U.S. patent application number 14/415269 was filed with the patent office on 2015-07-02 for methods for preventing and treating chronic kidney disease (ckd).
The applicant listed for this patent is ASSISTANCE PUBLIQUE - HOPITAUX DE PARIS, INDIANA UNIVERSITY RESEARCH AND TECHNOLOGY CORPORATION, INSERM (INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICALE). Invention is credited to Christos Chatziantoniou, Simon J. Conway, Jean-Claude Dussole.
Application Number | 20150184155 14/415269 |
Document ID | / |
Family ID | 49948316 |
Filed Date | 2015-07-02 |
United States Patent
Application |
20150184155 |
Kind Code |
A1 |
Chatziantoniou; Christos ;
et al. |
July 2, 2015 |
METHODS FOR PREVENTING AND TREATING CHRONIC KIDNEY DISEASE
(CKD)
Abstract
The present invention relates to methods for preventing and
treating chronic kidney disease (CKD).
Inventors: |
Chatziantoniou; Christos;
(Paris, FR) ; Dussole; Jean-Claude; (Paris,
FR) ; Conway; Simon J.; (Indianapolis, IN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
INSERM (INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE
MEDICALE)
ASSISTANCE PUBLIQUE - HOPITAUX DE PARIS
INDIANA UNIVERSITY RESEARCH AND TECHNOLOGY CORPORATION |
Paris
Paris
Indianapolis |
IN |
FR
FR
US |
|
|
Family ID: |
49948316 |
Appl. No.: |
14/415269 |
Filed: |
July 18, 2013 |
PCT Filed: |
July 18, 2013 |
PCT NO: |
PCT/EP2013/065152 |
371 Date: |
January 16, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61679211 |
Aug 3, 2012 |
|
|
|
Current U.S.
Class: |
424/172.1 ;
514/44A; 514/44R |
Current CPC
Class: |
A61P 13/02 20180101;
A61P 29/00 20180101; C12N 15/115 20130101; C07K 16/18 20130101;
C12N 2310/315 20130101; C12N 15/1138 20130101; C12N 2310/11
20130101; A61P 3/10 20180101; A61P 9/10 20180101; A61P 13/12
20180101; A61P 43/00 20180101; A61P 9/12 20180101; A61P 9/14
20180101; C07K 2317/76 20130101; A61P 37/06 20180101; C12N 15/113
20130101; C12N 2310/16 20130101 |
International
Class: |
C12N 15/113 20060101
C12N015/113; C12N 15/115 20060101 C12N015/115; C07K 16/18 20060101
C07K016/18 |
Foreign Application Data
Date |
Code |
Application Number |
Jul 18, 2012 |
EP |
12305869.5 |
Claims
1. A method of preventing or treating chronic kidney disease (CKD)
in a subject in need thereof, comprising administering to the
subject an agent which binds to periostin, wherein said agent is
selected from the group consisting of antibodies, aptamers, small
organic molecules and polypeptides or an inhibitor of periostin
gene expression.
2. The method according to claim 1, wherein said agent is an
anti-periostin neutralizing antibody or aptamer.
3. (canceled)
4. The method according to claim 1, wherein said inhibitor of
periostin gene expression is selected from the group consisting of
a small inhibitory RNA (siRNA), a ribozyme, and an antisense
oligonucleotide.
5. The method according to claim 1, wherein the subject in need
thereof is suffering from a disease selected from the group
consisting of nephropathy, glomerulonephritis, interstitial
nephritis, lupus nephritis, idiopathic nephrotic syndrome (INS),
obstructive uropathy, polycystic kidney disease, cardiovascular
disease, hypertension, diabetes, and kidney graft rejection.
6. A pharmaceutical composition for use in the prevention or
treatment of CKD comprising an agent which binds to periostin,
wherein said agent is selected from the group consisting of
antibodies, aptamers, small organic molecules and polypeptides or
an inhibitor of periostin gene expression, wherein said inhibitor
is selected from the group consisting of a small inhibitory RNA
(siRNA), a ribozyme, and an antisense oligonucleotide; and a
pharmaceutically acceptable carrier.
7. The method of claim 5, wherein said nephropathy is selected from
the group consisting of membranous nephropathy (MN), diabetic
nephropathy and hypertensive nephropathy.
8. The method of claim 5, wherein said glomerulonephritis is
selected from the group consisting of membranous
glomerulonephritis, membranoproliferative glomerulonephritis (MPGN)
and rapidly progressive glomerulonephritis (RPGN).
9. The method of claim 5, wherein said INS is selected from the
group consisting of minimal change nephrotic syndrome (MCNS) and
focal segmental glomerulosclerosis (FSGS).
10. The method of claim 5, wherein said polycystic kidney disease
is selected from the group consisting of Autosomal Dominant
Polycystic Kidney Disease (ADPKD) and Autosomal Recessive
Polycystic Kidney Disease (ARPKD).
11. The method of claim 5, wherein said kidney graft rejection
disease is selected from the group consisting of acute kidney
rejection and chronic kidney rejection.
12. The method according to claim 3, wherein the subject in need
thereof is suffering from a disease selected from the group
consisting of nephropathy, glomerulonephritis, interstitial
nephritis, lupus nephritis, idiopathic nephrotic syndrome (INS),
obstructive uropathy, polycystic kidney disease, cardiovascular
disease, hypertension, diabetes, and kidney graft rejection.
13. The method of claim 12, wherein said nephropathy is selected
from the group consisting of membranous nephropathy (MN), diabetic
nephropathy and hypertensive nephropathy.
14. The method of claim 12, wherein said glomerulonephritis is
selected from the group consisting of membranous
glomerulonephritis, membranoproliferative glomerulonephritis (MPGN)
and rapidly progressive glomerulonephritis (RPGN).
15. The method of claim 12, wherein said INS is selected from the
group consisting of minimal change nephrotic syndrome (MCNS) and
focal segmental glomerulosclerosis (FSGS).
16. The method of claim 12, wherein said polycystic kidney disease
is selected from the group consisting of Autosomal Dominant
Polycystic Kidney Disease (ADPKD) and Autosomal Recessive
Polycystic Kidney Disease (ARPKD).
17. The method of claim 12, wherein said kidney graft rejection
disease is selected from the group consisting of acute kidney
rejection and chronic kidney rejection.
Description
FIELD OF THE INVENTION
[0001] The present invention relates to methods for preventing and
treating chronic kidney disease (CKD).
BACKGROUND OF THE INVENTION
[0002] Chronic Kidney Disease (CKD) can result from different
causes, but the final pathway remains renal fibrosis characterized
by chronic inflammation leading to abnormal accumulation of
extracellular matrix (ECM). This fibrotic process leading to a
decrease in the number of functioning nephrons is still not clear
and constitutes the key of CKD progression. Thus, new insights into
the pathophysiological mechanisms of renal fibrogenesis will guide
us to a more efficient therapy. The amount of ECM is regulated by
the balance between protein synthesis and degradation and it's
particularly important during embryonic development and
pathological states. While fibrogenesis mechanisms have been the
subject of ongoing studies, attention has become focused on ECM
proteins, due to their importance not only as components of
fibrosis, but also as active regulators of tissue remodeling via
cell-matrix signaling. In light of the foregoing, a need in the art
exists for identifying a factor liable to be responsible for
progression of renal fibrosis and therefore for the progression of
CKD so as to envisage new tools for the treatment of such a
disease.
[0003] Periostin (POSTN) also called Osteoblast-Specific Factor 2
(OSF-2) is a 90 kDa extracellular protein expressed during
development and in very early postnatal tissue; its expression in
healthy adult tissues is very low but increases considerably
following injury.
[0004] Periostin expression has previously been shown to be
significantly increased by both transforming growth factor beta-1
(TGFbeta1) and bone morphogenetic protein (BMP-2). Many studies in
the heart showed that periostin is secreted by fibroblasts and
regulates collagen deposition, thereby altering mechanical
properties of connective tissues. When periostin was knocked out,
animals showed reduced fibrosis after myocardial infarction. This
matricellular protein has also the ability to associate to other
ECM components as tenascin, fibronectin and to interact with
integrins such as avb3 avbv, resulting in activation of Akt or PI3
kinase pathways. Recently, periostin was described in a wild range
of pathologies (cancers, asthma . . . ) but little is known about
periostin in the kidney, and its potential role in the progression
of chronic kidney disease. To date, periostin was described in
human autosomal dominant polycystic kidney and was shown to be de
novo expressed in cyst epithelial cells (Wallace et al. 2008).
Another study described gene expression profiles of several
matricellular proteins on biopsies from patients with
glomerulopathies and renal dysfunction; it showed that periostin
was highly induced in tubuloibterstitial and fibrotic compartments
and negatively correlated with renal function. Recently, periostin
was identified in hypertensive nephropathy induced by L-NAME as an
indicator of CKD progression and regression (Guerrot et al. 2012).
It was indeed shown that periostin expression correlates with
functional markers of kidney disease (plasma creatinine,
proteinuria, renal blood flow) and that its localization was
associated with perivascular fibrotic areas, hallmark of
experimental hypertensive nephropathy. Interestingly, periostin was
overexpressed in human kidney disease and was found in the injured
fibrotic tubulointerstitial regions of chronic allograft
nephropathy. Together, these results indicate that periostin is a
good marker of progression and probably regression of renal
fibrosis. These studies however, did not address the issue whether
or not periostin participates in the development of renal fibrosis
and CKD.
SUMMARY OF THE INVENTION
[0005] The present invention relates to an agent which binds to
periostin selected from the group consisting of antibodies,
aptamers, small organic molecules and polypeptides for use in the
prevention or treatment of chronic kidney disease (CKD) in a
subject in need thereof.
[0006] The present invention also relates to an inhibitor of
periostin gene expression for use in the prevention or the
treatment of a CKD in a subject in need thereof.
[0007] The present invention further relates to an agent which
binds to periostin selected from the group consisting of
antibodies, aptamers, small organic molecules and polypeptides or
an inhibitor of periostin gene expression for preventing or
reducing renal fibrosis.
DETAILED DESCRIPTION OF THE INVENTION
[0008] The inventors focused on the implication of periostin in the
establishment of renal fibrosis. To this end, they investigated its
role and mechanisms in experimental tubulointerstitial nephropathy;
therefore they performed unilateral ureteral obstruction model
(UUO) on wild-type (WT) and periostin knock-out (KO) mice, and
showed that mice lacking periostin are protected against the
development of renal fibrosis and renal disease.
[0009] Then, the inventors showed that administration of an
inhibitor of periostin gene inhibitor (i.e. an antisense
oligonucleotide) in a hypertensive nephropathy rat model
(L-NAME-treated rats) is also useful for protecting them against
the development of renal fibrosis and renal disease. Together,
these data provide initial evidence that periostin can be a
promising target against CKD progression.
[0010] Accordingly, a first object of the present invention relates
to an agent which binds to periostin selected from the group
consisting of antibodies, aptamers, small organic molecules, and
polypeptides for use in the prevention or treatment of chronic
kidney disease (CKD) in a subject in need thereof.
[0011] As used herein, the term "periostin" is intended to
encompass all synonyms including, but not limited to, "osteoblast
specific factor 2", "OSF-2" or "POSTN", and includes naturally
occurring periostin as well as variants thereof.
[0012] The term "periostin protein" refers to the periostin protein
of 834 amino acids provided in the GenPept database under accession
number NP.sub.--006466.
[0013] As used herein, the term "prevention" refers to preventing
the disease or condition from occurring in a subject which has not
yet been diagnosed as having it.
[0014] As used herein, the term "treatment" refers to inhibiting
the disease or condition, i.e. arresting its development; relieving
the disease or condition, i.e. causing regression of the condition;
or relieving the conditions caused by the disease, i.e. symptoms of
the disease.
[0015] As used herein, the term "chronic kidney disease" (CKD)
refers to a progressive loss in renal function over a period of
months or years. CKD has its general meaning in the art and is used
to classify numerous conditions that affect the kidney, destruction
of the renal parenchyma and the loss of functional nephrons or
glomeruli. It should be further noted that CKD can result from
different causes, but the final pathway remains renal fibrosis.
Examples of etiology of CKD include, but are not limited to,
cardiovascular diseases, hypertension, diabetes,
glomerulonephritis, polycystic kidney diseases, and kidney graft
rejection.
[0016] As used herein, the terms "renal fibrosis" or "renal
fibrogenesis" refer to a pathologic mechanism characterized by a
chronic inflammation leading to abnormal accumulation of
extracellular matrix (ECM) (e.g. qualitative and quantitative
changes in the composition of tubular basement membranes (TBMs),
interstitial matrix, tubular atrophy, and the accumulation of
myofibroblasts. This fibrotic process leading to a decrease in the
number of functioning nephrons is still not clear and constitutes
the key of CKD progression.
[0017] More precisely, Kidney Disease Improving Global Outcomes
(KDIGO) developed and published for the first time a system for the
definition and classification of stages of CKD. Thus, CKD has been
defined according to the criteria listed in according to the KDOQI
CKD classification Table 11 (on the basis of reduction of
glomerular filtration rate (GFR) in combination with signs of
kidney damage) as reproduced in Table 1 below):
TABLE-US-00001 TABLE 1 Definition of Chronic Kidney Disease
Criteria 1. Kidney damage for .gtoreq.3 months, as defined by
structural or functional abnormalities of the kidney, with or
without decreased GFR, manifest by either: Pathological
abnormalities; or Markers of kidney damage, including abnormalities
in the composition of the blood or urine, or abnormalities in
imaging tests 2. GFR <60 mL/min/1.73 m.sup.2 for .gtoreq.3
months, with or without kidney damage Methods to estimate GFR are
disuse in Guideline 4. Markers of kidney damage are discussed in
Guidelines 5-6.
[0018] A "subject" in the context of the present invention is a
human (male or female). Typically said subject has been previously
diagnosed with a disease leading to CKD.
[0019] In one embodiment, the patient in need thereof is suffering
from a disease selected from the group consisting of nephropathy
(e.g. membranous nephropathy (MN), diabetic nephropathy and
hypertensive nephropathy), glomerulonephritis (e.g. membranous
glomerulonephritis and membranoproliferative glomerulonephritis
(MPGN) such as rapidly progressive glomerulonephritis (RPGN)),
interstitial nephritis, lupus nephritis, idiopathic nephrotic
syndrome (INS) (e.g. minimal change nephrotic syndrome (MCNS) and
focal segmental glomerulosclerosis (FSGS)), obstructive uropathy,
polycystic kidney disease (e.g. Autosomal Dominant Polycystic
Kidney Disease (ADPKD) and Autosomal Recessive Polycystic Kidney
Disease (ARPKD)), cardiovascular diseases, hypertension, diabetes,
and kidney graft rejection (e.g. acute and chronic kidney
rejection).
[0020] In one embodiment, the agent is an antibody or a portion
thereof. In one embodiment of the antibodies or portions thereof
described herein, the antibody is a monoclonal antibody. In one
embodiment of the antibodies or portions thereof described herein,
the antibody is a polyclonal antibody. In one embodiment of the
antibodies or portions thereof described herein, the antibody is a
humanized antibody. In one embodiment of the antibodies or portions
thereof described herein, the antibody is a chimeric antibody. In
one embodiment of the antibodies or portions thereof described
herein, the portion of the antibody comprises a light chain of the
antibody. In one embodiment of the antibodies or portions thereof
described herein, the portion of the antibody comprises a heavy
chain of the antibody. In one embodiment of the antibodies or
portions thereof described herein, the portion of the antibody
comprises a Fab portion of the antibody. In one embodiment of the
antibodies or portions thereof described herein, the portion of the
antibody comprises a F(ab')2 portion of the antibody. In one
embodiment of the antibodies or portions thereof described herein,
the portion of the antibody comprises a Fc portion of the antibody.
In one embodiment of the antibodies or portions thereof described
herein, the portion of the antibody comprises a Fv portion of the
antibody. In one embodiment of the antibodies or portions thereof
described herein, the portion of the antibody comprises a variable
domain of the antibody. In one embodiment of the antibodies or
portions thereof described herein, the portion of the antibody
comprises one or more CDR domains of the antibody.
[0021] As used herein, "antibody" includes both naturally occurring
and non-naturally occurring antibodies. Specifically, "antibody"
includes polyclonal and monoclonal antibodies, and monovalent and
divalent fragments thereof. Furthermore, "antibody" includes
chimeric antibodies, wholly synthetic antibodies, single chain
antibodies, and fragments thereof. The antibody may be a human or
nonhuman antibody. A nonhuman antibody may be humanized by
recombinant methods to reduce its immunogenicity in man.
[0022] Antibodies are prepared according to conventional
methodology. Monoclonal antibodies may be generated using the
method of Kohler and Milstein (Nature, 256:495, 1975). To prepare
monoclonal antibodies useful in the invention, a mouse or other
appropriate host animal is immunized at suitable intervals (e.g.,
twice-weekly, weekly, twice-monthly or monthly) with antigenic
forms of periostin. The animal may be administered a final "boost"
of antigen within one week of sacrifice. It is often desirable to
use an immunologic adjuvant during immunization. Suitable
immunologic adjuvants include Freund's complete adjuvant, Freund's
incomplete adjuvant, alum, Ribi adjuvant, Hunter's Titermax,
saponin adjuvants such as QS21 or Quil A, or CpG-containing
immunostimulatory oligonucleotides. Other suitable adjuvants are
well-known in the field. The animals may be immunized by
subcutaneous, intraperitoneal, intramuscular, intravenous,
intranasal or other routes. A given animal may be immunized with
multiple forms of the antigen by multiple routes.
[0023] Briefly, the recombinant periostin may be provided by
expression with recombinant cell lines. Recombinant form of
periostin may be provided using any previously described method.
Following the immunization regimen, lymphocytes are isolated from
the spleen, lymph node or other organ of the animal and fused with
a suitable myeloma cell line using an agent such as polyethylene
glycol to form a hydridoma. Following fusion, cells are placed in
media permissive for growth of hybridomas but not the fusion
partners using standard methods, as described (Coding, Monoclonal
Antibodies: Principles and Practice: Production and Application of
Monoclonal Antibodies in Cell Biology, Biochemistry and Immunology,
3rd edition, Academic Press, New York, 1996). Following culture of
the hybridomas, cell supernatants are analyzed for the presence of
antibodies of the desired specificity, i.e., that selectively bind
the antigen. Suitable analytical techniques include ELISA, flow
cytometry, immunoprecipitation, and western blotting. Other
screening techniques are well-known in the field. Preferred
techniques are those that confirm binding of antibodies to
conformationally intact, natively folded antigen, such as
non-denaturing ELISA, flow cytometry, and immunoprecipitation.
[0024] Significantly, as is well-known in the art, only a small
portion of an antibody molecule, the paratope, is involved in the
binding of the antibody to its epitope (see, in general, Clark, W.
R. (1986) The Experimental Foundations of Modern Immunology Wiley
& Sons, Inc., New York; Roitt, I. (1991) Essential Immunology,
7th Ed., Blackwell Scientific Publications, Oxford). The Fc' and Fc
regions, for example, are effectors of the complement cascade but
are not involved in antigen binding. An antibody from which the
pFc' region has been enzymatically cleaved, or which has been
produced without the pFc' region, designated an F(ab')2 fragment,
retains both of the antigen binding sites of an intact antibody.
Similarly, an antibody from which the Fc region has been
enzymatically cleaved, or which has been produced without the Fc
region, designated an Fab fragment, retains one of the antigen
binding sites of an intact antibody molecule. Proceeding further,
Fab fragments consist of a covalently bound antibody light chain
and a portion of the antibody heavy chain denoted Fd. The Fd
fragments are the major determinant of antibody specificity (a
single Fd fragment may be associated with up to ten different light
chains without altering antibody specificity) and Fd fragments
retain epitope-binding ability in isolation.
[0025] Within the antigen-binding portion of an antibody, as is
well-known in the art, there are complementarity determining
regions (CDRs), which directly interact with the epitope of the
antigen, and framework regions (FRs), which maintain the tertiary
structure of the paratope (see, in general, Clark, 1986; Roitt,
1991). In both the heavy chain Fd fragment and the light chain of
IgG immunoglobulins, there are four framework regions (FR1 through
FR4) separated respectively by three complementarity determining
regions (CDR1 through CDRS). The CDRs, and in particular the CDRS
regions, and more particularly the heavy chain CDRS, are largely
responsible for antibody specificity.
[0026] It is now well-established in the art that the non CDR
regions of a mammalian antibody may be replaced with similar
regions of conspecific or heterospecific antibodies while retaining
the epitopic specificity of the original antibody. This is most
clearly manifested in the development and use of "humanized"
antibodies in which non-human CDRs are covalently joined to human
FR and/or Fc/pFc' regions to produce a functional antibody.
[0027] This invention provides in certain embodiments compositions
and methods that include humanized forms of antibodies. As used
herein, "humanized" describes antibodies wherein some, most or all
of the amino acids outside the CDR regions are replaced with
corresponding amino acids derived from human immunoglobulin
molecules. Methods of humanization include, but are not limited to,
those described in U.S. Pat. Nos. 4,816,567, 5,225,539, 5,585,089,
5,693,761, 5,693,762 and 5,859,205, which are hereby incorporated
by reference. The above U.S. Pat. Nos. 5,585,089 and 5,693,761, and
WO 90/07861 also propose four possible criteria which may used in
designing the humanized antibodies. The first proposal was that for
an acceptor, use a framework from a particular human immunoglobulin
that is unusually homologous to the donor immunoglobulin to be
humanized, or use a consensus framework from many human antibodies.
The second proposal was that if an amino acid in the framework of
the human immunoglobulin is unusual and the donor amino acid at
that position is typical for human sequences, then the donor amino
acid rather than the acceptor may be selected. The third proposal
was that in the positions immediately adjacent to the 3 CDRs in the
humanized immunoglobulin chain, the donor amino acid rather than
the acceptor amino acid may be selected. The fourth proposal was to
use the donor amino acid reside at the framework positions at which
the amino acid is predicted to have a side chain atom within 3 A of
the CDRs in a three dimensional model of the antibody and is
predicted to be capable of interacting with the CDRs. The above
methods are merely illustrative of some of the methods that one
skilled in the art could employ to make humanized antibodies. One
of ordinary skill in the art will be familiar with other methods
for antibody humanization.
[0028] In one embodiment of the humanized forms of the antibodies,
some, most or all of the amino acids outside the CDR regions have
been replaced with amino acids from human immunoglobulin molecules
but where some, most or all amino acids within one or more CDR
regions are unchanged. Small additions, deletions, insertions,
substitutions or modifications of amino acids are permissible as
long as they would not abrogate the ability of the antibody to bind
a given antigen. Suitable human immunoglobulin molecules would
include IgG1, IgG2, IgG3, IgG4, IgA and IgM molecules. A
"humanized" antibody retains a similar antigenic specificity as the
original antibody. However, using certain methods of humanization,
the affinity and/or specificity of binding of the antibody may be
increased using methods of "directed evolution", as described by Wu
et al., J. Mol. Biol. 294:151, 1999, the contents of which are
incorporated herein by reference.
[0029] Fully human monoclonal antibodies also can be prepared by
immunizing mice transgenic for large portions of human
immunoglobulin heavy and light chain loci. See, e.g., U.S. Pat.
Nos. 5,591,669, 5,598,369, 5,545,806, 5,545,807, 6,150,584, and
references cited therein, the contents of which are incorporated
herein by reference. These animals have been genetically modified
such that there is a functional deletion in the production of
endogenous (e.g., murine) antibodies. The animals are further
modified to contain all or a portion of the human germ-line
immunoglobulin gene locus such that immunization of these animals
will result in the production of fully human antibodies to the
antigen of interest. Following immunization of these mice (e.g.,
XenoMouse (Abgenix), HuMAb mice (Medarex/GenPharm)), monoclonal
antibodies can be prepared according to standard hybridoma
technology. These monoclonal antibodies will have human
immunoglobulin amino acid sequences and therefore will not provoke
human anti-mouse antibody (KAMA) responses when administered to
humans.
[0030] In vitro methods also exist for producing human antibodies.
These include phage display technology (U.S. Pat. Nos. 5,565,332
and 5,573,905) and in vitro stimulation of human B cells (U.S. Pat.
Nos. 5,229,275 and 5,567,610). The contents of these patents are
incorporated herein by reference.
[0031] Thus, as will be apparent to one of ordinary skill in the
art, the present invention also provides for F(ab') 2 Fab, Fv and
Fd fragments; chimeric antibodies in which the Fc and/or FR and/or
CDR1 and/or CDR2 and/or light chain CDR3 regions have been replaced
by homologous human or non-human sequences; chimeric F(ab')2
fragment antibodies in which the FR and/or CDR1 and/or CDR2 and/or
light chain CDR3 regions have been replaced by homologous human or
non-human sequences; chimeric Fab fragment antibodies in which the
FR and/or CDR1 and/or CDR2 and/or light chain CDR3 regions have
been replaced by homologous human or non-human sequences; and
chimeric Fd fragment antibodies in which the FR and/or CDR1 and/or
CDR2 regions have been replaced by homologous human or non-human
sequences. The present invention also includes so-called single
chain antibodies.
[0032] The various antibody molecules and fragments may derive from
any of the commonly known immunoglobulin classes, including but not
limited to IgA, secretory IgA, IgE, IgG and IgM. IgG subclasses are
also well known to those in the art and include but are not limited
to human IgG1, IgG2, IgG3 and IgG4.
[0033] In another embodiment, the antibody according to the
invention is a single domain antibody. The term "single domain
antibody" (sdAb) or "VHH" refers to the single heavy chain variable
domain of antibodies of the type that can be found in Camelid
mammals which are naturally devoid of light chains. Such VHH are
also called "Nanobody.RTM.". According to the invention, sdAb can
particularly be llama sdAb.
[0034] Then, for this invention, once antibodies which bind to
periostin have been obtained, neutralizing antibodies of periostin
are selected. Accordingly, in a particular embodiment, the antibody
which binds to periostin is a neutralizing anti-periostin antibody
(i.e. an antibody which blocks the activity of periostin leading to
the prevention of renal fibrosis and excessive accumulation of
extracellular matrix (ECM) in the kidney.
[0035] An example of neutralizing antibody (MZ-1) has been
described in Zhu et al., 20011 which is incorporated herein by
reference.
[0036] Methods for obtaining neutralizing anti-periostin antibodies
are well known from the skilled man in the art as those disclosed
in the patent application EP1978034.
[0037] In another embodiment, the agent is an aptamer. Aptamers are
a class of molecule that represents an alternative to antibodies in
term of molecular recognition. Aptamers are oligonucleotide or
oligopeptide sequences with the capacity to recognize virtually any
class of target molecules with high affinity and specificity. Such
ligands may be isolated through Systematic Evolution of Ligands by
EXponential enrichment (SELEX) of a random sequence library, as
described in Tuerk C. and Gold L., 1990. The random sequence
library is obtainable by combinatorial chemical synthesis of DNA.
In this library, each member is a linear oligomer, eventually
chemically modified, of a unique sequence. Possible modifications,
uses and advantages of this class of molecules have been reviewed
in Jayasena S. D., 1999. Peptide aptamers consists of a
conformationally constrained antibody variable region displayed by
a platform protein, such as E. coli Thioredoxin A that are selected
from combinatorial libraries by two hybrid methods (Colas et al.,
1996).
[0038] Then, for this invention, neutralizing aptamers of periostin
are selected.
[0039] In another embodiment, the agent is a polypeptide. In a
particular embodiment the polypeptide is a functional equivalent of
an extracellular matrix protein or an adhesion receptor which is
capable of binding to periostin. As used herein, "an extracellular
matrix protein" is a protein selected from the group consisting of
fibronectin, tenascin-C, collagens (e.g. type I and V collagen). As
used herein, "an adhesion receptor is a receptor selected from the
group consisting of integrins (e.g. .alpha.v.beta.3,
.alpha.v.beta.5 and .alpha.6.beta.4).
[0040] As used herein, a "functional equivalent of an extracellular
matrix protein or an adhesion receptor" is a compound which is
capable of binding to periostin. The term "functional equivalent"
includes fragments, mutants, and muteins of an extracellular matrix
protein or an adhesion receptor. The term "functionally equivalent"
thus includes any equivalent of an extracellular matrix protein or
an adhesion receptor obtained by altering the amino acid sequence,
for example by one or more amino acid deletions, substitutions or
additions such that the protein analogue retains the ability to
bind to periostin. Amino acid substitutions may be made, for
example, by point mutation of the DNA encoding the amino acid
sequence. Preferably, the functional equivalent is at least 80%
homologous to the corresponding protein. In a preferred embodiment,
the functional equivalent is at least 90% homologous as assessed by
any conventional analysis algorithm such as for example, the Pileup
sequence analysis software (Program Manual for the Wisconsin
Package, 1996). It is envisaged that such molecules will be useful
for the prevention or treatment of CKD since these molecules will
bind specifically to periostin, and thus prevent renal fibrosis
induced by periostin and finally prevent or treat CKD. As used
herein, "binding specifically" means that the functionally
equivalent analogue has high affinity for periostin but not for
control proteins. Specific binding may be measured by a number of
techniques such as ELISA, flow cytometry, western blotting, or
immunoprecipitation. Preferably, the functionally equivalent
analogue specifically binds to periostin at nanomolar or picomolar
levels.
[0041] The polypeptides of the invention may be produced by any
suitable means, as will be apparent to those of skill in the art.
In order to produce sufficient amounts of an extracellular matrix
protein, an adhesion receptor or functional equivalents thereof for
use in accordance with the present invention, expression may
conveniently be achieved by culturing under appropriate conditions
recombinant host cells containing the polypeptide of the invention.
Preferably, the polypeptide is produced by recombinant means, by
expression from an encoding nucleic acid molecule. Systems for
cloning and expression of a polypeptide in a variety of different
host cells are well known.
[0042] When expressed in recombinant form, the polypeptide is
preferably generated by expression from an encoding nucleic acid in
a host cell. Any host cell may be used, depending upon the
individual requirements of a particular system. Suitable host cells
include bacteria mammalian cells, plant cells, yeast and
baculovirus systems. Mammalian cell lines available in the art for
expression of a heterologous polypeptide include Chinese hamster
ovary cells. HeLa cells, baby hamster kidney cells and many others.
Bacteria are also preferred hosts for the production of recombinant
protein, due to the ease with which bacteria may be manipulated and
grown. A common, preferred bacterial host is E coli.
[0043] In specific embodiments, it is contemplated that
polypeptides used in the therapeutic methods of the present
invention may be modified in order to improve their therapeutic
efficacy. Such modification of therapeutic compounds may be used to
decrease toxicity, increase circulatory time, or modify
biodistribution. For example, the toxicity of potentially important
therapeutic compounds can be decreased significantly by combination
with a variety of drug carrier vehicles that modify
biodistribution. In example adding dipeptides can improve the
penetration of a circulating agent in the eye through the blood
retinal barrier by using endogenous transporters.
[0044] A strategy for improving drug viability is the utilization
of water-soluble polymers. Various water-soluble polymers have been
shown to modify biodistribution, improve the mode of cellular
uptake, change the permeability through physiological barriers; and
modify the rate of clearance from the body. To achieve either a
targeting or sustained-release effect, water-soluble polymers have
been synthesized that contain drug moieties as terminal groups, as
part of the backbone, or as pendent groups on the polymer
chain.
[0045] Polyethylene glycol (PEG) has been widely used as a drug
carrier, given its high degree of biocompatibility and ease of
modification. Attachment to various drugs, proteins, and liposomes
has been shown to improve residence time and decrease toxicity. PEG
can be coupled to active agents through the hydroxyl groups at the
ends of the chain and via other chemical methods; however, PEG
itself is limited to at most two active agents per molecule. In a
different approach, copolymers of PEG and amino acids were explored
as novel biomaterials which would retain the biocompatibility
properties of PEG, but which would have the added advantage of
numerous attachment points per molecule (providing greater drug
loading), and which could be synthetically designed to suit a
variety of applications.
[0046] Those of skill in the art are aware of PEGylation techniques
for the effective modification of drugs. For example, drug delivery
polymers that consist of alternating polymers of PEG and
tri-functional monomers such as lysine have been used by VectraMed
(Plainsboro, N.J.). The PEG chains (typically 2000 daltons or less)
are linked to the a- and e-amino groups of lysine through stable
urethane linkages. Such copolymers retain the desirable properties
of PEG, while providing reactive pendent groups (the carboxylic
acid groups of lysine) at strictly controlled and predetermined
intervals along the polymer chain. The reactive pendent groups can
be used for derivatization, cross-linking, or conjugation with
other molecules. These polymers are useful in producing stable,
long-circulating pro-drugs by varying the molecular weight of the
polymer, the molecular weight of the PEG segments, and the
cleavable linkage between the drug and the polymer. The molecular
weight of the PEG segments affects the spacing of the drug/linking
group complex and the amount of drug per molecular weight of
conjugate (smaller PEG segments provides greater drug loading). In
general, increasing the overall molecular weight of the block
co-polymer conjugate will increase the circulatory half-life of the
conjugate. Nevertheless, the conjugate must either be readily
degradable or have a molecular weight below the threshold-limiting
glomular filtration (e.g., less than 60 kDa).
[0047] In addition, to the polymer backbone being important in
maintaining circulatory half-life, and biodistribution, linkers may
be used to maintain the therapeutic agent in a pro-drug form until
released from the backbone polymer by a specific trigger, typically
enzyme activity in the targeted tissue. For example, this type of
tissue activated drug delivery is particularly useful where
delivery to a specific site of biodistribution is required and the
therapeutic agent is released at or near the site of pathology.
Linking group libraries for use in activated drug delivery are
known to those of skill in the art and may be based on enzyme
kinetics, prevalence of active enzyme, and cleavage specificity of
the selected disease-specific enzymes. Such linkers may be used in
modifying the protein or fragment of the protein described herein
for therapeutic delivery.
[0048] The present invention further relates to an agent which
binds to periostin selected from the group consisting of
antibodies, aptamers, small organic molecules and polypeptides for
preventing or reducing renal fibrosis.
[0049] Another object of the present invention relates to an
inhibitor of periostin gene expression for use in the prevention or
the treatment of a CKD in a subject in need thereof.
[0050] An "inhibitor of expression" refers to a natural or
synthetic compound that has a biological effect to inhibit the
expression of a gene. Therefore, an "inhibitor of periostin gene
expression" denotes a natural or synthetic compound that has a
biological effect to inhibit the expression of periostin gene.
[0051] In a preferred embodiment of the invention, said inhibitor
of periostin gene expression is a siRNA, an antisense
oligonucleotide or a ribozyme.
[0052] Inhibitors of periostin gene expression for use in the
present invention may be based on antisense oligonucleotide
constructs. Anti-sense oligonucleotides, including anti-sense RNA
molecules and anti-sense DNA molecules, would act to directly block
the translation of periostin mRNA by binding thereto and thus
preventing protein translation or increasing mRNA degradation, thus
decreasing the level of periostin, and thus activity, in a cell.
For example, antisense oligonucleotides of at least about 15 bases
and complementary to unique regions of the mRNA transcript sequence
encoding periostin can be synthesized, e.g., by conventional
phosphodiester techniques and administered by e.g., intravenous
injection or infusion. Methods for using antisense techniques for
specifically inhibiting gene expression of genes whose sequence is
known are well known in the art (e.g. see U.S. Pat. Nos. 6,566,135;
6,566,131; 6,365,354; 6,410,323; 6,107,091; 6,046,321; and
5,981,732).
[0053] It should be further noted that antisense oligonucleotides
may be modified with phosphorothioate to prevent their in vivo
hydrolysis by nucleases. Such modifications are' well known from
the skilled man in the art.
[0054] In one embodiment, the sequence of the anti-sense
oligonucleotide targeting periostin is represented by SEQ ID NO:
1.
[0055] In one embodiment, the sequence of the anti-sense
oligonucleotide targeting periostin is represented by SEQ ID NO:
2.
[0056] Small inhibitory RNAs (siRNAs) can also function as
inhibitors of periostin gene expression for use in the present
invention. periostin gene expression can be reduced by contacting
the tumor, subject or cell with a small double stranded RNA
(dsRNA), or a vector or construct causing the production of a small
double stranded RNA, such that periostin gene expression is
specifically inhibited (i.e. RNA interference or RNAi). Methods for
selecting an appropriate dsRNA or dsRNA-encoding vector are well
known in the art for genes whose sequence is known (e.g. see
Tuschi, T. et al. (1999); Elbashir, S. M. et al. (2001); Hannon, G
J. (2002); McManus, M T. et al. (2002); Brummelkamp, T R. et al.
(2002); U.S. Pat. Nos. 6,573,099 and 6,506,559; and International
Patent Publication Nos. WO 01/36646, WO 99/32619, and WO
01/68836).
[0057] Ribozymes can also function as inhibitors of periostin gene
expression for use in the present invention. Ribozymes are
enzymatic RNA molecules capable of catalyzing the specific cleavage
of RNA. The mechanism of ribozyme action involves sequence specific
hybridization of the ribozyme molecule to complementary target RNA,
followed by endonucleolytic cleavage. Engineered hairpin or
hammerhead motif ribozyme molecules that specifically and
efficiently catalyze endonucleolytic cleavage of periostin mRNA
sequences are thereby useful within the scope of the present
invention. Specific ribozyme cleavage sites within any potential
RNA target are initially identified by scanning the target molecule
for ribozyme cleavage sites, which typically include the following
sequences, GUA, GUU, and GUC. Once identified, short RNA sequences
of between about 15 and 20 ribonucleotides corresponding to the
region of the target gene containing the cleavage site can be
evaluated for predicted structural features, such as secondary
structure, that can render the oligonucleotide sequence unsuitable.
The suitability of candidate targets can also be evaluated by
testing their accessibility to hybridization with complementary
oligonucleotides, using, e.g., ribonuclease protection assays.
[0058] Both antisense oligonucleotides and ribozymes useful as
inhibitors of periostin gene expression can be prepared by known
methods. These include techniques for chemical synthesis such as,
e.g., by solid phase phosphoramadite chemical synthesis.
Alternatively, anti-sense RNA molecules can be generated by in
vitro or in vivo transcription of DNA sequences encoding the RNA
molecule. Such DNA sequences can be incorporated into a wide
variety of vectors that incorporate suitable RNA polymerase
promoters such as the T7 or SP6 polymerase promoters. Various
modifications to the oligonucleotides of the invention can be
introduced as a means of increasing intracellular stability and
half-life. Possible modifications include but are not limited to
the addition of flanking sequences of ribonucleotides or
deoxyribonucleotides to the 5' and/or 3' ends of the molecule, or
the use of phosphorothioate or 2'-O-methyl rather than
phosphodiesterase linkages within the oligonucleotide backbone.
[0059] Antisense oligonucleotides siRNAs and ribozymes of the
invention may be delivered in vivo alone or in association with a
vector. In its broadest sense, a "vector" is any vehicle capable of
facilitating the transfer of the antisense oligonucleotide siRNA or
ribozyme nucleic acid to the cells and preferably cells expressing
periostin. Preferably, the vector transports the nucleic acid to
cells with reduced degradation relative to the extent of
degradation that would result in the absence of the vector. In
general, the vectors useful in the invention include, but are not
limited to, plasmids, phagemids, viruses, other vehicles derived
from viral or bacterial sources that have been manipulated by the
insertion or incorporation of the the antisense oligonucleotide
siRNA or ribozyme nucleic acid sequences. Viral vectors are a
preferred type of vector and include, but are not limited to
nucleic acid sequences from the following viruses: retrovirus, such
as moloney murine leukemia virus, harvey murine sarcoma virus,
murine mammary tumor virus, and rouse sarcoma virus; adenovirus,
adeno-associated virus; SV40-type viruses; polyoma viruses;
Epstein-Barr viruses; papilloma viruses; herpes virus; vaccinia
virus; polio virus; and RNA virus such as a retrovirus. One can
readily employ other vectors not named but known to the art.
[0060] Preferred viral vectors are based on non-cytopathic
eukaryotic viruses in which non-essential genes have been replaced
with the gene of interest. Non-cytopathic viruses include
retroviruses (e.g., lentivirus), the life cycle of which involves
reverse transcription of genomic viral RNA into DNA with subsequent
proviral integration into host cellular DNA. Retroviruses have been
approved for human gene therapy trials. Most useful are those
retroviruses that are replication-deficient (i.e., capable of
directing synthesis of the desired proteins, but incapable of
manufacturing an infectious particle). Such genetically altered
retroviral expression vectors have general utility for the
high-efficiency transduction of genes in vivo. Standard protocols
for producing replication-deficient retroviruses (including the
steps of incorporation of exogenous genetic material into a
plasmid, transfection of a packaging cell lined with plasmid,
production of recombinant retroviruses by the packaging cell line,
collection of viral particles from tissue culture media, and
infection of the target cells with viral particles) are provided in
KRIEGLER (A Laboratory Manual," W.H. Freeman C.O., New York, 1990)
and in MURRY ("Methods in Molecular Biology," vol. 7, Humana Press,
Inc., Chiffon, N.J., 1991).
[0061] Preferred viruses for certain applications are the
adeno-viruses and adeno-associated viruses, which are
double-stranded DNA viruses that have already been approved for
human use in gene therapy. The adeno-associated virus can be
engineered to be replication deficient and is capable of infecting
a wide range of cell types and species. It further has advantages
such as, heat and lipid solvent stability; high transduction
frequencies in cells of diverse lineages, including hemopoietic
cells; and lack of superinfection inhibition thus allowing multiple
series of transductions. Reportedly, the adeno-associated virus can
integrate into human cellular DNA in a site-specific manner,
thereby minimizing the possibility of insertional mutagenesis and
variability of inserted gene expression characteristic of
retroviral infection. In addition, wild-type adeno-associated virus
infections have been followed in tissue culture for greater than
100 passages in the absence of selective pressure, implying that
the adeno-associated virus genomic integration is a relatively
stable event. The adeno-associated virus can also function in an
extrachromosomal fashion.
[0062] Other vectors include plasmid vectors. Plasmid vectors have
been extensively described in the art and are well known to those
of skill in the art. See e.g., SANBROOK et al., "Molecular Cloning:
A Laboratory Manual," Second Edition, Cold Spring Harbor Laboratory
Press, 1989. In the last few years, plasmid vectors have been used
as DNA vaccines for delivering antigen-encoding genes to cells in
vivo. They are particularly advantageous for this because they do
not have the same safety concerns as with many of the viral
vectors. These plasmids, however, having a promoter compatible with
the host cell, can express a peptide from a gene operatively
encoded within the plasmid. Some commonly used plasmids include
pBR322, pUC18, pUC19, pRC/CMV, SV40, and pBlueScript. Other
plasmids are well known to those of ordinary skill in the art.
Additionally, plasmids may be custom designed using restriction
enzymes and ligation reactions to remove and add specific fragments
of DNA. Plasmids may be delivered by a variety of parenteral,
mucosal and topical routes. For example, the DNA plasmid can be
injected by intramuscular, intradermal, subcutaneous, or other
routes. It may also be administered by intranasal sprays or drops,
rectal suppository and orally. It may also be administered into the
epidermis or a mucosal surface using a gene-gun. The plasmids may
be given in an aqueous solution, dried onto gold particles or in
association with another DNA delivery system including but not
limited to liposomes, dendrimers, cochleate and
microencapsulation.
[0063] The present invention further relates to an inhibitor of
periostin gene expression for preventing or reducing renal
fibrosis.
[0064] Another object of the invention relates to a method for the
prevention or treatment of CKD comprising a step of administering a
therapeutically effective amount of at least one agent which binds
to periostin selected from the group consisting of antibodies,
aptamers, small organic molecules and polypeptides or an inhibitor
of periostin gene expression to a subject in need thereof.
[0065] Another object of the invention relates to a method for
preventing or reducing renal fibrosis comprising a step of
administering a therapeutically effective amount of at least one
agent which binds to periostin selected from the group consisting
of antibodies, aptamers, small organic molecules and polypeptides
or an inhibitor of periostin gene expression to a subject in need
thereof.
[0066] By a "therapeutically effective amount" of the agent or
inhibitor of periostin gene expression as above described is meant
a sufficient amount of the agent or inhibitor to prevent or treat
CKD. It will be understood, however, that the total daily usage of
the compounds and compositions of the present invention will be
decided by the attending physician within the scope of sound
medical judgment. The specific therapeutically effective dose level
for any particular subject will depend upon a variety of factors
including the disorder being treated and the severity of the
disorder; activity of the specific compound employed; the specific
composition employed, the age, body weight, general health, sex and
diet of the subject; the time of administration, route of
administration, and rate of excretion of the specific compound
employed; the duration of the treatment; drugs used in combination
or coincidential with the specific polypeptide employed; and like
factors well known in the medical arts. For example, it is well
within the skill of the art to start doses of the compound at
levels lower than those required to achieve the desired therapeutic
effect and to gradually increase the dosage until the desired
effect is achieved. However, the daily dosage of the products may
be varied over a wide range from 0.01 to 1,000 mg per adult per
day. Preferably, the compositions contain 0.01, 0.05, 0.1, 0.5,
1.0, 2.5, 5.0, 10.0, 15.0, 25.0, 50.0, 100, 250 and 500 mg of the
active ingredient for the symptomatic adjustment of the dosage to
the subject to be treated. A medicament typically contains from
about 0.01 mg to about 500 mg of the active ingredient, preferably
from 1 mg to about 100 mg of the active ingredient. An effective
amount of the drug is ordinarily supplied at a dosage level from
0.0002 mg/kg to about 20 mg/kg of body weight per day, especially
from about 0.001 mg/kg to 7 mg/kg of body weight per day.
[0067] The agent which binds to periostin or inhibitor of the
periostin gene expression of the invention may be combined with
pharmaceutically acceptable excipients, and optionally
sustained-release matrices, such as biodegradable polymers, to form
therapeutic compositions.
[0068] Thus, the present invention relates to a pharmaceutical
composition for use in the prevention or treatment of CKD
comprising an agent or an inhibitor according to the invention and
a pharmaceutically acceptable carrier.
[0069] The present invention also relates to a pharmaceutical
composition for preventing or reducing renal fibrosis comprising an
agent or an inhibitor according to the invention and a
pharmaceutically acceptable carrier.
[0070] "Pharmaceutically" or "pharmaceutically acceptable" refers
to molecular entities and compositions that do not produce an
adverse, allergic or other untoward reaction when administered to a
mammal, especially a human, as appropriate. A pharmaceutically
acceptable carrier or excipient refers to a non-toxic solid,
semi-solid or liquid filler, diluent, encapsulating material or
formulation auxiliary of any type.
[0071] In the pharmaceutical compositions of the present invention
for oral, sublingual, subcutaneous, intramuscular, intravenous,
transdermal, local or rectal administration, the active principle,
alone or in combination with another active principle, can be
administered in a unit administration form, as a mixture with
conventional pharmaceutical supports, to animals and human beings.
Suitable unit administration forms comprise oral-route forms such
as tablets, gel capsules, powders, granules and oral suspensions or
solutions, sublingual and buccal administration forms, aerosols,
implants, subcutaneous, transdermal, topical, intraperitoneal,
intramuscular, intravenous, subdermal, transdermal, intrathecal and
intranasal administration forms and rectal administration
forms.
[0072] Preferably, the pharmaceutical compositions contain vehicles
which are pharmaceutically acceptable for a formulation capable of
being injected. These may be in particular isotonic, sterile,
saline solutions (monosodium or disodium phosphate, sodium,
potassium, calcium or magnesium chloride and the like or mixtures
of such salts), or dry, especially freeze-dried compositions which
upon addition, depending on the case, of sterilized water or
physiological saline, permit the constitution of injectable
solutions.
[0073] The pharmaceutical forms suitable for injectable use include
sterile aqueous solutions or dispersions; formulations including
sesame oil, peanut oil or aqueous propylene glycol; and sterile
powders for the extemporaneous preparation of sterile injectable
solutions or dispersions. In all cases, the form must be sterile
and must be fluid to the extent that easy syringability exists. It
must be stable under the conditions of manufacture and storage and
must be preserved against the contaminating action of
microorganisms, such as bacteria and fungi.
[0074] Solutions comprising compounds of the invention as free base
or pharmacologically acceptable salts 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 contain a
preservative to prevent the growth of microorganisms.
[0075] The agent which binds to periostin or inhibitor of the
periostin gene expression of the invention can be formulated into a
composition in a neutral or salt form. Pharmaceutically acceptable
salts include the acid addition salts (formed with the free amino
groups of the protein) and which are formed with inorganic acids
such as, for example, hydrochloric or phosphoric acids, or such
organic acids as acetic, oxalic, tartaric, mandelic, and the like.
Salts formed with the free carboxyl groups can also be derived from
inorganic bases such as, for example, sodium, potassium, ammonium,
calcium, or ferric hydroxides, and such organic bases as
isopropylamine, trimethylamine, histidine, procaine and the
like.
[0076] The carrier can also be a solvent or dispersion medium
containing, for example, water, ethanol, polyol (for example,
glycerol, propylene glycol, and liquid polyethylene glycol, and the
like), suitable mixtures thereof, and vegetables oils. The proper
fluidity can be maintained, for example, by the use of a coating,
such as lecithin, by the maintenance of the required particle size
in the case of dispersion and by the use of surfactants. The
prevention of the action of microorganisms can be brought about by
various antibacterial and antifungal agents, for example, parabens,
chlorobutanol, phenol, sorbic acid, thimerosal, and the like. In
many cases, it will be preferable to include isotonic agents, for
example, sugars or sodium chloride. Prolonged absorption of the
injectable compositions can be brought about by the use in the
compositions of agents delaying absorption, for example, aluminium
monostearate and gelatin.
[0077] Sterile injectable solutions are prepared by incorporating
the active polypeptides in the required amount in the appropriate
solvent with various of the other ingredients enumerated above, as
required, 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 and the required other ingredients from those
enumerated above. In the case of sterile powders for the
preparation of sterile injectable solutions, the preferred methods
of preparation are vacuum-drying and freeze-drying techniques which
yield a powder of the active ingredient plus any additional desired
ingredient from a previously sterile-filtered solution thereof.
[0078] Upon formulation, solutions will be administered in a manner
compatible with the dosage formulation and in such amount as is
therapeutically effective. The formulations are easily administered
in a variety of dosage forms, such as the type of injectable
solutions described above, but drug release capsules and the like
can also be employed.
[0079] For parenteral administration in an aqueous solution, for
example, the solution should be suitably buffered if necessary and
the liquid diluent first rendered isotonic with sufficient saline
or glucose. These particular aqueous solutions are especially
suitable for intravenous, intramuscular, subcutaneous and
intraperitoneal administration. In this connection, sterile aqueous
media which can be employed will be known to those of skill in the
art in light of the present disclosure. For example, one dosage
could 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. Some variation in dosage will
necessarily occur depending on the condition of the subject being
treated. The person responsible for administration will, in any
event, determine the appropriate dose for the individual
subject.
[0080] The agent which binds to periostin or inhibitor of the
periostin gene expression of the invention may be formulated within
a therapeutic mixture to comprise about 0.0001 to 1.0 milligrams,
or about 0.001 to 0.1 milligrams, or about 0.1 to 1.0 or even about
10 milligrams per dose or so. Multiple doses can also be
administered.
[0081] In addition to the compounds of the invention formulated for
parenteral administration, such as intravenous or intramuscular
injection, other pharmaceutically acceptable forms include, e.g.
tablets or other solids for oral administration; liposomal
formulations; time release capsules; and any other form currently
used.
[0082] The invention will be further illustrated by the following
figures and examples. However, these examples and figures should
not be interpreted in any way as limiting the scope of the present
invention.
FIGURES
[0083] FIG. 1: Periostin expression is highly induced in the renal
cortex of mice after Unilateral Ureteral Obstruction (UUO). A.
Periostin mRNA; B. Periostin protein.
[0084] FIG. 2: Mice lacking periostin expression are protected
against the typical structural alterations induced by UUO. A.
Tubular dilation; B. Fibrosis; C. Fibrillar collagen accumulation
(Sirius red-staining) and D. Collagen III mRNA expression.
[0085] FIG. 3: Mice lacking periostin expression display a better
degree of renal parenchyma preservation following UUO. A. Tubular
preservation (Vimentin RNA expression); B. Cellular proliferation
(Ki 67 immunostaining); C. Apoptosis
[0086] FIG. 4: Mice lacking periostin expression have a blunted
inflammatory response after UUO. A. MCP-1 RNA expression; B. IL-17
RNA expression; C. Foxp3 RNA expression; D. ROR.delta.T RNA
expression.
[0087] FIG. 5: In vivo specific ODN antisense delivery decreases
periostin expression in the kidneys of hypertensive (L-NAME model)
rats.
[0088] FIG. 6: In vivo administration of specific periostin
antisense ODN blunted the typical structural alterations observed
in hypertensive nephropathy in rats. A. Tubular dilation; B.
Glomerulosclerosis; C. Vascular Hypertrophy; D. Fibrosis.
[0089] FIG. 7: Administration of specific periostin antisense ODN
in hypertensive rats in which proteinuria exceeded 2 grams
substantially decreased mortality rates.
EXAMPLES
Periostin, an Extracellular Protein Involved in the Development of
CKD
Example 1
Periostin KO Mice are Protected Against the Development of CKD in
an Experimental Tubulointerstitial Nephropathy (UUO Model)
[0090] Material & Methods
[0091] Animals:
[0092] Experiments were performed on wild type and periostin null
mice (POSTN KO) donated kindly by S.J. Conway (Indianapolis, Ind.).
These mice are characterized by the lack of the periostin gene and
the replacement of the translation start site and the first exon by
a lacZ reporter gene (ref). C57BL/6 WT and POSTN KO female mice
aged 4 to 6 months were used (n=9). Tubulointerstitial nephropathy
model was induced by the unilateral ureteral obstruction (UUO).
After induction of general anesthesia (intraperitoneal injection of
pentobarbital 50 mg/kg), POSTN KO mice and WT counterparts were
subjected to a left flank incision. UUO was performed by complete
ligation of the left ureter at the ureteropelvic junction, using
double silk sutures. Controlateral kidneys were used as controls.
Mice were sacrificed at day 15.
[0093] Animals were maintained with free access to standard chow
and tap water during the protocols. They were sacrificed under
general anesthesia (pentobarbital 150 mg/kg). Kidneys were removed
and divided in four equal parts (for RNA, protein, cryosections and
paraffin sections). All procedures were in accordance with European
Union Guidelines for the Care and the use of laboratory animals and
were approved the local ethic committee.
[0094] Renal Histology:
[0095] Kidneys were immersed 24 h in alcool-formalin-acetic acid
(AFA) and then embedded in paraffin wax prior to sectioning. The
tissues were cut into 4-.mu.m sections and stained with Masson's
trichrome. The slides were independently examined on a blinded
basis for the level of tubular dilation, perivascular fibrosis (for
mice and rats), glomerulosclerosis and vascular hypertrophy (for
rats), using a 0 to 4 injury scale as described previously. The
mean value was used to compare the animals' groups.
[0096] Sirius Red:
[0097] Interstitial fibrosis was assessed on 4 .mu.m-thick Sirius
red-stained paraffin sections at 40.times. magnification, under
polarized light. Five cortical fields excluding interlobular
arteries were selected randomly from each kidney and the
red-stained area per total area, reflecting interstitial fibrosis,
was quantified using computer-based morphometric analysis software
(Axionplan, Axiophot2, Zeiss, Germany). Scoring was performed in a
blinded manner on coded slides. Data are expressed as the mean
value of the percentage of positive area examined.
[0098] IHC:
[0099] Staining for periostin was performed on 5 .mu.m frozen
sections. Sections were incubated with monoclonal rat anti-mouse
periostin antibody (R&D Systems, 1/1000), for one hour at
37.degree. C. To stain proliferation, T lymphocytes and
macrophages, 5 .mu.m sections of paraffin-embedded kidneys were
dewaxed, heated in citric acid solution (pH6) at 98.degree. C. for
30 min, and respectively incubated with: Ki 67 (polyclonal rabbit,
Abcam, 1/1000), CD3 (mouse anti-human, Dako 1/200), F4/80
(monoclonal rat anti-mouse, AbD Serotec, 1/200). Secondary
antibodies are from N-Histofine kit (Nichirei Biochemicals, Japan).
They were incubated for 30 min at room temperature. Staining was
revealed by applying AEC (Dako), counterstained with hematoxylin QS
(Vector, Burlingame, Calif.), and finalized with Permanent Aqueous
Mounting Media (Innovex).
[0100] .beta.-Gal Staining:
[0101] .beta.-gal staining was described by J S. Duffield et al.
Tissues were fixed with 4% PFA at 4.degree. C. for one hour,
transferred to PBS containing 18% sucrose overnight (4.degree. C.),
and then stored at -80.degree. C. 5 .mu.m sections were cut, washed
in PBS for 10 minutes, incubated in blocking buffer (1 mM MgCl2,
0.01% Na-deoxycholate, 0.02% IGEPAL-CA630, and 5 mMEGTA in PBS) for
20 minutes at room temperature, and incubated in the X-gal mixture
[1 mM MgCl2, 0.01% Na-deoxycholate, 0.02% IGEPAL-CA630, 5 mM EGTA,
5 mM K3Fe(CN)6, 5 mM K4Fe(CN)6.3H2O, and 1 .mu.g X-gal; all from
invivogen)]; Care was taken to perform X-gal staining at neutral pH
and the incubation was carried out for 16 hours at 37.degree. C.
After 5 min PBS wash, the sections were counterstained with eosin
(Sigma-Aldrich, St. Louis, Mo.) and mounted.
[0102] In Situ End-Labeling for the Detection of Apoptotic
Cells:
[0103] To detect apoptotic cells, 5 .mu.m tissue sections fixed in
AFA and embedded in paraffin were stained by the TUNEL assay, using
ApopTag Plus, peroxidase Kit (Qbiogen, France S7101-KIT) according
to the manufacturer's instructions. For each kidney section, the
whole cortical area was analyzed at 40.times. magnification. The
number of stained apoptotic cells by power field was counted
manually and the mean value was used to compare the animals.
[0104] PCR:
[0105] The inventors extracted RNA from the renal cortex using
TRIzol solution (Life Technologies BRL, Gaithersburg, Md.). RNA
quality was checked by measuring the ratio of optical densities at
260 and 280 nm and residual genomic DNA was removed by DNase I
treatment for 30 min at 37.degree. C. (Fermentas). The inventors
used reverse transcription with Revert Aid H minus First Strand DNA
Synthesis kit (Fermentas) to convert 1 .mu.g RNA into cDNA.
Transcriptomic analyses were performed with RT.sup.2Profiler PCR
Array (Superarray, Bioscience Corp, Tebu Bio, Le Perray en
Yvelines, France). cDNA was amplified by PCR using a LightCycler
480 (Roche Diagnostic) using SYBR Green (Fast Start DNA Master
SYBRGreen I; Roche Applied Science, Roche Diagnostic), specific
primers for selected mRNA and 60S ribosomal protein L32 (RPL32)
housekeeping gene under the following conditions: 95.degree. C. for
5 min, and 45 cycles at 95.degree. C. for 15 s and 60.degree. C.
for 15 s, then 72.degree. C. for 15 s. Specific primers were
designed by Universal Probe Library system (UPL, Roche Applied
Science). To normalize the qRT-PCR results the inventors used Roche
LightCycler 2.0 software (Roche Diagnostics). The inventors
expressed results as 2-.DELTA.Cp, where Cp is the cycle threshold
number. They analyzed dissociation curves after each run for every
amplicon to assess the specificity of quantification when using
SYBR Green.
[0106] Western Blot Analysis:
[0107] Proteins were extracted from renal cortex using RIPA buffer
supplemented with protease inhibitor cocktail (Sigma-Aldrich). 20
.mu.g of proteins diluted in SDS sample buffer were heated at
70.degree. C. for 10 min, separated on a 4-15% tris-HCL gel and
then transferred to a PVDF membrane (Thermo Scientific). After
blocking in PBS 1.times., 5% milk (thermoscientific) for 2 hours at
room temperature, the membrane was incubated with the primary
antibodies (Periostin, E-cadherin) overnight at 4.degree. C.,
washed and incubated with secondary antibodies conjugated to
horseradish peroxidase (SouthernBiotech or Vector) for 2 hours at
room temperature. Protein bands were visualized using enhanced
Supersignal.RTM. west picochemiluminescent reagents according to
the manufacturer's instructions (Thermoscientific) and quantified
using densitometry (Chemicapt, Fisher Bioblock scientific).
[0108] Statistics:
[0109] Statistical analyses were performed using ANOVA followed by
Protected Least Significance. Difference Fisher test (Statview
software). Results with p<0.05 were considered statistically
significant. All values are means.+-.SEM.
[0110] Results
[0111] Periostin Expression is Induced after UUO:
[0112] Periostin messenger RNA (mRNA) examined by RT-qPCR, shows a
very low baseline expression of periostin in the control kidneys.
This expression is 50-fold upregulated at day 15 after obstruction
(FIG. 1A). This finding is confirmed by immunoblotting that shows
no periostin in control kidneys and a significant induction of
renal periostin at day 5 and day 15 after UUO (FIG. 1B). In order
to follow the emergence and the localization of periostin, the
inventors performed a .beta.-galatosidase staining in KO mice and
an immunostaining for the corresponding WT at day 2, day 5 and day
15 after UUO. The .beta.-galatosidase and periostin staining was
not detected in all control kidneys. After UUO, .beta.-galatosidase
shows that periostin expression starts in collecting duct
epithelial cells (day 2), then in tubular epithelial cells (day 5,
day 15) and in interstitial cells (day 15). The
immuno-histochemistry shows an interstitial staining for periostin
that starts in the medulla (day 2) and expand to cortex (day 5, day
15). Taken together, this data demonstrate that periostin
expression is induced by UUO and correlates with the progression of
the injury.
[0113] Periostin Null Mice are Protected Against Tubular Dilation
and Fibrosis Induced by UUO:
[0114] Evaluation of renal histology was assessed by Masson's
trichrom staining on normal and obstructed kidneys. 15 days after
UUO, KO mice show less tubular dilation (FIG. 2A) and less fibrosis
(FIG. 2B). To underscore fibrillar collagen accumulation, renal
sections were Sirius red-stained and the morphometric analysis
proved that KO mice had less fibrillar collagen comparing to WT
(FIG. 2C). This data was confirmed by collagen III mRNA expression
assessed by RT-qPCR (FIG. 2D).
[0115] Periostin Null Mice Present a Better Preservation of
Epithelial Tubular Cells:
[0116] To elucidate the difference observed between WT and KO mice
in terms of tubular dilation, the inventors examined cellular
proliferation (FIG. 3B), tubular preservation (FIG. 3A) and
apoptosis (FIG. 3C). Proliferation was assessed by Ki 67
immunostaining (proliferative cell marker); tubular preservation
was demonstrated by vimentin RNA expression (mensenchymal cell
marker) and E-cadherin protein level (epithelial cell adhesion
molecule). Apoptosis was evaluated by TUNNEL. At Day 15, epithelial
tubular cells proliferate more in the obstructed kidney of KO mice
comparing to the WT. The increase of vimentin RNA level was
concomitant with the loss of E-cadherin for WT mice, whereas KO
mice showed less increase of vimentin and maintenance of
E-cadherin. On the contrary, apoptotic cells were similarly
increased in WT and KO mice after UUO.
[0117] Periostin and Inflammation:
[0118] Obstructive nephropathy is characterized by an inflammatory
response in the kidney that contributes to tubular atrophy and
interstitial fibrosis. Since the POSTN KO mice were protected in
terms of fibrosis and tubular damage, the inventors investigated
inflammation. Interestingly, after UUO, RT-qPCR showed that
monocyte chemoattractant protein-1 (MCP-1) upregulation was
signicantly blunted in POSTN KO mice (FIG. 4A). However, there was
no significant difference between POSTN KO and WT mice for IL-17
(FIG. 4B) or ROR.delta.T/Foxp3 expression (FIGS. 4C and 4D).
Macrophages infiltration was evaluated by IHC, no difference in
F4/80+ cells was observed 15 days after UUO.
Example 2
Periostin Antisens Oligonucleotide Periostin Protect Against the
Development of in a Hypertensive Nephropathy Rat Model (L-NAME
Treated Rats)
[0119] Material & Methods
[0120] Animals:
[0121] Male Sprague-Dawley rats, weighing 250 g, were maintained on
a normal-salt diet and had free access to chow and water. To induce
a hypertensive nephropathy model, LNAME, an inhibitor of NO
synthesis, was given via drinking water at the dose of 30
mg/kg/day. In order to investigate the role of periostin, the
inventors used an antisense approach to down regulate its
expression.
[0122] Administration of Antisense (AS) Against Periostin:
[0123] To block periostin expression, the inventors used a specific
AS oligodeoxynucleotides (ODN) modified with phosphorothioate to
prevent their in vivo hydrolysis by nucleases. The AS or scrambled
control ODNs were administrated by intraperitoneal (IP, 1 .mu.M)
either in a preventive or curative way. In the preventive protocol,
antisense injection started with LNAME administration and rats were
sacrified at day 19. However, in the curative protocol, antisense
injection started after LNAME administration, when rats reached a
proteinuria of 1 g/mmol. LNAME was maintained but the dose was
decreased to 15 mg/kg/day and rats were sacrified one week after
antisense treatment.
[0124] Results
[0125] As shown in FIG. 5, in vivo specific ODN antisense delivery
decreases periostin expression in the kidneys of hypertensive
(L-NAME model) rats. As shown in FIG. 6, in vivo administration of
specific periostin antisense ODN blunted the typical structural
alterations observed in hypertensive nephropathy in rats (i.e.
tubular dilation, glomerulosclerosis, vascular hypertrophy and
fibrosis). Moreover, as shown in FIG. 7, administration of specific
periostin antisense ODN in hypertensive rats in which proteinuria
exceeded 2 grams substantially decreased mortality rates
demonstrating the interest of targeting periostin (e.g. by
inhibitor of periostin gene expression or by an anti-periostin
neutralizing antibody or aptamer) for preventing and also for
treating CKD.
CONCLUSION
[0126] The inventors have shown that periostin is involved in the
development of CKD by promoting renal fibrosis and excessive
accumulation of ECM in the kidney by using two distinct models as
previously described. It results that agents which binds periostin
(e.g. anti-periostin neutralizing antibody or aptamer) and
inhibitors of periostin gene expression) are useful for preventing
renal fibrosis and excessive accumulation of ECM in the kidney and
are therefore useful in the prevention or the treatment of CKD in a
subject in need thereof.
REFERENCES
[0127] Throughout this application, various references describe the
state of the art to which this invention pertains. The disclosures
of these references are hereby incorporated by reference into the
present disclosure. [0128] Guerrot D, Dussaule J C, Mael-Ainin M,
Xu-Dubois Y C, Rondeau E, Chatziantoniou C, Placier S.
Identification of periostin as a critical marker of
progression/reversal of hypertensive nephropathy. PLoS One. 2012;
7(3):e31974. [0129] Wallace D P, Quante M T, Reif G A, Nivens E,
Ahmed F, Hempson S J, Blanco G, Yamaguchi T. Periostin induces
proliferation of human autosomal dominant polycystic kidney cells
through alphaV-integrin receptor. Am J Physiol Renal Physiol. 2008
November; 295(5):F1463-71 [0130] Zhu M, Saxton R E, Ramos L, Chang
D D, Karlan B Y, Gasson J C, Slamon D J. Neutralizing monoclonal
antibody to periostin inhibits ovarian tumor growth and metastasis.
Mol Cancer Ther. 2011 August; 10(8):1500-8.
Sequence CWU 1
1
2130DNAArtificialSynthetic antisense (AS) oligodeoxynucleotides
(ODN) against periostin 1gagaggaacc atcttcagcc ctgagctccg
30221DNAArtificialSynthetic antisense (AS) oligodeoxynucleotide
(ODN) against periostin 2tctccctcac accctatttc a 21
* * * * *