded
RNA, thereby initiating the cascade of events leading to
degradation of specific mRNA gene sequences, and silencing specific
genes. The phenomenon of RNA interference is described and
discussed in Bass, Nature 411: 428-29 (2001); Elbahir et al.,
Nature 411: 494-98 (2001); and Fire et al., Nature 391: 806-11
(1998); and WO 01/75164, where methods of making interfering RNA
also are discussed.
[0101] The term "siRNA" refers to small interfering RNAs, that are
capable of causing interference with gene expression and can cause
post-transcriptional silencing of specific genes in cells, for
example, mammalian cells (including human cells) and in the body,
for example, in a mammal (including humans). The siRNAs based upon
the sequences and nucleic acids encoding the gene products
disclosed herein typically have fewer than 100 base pairs and can
be, e.g., about 30 bps or shorter, and can be made by approaches
known in the art, including the use of complementary DNA strands or
synthetic approaches. The siRNAs are capable of causing
interference and can cause post-transcriptional silencing of
specific genes in cells, for example, mammalian cells (including
human cells) and in the body, for example, in a mammal (including
humans). Exemplary siRNAs have up to 40 bps, 35 bps, 29 bps, 25
bps, 22 bps, 21 bps, 20 bps, 15 bps, 10 bps, 5 bps or any integer
thereabout or therebetween. Tools for designing optimal inhibitory
siRNAs include that available from DNAengine Inc. (Seattle, Wash.)
and Ambion, Inc. (Austin, Tex.).
[0102] A "short hairpin RNA" or "small hairpin RNA" is a
ribonucleotide sequence forming a hairpin turn which can be used to
silence gene expression. After processing by cellular factors the
short hairpin RNA interacts with a complementary RNA thereby
interfering with the expression of the complementary RNA.
[0103] The FGF-1 inhibitor can also be an antibody that interferes
with FGF-1 signaling, e.g., a FGF-1 specific antibody, or a
functional fragment thereof. An example of an FGF-1 antibody is
described, e.g., in Shi et al. (2011) IUBMB Life 63:129, but
several are commercially available. Antibodies can exist as intact
immunoglobulins or as any of a number of well-characterized
fragments that include specific antigen-binding activity.
Typically, the "variable region" of the antibody contains the
antigen-binding activity, and is most critical in specificity and
affinity of binding. See Paul, Fundamental Immunology (2003). Such
fragments can be produced by digestion with various peptidases.
Pepsin digests an antibody below the disulfide linkages in the
hinge region to produce F(ab)'.sub.2, a dimer of Fab which itself
is a light chain joined to V.sub.H-C.sub.H1 by a disulfide bond.
The F(ab)'.sub.2 may be reduced under mild conditions to break the
disulfide linkage in the hinge region, thereby converting the
F(ab)'.sub.2 dimer into an Fab' monomer. The Fab' monomer is
essentially Fab with part of the hinge region (see Fundamental
Immunology (Paul ed., 3d ed. 1993). While various antibody
fragments are defined in terms of the digestion of an intact
antibody, one of skill will appreciate that such fragments may be
synthesized de novo either chemically or by using recombinant DNA
methodology. The term antibody includes antibody fragments either
produced by the modification of whole antibodies, or those
synthesized de novo using recombinant DNA methodologies (e.g.,
single chain Fv) or those identified using phage display libraries
(see, e.g., McCafferty et al., Nature 348:552-554 (1990)).
[0104] The FGF-1 inhibitor can also be an inhibitor of the FGF-1
signaling pathway, e.g., a MAP kinase pathway inhibitor such as
PD-098059, PD-161570, SU5402, or SB203580.
Iv. Metabolic Disorders Amenable to Treatment with an FGF-1
Compound
[0105] The FGF-1 compound described herein can be used to treat
metabolic disorders, e.g., type 2 diabetes, insulin insensitivity,
glucose intolerance, metabolic syndrome, fatty liver disease,
obesity, and conditions related thereto. Related to the obesity
application, the FGF-1 compound can also be used to reduce
percentage body fat and/or increase the percentage of lean mass in
an individual. Conditions related to the metabolic disorders, that
can also benefit from treatment with and FGF-1 compound include
high blood pressure (hypertension), cardiovascular disease,
hyperglycemia, hyperuricemia, and polycystic ovary syndrome.
[0106] Metabolic syndrome (also known as metabolic syndrome X or
syndrome X) is a combination of medical disorders that increases
the risk of cardiovascular disease. In general, a diagnosis of
metabolic syndrome requires at least three of the following
criteria (see International Diabetes Foundation (IDF) and U.S.
National Cholesterol Education Program (NCEP)): [0107] Central
obesity: waist circumference .gtoreq.40 inches (male), .gtoreq.36
inches (female) [0108] BMI: >30 kg/m.sup.2 [0109] Elevated
triglycerides (dyslipidaemia): >150 mg/dL [0110] Lowered HDL
cholesterol: <40 mg/dL (males), <50 mg/dL (females) [0111]
Raised blood pressure (BP) (hypertension): systolic BP >130 or
diastolic BP >85 mm Hg [0112] Raised fasting plasma glucose
(FPG): >100 mg/dL
[0113] Elevated LDL cholesterol is marked by levels above about
100, about 130, about 160 or about 200 mg/dL. Metabolic syndrome
may also be related to elevated total cholesterol.
[0114] Impaired glucose intolerance is defined as a two-hour
glucose levels (glycemia) of about 140 to about 199 mg/dL (7.8 to
11.0 mmol) on the 75-g oral glucose tolerance test (according to
WHO and ADA). Glycemia of about 200 mg/dl or greater is considered
diabetes mellitus.
[0115] Hyperglycemia, or high blood sugar, can be defined as a
blood glucose level higher than about 7, about 10, about 15, or
about 20 mmol/L.
[0116] Hypoglycemia, or low blood sugar, can be defined as
preprandial blood glucose below about 4 or about 6 mmol/L (72 to
108 mg/dl) or 2-hour postprandial blood glucose below about 5 or
about 8 mmol/L (90 to 144 mg/dl).
[0117] Insulin resistance is defined as a state in which a normal
amount of insulin produces a subnormal biologic response. Insulin
resistance can be measured by the hyperinsulinemic euglycemic clamp
technique, Homeostatic Model Assessment (HOMA), or Quantitative
insulin sensitivity check index (QUICKI).
[0118] Hyperuricemia is an abnormally high level of uric acid in
the blood, e.g., above 360 .mu.mol/L (6 mg/dL) for women and 400
.mu.mol/L (6.8 mg/dL) for men.
[0119] Polycystic ovarian syndrome (PCOS) is associated with
oligoovulation, anovulation, excess androgen, and/or polycystic
ovaries. Metabolic syndrome may also be associated with acanthosis
nigricans.
[0120] Metabolic syndrome may also be associated with a
pro-inflammatory state (e.g., elevated C-reactive protein levels in
the blood, e.g., above 10 mg/L) and microalbuminuria (urinary
albumin excretion ratio .gtoreq.20 mg/min or albumin:creatinine
ratio .gtoreq.30 mg/g).
[0121] In some embodiments, the FGF-1 compound can be used to treat
fatty liver disease or a condition related thereto. The fatty liver
disease can be a method of treating nonalcoholic steatohepatitis
(NASH), nonalcoholic fatty liver disease (NAFLD), simple fatty
liver (steatosis), cirrhosis, hepatitis, liver fibrosis, or
steatonecrosis. Fatty liver disease can be assessed by diagnostic
methods known in the art including liver enzyme tests (ALT, AST),
liver ultrasound, FibroTest.RTM., SteatoTest.RTM., coagulation
studies including international normalized ratio (INR), as well as
blood tests including M30-Apoptosense ELISA, erythrocyte
sedimentation rate, glucose, albumin, and renal function.
[0122] Fatty liver disease may also be associated with a
pro-inflammatory state (e.g., elevated C-reactive protein levels in
the blood, e.g., above 10 mg/L) as well as hepatocellular
carcinoma. Fatty liver disease may also be associated with
abetalipoproteinemia, glycogen storage diseases, Weber-Christian
disease, Wolman disease, acute fatty liver of pregnancy,
lipodystrophy, inflammatory bowel disease, HIV, and hpatitis C
(especially genotype 3), and alpha 1-antitrypsin deficiency.
[0123] In some embodiments, the FGF-1 compound is used to reduce
percentage body fat, increase percentage lean mass, or to treat
obesity (as well as associated conditions). The method can be used
to treat class I obesity, class II obesity, class III obesity,
elevated body weight, elevated body mass index (BMI), elevated body
volume index (BVI), elevated body fat percentage, elevated fat to
muscle ratio, elevated waist circumference, or elevated waist-hip
ratio.
[0124] Class I obesity is characterized by a BMI of about 30 to
about 35, class II obesity (severe obesity) is characterized by a
BMI of about 35 to about 40, and class III obesity (morbid obesity)
is characterized by a BMI of 40 or greater. A BMI of greater than
about 45 or 50 is considered super obese. Elevated body weight can
be assessed in consideration of age, gender, height, frame, and/or
ethnicity.
[0125] Elevated waist-hip ratio is defined as greater than about
0.9 for men and greater than about 0.7 for women.
[0126] Metabolic disorders are inter-related and can result in
disorders across various systems. Addressing the core metabolic
disorder can reduce the severity of related conditions in a
patient, including, e.g.:
[0127] cardiovascular disorders including, e.g., ischemic heart
disease, angina and myocardial infarction, congestive heart
failure, high blood pressure, abnormal cholesterol levels, deep
vein thrombosis, and pulmonary embolism,
[0128] neurological disorders including, e.g., stroke, meralgia
paresthetica, migraines, idiopathic, and intracranial
hypertension,
[0129] depression (especially in women) and social stigmatism,
[0130] rheumatological and orthopedic disorders including, e.g.,
gout, poor mobility, osteoarthritis, and lower back pain,
[0131] dermatological disorders including, e.g., stretch marks,
acanthosis nigricans, lymphedema, cellulitis,
[0132] gastrointestinal disorders including, e.g., gastroesophageal
reflux disease (GERD) and cholelithiasis (gallstones),
[0133] respiratory disorders including, e.g., obstructive sleep
apnea, obesity hypoventilation syndrome, asthma, and increased
complications during general anaesthesia,
[0134] urology and nephrology disorders including, e.g., erectile
dysfunction, urinary incontinence, chronic renal failure, and
hypogonadism.
V. Pharmaceutical Compositions
[0135] The FGF-1 compounds can be used and formulated into any of a
number of pharmaceutical compositions, including those described in
the United States Pharmacopeia (U.S.P.), Goodman and Gilman's The
Pharmacological Basis of Therapeutics, 10.sup.th Ed., McGraw Hill,
2001; Katzung, Ed., Basic and Clinical Pharmacology,
McGraw-Hill/Appleton & Lange, 8.sup.th ed., Sep. 21, 2000;
Physician's Desk Reference (Thomson Publishing; and/or The Merck
Manual of Diagnosis and Therapy, 18.sup.th ed., 2006, Beers and
Berkow, Eds., Merck Publishing Group; or, in the case of animals,
The Merck Veterinary Manual, 9.sup.th ed., Kahn Ed., Merck
Publishing Group, 2005.
[0136] The compositions disclosed herein can be administered by any
means known in the art. For example, compositions may include
administration to a subject intravenously, intradermally,
intraarterially, intraperitoneally, intralesionally,
intracranially, intraarticularly, intraprostaticaly,
intrapleurally, intratracheally, intranasally, intravitreally,
intravaginally, intrarectally, topically, intratumorally,
intramuscularly, intrathecally, subcutaneously, subconjunctival,
intravesicularlly, mucosally, intrapericardially, intraumbilically,
intraocularly, orally, locally, by inhalation, by injection, by
infusion, by continuous infusion, by localized perfusion, via a
catheter, via a lavage, in a creme, or in a lipid composition.
Administration can be local, e.g., to adipose tissue or to the
liver, or systemic.
[0137] Solutions of the active compounds as free base or
pharmacologically acceptable salt can be prepared in water suitably
mixed with a surfactant, such as hydroxypropylcellulose.
Dispersions can also be prepared in glycerol, liquid polyethylene
glycols, and mixtures thereof and in oils. Under ordinary
conditions of storage and use, these preparations can contain a
preservative to prevent the growth of microorganisms.
[0138] For parenteral administration in an aqueous solution, for
example, the solution should be suitably buffered and the liquid
diluent first rendered isotonic with sufficient saline or glucose.
Aqueous solutions, in particular, sterile aqueous media, are
especially suitable for intravenous, intramuscular, subcutaneous
and intraperitoneal administration. For example, one dosage can be
dissolved in 1 ml of isotonic NaCl solution and either added to
1000 ml of hypodermoclysis fluid or injected at the proposed site
of infusion.
[0139] Sterile injectable solutions can be prepared by
incorporating the active compounds or constructs in the required
amount in the appropriate solvent followed by filtered
sterilization. Generally, dispersions are prepared by incorporating
the various sterilized active ingredients into a sterile vehicle
which contains the basic dispersion medium. Vacuum-drying and
freeze-drying techniques, which yield a powder of the active
ingredient plus any additional desired ingredients, can be used to
prepare sterile powders for reconstitution of sterile injectable
solutions. The preparation of more, or highly, concentrated
solutions for direct injection is also contemplated. DMSO can be
used as solvent for extremely rapid penetration, delivering high
concentrations of the active agents to a small area.
[0140] Heparin can interfere with FGF-1 circulation when the FGF-1
compound is not administered intravenously. For non-i.v.
administration, e.g., subcutaneous administration, the FGF-1
compound can be linked to a heparin molecule, or another compound
that interferes with FGF-1 binding to heparin. The FGF-1-heparin
interaction in vivo reduces the amount of circulating FGF-1, and
the duration of the therapeutic effect. Thus, in some embodiments,
the invention provides a pharmaceutical composition comprising an
FGF-1 compound linked to heparin. Diabetes medications are commonly
administered s.c., thus, it can be more convenient to the patient
to receive the FGF-1 compound in the same s.c. composition, or in a
different composition but using a familiar route of
administration.
[0141] Pharmaceutical compositions can be delivered via intranasal
or inhalable solutions or sprays, aerosols or inhalants. Nasal
solutions can be aqueous solutions designed to be administered to
the nasal passages in drops or sprays. Nasal solutions can be
prepared so that they are similar in many respects to nasal
secretions. Thus, the aqueous nasal solutions usually are isotonic
and slightly buffered to maintain a pH of 5.5 to 6.5. In addition,
antimicrobial preservatives, similar to those used in ophthalmic
preparations, and appropriate drug stabilizers, if required, may be
included in the formulation.
[0142] Oral formulations can include excipients as, for example,
pharmaceutical grades of mannitol, lactose, starch, magnesium
stearate, sodium saccharine, cellulose, magnesium carbonate and the
like. These compositions take the form of solutions, suspensions,
tablets, pills, capsules, sustained release formulations or
powders. In some embodiments, oral pharmaceutical compositions will
comprise an inert diluent or assimilable edible carrier, or they
may be enclosed in hard or soft shell gelatin capsule, or they may
be compressed into tablets, or they may be incorporated directly
with the food of the diet. For oral therapeutic administration, the
active compounds may be incorporated with excipients and used in
the form of ingestible tablets, buccal tablets, troches, capsules,
elixirs, suspensions, syrups, wafers, and the like. Such
compositions and preparations should contain at least 0.1% of
active compound. The percentage of the compositions and
preparations may, of course, be varied and may conveniently be
between about 2 to about 75% of the weight of the unit, or
preferably between 25-60%. The amount of active compounds in such
compositions is such that a suitable dosage can be obtained.
[0143] In some embodiments, FGF-1 is administered using a gene
therapy construct, e.g., as described in Nikol et al. (2008) Mol.
Ther. Thus, in some embodiments, an individual is treated for a
metabolic disorder by administering to the individual an expression
vector comprising a sequence that codes for a FGF-1 compound.
Similarly, the methods of inducing fatty liver in an animal can
rely on administration of an expression vector, in this case, an
expression vector encoding an antisense construct specific for
FGF-1.
[0144] In some cases, a polynucleotide encoding FGF-1 is introduced
into a cell in vitro and the cell is subsequently introduced into a
subject. In some cases, the cells are first isolated from the
subject and then re-introduced into the subject after the
polynucleotide is introduced. In some embodiments, FGF-1-encoding
polynucleotides or FGF-1 inhibitory polynucleotides are introduced
directly into cells in the subject in vivo.
[0145] Conventional viral and non-viral based gene transfer methods
can be used to introduce nucleic acids encoding FGF-1 polypeptides
in mammalian cells or target tissues. Such methods can be used to
administer nucleic acids encoding FGF-1 polypeptides, or FGF-1
inhibitory polynucleotides to cells in vitro. In some embodiments,
such polynucleotides are administered for in vivo or ex vivo gene
therapy uses. Non-viral vector delivery systems include DNA
plasmids, naked nucleic acid, and nucleic acid complexed with a
delivery vehicle such as a liposome. Viral vector delivery systems
include DNA and RNA viruses, which have either episomal or
integrated genomes after delivery to the cell. For a review of gene
therapy procedures, see Anderson, Science 256:808-813 (1992); Nabel
& Felgner, TIBTECH 11:211-217 (1993); Mitani & Caskey,
TIBTECH 11:162-166 (1993); Dillon, TIBTECH 11:167-175 (1993);
Miller, Nature 357:455-460 (1992); Van Brunt, Biotechnology
6(10):1149-1154 (1988); Vigne, Restorative Neurology and
Neuroscience 8:35-36 (1995); Kremer & Perricaudet, British
Medical Bulletin 51(1):31-44 (1995); Haddada et al., in Current
Topics in Microbiology and Immunology Doerfler and Bohm (eds)
(1995); and Yu et al., Gene Therapy 1:13-26 (1994).
[0146] Methods of non-viral delivery of nucleic acids encoding
engineered polypeptides of the invention include lipofection,
microinjection, biolistics, virosomes, liposomes, immunoliposomes,
polycation or lipid:nucleic acid conjugates, naked DNA, artificial
virions, and agent-enhanced uptake of DNA. Lipofection is
described, e.g., in U.S. Pat. No. 5,049,386, U.S. Pat. No.
4,946,787; and U.S. Pat. No. 4,897,355, and lipofection reagents
are sold commercially (e.g., Transfectam.TM. and Lipofectin.TM.).
Cationic and neutral lipids that are suitable for efficient
receptor-recognition lipofection of polynucleotides include those
of Felgner, WO 91/17424, WO 91/16024. Delivery can be to cells (ex
vivo administration) or target tissues (in vivo administration).
The preparation of lipid:nucleic acid complexes, including targeted
liposomes such as immunolipid complexes, is well known to one of
skill in the art (see, e.g., Crystal, Science 270:404-410 (1995);
Blaese et al., Cancer Gene Ther. 2:291-297 (1995); Behr et al.,
Bioconjugate Chem. 5:382-389 (1994); Remy et al., Bioconjugate
Chem. 5:647-654 (1994); Gao et al., Gene Therapy 2:710-722 (1995);
Ahmad et al., Cancer Res. 52:4817-4820 (1992); U.S. Pat. Nos.
4,186,183, 4,217,344, 4,235,871, 4,261,975, 4,485,054, 4,501,728,
4,774,085, 4,837,028, and 4,946,787).
[0147] RNA or DNA viral based systems can be used to target the
delivery of polynucleotides carried by the virus to specific cells
in the body and deliver the polynucleotides to the nucleus. Viral
vectors can be administered directly to patients (in vivo) or they
can be used to transfect cells in vitro. In some cases, the
transfected cells are administered to patients (ex vivo).
Conventional viral based systems for the delivery of polypeptides
of the invention could include retroviral, lentivirus, adenoviral,
adeno-associated and herpes simplex virus vectors for gene
transfer. Viral vectors are currently the most efficient and
versatile method of gene transfer in target cells and tissues.
Integration in the host genome is possible with the retrovirus,
lentivirus, and adeno-associated virus gene transfer methods, often
resulting in long term expression of the inserted transgene, and
high transduction efficiencies.
VI. Methods of Treatment
[0148] The invention provides methods of treating, preventing,
and/or ameliorating a metabolic disorder in a subject in need
thereof. The course of treatment is best determined on an
individual basis depending on the particular characteristics of the
subject. The treatment can be administered to the subject on a
daily, twice daily, every other day, bi-weekly, weekly, monthly or
any applicable basis that is therapeutically effective. The
treatment can be administered alone or in combination with at least
one other therapeutic agent, e.g., targeting the same metabolic
disorder or a related symptom. The additional agent can be
administered simultaneously with the FGF-1 compound, at a different
time, or on an entirely different therapeutic schedule (e.g., the
FGF-1 compound can be administered daily, while the additional
agent is weekly).
[0149] The suitability of a particular route of administration will
depend in part on the pharmaceutical composition, its components,
and the disorder being treated. Parenteral administration is often
effective for systemic treatment.
[0150] The dosage of a therapeutic agent administered to a patient
will vary depending on a wide range of factors. For example, it
would be necessary to provide substantially larger doses to humans
than to smaller animals. The dosage will depend upon the size, age,
sex, weight, medical history and condition of the patient, use of
other therapies, the potency of the substance being administered,
and the frequency of administration.
[0151] The dose of the FGF-1 compound can be equivalent to 0.005-1
mg FGF-1 per kg body weight. For example, the dose can be
equivalent to 0.01-0.1, 0.1-0.2, 0.1-0.5. 0.2-0.5, 0.5-0.8. or 0.5
or more mg FGF-1 per kg body weight. One of skill will understand
and be able to adjust to situations where the FGF-1 compound is
smaller (e.g., a functional FGF-1 fragment) or larger (e.g., a
modified FGF-1 polypeptide) than FGF-1.
[0152] Having indicated that there is variability in terms of
dosing, it is believed that those skilled in the art can determine
appropriate dosing by administering relatively small amounts and
monitoring the patient for therapeutic effect. If necessary,
incremental increases in the dose can be made until the desired
results are obtained. Generally, treatment is initiated with
smaller dosages which may be less than the optimum dose of the
therapeutic agent. Thereafter, the dosage is increased by small
increments until the optimum effect under circumstances is reached.
The total daily dosage can be divided and administered in portions
during the day if desired.
[0153] The pharmaceutical preparation can be packaged or prepared
in unit dosage form. In such form, the preparation is subdivided
into unit doses containing appropriate quantities of the active
component, e.g., according to the dose of the therapeutic agent.
The unit dosage form can be a packaged preparation, the package
containing discrete quantities of preparation. The composition can,
if desired, also contain other compatible therapeutic agents.
[0154] In some embodiments, the FGF-1 compound is co-administered
with at least one additional therapeutic agent, e.g., another
therapeutic agent for treating a metabolic disorder, or a
therapeutic agent to address associated symptoms, e.g., a blood
thinner or analgesic. Therapeutic agents commonly used for
metabolic disorders include drugs from the following classes:
alpha-glucosidase inhibitors, amylin agonists, dipeptidyl-peptidase
4 (DPP-4) inhibitors, meglitinides, sulfonylureas and PPAR agonists
such as thiazolidinediones (TZD). The PPAR agonist, e.g.,
PPAR.gamma. agonist, can include, e.g., aleglitazar, farglitazar,
muraglitazar, tesaglitazar, and thiazolidinedione (TZD). Exemplary
TZDs include pioglitazone (Actos.RTM.), rosiglitazone
(Avandia.RTM.), rivoglitazone, and troglitazone (Hauner, Diabetes
Metab Res Rev 18:S10-S15 (2002)).
[0155] Additional complementary active agents, such as biguanides
(e.g., metformin) or sulfonylureas, can also be used in appropriate
circumstances.
[0156] The combination of an FGF-1 compound with another
therapeutic agent can result in a synergistic effect with enhanced
efficacy in the treatment of metabolic disorders such as type 2
diabetes and related conditions. The synergy allows for reduced
dosages of the active agents in combination as compared to the
dosages for either active individually. The reduced dosage can help
reduce any side effects that may appear.
[0157] Accordingly, in combination therapy, the effective amount of
the additional (second) therapeutic agent and the effective amount
of the FGF-1 compound are together effective to reduce the
symptoms/effects of metabolic disorder. In some embodiments, the
combination is an FGF-1 compound and TZD. The FGF/TZD combination
allows for a reduced dose of TZD required for therapeutic treatment
of type 2 diabetes, thereby minimizing the side effects typically
observed with TZD therapy. For example the amount of TZD
administered in combination with the FGF-1 compound is reduced by
about 10%, 20%, 30%, 40%, 50%, 60%, 70%, or to about 80% compared
to the typical dose of TZD utilized in the treatment of type 2
diabetes.
[0158] One of skill in medicine can best determine the appropriate
dose of the additional therapeutic agent by considering the state
of the patient, the recommended dose, the severity of disease, and
the synergistic effect of the FGF compound. For example, the amount
of rosiglitazone can be about 4 mg to about 8 mg per day (e.g.,
about 2 mg, about 4 mg, or about 8 mg per dose). The amount of
pioglitazone can be about 15 mg to about 45 mg per day, e.g., about
30 mg per day.
[0159] The following discussion of the invention is for the
purposes of illustration and description, and is not intended to
limit the invention to the form or forms disclosed herein. Although
the description of the invention has included description of one or
more embodiments and certain variations and modifications, other
variations and modifications are within the scope of the invention,
e.g., as may be within the skill and knowledge of those in the art,
after understanding the present disclosure. All publications,
patents, patent applications, Genbank numbers, and websites cited
herein are hereby incorporated by reference in their entireties for
all purposes.
VII. Examples
Materials and Methods
[0160] Animals.
[0161] The animals that were used were FGF-1.sup.-/- (Miller et
al., 2000), PPAR.gamma..sup.f/f/aP2-Cre mice (He et al., 2003) and
wild-type littermate controls of a >99% C57/B6 genetic
background.
[0162] Ob/ob male mice (8 wks old,
B6.Cg-Lep.sup.obLdlr.sup.tmlHer/J) were from Jackson labs. The
Ob/ob mouse model is an animal model for hyperglycemia, insulin
resistance, and obesity. Male ob/ob mice are used to monitor plasma
glucose levels, lipid levels, etc.
[0163] Animals were kept in a temperature-controlled environment
with a 12-hour light/12-hour dark cycle. They received a standard
diet (MI laboratory rodent diet 5001, Harlan Teklad) or high fat
(60%), high carbohydrate (HFD) diet (F3282, Bio-Serv), and
acidified water ad libitum.
[0164] Cell Culture.
[0165] 3T3-L1 mouse pre-adipocytes were from American Type Culture
Collection (ATCC, Rockville, Md.). Cells were maintained at
sub-confluence in growth medium (GM) containing 10% calf serum in
Dulbecco's modified Eagle's medium (DMEM) at 37.degree. C. and 5%
CO.sub.2. For standard adipocyte differentiation, cells were
stimulated at 2 days post confluency (referred as day 0) with
differentiation medium (DM) containing 10% fetal bovine serum
(FBS), 5 .mu.g/ml insulin, 1 .mu.M dexamethasone, and 0.5 .mu.M
3-isobutyl-1-methylxanthine (IBMX) for 48 hours. Then, the medium
was replaced with DMEM 10% FBS with 5 .mu.g/ml insulin for an
additional 48 hours. Then, the cells were maintained in post
differentiation medium containing 10% FBS. CV-1 cells were used for
luciferase reporter assays. CV-1 cells were cultured in DMEM medium
with 10% fetal bovine serum at 37.degree. C. and 5% CO.sub.2.
[0166] Western Analysis.
[0167] Total cell lysates from tissues were prepared as described.
Western blotting was performed as described using polyclonal goat
anti-human FGF-1 (C-19) antibody (1:200, Santa Cruz), anti-AKT
(1:1000, Cell Signaling Technology, 9272), monoclonal rabbit
anti-GSK3b (1:1000, Cell Signaling Technology, 9315), and
polyclonal rabbit anti-p44/42 MAPK (1:1000, Cell Signaling
Technology, 9102). Antibody binding was detected using
peroxidase-conjugated donkey anti-goat IgG (1:5000, Santa
Cruz).
[0168] Serum Analysis.
[0169] Blood was collected by tail bleeding either in the ad
libitum fed state or following overnight fasting. Free fatty acids
(Wako), triglycerides (Thermo), and cholesterol (Thermo) were
measured using enzymatic colorimetric methods following the
manufacturer's instructions. Serum insulin levels were measured
using an Ultra Sensitive Insulin ELISA kit (Crystal Chem). Serum
adiponectin levels were measured by ELISA (Millipore). Plasma
adipokine levels were measured using a Milliplex.TM. MAP kit
(Millipore).
[0170] Histological Analysis and Immunohistochemistry.
[0171] Tissues were fixed in 4% phosphate-buffered formalin,
embedded in paraffin, sectioned at 4 .mu.m, and stained with
hematoxylin and eosin according to standard procedures. For
immunohistochemistry, tissues were deparaffinized in xylene and
rehydrated. Slides were incubated with 5% normal donkey serum in
PBS (+0.2% Triton-X100 and 1% BSA) for 30 min, and subsequently
sections were incubated overnight with a 1:200 dilution of primary
antibodies at 4.degree. C. and using Alexa Fluor 488 or 595 as
secondary antibodies for 2 hrs at RT.
[0172] Metabolic Studies.
[0173] Glucose tolerance tests (GTT) were conducted after overnight
fasting. Mice were injected intraperitoneally (i.p.) with 1 g of
glucose per/kg body weight, and blood glucose was monitored at 0,
15, 30, 60, 90, and 120 min using a OneTouch Ultra glucometer
(Lifescan Inc). Insulin tolerance tests (ITT) were conducted after
overnight fasting. Mice were injected i.p. with 0.5 U of insulin/kg
body weight (Humulin R; Eli Lilly), and blood glucose was monitored
at 0, 15, 30, 60, 90, and 120 min using a OneTouch Ultra glucometer
(Lifescan Inc). Real-time metabolic analyses were conducted in an
undisturbed room under 12 h/12 h light/dark cycles using a
Comprehensive Lab Animal Monitoring System (Columbus
Instruments).
[0174] In Example 5, ob/ob male mice (8 wk old) were randomized
into three groups and treated with daily subcutaneous (s.c.)
injections of recombinant mouse FGF-1 (0.5 mg/kg in PBS), oral
rosiglitazone (TZD, 5 mg/kg in 0.5% carboxymethyl cellulose), or
vehicle. Blood glucose levels were measure in fed animals one hour
after treatment. Total body composition analysis was performed
using an EchoMRI-100.TM. (Echo Medical Systems, LLC).
[0175] Gene Expression Analysis.
[0176] Total RNA was isolated from mouse tissue and cells using
TRIzol reagent (Invitrogen). cDNA was synthesized from 1 .mu.g of
DNase-treated total RNA using SuperScript II reverse transcriptase
(Invitrogen). mRNA levels were quantified by QPCR with SYBR Green
(Invitrogen). Samples were run in technical triplicates, and
relative mRNA levels were calculated by using the standard curve
methodology and normalized against 36B4 mRNA levels in the same
samples.
[0177] Statistical Analysis.
[0178] All values are given as means.+-.standard errors. The
two-tailed unpaired Student's t-test was used to assess the
significance of difference between two sets of data. Differences
were considered to be statistically significant when P<0.05.
Example 1
Identification of FGF-1 as a Direct Target of PPAR.gamma.
[0179] To identify nuclear hormone receptor (NHR) targets, we used
a "Promoter Ontology" screen, which encompasses a validated cDNA
expression library including all 49 mouse NHRs combinatorially
paired with a large collection of pathway specific
promoter-reporter libraries. The pairing facilitates rapid
evaluation of the transcriptional regulation of each genetic
pathway by any NHR in a given context. Using this high-throughput
promoter screen, we screened promoter constructs for members of the
FGF family for regulation by the NHRs, and identified FGF-1 as a
direct target of PPAR.gamma.. More specifically, we identified
strong and specific transcriptional regulation of FGF-1 by
PPAR.gamma..
[0180] FGF-1A Promoter Characterization.
[0181] The expression of the FGF-1 gene is directed by at least
three distinct promoters driving the untranslated exons: 1A, 1B,
and 1D, spaced up to 70 kilobase pairs apart (FIG. 1A) (Myers et
al., 1993). Alternative splicing of these untranslated exons to the
three coding exons of the FGF-1 gene results in identical but
differentially expressed FGF-1 polypeptides. In mice, FGF-1A shows
the highest expression in heart and kidney but is also expressed in
adipose and several other tissues (FIG. 1B). FGF-1B is the only
variant expressed in brain, and is also expressed in several other
tissues (FIG. 1C). FGF-1D is primarily expressed in liver (FIG.
1D).
[0182] The transcriptional regulation of FGF-1 by PPAR.gamma. was
mediated through binding of PPAR.gamma. to a PPAR response element
(PPRE) located in one of the alternative promoters of FGF-1, named
FGF-1A (FIG. 2A). Inactivation of the PPRE in the FGF-1A promoter
(located at -60 bp relative to the transcription start site (TSS))
by site directed mutagenesis resulted in a complete loss of
response of the FGF-1A promoter to PPAR.gamma. (FIG. 2F, compare
human vs. .DELTA.PPRE).
[0183] The gene structure of FGF-1 is highly conserved in a wide
range of mammals (e.g., bovine, canine, horse, chimpanzee,
orangutan, rat, mouse, and opossum). The PPRE in the FGF-1A
promoter in these species also showed strong conservation (FIG. 2D,
E). To test the responsiveness of these PPREs to PPAR.gamma., we
changed the PPRE of the human FGF-1 promoter by site directed
mutagenesis into the PPRE sequence of species that displayed
sequence variation (rat, canine, horse, and opossum). PPAR.gamma.
activation of the promoter was retained in all species except for
the more distantly related canine and opossum (FIG. 2F). Together,
these findings suggest a physiologically important function of
regulation of the FGF-1A promoter by PPAR.gamma., present in a wide
range of mammals. In addition to a strong conservation of the PPRE
in this promoter, several other highly conserved elements were
detected (e.g., SP1, HMTB, EVIL, and E-box).
[0184] The role of PPAR.gamma. in FGF-1 expression was confirmed in
mature adipose cells. FIG. 21 shows the results of quantitative
PCR, demonstrating that PPAR.gamma. specifically binds the FGF1
promoter region. 36b4 is a negative control locus that does not
include PPAR.gamma.binding sites.
[0185] FGF-1 is Regulated by PPAR.gamma. in vivo.
[0186] Short term oral administration of rosiglitazone (5 mg/kg for
3 days) or high-fat diet (two weeks) significantly increased the
mRNA levels of FGF-1A in WAT (FIG. 3A, D). This increase was
similar to that of the adipocyte protein aP2 (also known as fatty
acid binding protein 4, FABP4), which is the strongest known
PPAR.gamma. target in adipose tissue. On the other hand, overnight
fasting resulted in an about two-fold decrease in FGF-1A mRNA
levels. For comparison, levels of FGF-21 were highly induced in the
liver by fasting and HFD (FIG. 3B, E) whereas no effects of
rosiglitazone or HFD were observed in WAT (FIG. 3C, F).
Interestingly, rosiglitazone also reduced the expression of FGF-21
in fasted liver (FIG. 3B), which is also observed in patients with
type 2 diabetes (Li et al., 2009). No changes in expression by TZD,
HFD, or fasting were observed for FGF-1B and FGF-1D in liver, and
for FGF-1B in WAT. FGF-1A and FGF-1D were not detected in liver and
WAT, respectively. HFD treatment for 3 months in mice also resulted
in increased protein levels of FGF-1 (FIG. 3G).
Example 2
FGF-1 Protects Against HFD-Induced Insulin Resistance
[0187] Next, we determined the consequences of loss of FGF-1 in
vivo, using FGF-1 knockout (KO) mice. FGF-1 KO mice have been
studied in the context of wound healing and cardiovascular changes.
Neither these mice, nor FGF-1/FGF2 double KO mice, displayed any
significant phenotype under normal feeding conditions (Miller et
al., 2000). To study the role of PPAR.gamma.-mediated regulation of
FGF-1, FGF-1 KO and wild-type littermates were fed a high fat diet
(HFD). Although no difference in HFD-induced weight gain was
observed (FIG. 4A), FGF-1 KO mice had smaller WAT and larger,
steatotic livers, suggesting that FGF-1 KO mice fail to increase
their adipose mass and alternatively mobilize fat into the liver
(FIG. 4B, C). At the same time, FGF-1 KO mice displayed increased
fasting levels of glucose and insulin and increased insulin
resistance compared to wild-type littermates as demonstrated by
glucose- and insulin-tolerance tests (GTT, ITT), respectively
(Tables 1 and 2, FIG. 4 D-F). No obvious abnormalities were
observed in pancreas function as indicated by normal islet
morphology, histology, and glucose-stimulated insulin secretion.
The number of islets per pancreas, however, was slightly increased
(FIG. 4H).
TABLE-US-00001 TABLE 1 Metabolic parameters of male wild-type and
FGF-1.sup.-/- mice after 3 months high fat diet feeding. wild-type
FGF-1.sup.-/- Insulin 0.32 .+-. 0.12 0.50 .+-. 0.34 ng/ml Glucose
103 .+-. 21 119 .+-. 24 mg/dl Leptin 6.3 .+-. 2.0 6.7 .+-. 1.2
ng/ml Resistin 5.4 .+-. 1.4 5.6 .+-. 1.4 ng/ml IL-6 12.4 .+-. 3.6
13.9 .+-. 11.0 pg/ml TNF.alpha. 8.7 .+-. 1.2 8.1 .+-. 0.7 pg/ml
MCP-1 48.0 .+-. 3.4 59.0 .+-. 3.4** pg/ml tPAI-1 0.58 .+-. 0.68
0.33 .+-. 0.33 ng/ml Body weight 39.9 .+-. 2.8 40.9 .+-. 2.8 g
Results are expressed as mean serum concentrations after an
overnight fast .+-.SD, n = 6; nd, *P < 0.05.
TABLE-US-00002 TABLE 2 Metabolic parameters of male wild-type and
FGF-1.sup.-/- mice after 5 months high fat diet feeding. wild-type
FGF-1.sup.-/- Insulin (fast) 2.7 .+-. 0.9 3.7 .+-. 0.4* ng/ml
Glucose (fast) 159 .+-. 17 183 .+-. 29* mg/dl Adiponectin (fast)
12.9 .+-. 1.2 13.7 .+-. 1.8 .mu.g/ml Total cholesterol (fed) 46.6
.+-. 12.3 44.6 .+-. 6.6 mg/dl Total cholesterol (fast) 49.2 .+-.
17.5 50.4 .+-. 3.1 mg/dl Free Fatty Acids (fed) 0.13 .+-. 0.02 0.11
.+-. 0.04 ng/ml Free Fatty Acids (fast) 0.20 .+-. 0.01 0.19 .+-.
0.02 ng/ml Triglycerides (fed) 16.88 .+-. 2.3 16.1 .+-. 1.9 mg/dl
Triglycerides (fast) 11.2 .+-. 1.5 10.2 .+-. 0.9 mg/dl Body weight
(BW) 46 .+-. 2.4 47 .+-. 1.2 g Liver weight 1.9 .+-. 0.3 2.4 .+-.
0.3* g Liver % 4.1 .+-. 0.5 5.1 .+-. 0.5* % BW WAT weight 1.9 .+-.
0.3 1.3 .+-. 0.1* g WAT % 4.4 .+-. 0.9 2.8 .+-. 0.2* % BW Kidney
weight 486 .+-. 30 463 .+-. 45 mg Heart weight 209 .+-. 12 196 .+-.
9 mg Results are expressed as mean serum concentrations or weights
.+-.SD, n = 5; nd, *P < 0.05.
Example 3
AKT Signaling is Impaired in WAT of HFD-fed FGF-1 KO Mice
[0188] FGFs signal through four cognate high-affinity tyrosine
kinase receptors, designated FGFR-1 to -4, leading to downstream
activation of multiple signal transduction pathways, including the
MAPK (ERK1/2) and PI3K/AKT pathways. These pathways regulate
components of the insulin/glucose signaling pathways including
activation of glycogen synthase kinase-3 (GSK-3), which regulates
glycogen synthesis in response to insulin, and translocation of the
glucose transporter GLUT4 (Cho et al., 2001). To investigate the
integrity of these signaling pathways, we determined the expression
of its critical components in WAT, BAT, liver, and muscle of
HFD-fed FGF-1 KO and wild-type mice (FIG. 5). Interestingly, we
found that total levels of AKT (and to a lesser extent GSK3(3) were
reduced in WAT of HFD-treated FGF-1 KO mice compared to WT mice. In
contrast, levels of AKT were normal in liver, BAT, or muscle, and
levels of ERK1/2 were normal in all four tissues.
Example 4
FGF-1 Induces GLUT1 In Vitro
[0189] FGF-1 induces the expression of GLUT1 and acts
synergistically with rosiglitazone in 3T3-L1 adipocytes. FGF-1
induces the expression of Glucose Transporter 1 (Glutl) in mouse
3T3-L1 adipocytes after prolonged treatment (FIG. 6), and it
decreases fed blood glucose in ob/ob mice. The results indicate
that FGF-1 can be used as a therapy for treating diabetes and
obesity.
Example 5
FGF-1 has Hypoglycemic Effects In Vivo
[0190] Eight-week-old male ob/ob mice were treated with recombinant
mouse FGF-1 (0.5 mg/kg/day, s.c. in 250 .mu.l), rosiglitazone (TZD,
5 mg/kg/day, p.o. in 300 .mu.l), or vehicle control (s.c. vehicle
control 0.9% NaCl, 250 .mu.l/mouse; p.o. vehicle control 0.5% CMC,
300 .mu.l/mouse). Blood glucose was measured one hour after
treatment at day 3 and day 6 using a standard protocol. (FIG.
7A).
[0191] Before treatment, all groups were severely hyperglycemic, as
indicated by blood glucose levels of about 400 mg/dl. At day three,
both FGF-1-treated and TZD-treated groups exhibited greatly reduced
blood glucose levels, about 200 mg/dl. At 6 days, blood glucose
levels were even further reduced to around 130-140 mg/dl for both
groups. After the sixth dose, blood glucose levels were monitored
for another 72 hrs. During this period, both FGF-1- and TZD-treated
cohorts maintained normoglycemic levels (<140 mg/dl) for at
least 48 hrs (FIG. 7B). At 72 hrs after the sixth dose, a final
dose was given, and 12 hrs later, a total body composition analysis
was performed by MRI followed by necropsy.
[0192] The results show that FGF-1 is selectively induced in
adipose tissue by high-fat diet (HFD) and TZD, and mice lacking
FGF-1 develop HFD-induced insulin resistance (1R). At the molecular
level, the IR of these mice can be explained by impaired AKT
signaling in adipose. Administration of FGF-1 to diabetic mice
normalizes their glucose levels and improves their fat-lean ratio.
Thus, FGF-1 acts as a powerful insulin sensitizer in adipose tissue
and mediates insulin sensitizing actions of TZDs and
PPAR.gamma..
Example 6
FGF-1 Rapidly and Dramatically Reduces Glucose Levels in ob/ob
Diabetic Mice
[0193] In order to establish the acute effects of FGF-1 on blood
glucose levels, dose response curves (FIG. 8) and time courses
after subcutaneous (FIG. 9) and intravenous (FIG. 10)
administration were performed. The results show that FGF-1 causes
dramatic dose-dependent reduction of glucose levels in ob/ob mice.
Subcutaneous dosing is effective within a matter of hours, and the
significant reduction in glucose levels lasts at least 2 days (FIG.
9). FIG. 10 shows that intravenous administration results in an
even longer lasting effect on glucose levels, so that a dose of 0.2
mg/kg body weight resulted in significantly reduced blood glucose
for at least one week.
Example 7
Chronic Administration of FGF-1 Results in Normalized Blood Glucose
Levels
[0194] To investigate the metabolic effects of chronic FGF-1
treatment in ob/ob mice, eight weeks old male ob/ob mice were
treated with vehicle or recombinant mouse FGF-1 (0.5 mg/kg/3 days,
s.c.) for a period of 36 days. During this time, glucose levels,
food intake, and body composition were monitored. FIG. 11 shows
that glucose levels are normalized by the first time point tested
(day 2) and remain stable for the remainder of the test period.
Example 8
Administration of FGF-1 Results in Reduced Body Weight and Percent
Body Fat
[0195] FIG. 12 shows that FGF-1 administration initially results in
reduced food intake of ob/ob mice. Food intake returns to normal
within about 2 weeks, but as shown in FIG. 13, body weight in FGF-1
treated ob/ob mice remains lower than in untreated ob/ob mice. The
reduction in body weight shown in FIG. 13 indicates that FGF-1 can
be used to produce rapid and durable body weight reduction.
[0196] FIGS. 14 and 15 compare percent body fat and percent lean
mass in FGF-1 treated and untreated ob/ob mice. The results
indicate that the reduction in body weight is largely due to
reduced percentage body fat. The relative percentage of lean mass
in FGF-1 treated mice is significantly higher than in untreated
mice (FIG. 15).
Example 9
FGF-1 Results in Improved Glucose Tolerance and Reduced Insulin
Resistance
[0197] FIG. 16 shows the results of a glucose tolerance test
carried out after four weeks of FGF-1 administration (0.5 mg/kg/3
days, s.c.). FGF-1 treated ob/ob mice cleared glucose more
effectively than untreated controls. FGF-1 treated mice also showed
increased insulin sensitivity, as indicated by more rapid clearance
of glucose in the ITT (FIG. 17). Serum lipid levels (triglycerides,
free fatty acids, and cholesterol) were similar between the two
groups (FIG. 18). These tests were carried out as described
above.
Example 10
FGF-1 Reduces Fatty Liver in ob/ob Mice
[0198] Analysis of liver tissue after the 36 day treatment period
revealed that the livers of FGF-1 treated ob/ob mice were much
healthier than their untreated counterparts. FIG. 19 shows H&E
stained tissue from untreated (A) and treated (B) mice. The
untreated liver displays significant steatosis (fat deposit and
damage), while the liver from FGF-1 treated mice shows much less
steatosis, and little if any inflammation. Moreover, liver glycogen
levels were much higher in FGF-1 treated mice, which is indicative
of proper glucose processing and insulin response (FIG. 20).
Example 11
Multiple Delivery Methods of FGF-1 are Effective for Reducing Blood
Glucose
[0199] To determine if the effects of FGF-1 depend on the route of
administration, we tested blood glucose levels of ob/ob mice in
response to 0.5 mg/kg body weight FGF-1 delivered s.c., i.p. and
i.v. PBS injections were used as controls. FIG. 22 shows that the
acute effects of FGF-1 are about the same for all three injection
methods. We next compared i.v. and s.c. injections for duration of
the glucose normalizing effect. As shown in FIG. 23, FGF-1
administered intravenously resulted in stable glucose levels for
the duration of the test, at least 60 hours. The data from FIG. 10
indicate that the effects of intravenous injection are indeed much
longer lasting (at least one week).
Example 12
FGF-1 is Effective for Normalizing Glucose in Other Diabetic
Models
[0200] The ob/ob model is considered to represent a very severe
diabetic disease. In order to investigate the effect of FGF-1 on
less severe diabetic/metabolic disorder models, we tested blood
glucose levels in db/db mice and diet induced obese mice. FIGS. 24
and 25 show that subcutaneous administration of 0.5 mg/kg FGF-1 was
effective for reducing blood glucose levels in both systems. The
data indicate that FGF-1 can be used to normalize glucose levels
and treat metabolic disorders arising from different causes.
Example 13
Human Recombinant FGF-1 Effectively Reduces Glucose Levels in ob/ob
Mice
[0201] FIG. 26 shows that the same dose of hrFGF-1 administered
s.c. can effectively reduce glucose levels in ob/ob mice. As human
recombinant FGF-1 is already being used in the clinic, the present
methods of using it to treat metabolic disorders offer a
straightforward regulatory path to treatment.
Example 14
Glucose Reducing Effects are Specific to FGF-1
[0202] As explained above, the FGF family of factors bind to
members of the FGFR family of receptors with different
specificities. FGF-1 binds preferentially to FGFR1 and FGFR4, and
can be internalized into a cell expressing these receptors. To
determine if other FGF proteins have similar metabolic effects as
FGF-1, we tested blood glucose in ob/ob mice treated with FGF-2,
FGF-9, and FGF-10 (0.5 mg/kg s.c.). This combination of FGF
proteins binds to the spectrum of FGFRs. The results shown in FIG.
27 demonstrate that the particular receptor binding and signaling
properties of FGF-1 are required for the observed metabolic
effects.
Sequence CWU 1
1
17188DNABos primigenius 1ataactgtcc tttcacctgg cagctgtcca
gccctcaaat agctcttgtg tttggtccaa 60aaataagatc acatgagaag gggagaaa
88287DNACanis lupus familiaris 2acaccggtcc tttcgcctgg cagctgtcca
gcccccaaat agcttttgtg tccattccaa 60aaataagatc acatgagagg ggagaaa
87388DNAEquus ferus caballus 3agaactgccc tttcacctgg cagctctcca
gcccgcaaat agcttttgtg tccagtccaa 60aaataagatc acatgaaagg gggagaaa
88488DNAPan troglodytes 4atcattgtcc tttcacctgg cagctgtcca
gcccccaaat agcttttgtg tccagtccaa 60aaataagatc acatgagagg gggagaaa
88588DNAHomo sapiens 5atcactgtcc tttcacctgg cagctgtcca gcccccaaat
agcttttgtg tccagtccaa 60aaataagatc acatgagagg gggagaaa
88688DNAPongo pygmaeus 6atcattgtcc tttcacctgg cagctgtcca gcccccaaat
agcttttgtg tccagtccaa 60aaataagatc acatgagagg gggagaaa
88784DNARattus norvegicus 7atatttagcc tttcacctgg cagctatcca
gcccccaaat agcctgcgtg tctaatccaa 60aaataaatca catgagagga aaaa
84884DNAMus musculus 8atatttgtcc tttcacctgg cagctgtcca gcccccaaat
agcctgcgtg tctaatccaa 60aaataaatca cacgagaggg gaaa
84986DNADidelphis virginiana 9atgtttgtcc ttttatctgg ctgatttcca
gcccccaaat agctcttatg tctactccaa 60aaataagatc acatgaaggg gaaaaa
861013DNAArtificial sequenceSynthetic polynucleotide 10aggtcaaagg
tca 131113DNAHomo sapiens 11aggtgaaagg aca 131213DNAMus musculus
12aggtgaaagg aca 131313DNARattus norvegicus 13aggtgaaagg cta
131413DNACanis lupus familiaris 14aggcgaaagg acc 131513DNAEquus
ferus caballus 15aggtgaaagg gca 131613DNADidelphis virginiana
16agataaaagg aca 131713DNAArtificial sequenceSynthetic
polynucleotide 17aggtgaaatt taa 13
* * * * *