U.S. patent application number 15/435658 was filed with the patent office on 2017-09-14 for low affinity blood brain barrier receptor antibodies and uses thereof.
This patent application is currently assigned to Genentech, Inc.. The applicant listed for this patent is Genentech, Inc.. Invention is credited to Mark DENNIS, Ryan Jefferson WATTS, Yin ZHANG, Yunhua Yu ZUCHERO.
Application Number | 20170260292 15/435658 |
Document ID | / |
Family ID | 45316102 |
Filed Date | 2017-09-14 |
United States Patent
Application |
20170260292 |
Kind Code |
A1 |
DENNIS; Mark ; et
al. |
September 14, 2017 |
LOW AFFINITY BLOOD BRAIN BARRIER RECEPTOR ANTIBODIES AND USES
THEREOF
Abstract
The present invention relates to antibodies that bind blood
brain barrier receptors (BBB-R) and methods of using the same.
Inventors: |
DENNIS; Mark; (South San
Francisco, CA) ; WATTS; Ryan Jefferson; (South San
Francisco, CA) ; ZUCHERO; Yunhua Yu; (South San
Francisco, CA) ; ZHANG; Yin; (South San Francisco,
CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Genentech, Inc. |
South San Francisco |
CA |
US |
|
|
Assignee: |
Genentech, Inc.
South San Francisco
CA
|
Family ID: |
45316102 |
Appl. No.: |
15/435658 |
Filed: |
February 17, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14577006 |
Dec 19, 2014 |
9611323 |
|
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15435658 |
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13306524 |
Nov 29, 2011 |
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14577006 |
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61418223 |
Nov 30, 2010 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
C07K 2317/70 20130101;
C07K 2317/92 20130101; A61P 21/00 20180101; A61P 9/00 20180101;
C07K 2317/76 20130101; A61P 31/12 20180101; C07K 2317/54 20130101;
A61P 25/16 20180101; A61P 35/00 20180101; A61K 2039/505 20130101;
A61P 31/04 20180101; C07K 16/40 20130101; C07K 16/2881 20130101;
A61P 25/28 20180101; A61P 17/02 20180101; A61P 25/00 20180101; A61P
21/02 20180101; C07K 16/18 20130101; C07K 16/468 20130101; A61P
9/10 20180101; C07K 2317/31 20130101; A61P 25/04 20180101; A61P
25/14 20180101; C07K 16/28 20130101; A61K 47/68 20170801; A61P
27/02 20180101; Y02A 50/30 20180101 |
International
Class: |
C07K 16/46 20060101
C07K016/46; C07K 16/40 20060101 C07K016/40; C07K 16/28 20060101
C07K016/28 |
Claims
1-55. (canceled)
56. A multispecific antibody comprising a first antigen binding
site and a second antigen binding site, wherein the first antigen
binding site binds to a transferrin receptor (TfR) with low
affinity from about 20 nM to about 10 .mu.M, and wherein the second
antigen binding site binds to a brain antigen.
57. The multispecific antibody of claim 56, wherein the affinity of
the antibody for the TfR is from about 30 nM to about 10 .mu.M.
58. The multispecific antibody of claim 56, wherein the affinity of
the antibody for the TfR is from about 100 nM to about 10
.mu.M.
59. The multispecific antibody of claim 56, wherein the affinity of
the antibody for the TfR is from about 20 nM to about 1 .mu.M.
60. The multispecific antibody of claim 56 wherein the TfR is a
human TfR.
61. The multispecific antibody of claim 56 wherein the brain
antigen is selected from beta-secretase 1 (BACE1), Abeta, epidermal
growth factor receptor (EGFR), human epidermal growth factor
receptor 2 (HER2), Tau, apolipoprotein E4 (ApoE4), alpha-synuclein,
CD20, huntingtin, prion protein (PrP), leucine rich repeat kinase 2
(LRRK2), parkin, presenilin 1, presenilin 2, gamma secretase, death
receptor 6 (DR6), amyloid precursor protein (APP), p75 neurotrophin
receptor (p75NTR), and caspase 6.
62. The multispecific antibody of claim 61, wherein the brain
antigen is BACE1.
63. The multispecific antibody of claim 61, wherein the brain
antigen is Abeta.
64. The multispecific antibody of claim 56, wherein the antibody
does not inhibit the binding of TfR to transferrin.
65. The multispecific antibody of claim 56, which is an antibody
fragment with a first antigen binding site that binds the TfR and a
second antigen binding site that binds a brain antigen.
66. The multispecific antibody of claim 65, wherein the affinity of
the antibody for the TfR is from about 30 nM to about 10 .mu.M.
67. The multispecific antibody of claim 65, wherein the affinity of
the antibody for the TfR is from about 100 nM to about 10
.mu.M.
68. The multispecific antibody of claim 65, wherein the affinity of
the antibody for the TfR is from about 20 nM to about 1 .mu.M.
69. The multispecific antibody of claim 65, which is a F(ab')2
fragment.
70. The multispecific antibody of claim 65, wherein the brain
antigen is selected from beta-secretase 1 (BACE1), Abeta, epidermal
growth factor receptor (EGFR), human epidermal growth factor
receptor 2 (HER2), Tau, apolipoprotein E4 (ApoE4), alpha-synuclein,
CD20, huntingtin, prion protein (PrP), leucine rich repeat kinase 2
(LRRK2), parkin, presenilin 1, presenilin 2, gamma secretase, death
receptor 6 (DR6), amyloid precursor protein (APP), p75 neurotrophin
receptor (p75NTR), and caspase 6.
71. The multispecific antibody of claim 65, wherein the antibody
does not inhibit the binding of TfR to transferrin.
72. A pharmaceutical formulation comprising the multispecific
antibody of claim 56 and a pharmaceutically acceptable carrier.
73. A pharmaceutical formulation comprising the multispecific
antibody of claim 57 and a pharmaceutically acceptable carrier.
74. A pharmaceutical formulation comprising the multispecific
antibody of claim 58 and a pharmaceutically acceptable carrier.
75. A pharmaceutical formulation comprising the multispecific
antibody of claim 59 and a pharmaceutically acceptable carrier.
Description
RELATED APPLICATIONS
[0001] This application is a division of U.S. application Ser. No.
14/577,006, filed Dec. 19, 2014; which is a continuation of U.S.
application Ser. No. 13/306,524, filed Nov. 29, 2011; which claims
priority under 35 U.S.C. .sctn.119(e) to U.S. provisional
application No. 61/418,223, filed Nov. 30, 2010, the contents of
all of which are incorporated in their entirety herein by
reference.
REFERENCE TO SEQUENCE LISTING SUBMITTED AS A TEXT FILE VIA
EFS-WEB
[0002] A sequence listing is submitted concurrently with the
specification as an ASCII formatted text file via EFS-Web, with a
file name of "2017-02-17_01146-0048-02US_SeqList.txt", a creation
date of Feb. 17, 2017, and a size of 19,746 bytes. The sequence
listing filed via EFS-Web is part of the specification and is
hereby incorporated by reference in its entirety.
FIELD OF THE INVENTION
[0003] The present invention relates to antibodies that bind blood
brain barrier receptors (BBB-R) and methods of using the same.
BACKGROUND
[0004] Brain penetration of large molecule drugs is severely
limited by the largely impermeable blood-brain barrier (BBB). Among
the many strategies to overcome this obstacle is to utilize
transcytosis trafficking pathways of endogenous receptors expressed
at the brain capillary endothelium. Recombinant proteins such as
monoclonal antibodies have been designed against these receptors to
enable receptor-mediated delivery of large molecules to the brain.
However, strategies to maximize brain uptake while minimizing
reverse transcytosis back to the blood, and the extent of
accumulation after therapeutic dosing, remain unexplored.
Furthermore, whether antibodies that cross the BBB are
pharmacodynamically functional is unknown.
SUMMARY
[0005] Monoclonal antibodies have vast therapeutic potential for
treatment of neurological or central nervous system (CNS) diseases,
but their passage into the brain is restricted by the blood-brain
barrier (BBB). Past studies have shown that a very small percentage
(approximately 0.1%) of an IgG circulating in the bloodstream
crosses through the BBB into the CNS (Felgenhauer, Klin. Wschr. 52:
1158-1164 (1974)), where the CNS concentration of the antibody may
be insufficient to permit a robust effect. The methods and
compositions of the invention provide a way to improve the
percentage of the antibody that distributes into the CNS and thus
more readily attain therapeutic antibody concentrations in the
CNS.
[0006] Herein is described a group of antibodies against the
transferrin receptor (TfR) that can deliver therapeutics including
antibodies and small molecules across the BBB at both trace and
therapeutically relevant doses after a single systemic injection in
mice. Distribution of antibody changed from vascular to neuronal 24
hours after injection, indicating that a significant amount of
antibody had transcytosed through brain endothelial cells to reach
the parenchyma. The magnitude of antibody uptake into and
distribution in the CNS was inversely related to its binding
affinity to TfR for the anti-TfR variants studied. Proof of BBB
transport was achieved using a bispecific antibody that binds both
TfR and the amyloid precursor protein (APP) cleavage enzyme,
.beta.-secretase (BACE1). A single systemic dose of the bispecific
anti-TfR/BACE1 antibody engineered using the methodology of the
invention not only resulted in significant antibody uptake in
brain, but also dramatically reduced levels of brain
A.beta..sub.1-40 compared to monospecific anti-BACE1 alone,
suggesting that BBB penetrance affects the potency of anti-BACE1.
Similarly, a bispecific antibody that binds both TfR and amyloid
beta (i.e., a portion of APP that results from BACE1 cleavage of
APP, which is one of the main constituents of amyloid plaques) was
shown to be readily taken up into the brain using the methodology
of the invention. The data and experiments described herein
highlight several causative mechanisms behind increasing uptake of
an antibody into the CNS using a lower-affinity antibody approach.
First, high affinity anti-BBB receptor (BBB-R) antibodies (e.g.,
anti-TfR.sup.A) limit brain uptake by quickly saturating the BBB-R
in the brain vasculature, thus reducing the total amount of
antibody taken up into the brain and also restricting its
distribution to the vasculature. Strikingly, lowering affinity for
the BBB-R improves brain uptake and distribution, with a robust
shift observed in localization from the vasculature to neurons and
associated neuropil distributed within the CNS. Second, the lower
affinity of the antibody for the BBB-R is proposed to impair the
ability of the antibody to return to the vascular side of the BBB
via the BBB-R from the CNS side of the membrane because the overall
affinity of the antibody for the BBB-R is low and the local
concentration of the antibody on the CNS side of the BBB is
non-saturating due to the rapid dispersal of the antibody into the
CNS compartment. Third, in vivo, and as observed for the TfR
system, antibodies with less affinity for the BBB-R are not cleared
from the system as efficiently as those with greater affinity for
the BBB-R, and thus remain at higher circulating concentrations
than their higher-affinity counterparts. This is advantageous
because the circulating antibody levels of the lower-affinity
antibody are sustained at therapeutic levels for a longer period of
time than the higher-affinity antibody, which consequently improves
uptake of antibody in brain for a longer period of time.
Furthermore, this improvement in both plasma and brain exposure may
reduce the frequency of dosing in the clinic, which would have
potential benefit not only for patient compliance and convenience
but also in lessening any potential side effects or off-target
effects of the antibody and/or of a therapeutic compound coupled
thereto. Anti-TfR/BACE1 and anti-TfR/Abeta are each promising and
novel therapeutic candidates for the treatment of Alzheimer's
disease. Furthermore, receptor mediated transport (RMT)-based
bispecific targeting technology opens the door for a wide range of
potential therapeutics for CNS diseases. The invention provides
methods of engineering BBB-penetrant therapeutics that greatly
improve transport across the BBB and CNS distribution of the
therapeutic.
[0007] Accordingly, in a first embodiment, the invention provides a
method of transporting a compound across the blood-brain barrier
comprising exposing an antibody which binds with low affinity to a
blood-brain barrier receptor (BBB-R) coupled to a compound to the
blood-brain barrier such that the antibody transports the compound
coupled thereto across the blood-brain barrier. In one aspect, the
compound is a neurological disorder drug. In another aspect, the
compound is an imaging agent. In another aspect, the compound is
labeled. In another aspect, the antibody is labeled. In another
aspect, the antibody does not impair the binding of the BBB-R to
one or more of its native ligands. In another such aspect, the
antibody specifically binds to TfR in such a manner that it does
not inhibit binding of the TfR to transferrin. In another aspect,
the BBB is in a mammal. In another such aspect, the mammal is a
human. In another such aspect, the mammal has a neurological
disorder. In another such aspect, the neurological disorder is
selected from the group consisting of Alzheimer's disease (AD),
stroke, dementia, muscular dystrophy (MD), multiple sclerosis (MS),
amyotrophic lateral sclerosis (ALS), cystic fibrosis, Angelman's
syndrome, Liddle syndrome, Parkinson's disease, Pick's disease,
Paget's disease, cancer, and traumatic brain injury. In another
aspect, the BBB is in a human.
[0008] In another aspect, the antibody has an IC50 for the BBB-R
from about 1 nM to about 100 .mu.M. In another such aspect, the
IC50 is from about 5 nM to about 100 .mu.M. In another such aspect,
the IC50 is from about 50 nM to about 100 .mu.M. In another such
aspect, the IC50 is from about 100 nM to about 100 .mu.M. In
another aspect, the antibody has an affinity for the BBB-R from
about 5 nM to about 10 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 30 nM to about 1 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 50 nM to about 1 .mu.M. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an
affinity for TfR between those affinities observed for the
anti-TfR.sup.A/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In another such aspect, the compound-coupled antibody
specifically binds to TfR and has an affinity for TfR between those
affinities observed for the anti-TfR.sup.D/BACE1 antibody and the
anti-TfR.sup.E/BACE1 antibody. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an IC50
for TfR between those IC50s observed for the anti-TfR.sup.A/BACE1
antibody and the anti-TfR.sup.E/BACE1 antibody. In another such
aspect, the compound-coupled antibody specifically binds to TfR and
has an IC50 for TfR between those IC50s observed for the
anti-TfR.sup.D/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In one aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using scatchard
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using BIACORE
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using a competition
ELISA.
[0009] In another aspect, the BBB-R is selected from the group
consisting of transferrin receptor (TfR), insulin receptor,
insulin-like growth factor receptor (IGF receptor), low density
lipoprotein receptor-related protein 8 (LRP8), low density
lipoprotein receptor-related protein 1 (LRP1), and heparin-binding
epidermal growth factor-like growth factor (HB-EGF). In another
such aspect, the BBB-R is a human BBB-R. In one such aspect, the
BBB-R is TfR. In another such aspect, the BBB-R is TfR and the
antibody does not inhibit TfR activity. In another such aspect, the
BBB-R is TfR and the antibody does not inhibit the binding of TfR
to transferrin. In another aspect, the compound-coupled antibody is
administered at a therapeutic dose. In one such aspect, the
therapeutic dose is a dose that saturates the BBB-R to which the
antibody specifically binds.
[0010] In another aspect, the compound is covalently coupled to the
antibody. In one such aspect, the compound is joined to the
antibody by a linker. In one such aspect, the linker is cleavable.
In another such aspect, the linker is not cleavable. In another
such aspect, the compound is directly linked to the antibody. In
one such aspect, the antibody is a multispecific antibody and the
compound forms one portion of the multispecific antibody. In
another such aspect, the multispecific antibody comprises a first
antigen binding site which binds the BBB-R and a second antigen
binding site which binds a brain antigen. In another such aspect,
the brain antigen is selected from the group consisting of:
beta-secretase 1 (BACE1), Abeta, epidermal growth factor receptor
(EGFR), human epidermal growth factor receptor 2 (HER2), Tau,
apolipoprotein E4 (ApoE4), alpha-synuclein, CD20, huntingtin, prion
protein (PrP), leucine rich repeat kinase 2 (LRRK2), parkin,
presenilin 1, presenilin 2, gamma secretase, death receptor 6
(DR6), amyloid precursor protein (APP), p75 neurotrophin receptor
(p75NTR), and caspase 6. In another such aspect, the multispecific
antibody binds both TfR and BACE1. In another such aspect, the
multispecific antibody binds both TfR and Abeta. In another such
aspect, the multispecific antibody is labeled. In another aspect,
the compound is reversibly coupled to the antibody such that the
compound is released from the antibody concurrent with or after BBB
transport.
[0011] In another embodiment, the invention provides a method of
increasing exposure of the CNS to a compound, wherein the compound
is coupled to an antibody which binds with low affinity to a BBB-R,
thereby increasing the exposure of the CNS to the compound. In one
aspect, the compound is a neurological disorder drug. In another
aspect, the compound is an imaging agent. In another aspect, the
compound is labeled. In another aspect, the antibody is labeled. In
another aspect, the antibody does not impair the binding of the
BBB-R to one or more of its native ligands. In another such aspect,
the antibody specifically binds to TfR in such a manner that it
does not inhibit binding of the TfR to transferrin. In another
aspect, the antibody-coupled compound is administered to a mammal.
In another such aspect, the mammal is a human. In another such
aspect, the mammal has a neurological disorder. In another such
aspect, the neurological disorder is selected from the group
consisting of Alzheimer's disease (AD), stroke, dementia, muscular
dystrophy (MD), multiple sclerosis (MS), amyotrophic lateral
sclerosis (ALS), cystic fibrosis, Angelman's syndrome, Liddle
syndrome, Parkinson's disease, Pick's disease, Paget's disease,
cancer, and traumatic brain injury.
[0012] In another aspect, the increase in CNS exposure to the
compound is measured relative to the CNS exposure of a compound
coupled with a typical antibody not having lowered affinity for the
BBB-R. In another aspect, the increase in CNS exposure to the
compound is measured as a ratio of the amount of the compound found
in the CNS relative to the amount found in the serum after
administration. In another such aspect, the increase in CNS
exposure results in a ratio of greater than 0.1%. In another
aspect, the increase in CNS exposure to the compound is measured
relative to the CNS exposure of a compound in the absence of a
coupled antibody. In another aspect, the increase in CNS exposure
to the compound is measured by imaging. In another aspect, the
increase in CNS exposure to the compound is measured by an indirect
readout such as a modification of one or more physiological
symptoms.
[0013] In another aspect, the antibody has an IC50 for the BBB-R
from about 1 nM to about 100 .mu.M. In another such aspect, the
IC50 is from about 5 nM to about 100 .mu.M. In another such aspect,
the IC50 is from about 50 nM to about 100 .mu.M. In another such
aspect, the IC50 is from about 100 nM to about 100 .mu.M. In
another aspect, the antibody has an affinity for the BBB-R from
about 5 nM to about 10 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 30 nM to about 1 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 50 nM to about 1 .mu.M. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an
affinity for TfR between those affinities observed for the
anti-TfR.sup.A/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In another such aspect, the compound-coupled antibody
specifically binds to TfR and has an affinity for TfR between those
affinities observed for the anti-TfR.sup.D/BACE1 antibody and the
anti-TfR.sub.E/BACE1 antibody. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an IC50
for TfR between those IC50s observed for the anti-TfR.sup.A/BACE1
antibody and the anti-TfR.sup.E/BACE1 antibody. In another such
aspect, the compound-coupled antibody specifically binds to TfR and
has an IC50 for TfR between those IC50s observed for the
anti-TfR.sup.D/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In one aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using scatchard
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using BIACORE
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using a competition
ELISA.
[0014] In another aspect, the BBB-R is selected from the group
consisting of transferrin receptor (TfR), insulin receptor,
insulin-like growth factor receptor (IGF receptor), low density
lipoprotein receptor-related protein 8 (LRP8), low density
lipoprotein receptor-related protein 1 (LRP1), and heparin-binding
epidermal growth factor-like growth factor (HB-EGF). In another
such aspect, the BBB-R is a human BBB-R. In one such aspect, the
BBB-R is TfR. In another such aspect, the BBB-R is TfR and the
antibody does not inhibit TfR activity. In another such aspect, the
BBB-R is TfR and the antibody does not inhibit the binding of TfR
to transferrin. In another aspect, the compound-coupled antibody is
administered at a therapeutic dose. In one such aspect, the
therapeutic dose is a dose that saturates the BBB-R to which the
antibody specifically binds.
[0015] In another aspect, the compound is covalently coupled to the
antibody. In one such aspect, the compound is joined to the
antibody by a linker. In one such aspect, the linker is cleavable.
In another such aspect, the linker is not cleavable. In another
such aspect, the compound is directly linked to the antibody. In
one such aspect, the antibody is a multispecific antibody and the
compound forms one portion of the multispecific antibody. In
another such aspect, the multispecific antibody comprises a first
antigen binding site which binds the BBB-R and a second antigen
binding site which binds a brain antigen. In another such aspect,
the brain antigen is selected from the group consisting of:
beta-secretase 1 (BACE1), Abeta, epidermal growth factor receptor
(EGFR), human epidermal growth factor receptor 2 (HER2), Tau,
apolipoprotein E4 (ApoE4), alpha-synuclein, CD20, huntingtin, prion
protein (PrP), leucine rich repeat kinase 2 (LRRK2), parkin,
presenilin 1, presenilin 2, gamma secretase, death receptor 6
(DR6), amyloid precursor protein (APP), p75 neurotrophin receptor
(p75NTR), and caspase 6. In another such aspect, the multispecific
antibody binds both TfR and BACE1. In another such aspect, the
multispecific antibody binds both TfR and Abeta. In another such
aspect, the multispecific antibody is labeled. In another aspect,
the compound is reversibly coupled to the antibody such that the
compound is released from the antibody concurrent with or after BBB
transport.
[0016] In another embodiment, the invention provides a method of
decreasing clearance of a compound administered to a subject,
wherein the compound is coupled to an antibody which binds with low
affinity to a BBB-R, such that the clearance of the compound is
decreased. In one aspect, the compound is a neurological disorder
drug. In another aspect, the compound is an imaging agent. In
another aspect, the compound is labeled. In another aspect, the
antibody is labeled. In another aspect, the antibody does not
impair the binding of the BBB-R to one or more of its native
ligands. In another such aspect, the antibody specifically binds to
TfR in such a manner that it does not inhibit binding of the TfR to
transferrin. In another aspect, the subject is a mammal. In another
such aspect, the mammal is a human. In another such aspect, the
mammal has a neurological disorder. In another such aspect, the
neurological disorder is selected from the group consisting of
Alzheimer's disease (AD), stroke, dementia, muscular dystrophy
(MD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS),
cystic fibrosis, Angelman's syndrome, Liddle syndrome, Parkinson's
disease, Pick's disease, Paget's disease, cancer, and traumatic
brain injury.
[0017] In another aspect, the decrease in clearance of the compound
is measured relative to the clearance of a compound coupled with a
typical antibody not having lowered affinity for the BBB-R. In
another aspect, the decrease in clearance of the compound is
measured relative to the clearance of the compound in the absence
of a coupled antibody.
[0018] In another aspect, the antibody has an IC50 for the BBB-R
from about 1 nM to about 100 .mu.M. In another such aspect, the
IC50 is from about 5 nM to about 100 .mu.M. In another such aspect,
the IC50 is from about 50 nM to about 100 .mu.M. In another such
aspect, the IC50 is from about 100 nM to about 100 .mu.M. In
another aspect, the antibody has an affinity for the BBB-R from
about 5 nM to about 10 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 30 nM to about 1 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 50 nM to about 1 .mu.M. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an
affinity for TfR between those affinities observed for the
anti-TfR.sup.A/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In another such aspect, the compound-coupled antibody
specifically binds to TfR and has an affinity for TfR between those
affinities observed for the anti-TfR.sup.D/BACE1 antibody and the
anti-TfR.sup.E/BACE1 antibody. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an IC50
for TfR between those IC50s observed for the anti-TfR.sup.A/BACE1
antibody and the anti-TfR.sup.E/BACE1 antibody. In another such
aspect, the compound-coupled antibody specifically binds to TfR and
has an IC50 for TfR between those IC50s observed for the
anti-TfR.sup.D/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In one aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using scatchard
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using BIACORE
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using a competition
ELISA.
[0019] In another aspect, the BBB-R is selected from the group
consisting of transferrin receptor (TfR), insulin receptor,
insulin-like growth factor receptor (IGF receptor), low density
lipoprotein receptor-related protein 8 (LRP8), low density
lipoprotein receptor-related protein 1 (LRP1), and heparin-binding
epidermal growth factor-like growth factor (HB-EGF). In another
such aspect, the BBB-R is a human BBB-R. In one such aspect, the
BBB-R is TfR. In another such aspect, the BBB-R is TfR and the
antibody does not inhibit TfR activity. In another such aspect, the
BBB-R is TfR and the antibody does not inhibit the binding of TfR
to transferrin. In another aspect, the compound-coupled antibody is
administered at a therapeutic dose. In one such aspect, the
therapeutic dose is a dose that saturates the BBB-R to which the
antibody specifically binds.
[0020] In another aspect, the compound is covalently coupled to the
antibody. In one such aspect, the compound is joined to the
antibody by a linker. In one such aspect, the linker is cleavable.
In another such aspect, the linker is not cleavable. In another
such aspect, the compound is directly linked to the antibody. In
one such aspect, the antibody is a multispecific antibody and the
compound forms one portion of the multispecific antibody. In
another such aspect, the multispecific antibody comprises a first
antigen binding site which binds the BBB-R and a second antigen
binding site which binds a brain antigen. In another such aspect,
the brain antigen is selected from the group consisting of:
beta-secretase 1 (BACE1), Abeta, epidermal growth factor receptor
(EGFR), human epidermal growth factor receptor 2 (HER2), Tau,
apolipoprotein E4 (ApoE4), alpha-synuclein, CD20, huntingtin, prion
protein (PrP), leucine rich repeat kinase 2 (LRRK2), parkin,
presenilin 1, presenilin 2, gamma secretase, death receptor 6
(DR6), amyloid precursor protein (APP), p75 neurotrophin receptor
(p75NTR), and caspase 6. In another such aspect, the multispecific
antibody binds both TfR and BACE1. In another such aspect, the
multispecific antibody binds both TfR and Abeta. In another such
aspect, the multispecific antibody is labeled. In another aspect,
the compound is reversibly coupled to the antibody such that the
compound is released from the antibody concurrent with or after BBB
transport.
[0021] A method of increasing retention in the CNS of a compound
administered to a subject, wherein the compound is coupled to an
antibody which binds with low affinity to a BBB-R, such that the
retention in the CNS of the compound is increased. In one aspect,
the compound is a neurological disorder drug. In another aspect,
the compound is an imaging agent. In another aspect, the compound
is labeled. In another aspect, the antibody is labeled. In another
aspect, the antibody does not impair the binding of the BBB-R to
one or more of its native ligands. In another such aspect, the
antibody specifically binds to TfR in such a manner that it does
not inhibit binding of the TfR to transferrin. In another aspect,
the compound is administered to a mammal. In another such aspect,
the mammal is a human. In another such aspect, the mammal has a
neurological disorder. In another such aspect, the neurological
disorder is selected from the group consisting of Alzheimer's
disease (AD), stroke, dementia, muscular dystrophy (MD), multiple
sclerosis (MS), amyotrophic lateral sclerosis (ALS), cystic
fibrosis, Angelman's syndrome, Liddle syndrome, Parkinson's
disease, Pick's disease, Paget's disease, cancer, and traumatic
brain injury.
[0022] In another aspect, the increase in CNS retention of the
compound is measured relative to the CNS retention of a compound
coupled with a typical antibody not having lowered affinity for the
BBB-R. In another aspect, the increase in CNS retention of the
compound is measured as a ratio of the amount of the compound found
in the CNS relative to the amount found in the serum at one or more
time points after administration. In another such aspect, the
increase in CNS retention results in a ratio of greater than 0.1%
at one or more time points after administration. In another aspect,
the increase in CNS retention of the compound is measured relative
to the CNS retention of a compound in the absence of a coupled
antibody. In another aspect, the increase in CNS retention of the
compound is measured by imaging. In another aspect, the increase in
CNS retention of the compound is measured by an indirect readout
such as a modification of one or more physiological symptoms.
[0023] In another aspect, the antibody has an IC50 for the BBB-R
from about 1 nM to about 100 .mu.M. In another such aspect, the
IC50 is from about 5 nM to about 100 .mu.M. In another such aspect,
the IC50 is from about 50 nM to about 100 .mu.M. In another such
aspect, the IC50 is from about 100 nM to about 100 .mu.M. In
another aspect, the antibody has an affinity for the BBB-R from
about 5 nM to about 10 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 30 nM to about 1 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 50 nM to about 1 .mu.M. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an
affinity for TfR between those affinities observed for the
anti-TfR.sup.A/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In another such aspect, the compound-coupled antibody
specifically binds to TfR and has an affinity for TfR between those
affinities observed for the anti-TfR.sup.D/BACE1 antibody and the
anti-TfR.sup.E/BACE1 antibody. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an IC50
for TfR between those IC50s observed for the anti-TfR.sup.A/BACE1
antibody and the anti-TfR.sup.E/BACE1 antibody. In another such
aspect, the compound-coupled antibody specifically binds to TfR and
has an IC50 for TfR between those IC50s observed for the
anti-TfR.sup.D/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In one aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using scatchard
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using BIACORE
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using a competition
ELISA.
[0024] In another aspect, the BBB-R is selected from the group
consisting of transferrin receptor (TfR), insulin receptor,
insulin-like growth factor receptor (IGF receptor), low density
lipoprotein receptor-related protein 8 (LRP8), low density
lipoprotein receptor-related protein 1 (LRP1), and heparin-binding
epidermal growth factor-like growth factor (HB-EGF). In another
such aspect, the BBB-R is a human BBB-R. In one such aspect, the
BBB-R is TfR. In another such aspect, the BBB-R is TfR and the
antibody does not inhibit TfR activity. In another such aspect, the
BBB-R is TfR and the antibody does not inhibit the binding of TfR
to transferrin. In another aspect, the compound-coupled antibody is
administered at a therapeutic dose. In one such aspect, the
therapeutic dose is a dose that saturates the BBB-R to which the
antibody specifically binds.
[0025] In another aspect, the compound is covalently coupled to the
antibody. In one such aspect, the compound is joined to the
antibody by a linker. In one such aspect, the linker is cleavable.
In another such aspect, the linker is not cleavable. In another
such aspect, the compound is directly linked to the antibody. In
one such aspect, the antibody is a multispecific antibody and the
compound forms one portion of the multispecific antibody. In
another such aspect, the multispecific antibody comprises a first
antigen binding site which binds the BBB-R and a second antigen
binding site which binds a brain antigen. In another such aspect,
the brain antigen is selected from the group consisting of:
beta-secretase 1 (BACE1), Abeta, epidermal growth factor receptor
(EGFR), human epidermal growth factor receptor 2 (HER2), Tau,
apolipoprotein E4 (ApoE4), alpha-synuclein, CD20, huntingtin, prion
protein (PrP), leucine rich repeat kinase 2 (LRRK2), parkin,
presenilin 1, presenilin 2, gamma secretase, death receptor 6
(DR6), amyloid precursor protein (APP), p75 neurotrophin receptor
(p75NTR), and caspase 6. In another such aspect, the multispecific
antibody binds both TfR and BACE1. In another such aspect, the
multispecific antibody binds both TfR and Abeta. In another such
aspect, the multispecific antibody is labeled. In another aspect,
the compound is reversibly coupled to the antibody such that the
compound is released from the antibody concurrent with or after BBB
transport.
[0026] In another embodiment, the invention provides a method of
optimizing the pharmcokinetics and/or pharmacodynamics of a
compound to be efficacious in the CNS of a subject, wherein the
compound is coupled to an antibody which binds with low affinity to
a BBB-R, and the antibody is selected such that its affinity for
the BBB-R after coupling to the compound results in an amount of
transport of the antibody conjugated to the compound across the BBB
that optimizes the pharmacokinetics and/or pharmacodynamics of the
compound in the CNS. In one aspect, the compound is a neurological
disorder drug. In another aspect, the compound is an imaging agent.
In another aspect, the compound is labeled. In another aspect, the
antibody is labeled. In another aspect, the antibody does not
impair the binding of the BBB-R to one or more of its native
ligands. In another such aspect, the antibody specifically binds to
TfR in such a manner that it does not inhibit binding of the TfR to
transferrin. In another aspect, the BBB is in a mammal. In another
such aspect, the mammal is a human. In another such aspect, the
mammal has a neurological disorder. In another such aspect, the
neurological disorder is selected from the group consisting of
Alzheimer's disease (AD), stroke, dementia, muscular dystrophy
(MD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS),
cystic fibrosis, Angelman's syndrome, Liddle syndrome, Parkinson's
disease, Pick's disease, Paget's disease, cancer, and traumatic
brain injury. In another aspect, the BBB is in a human.
[0027] In one aspect, the optimizing may include the generation of
a series of antibody-compound complexes in which each antibody has
a different affinity for the BBB-R, and assessing the
pharmacokinetics and/or pharmacodynamics of each in the CNS. In
another aspect, optimizing may be relative to a known standard,
such as, but not limited to, the pharmacokinetics and/or
pharmacodynamics of the compound when directly introduced into the
CNS or when introduced to the subject in the absence of a coupled
anti-BBB-R antibody.
[0028] In another aspect, the antibody has an IC50 for the BBB-R
from about 1 nM to about 100 .mu.M. In another such aspect, the
IC50 is from about 5 nM to about 100 .mu.M. In another such aspect,
the IC50 is from about 50 nM to about 100 .mu.M. In another such
aspect, the IC50 is from about 100 nM to about 100 .mu.M. In
another aspect, the antibody has an affinity for the BBB-R from
about 5 nM to about 10 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 30 nM to about 1 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 50 nM to about 1 .mu.M. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an
affinity for TfR between those affinities observed for the
anti-TfR.sup.A/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In another such aspect, the compound-coupled antibody
specifically binds to TfR and has an affinity for TfR between those
affinities observed for the anti-TfR.sup.D/BACE1 antibody and the
anti-TfR.sup.E/BACE1 antibody. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an IC50
for TfR between those IC50s observed for the anti-TfR.sup.A/BACE1
antibody and the anti-TfR.sup.E/BACE1 antibody. In another such
aspect, the compound-coupled antibody specifically binds to TfR and
has an IC50 for TfR between those IC50s observed for the
anti-TfR.sup.D/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In one aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using scatchard
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using BIACORE
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using a competition
ELISA.
[0029] In another aspect, the BBB-R is selected from the group
consisting of transferrin receptor (TfR), insulin receptor,
insulin-like growth factor receptor (IGF receptor), low density
lipoprotein receptor-related protein 8 (LRP8), low density
lipoprotein receptor-related protein 1 (LRP1), and heparin-binding
epidermal growth factor-like growth factor (HB-EGF). In another
such aspect, the BBB-R is a human BBB-R. In one such aspect, the
BBB-R is TfR. In another such aspect, the BBB-R is TfR and the
antibody does not inhibit TfR activity. In another such aspect, the
BBB-R is TfR and the antibody does not inhibit the binding of TfR
to transferrin. In another aspect, the compound-coupled antibody is
administered at a therapeutic dose. In one such aspect, the
therapeutic dose is a dose that saturates the BBB-R to which the
antibody specifically binds.
[0030] In another aspect, the compound is covalently coupled to the
antibody. In one such aspect, the compound is joined to the
antibody by a linker. In one such aspect, the linker is cleavable.
In another such aspect, the linker is not cleavable. In another
such aspect, the compound is directly linked to the antibody. In
one such aspect, the antibody is a multispecific antibody and the
compound forms one portion of the multispecific antibody. In
another such aspect, the multispecific antibody comprises a first
antigen binding site which binds the BBB-R and a second antigen
binding site which binds a brain antigen. In another such aspect,
the brain antigen is selected from the group consisting of:
beta-secretase 1 (BACE1), Abeta, epidermal growth factor receptor
(EGFR), human epidermal growth factor receptor 2 (HER2), Tau,
apolipoprotein E4 (ApoE4), alpha-synuclein, CD20, huntingtin, prion
protein (PrP), leucine rich repeat kinase 2 (LRRK2), parkin,
presenilin 1, presenilin 2, gamma secretase, death receptor 6
(DR6), amyloid precursor protein (APP), p75 neurotrophin receptor
(p75NTR), and caspase 6. In another such aspect, the multispecific
antibody binds both TfR and BACE1. In another such aspect, the
multispecific antibody binds both TfR and Abeta. In another such
aspect, the multispecific antibody is labeled. In another aspect,
the compound is reversibly coupled to the antibody such that the
compound is released from the antibody concurrent with or after BBB
transport.
[0031] In another embodiment the invention provides a method of
treating a neurological disorder in a mammal comprising treating
the mammal with an antibody that binds a BBB-R and is coupled to a
compound, wherein the antibody has been selected to have a low
affinity for the BBB-R and thereby improves CNS uptake of the
antibody and coupled compound. In one aspect, the compound is a
neurological disorder drug. In another aspect, the compound is an
imaging agent. In another aspect, the compound is labeled. In
another aspect, the antibody is labeled. In another aspect, the
antibody does not impair the binding of the BBB-R to one or more of
its native ligands. In another such aspect, the antibody
specifically binds to TfR in such a manner that it does not inhibit
binding of the TfR to transferrin. In one aspect, the mammal is a
human.
[0032] In another such aspect, the mammal has a neurological
disorder. In another such aspect, the neurological disorder is
selected from the group consisting of Alzheimer's disease (AD),
stroke, dementia, muscular dystrophy (MD), multiple sclerosis (MS),
amyotrophic lateral sclerosis (ALS), cystic fibrosis, Angelman's
syndrome, Liddle syndrome, Parkinson's disease, Pick's disease,
Paget's disease, cancer, and traumatic brain injury.
[0033] In one aspect, the treating results in lessening or
elimination of disorder symptoms. In another aspect, the treating
results in amelioration of the neurological disorder.
[0034] In another aspect, the antibody has an IC50 for the BBB-R
from about 1 nM to about 100 .mu.M. In another such aspect, the
IC50 is from about 5 nM to about 100 .mu.M. In another such aspect,
the IC50 is from about 50 nM to about 100 .mu.M. In another such
aspect, the IC50 is from about 100 nM to about 100 .mu.M. In
another aspect, the antibody has an affinity for the BBB-R from
about 5 nM to about 10 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 30 nM to about 1 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 50 nM to about 1 .mu.M. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an
affinity for TfR between those affinities observed for the
anti-TfR.sup.A/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In another such aspect, the compound-coupled antibody
specifically binds to TfR and has an affinity for TfR between those
affinities observed for the anti-TfR.sup.D/BACE1 antibody and the
anti-TfR.sup.E/BACE1 antibody. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an IC50
for TfR between those IC50s observed for the anti-TfR.sup.A/BACE1
antibody and the anti-TfR.sup.E/BACE1 antibody. In another such
aspect, the compound-coupled antibody specifically binds to TfR and
has an IC50 for TfR between those IC50s observed for the
anti-TfR.sup.D/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In one aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using scatchard
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using BIACORE
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using a competition
ELISA.
[0035] In another aspect, the BBB-R is selected from the group
consisting of transferrin receptor (TfR), insulin receptor,
insulin-like growth factor receptor (IGF receptor), low density
lipoprotein receptor-related protein 8 (LRP8), low density
lipoprotein receptor-related protein 1 (LRP1), and heparin-binding
epidermal growth factor-like growth factor (HB-EGF). In another
such aspect, the BBB-R is a human BBB-R. In one such aspect, the
BBB-R is TfR. In another such aspect, the BBB-R is TfR and the
antibody does not inhibit TfR activity. In another such aspect, the
BBB-R is TfR and the antibody does not inhibit the binding of TfR
to transferrin. In another aspect, the compound-coupled antibody is
administered at a therapeutic dose. In one such aspect, the
therapeutic dose is a dose that saturates the BBB-R to which the
antibody specifically binds.
[0036] In another aspect, the compound is covalently coupled to the
antibody. In one such aspect, the compound is joined to the
antibody by a linker. In one such aspect, the linker is cleavable.
In another such aspect, the linker is not cleavable. In another
such aspect, the compound is directly linked to the antibody. In
one such aspect, the antibody is a multispecific antibody and the
compound forms one portion of the multispecific antibody. In
another such aspect, the multispecific antibody comprises a first
antigen binding site which binds the BBB-R and a second antigen
binding site which binds a brain antigen. In another such aspect,
the brain antigen is selected from the group consisting of:
beta-secretase 1 (BACE1), Abeta, epidermal growth factor receptor
(EGFR), human epidermal growth factor receptor 2 (HER2), Tau,
apolipoprotein E4 (ApoE4), alpha-synuclein, CD20, huntingtin, prion
protein (PrP), leucine rich repeat kinase 2 (LRRK2), parkin,
presenilin 1, presenilin 2, gamma secretase, death receptor 6
(DR6), amyloid precursor protein (APP), p75 neurotrophin receptor
(p75NTR), and caspase 6. In another such aspect, the multispecific
antibody binds both TfR and BACE1. In another such aspect, the
multispecific antibody binds both TfR and Abeta. In another such
aspect, the multispecific antibody is labeled. In another aspect,
the compound is reversibly coupled to the antibody such that the
compound is released from the antibody concurrent with or after BBB
transport.
[0037] In another embodiment, the invention provides a method of
making an antibody useful for transporting a compound across the
BBB comprising selecting an antibody specific for a blood-brain
barrier receptor (BBB-R) because it has a desirably low affinity
for the BBB-R.
[0038] In one aspect, the antibody is selected from a panel of
antibodies based upon the affinity of the selected antibody. In
another aspect, the antibody is engineered to have the affinity. In
one such aspect, the antibody is generated using any art-known
protein engineering methodology including, but not limited to,
phage display, yeast display, random mutagenesis, and site-directed
mutagenesis.
[0039] In one aspect, the compound is a neurological disorder drug.
In another aspect, the compound is an imaging agent. In another
aspect, the compound is labeled. In another aspect, the antibody is
labeled. In another aspect, the antibody does not impair the
binding of the BBB-R to one or more of its native ligands. In
another such aspect, the antibody specifically binds to TfR in such
a manner that it does not inhibit binding of the TfR to
transferrin. In another aspect, the BBB is in a mammal. In another
such aspect, the mammal is a human. In another such aspect, the
mammal has a neurological disorder. In another such aspect, the
neurological disorder is selected from the group consisting of
Alzheimer's disease (AD), stroke, dementia, muscular dystrophy
(MD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS),
cystic fibrosis, Angelman's syndrome, Liddle syndrome, Parkinson's
disease, Pick's disease, Paget's disease, cancer, and traumatic
brain injury. In another aspect, the BBB is in a human.
[0040] In another aspect, the antibody has an IC50 for the BBB-R
from about 1 nM to about 100 .mu.M. In another such aspect, the
IC50 is from about 5 nM to about 100 .mu.M. In another such aspect,
the IC50 is from about 50 nM to about 100 .mu.M. In another such
aspect, the IC50 is from about 100 nM to about 100 .mu.M. In
another aspect, the antibody has an affinity for the BBB-R from
about 5 nM to about 10 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 30 nM to about 1 .mu.M. In another such aspect, the antibody,
when coupled to a compound, has an affinity for the BBB-R from
about 50 nM to about 1 .mu.M. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an
affinity for TfR between those affinities observed for the
anti-TfR.sup.A/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In another such aspect, the compound-coupled antibody
specifically binds to TfR and has an affinity for TfR between those
affinities observed for the anti-TfR.sup.D/BACE1 antibody and the
anti-TfR.sup.E/BACE1 antibody. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an IC50
for TfR between those IC50s observed for the anti-TfR.sup.A/BACE1
antibody and the anti-TfR.sup.E/BACE1 antibody. In another such
aspect, the compound-coupled antibody specifically binds to TfR and
has an IC50 for TfR between those IC50s observed for the
anti-TfR.sup.D/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In one aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using scatchard
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using BIACORE
analysis. In another aspect, the affinity of the anti-BBB-R or
anti-BBB-R/compound for the BBB-R is measured using a competition
ELISA.
[0041] In another aspect, the BBB-R is selected from the group
consisting of transferrin receptor (TfR), insulin receptor,
insulin-like growth factor receptor (IGF receptor), low density
lipoprotein receptor-related protein 8 (LRP8), low density
lipoprotein receptor-related protein 1 (LRP1), and heparin-binding
epidermal growth factor-like growth factor (HB-EGF). In another
such aspect, the BBB-R is a human BBB-R. In one such aspect, the
BBB-R is TfR. In another such aspect, the BBB-R is TfR and the
antibody does not inhibit TfR activity. In another such aspect, the
BBB-R is TfR and the antibody does not inhibit the binding of TfR
to transferrin. In another aspect, the compound-coupled antibody is
administered at a therapeutic dose. In one such aspect, the
therapeutic dose is a dose that saturates the BBB-R to which the
antibody specifically binds.
[0042] In another aspect, the compound is covalently coupled to the
antibody. In one such aspect, the compound is joined to the
antibody by a linker. In one such aspect, the linker is cleavable.
In another such aspect, the linker is not cleavable. In another
such aspect, the compound is directly linked to the antibody. In
one such aspect, the antibody is a multispecific antibody and the
compound forms one portion of the multispecific antibody. In
another such aspect, the multispecific antibody comprises a first
antigen binding site which binds the BBB-R and a second antigen
binding site which binds a brain antigen. In another such aspect,
the brain antigen is selected from the group consisting of:
beta-secretase 1 (BACE1), Abeta, epidermal growth factor receptor
(EGFR), human epidermal growth factor receptor 2 (HER2), Tau,
apolipoprotein E4 (ApoE4), alpha-synuclein, CD20, huntingtin, prion
protein (PrP), leucine rich repeat kinase 2 (LRRK2), parkin,
presenilin 1, presenilin 2, gamma secretase, death receptor 6
(DR6), amyloid precursor protein (APP), p75 neurotrophin receptor
(p75NTR), and caspase 6. In another such aspect, the multispecific
antibody binds both TfR and BACE1. In another such aspect, the
multispecific antibody binds both TfR and Abeta. In another such
aspect, the multispecific antibody is labeled. In another aspect,
the compound is reversibly coupled to the antibody such that the
compound is released from the antibody concurrent with or after BBB
transport.
[0043] In another embodiment, the invention provides an antibody
which binds to a blood-brain barrier receptor (BBB-R) with low
affinity. In one aspect, the affinity of the antibody for the BBB-R
is from about 5 nM to about 10 .mu.M. In another aspect, the
affinity of the antibody for the BBB-R is from about 20 nM to about
1 .mu.M. In another aspect, the antibody has an IC50 for the BBB-R
from about 1 nM to about 100 .mu.M. In another such aspect, the
IC50 is from about 5 nM to about 100 .mu.M. In another such aspect,
the IC50 is from about 50 nM to about 100 .mu.M. In another such
aspect, the IC50 is from about 100 nM to about 100 .mu.M. In
another such aspect, the antibody, when coupled to a compound, has
an affinity for the BBB-R from about 50 nM to about 1 .mu.M. In
another such aspect, the compound-coupled antibody specifically
binds to TfR and has an affinity for TfR between those affinities
observed for the anti-TfR.sup.A/BACE1 antibody and the
anti-TfR.sup.E/BACE1 antibody. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an
affinity for TfR between those affinities observed for the
anti-TfR.sup.D/BACE1 antibody and the anti-TfR.sup.E/BACE1
antibody. In another such aspect, the compound-coupled antibody
specifically binds to TfR and has an IC50 for TfR between those
IC50s observed for the anti-TfR.sup.A/BACE1 antibody and the
anti-TfR.sup.E/BACE1 antibody. In another such aspect, the
compound-coupled antibody specifically binds to TfR and has an IC50
for TfR between those IC50s observed for the anti-TfR.sup.D/BACE1
antibody and the anti-TfR.sup.E/BACE1 antibody. In one aspect, the
affinity of the anti-BBB-R or anti-BBB-R/compound for the BBB-R is
measured using scatchard analysis. In another aspect, the affinity
of the anti-BBB-R or anti-BBB-R/compound for the BBB-R is measured
using BIACORE analysis. In another aspect, the affinity of the
anti-BBB-R or anti-BBB-R/compound for the BBB-R is measured using a
competition ELISA.
[0044] In another aspect, the BBB-R is selected from the group
consisting of transferrin receptor (TfR), insulin receptor,
insulin-like growth factor receptor (IGF receptor), low density
lipoprotein receptor-related protein 8 (LRP8), low density
lipoprotein receptor-related protein 1 (LRP1), and heparin-binding
epidermal growth factor-like growth factor (HB-EGF). In one such
aspect, the BBB-R is TfR. In another such aspect, the BBB-R is TfR
and the antibody does not inhibit TfR activity. In another such
aspect, the BBB-R is TfR and the antibody does not inhibit the
binding of TfR to transferrin. In another such aspect, the BBB-R is
a human BBB-R.
[0045] In another aspect, the antibody is coupled to a compound. In
one aspect, the compound is a neurological disorder drug. In
another aspect, the compound is an imaging agent. In another
aspect, the compound is labeled. In another aspect, the antibody is
labeled. In another aspect, the antibody does not impair the
binding of the BBB-R to one or more of its native ligands. In
another such aspect, the antibody specifically binds to TfR in such
a manner that it does not inhibit binding of the TfR to
transferrin.
[0046] In another aspect, the compound is covalently coupled to the
antibody. In one such aspect, the compound is joined to the
antibody by a linker. In one such aspect, the linker is cleavable.
In another such aspect, the linker is not cleavable. In another
such aspect, the compound is directly linked to the antibody. In
one such aspect, the antibody is a multispecific antibody and the
compound forms one portion of the multispecific antibody. In
another such aspect, the multispecific antibody comprises a first
antigen binding site which binds the BBB-R and a second antigen
binding site which binds a brain antigen. In another such aspect,
the brain antigen is selected from the group consisting of:
beta-secretase 1 (BACE1), Abeta, epidermal growth factor receptor
(EGFR), human epidermal growth factor receptor 2 (HER2), Tau,
apolipoprotein E4 (ApoE4), alpha-synuclein, CD20, huntingtin, prion
protein (PrP), leucine rich repeat kinase 2 (LRRK2), parkin,
presenilin 1, presenilin 2, gamma secretase, death receptor 6
(DR6), amyloid precursor protein (APP), p75 neurotrophin receptor
(p75NTR), and caspase 6. In another such aspect, the multispecific
antibody binds both TfR and BACE1. In another such aspect, the
multispecific antibody binds both TfR and Abeta. In another such
aspect, the multispecific antibody is labeled. In another aspect,
the compound is reversibly coupled to the antibody such that the
compound is released from the antibody concurrent with or after BBB
transport.
[0047] In another aspect, the antibody is an antibody fragment with
an antigen-binding region that binds the BBB-R, including, but not
limited to, Fab, Fab', F(ab').sub.2, and Fv. In another aspect, the
antibody is a full-length antibody.
[0048] In another embodiment, the invention provides the use of an
antibody that binds with low affinity to a BBB-R for the
manufacture of a medicament for treating a neurological disorder.
Any of the foregoing described low-affinity anti-BBB-R antibodies
or any of the low-affinity anti-BBB-R antibodies described
elsewhere herein may be used in the method.
[0049] In another embodiment, the invention provides an antibody
that binds with low affinity to a BBB-R for use in treating a
neurological disorder. Any of the foregoing described low-affinity
anti-BBB-R antibodies or any of the low-affinity anti-BBB-R
antibodies described elsewhere herein may be used in the method.
Accordingly, in a first aspect, the invention provides an antibody
which binds to a blood-brain barrier receptor (BBB-R), wherein the
affinity of the antibody for the BBB-R is from about 5 nM to about
10 .mu.M (e.g. from about 20 nM to about 1 .mu.M). Optionally, the
BBB-R is selected from the group consisting of transferrin receptor
(TfR), insulin receptor, insulin-like growth factor receptor (IGF
receptor), low density lipoprotein receptor-related protein 1
(LRP1), low density lipoprotein receptor-related protein 8 (LRP8),
and heparin-binding epidermal growth factor-like growth factor
(HB-EGF). Optionally, the antibody is coupled with a therapeutic
compound, such as a neurological disorder drug. In one embodiment,
the antibody is a multispecific antibody which comprises a first
antigen binding site which binds the BBB-R and a second antigen
binding site which binds a brain antigen, for instance where the
brain antigen is selected from the group consisting of:
beta-secretase 1 (BACE1), amyloid beta (Abeta), epidermal growth
factor receptor (EGFR), human epidermal growth factor receptor 2
(HER2), Tau, apolipoprotein A3 (ApoE3), apolipoprotein E4 (ApoE4),
alpha-synuclein, CD20, Huntingtin, prion protein (PrP), leucine
rich repeat kinase 2 (LRRK2), parkin, presenilin 1, presenilin 2,
gamma secretase, death receptor 6 (DR6), amyloid precursor protein
(APP), p75 neurotrophin receptor (p75NTR), and caspase 6. The
antibody (e.g. multispecific antibody) includes antibody fragments
and full-length antibodies.
[0050] In another embodiment, the invention provides a method of
transporting a therapeutic compound, such as a neurological
disorder drug, across the blood-brain barrier comprising exposing
the anti-BBB-R antibody coupled with a neurological disorder drug
to the blood-brain barrier such that the antibody transports the
neurological disorder drug coupled thereto across the blood-brain
barrier. The blood-brain barrier in this method may be in a mammal,
e.g. one with a neurological disorder, examples of which include:
Alzheimer's disease (AD) (including, but not limited to, mild
cognitive impairment and prodromal AD), stroke, dementia, muscular
dystrophy (MD), multiple sclerosis (MS), amyotrophic lateral
sclerosis (ALS), cystic fibrosis, Angelman's syndrome, Liddle
syndrome, Parkinson's disease, Pick's disease, Paget's disease,
cancer (e.g. cancer affecting the CNS or brain), and traumatic
brain injury.
[0051] The invention additionally concerns a method of making an
antibody useful for transporting a therapeutic compound such as a
neurological disorder drug across the blood-brain barrier
comprising selecting an antibody against a blood-brain barrier
receptor (BBB-R) because it has an affinity for the BBB-R which is
from about 5 nM to about 10 .mu.M. In one embodiment the antibody
is selected from a panel of antibodies because it has the desired
affinity. Alternatively, or additionally, the antibody is
engineered to have the desired affinity. The method optionally
further comprises coupling the antibody with a therapeutic compound
such as a neurological disorder drug. For example, the method can
comprise making a multispecific antibody which comprises a first
antigen binding site which binds the BBB-R and a second antigen
binding site which binds a brain antigen.
[0052] The invention additionally provides a method of treating a
neurological disorder in a mammal comprising treating the mammal
with a multispecific antibody that binds both a blood-brain barrier
receptor (BBB-R) and a brain antigen, wherein the anti-BBB-R
antibody has been selected to have a low affinity for the BBB-R and
thereby improves brain uptake of the anti-brain antigen antibody.
Optionally, the multispecific antibody binds both transferrin
receptor (TfR) and BACE1 or Abeta.
[0053] It will be understood that any of the foregoing methods and
compositions of the invention may be combined with one another
and/or with the further aspects of the invention described in the
specification herein.
BRIEF DESCRIPTION OF THE FIGURES
[0054] FIGS. 1A-E depict significant brain vascular uptake of
systemically administered anti-TfR antibody. FIG. 1A shows brain
uptake after IV administration of trace doses (approximately 50
.mu.g/kg) of [.sup.131I]anti-TfR.sup.A and [.sup.125I]control IgG
in mice and was quantified as a mean percentage of injected dose
per gram of brain at 5, 30 min., 1, 4, 24, 48, and 72 hours after
IV injection (n=6). Uptake of [.sup.131I]anti-TfR.sup.A was
decreased by injection with 4 mg/kg unlabeled anti-TfR.sup.A
(cold). FIG. 1B shows quantification of mean antibody uptake in
brain 1 and 24 hours after a 20 mg/kg IV injection of control IgG
or anti-TfR.sup.A (***p=0.0002, n=10). FIG. 1C shows ratio of mean
percent brain to serum concentrations (**p=0.003, n=10). FIGS. 1D
and 1E depict immunohistochemical staining of brain sections
following IV-injection with anti-TfR.sup.A (FIG. 1D, upper panels),
which shows co-localization with anti-collagen IV, a vascular
marker (lower panel). IV-injection with control IgG (FIG. 1E, upper
panels) exhibits vascular distribution in brain only after 1 hour
and an absence of antibody after 24 hours. Scale bar=50 .mu.m.
[0055] FIGS. 2A-F show that affinity of anti-TfR antibodies and
extent of brain uptake are inversely related when administered at a
therapeutically relevant dose (20 mg/kg) as compared to a low trace
dose (approximately 50 .mu.g/kg). FIG. 2A depicts a competitive
binding ELISA in which increasing concentrations of
anti-TfR.sup.A,B,C,D,E variant antibodies are used to compete
against biotinylated TfR.sup.A for binding to TfR. The anti-TfR
competition ELISA was performed in Maxisorp plates (Neptune, N.J.)
coated with 2.5 .mu.g/ml of purified murine TfR extracellular
domain in PBS at 4.degree. C. overnight. Plates were washed with
PBS/0.05% Tween 20 and blocked using Superblock blocking buffer in
PBS (Thermo Scientific, Hudson, N.H.). A titration of
anti-TfR.sup.A, anti-TfR.sup.B, anti-TfR.sup.C, or anti-TfR.sup.D
(1:3 serial dilution) was combined with biotinylated anti-TfR.sup.A
(0.5 nM final concentration) and added to the plate for 1 hour at
room temperature. Plates were washed with PBS/0.05% Tween 20, and
HRP-streptavidin (Southern Biotech, Birmingham) was added to the
plate and incubated for 1 hour at room temperature. Plates were
washed with PBS/0.05% Tween 20, and biotinylated anti-TfR.sup.A
bound to the plate was detected using TMB substrate (BioFX
Laboratories, Owings Mills). The results in FIG. 2A present data
from a single experiment in which all five anti-TfR variants were
separately assessed. The IC50 values determined from this data are
shown in Table 2. FIG. 2B depicts quantification of mean brain
uptake after IV-injection of trace doses (approximately 50
.mu.g/kg) of the [.sup.125I]anti_TfR.sup.A,B,C,D,E variants after 5
min., 1, 4, 6, and 24 hours (n=3). The results in FIG. 2B present
data from a single experiment in which all five anti-TfR variants
were separately assessed. FIG. 2C shows quantification of mean
brain uptake after 20 mg/kg IV injection of anti-TfR variants at 1
and 24 hours using the methods described with regard to FIG. 1B.
The experiment was replicated under the same conditions using
anti-TfR.sup.E, and all results presented in FIG. 2C. FIG. 2D is a
model illustrating the inverse relationship between affinity and
brain uptake. FIG. 2E is a comparison of immunohistochemical
staining of brain sections after IV injection with either the high
affinity anti-TfR.sup.A or lower affinity anti-TfR.sup.B,C,D
antibodies showing differences in antibody distribution (staining
in left panels is for anti-TfR alone) and extent of co-localization
with NeuN (staining in right panels is for both anti-TfR and NeuN).
Scale bar=50 .mu.m. FIG. 2F is a representative high magnification
image of anti-TfR.sup.D localizaton in neurons (as indicated by
NeuN staining); this data shows that anti-TfR.sup.D and NeuN
colocalize and thus that anti-TfR.sup.D traverses the BBB and
interacts with neurons, whereas anti-TfR.sup.A mainly localizes to
the vasculature as opposed to neurons. Scale bar=20 .mu.m.
[0056] FIGS. 3A-G show that a bispecific anti-TfR/BACE1 antibody
inhibits AP in vitro and accumulates in the brain. FIG. 3A is a
schematic model of a bispecific antibody which was engineered to
bind both TfR and .beta.-secretase (BACE1). FIG. 3B shows binding
affinity for TfR of the parental anti-TfR.sup.A and
anti-TfR.sup.A/BACE1 as measured by the anti-TfR competition ELISA
assay described above for FIG. 2A. FIG. 3C shows quantification of
AP levels produced by HEK293 cells stably expressing APP after
treatment with anti-TfR.sup.A/BACE1, anti-BACE1, and control IgG in
a cell-based assay. The ability of the antibodies to inhibit
A.beta.1-40 production in HEK293 cells stably expressing wild-type
human amyloid precursor protein was assessed as follows.
HEK293-APPWT cells were seeded overnight at a density of
3.times.10.sup.4 cells/well in a 96-well plate. 50 .mu.l of fresh
media (DMEM+10% FBS) containing an anti-BACE1 antibody or a control
IgG1 antibody was incubated with the cells for 24 hours at
37.degree. C. The cellular media was harvested and assayed for the
presence of A.beta.1-40 using a A.beta.1-40 HTRF.RTM. assay
(CisBio) according to the manufacturer's instructions.
A.beta..sub.1-40 values were normalized for cell viability, as
determined using the CellTiter-Glo Luminescent Cell Viability Assay
(Promega). Experiments were performed at least three times, and
each point in each experiment was repeated in duplicate. FIG. 3D
depicts quantification of mean brain uptake after trace doses of
[.sup.125I]-labeled antibody 30 min., 6, 24, and 48 hours after
IV-injection in mice (n=4). FIG. 3E shows quantification of mean
antibody uptake in brain and in FIG. 3F average brain to serum
ratio at 1, 12, 24, and 48 hours after a 20 mg/kg IV injection of
antibody in mice (n=10). The experiments in FIGS. 3E and 3F was
performed using the same protocol as the experiment described with
regard to FIG. 1B. FIG. 3G shows immunohistochemical staining of
brain sections from mice 24 hours after IV injection with either
anti-TfR/BACE1 (left panels) or control IgG (right panels).
Co-localization of antibody with NeuN is observed after
anti-TfR.sup.A/BACE1 treatment (NeuN neuronal staining coincides
with pervasive antibody staining) but absent in control IgG treated
mice (only the NeuN neuronal staining pattern is observed, no
antibody staining).
[0057] FIGS. 4A-E show that a single systemic dose of
anti-TfR.sup.A/BACE1 significantly reduces central and peripheral
A.beta..sub.1-40. FIGS. 4A-D show quantification of brain (A,B) and
plasma (C,D) A.beta..sub.1-40 levels after a 25 mg/kg or 50 mg/kg
IV-injection of control IgG, anti-BACE1, or anti-TfR/BACE1.
Briefly, for Abeta1-40 measurements, hemi-brains were homogenized
in 5M guanidine hydrochloride buffer and samples rotated for 3
hours at room temperature prior to dilution (1:10) in 0.25% casein,
5 mM EDTA (pH 8.0) in PBS containing freshly added aprotinin (20
mg/mL) and leupeptin (10 mg/ml). Diluted homogenates were
centrifuged at 14,000 rpm for 20 min. and supernates were isolated
for Abeta1-40 measurement. For antibody concentration measurements,
the corresponding hemi-brain from each mouse was homogenized in 1%
NP-40 as described above. Whole blood was collected in EDTA
microtainer tubes (BD Diagnostics) prior to perfusion, centrifuged
at 5,000.times.g for 15 minutes and the supernatant was isolated
for measuring plasma mouse Abeta 1-40 and anti-TfR/BACE1
concentrations. The concentrations of total mouse Abeta1-40 in
plasma and brain were determined using a sandwich ELISA following
similar procedures described above. Rabbit polyclonal antibody
specific for the C-terminus of Abeta1-40 (Millipore, Bedford Mass.)
was coated onto plates, and biotinylated anti-mouse Abeta
monoclonal antibody M3.2 (Covance, Dedham Mass.) was used for
detection. The assay had lower limit of quantification values of
1.96 pg/ml in plasma and 39.1 pg/g in brain. Statistical analysis
of differences between experimental groups was performed using a
two-tailed unpaired t-test. * represent significance compared to
control IgG, while # represent significance compared to anti-BACE1.
* p<0.05, ** p<0.01, *** p<0.001; n=10 for all groups.
FIG. 4E shows mean A.beta..sub.1-40 reduction from data in (A-D)
calculated as a percentage of A.beta..sub.1-40 levels relative to
control IgG-injected mice.
[0058] FIGS. 5A-B depict the light and heavy chain amino acid
sequences of anti-BACE1 clone YW412.8 obtained from a naive sort of
the natural diversity phage display library and affinity-matured
forms of YW412.8. FIG. 5A depicts the variable light (VL) sequence
alignments (SEQ ID NOs. 1-6). FIG. 5B depicts the variable heavy
(VH) sequence alignments (SEQ ID Nos. 7-8). In both figures, the
HVR sequences for each clone are indicated by the boxed regions,
with the first box indicating HVR-L1 (FIG. 5A) or HVR-H1 (FIG. 5B),
the second box indicating HVR-L2 (FIG. 5A) or HVR-H2 (FIG. 5B), and
the third box indicating HVR-L3 (FIG. 5A) or HVR-H3 (FIG. 5B).
[0059] FIGS. 6A-B depict the light and heavy chain amino acid
sequences of clone Fab 12 obtained from a naive sort of a synthetic
diversity phage display library and affinity-matured forms of Fab
12. FIG. 6A depicts the light chain sequence alignments (SEQ ID
NOs. 9-12). FIG. 6B depicts the heavy chain sequence alignments
(SEQ ID NO. 13). In both figures, the HVR sequences for each clone
are indicated by the boxed regions, with the first box indicating
HVR-L1 (FIG. 6A) or HVR-H1 (FIG. 6B), the second box indicating
HVR-L2 (FIG. 6A) or HVR-H2 (FIG. 6B), and the third box indicating
HVR-L3 (FIG. 6A) or HVR-H3 (FIG. 6B).
[0060] FIGS. 7A-B depict the heavy chain (FIG. 7A; SEQ ID NO. 14)
and light chain (FIG. 7B; SEQ ID NO. 15) of an exemplary anti-Abeta
antibody.
[0061] FIGS. 8A-B depict the quantification of
anti-TfR.sup.A,B,C,D,E in the serum (FIG. 8A) and brain (FIG. 8B)
after a single therapeutic dose administration in mice. Six-eight
week old wild type female C57B/6 mice were used for all studies.
Mice were intravenously injected with 20 mg/kg of anti-TfR variants
or control IgG. Antibody levels in brain and serum were measured at
1 and 12 hours and 1, 2, 4, 5, 6, and 8 days post injection. Total
injection volume did not exceed 260 .mu.L and antibodies were
diluted in D-PBS (Invitrogen) when necessary. The experiment was
performed using the same protocol as the experiment whose results
are shown in FIG. 1B.
[0062] FIGS. 9A-E show the varying degrees to which bispecific
anti-TfR.sup.A,D,E/BACE1 antibodies accumulate in the brain and
inhibit AP production in vivo. FIG. 9A depicts the results of an
anti-TfR competition ELISA assay using anti-TfR.sup.A,D,E/BACE1,
following the same assay procedure as that described in FIG. 2A.
The IC50 values determined from this data are shown in Table 3.
FIGS. 9B and 9D quantitate the amount of observed antibody (9B) and
the amount of Abeta1-40 (9D) observed in the plasma at 1, 2, 4, 6,
8 and 10 days after a 50 mg/kg IV injection of antibodies in mice
(n=6). FIG. 9C depicts quantification of mean brain uptake and FIG.
9E depicts the amount of Abeta1-40 observed in the brains of those
same treated mice at 1, 2, 4, 6, 8 and 10 days after treatment. Six
to eight week-old wild type female C57B/6 mice were used for all
studies. Mice were intravenously injected with 50 mg/kg
anti-TfR/BACE1 variants, control IgG, or anti-BACE1. After the
indicated time, mice were perfused with D-PBS, and brain and plasma
antibody concentration for each animal was measured as described
above. The assay was performed as described in the FIG. 4
description.
[0063] FIGS. 10A-B and 11A-B show the varying degrees to which
bispecific anti-TfR.sup.A,D,E/Abeta antibodies accumulate in the
brain of PS2APP mice (FIG. 10) and wild type mice (FIG. 11). FIGS.
10A and 11A depict quantification of the amount of observed
antibody in the plasma 1 day after a 50 mg/kg i.p. injection of
antibodies in mice (n=4-6). FIGS. 10B and 11B quantitate mean brain
uptake in the same treated mice.
DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION
I. Definitions
[0064] The "blood-brain barrier" or "BBB" refers to the
physiological barrier between the peripheral circulation and the
brain and spinal cord which is formed by tight junctions within the
brain capillary endothelial plasma membranes, creating a tight
barrier that restricts the transport of molecules into the brain,
even very small molecules such as urea (60 Daltons). The
blood-brain barrier within the brain, the blood-spinal cord barrier
within the spinal cord, and the blood-retinal barrier within the
retina are contiguous capillary barriers within the CNS, and are
herein collectively referred to a the blood-brain barrier or BBB.
The BBB also encompasses the blood-CSF barrier (choroid plexus)
where the barrier is comprised of ependymal cells rather than
capillary endothelial cells.
[0065] The "central nervous system" or "CNS" refers to the complex
of nerve tissues that control bodily function, and includes the
brain and spinal cord.
[0066] A "blood-brain barrier receptor" (abbreviated "BBB-R"
herein) is a transmembrane receptor protein expressed on brain
endothelial cells which is capable of transporting molecules across
the blood-brain barrier. Examples of BBB-R herein include:
transferrin receptor (TfR), insulin receptor, insulin-like growth
factor receptor (IGF-R), low density lipoprotein receptors
including without limitation low density lipoprotein
receptor-related protein 1 (LRP1) and low density lipoprotein
receptor-related protein 8 (LRP8), and heparin-binding epidermal
growth factor-like growth factor (HB-EGF). An exemplary BBB-R
herein is transferrin receptor (TfR).
[0067] The "transferrin receptor" ("TfR") is a transmembrane
glycoprotein (with a molecular weight of about 180,000) composed of
two disulphide-bonded sub-units (each of apparent molecular weight
of about 90,000) involved in iron uptake in vertebrates. In one
embodiment, the TfR herein is human TfR comprising the amino acid
sequence as in Schneider et al. Nature 311: 675-678 (1984), for
example.
[0068] A "neurological disorder" as used herein refers to a disease
or disorder which affects the CNS and/or which has an etiology in
the CNS. Exemplary CNS diseases or disorders include, but are not
limited to, neuropathy, amyloidosis, cancer, an ocular disease or
disorder, viral or microbial infection, inflammation, ischemia,
neurodegenerative disease, seizure, behavioral disorders, and a
lysosomal storage disease. For the purposes of this application,
the CNS will be understood to include the eye, which is normally
sequestered from the rest of the body by the blood-retina barrier.
Specific examples of neurological disorders include, but are not
limited to, neurodegenerative diseases (including, but not limited
to, Lewy body disease, postpoliomyelitis syndrome, Shy-Draeger
syndrome, olivopontocerebellar atrophy, Parkinson's disease,
multiple system atrophy, striatonigral degeneration, tauopathies
(including, but not limited to, Alzheimer disease and supranuclear
palsy), prion diseases (including, but not limited to, bovine
spongiform encephalopathy, scrapie, Creutzfeldt-Jakob syndrome,
kuru, Gerstmann-Straussler-Scheinker disease, chronic wasting
disease, and fatal familial insomnia), bulbar palsy, motor neuron
disease, and nervous system heterodegenerative disorders
(including, but not limited to, Canavan disease, Huntington's
disease, neuronal ceroid-lipofuscinosis, Alexander's disease,
Tourette's syndrome, Menkes kinky hair syndrome, Cockayne syndrome,
Halervorden-Spatz syndrome, lafora disease, Rett syndrome,
hepatolenticular degeneration, Lesch-Nyhan syndrome, and
Unverricht-Lundborg syndrome), dementia (including, but not limited
to, Pick's disease, and spinocerebellar ataxia), cancer (e.g. of
the CNS and/or brain, including brain metastases resulting from
cancer elsewhere in the body).
[0069] A "neurological disorder drug" is a drug or therapeutic
agent that treats one or more neurological disorder(s).
Neurological disorder drugs of the invention include, but are not
limited to, antibodies, peptides, proteins, natural ligands of one
or more CNS target(s), modified versions of natural ligands of one
or more CNS target(s), aptamers, inhibitory nucleic acids (i.e.,
small inhibitory RNAs (siRNA) and short hairpin RNAs (shRNA)),
ribozymes, and small molecules, or active fragments of any of the
foregoing. Exemplary neurological disorder drugs of the invention
are described herein and include, but are not limited to:
antibodies, aptamers, proteins, peptides, inhibitory nucleic acids
and small molecules and active fragments of any of the foregoing
that either are themselves or specifically recognize and/or act
upon (i.e., inhibit, activate, or detect) a CNS antigen or target
molecule such as, but not limited to, amyloid precursor protein or
portions thereof, amyloid beta, beta-secretase, gamma-secretase,
tau, alpha-synuclein, parkin, huntingtin, DR6, presenilin, ApoE,
glioma or other CNS cancer markers, and neurotrophins. Non-limiting
examples of neurological disorder drugs and disorders they may be
used to treat are provided in the following Table 1:
TABLE-US-00001 TABLE 1 Non-limiting examples of neurological
disorder drugs and the corresponding disorders they may be used to
treat Drug Neurological disorder Anti-BACE1 Antibody Alzheimer's,
acute and chronic brain injury, stroke Anti-Abeta Antibody
Alzheimer's disease Neurotrophin Stroke, acute brain injury, spinal
cord injury Brain-derived neurotrophic Chronic brain injury
(Neurogenesis) factor (BDNF), Fibroblast growth factor 2 (FGF-2)
Anti-Epidermal Growth Factor Brain cancer Receptor (EGFR)-antibody
Glial cell-line derived Parkinson's disease neural factor (GDNF)
Brain-derived neurotrophic Amyotrophic lateral sclerosis, factor
(BDNF) depression Lysosomal enzyme Lysosomal storage disorders of
the brain Ciliary neurotrophic factor Amyotrophic lateral sclerosis
(CNTF) Neuregulin-1 Schizophrenia Anti-HER2 antibody (e.g. Brain
metastasis from HER2-positive trastuzumab) cancer
[0070] An "imaging agent" is a compound that has one or more
properties that permit its presence and/or location to be detected
directly or indirectly. Examples of such imaging agents include
proteins and small molecule compounds incorporating a labeled
moiety that permits detection.
[0071] A "CNS antigen" or "brain antigen" is an antigen expressed
in the CNS, including the brain, which can be targeted with an
antibody or small molecule. Examples of such antigens include,
without limitation: beta-secretase 1 (BACE1), amyloid beta (Abeta),
epidermal growth factor receptor (EGFR), human epidermal growth
factor receptor 2 (HER2), Tau, apolipoprotein E4 (ApoE4),
alpha-synuclein, CD20, huntingtin, prion protein (PrP), leucine
rich repeat kinase 2 (LRRK2), parkin, presenilin 1, presenilin 2,
gamma secretase, death receptor 6 (DR6), amyloid precursor protein
(APP), p75 neurotrophin receptor (p75NTR), and caspase 6. In one
embodiment, the antigen is BACE1.
[0072] The term "BACE1," as used herein, refers to any native
beta-secretase 1 (also called .beta.-site amyloid precursor protein
cleaving enzyme 1, membrane-associated aspartic protease 2,
memapsin 2, aspartyl protease 2 or Asp2) from any vertebrate
source, including mammals such as primates (e.g. humans) and
rodents (e.g., mice and rats), unless otherwise indicated. The term
encompasses "full-length," unprocessed BACE1 as well as any form of
BACE1 which results from processing in the cell. The term also
encompasses naturally occurring variants of BACE1, e.g., splice
variants or allelic variants. The amino acid sequence of an
exemplary BACE1 polypeptide is the sequence for human BACE1,
isoform A as reported in Vassar et al., Science 286:735-741 (1999),
which is incorporated herein by reference in its entirety. Several
other isoforms of human BACE1 exist including isoforms B, C and D.
See UniProtKB/Swiss-Prot Entry P56817, which is incorporated herein
by reference in its entirety.
[0073] The terms "anti-beta-secretase antibody", "anti-BACE1
antibody", "an antibody that binds to beta-secretase" and "an
antibody that binds to BACE1" refer to an antibody that is capable
of binding BACE1 with sufficient affinity such that the antibody is
useful as a diagnostic and/or therapeutic agent in targeting BACE1.
In one embodiment, the extent of binding of an anti-BACE1 antibody
to an unrelated, non-BACE1 protein is less than about 10% of the
binding of the antibody to BACE1 as measured, e.g., by a
radioimmunoassay (MA). In certain embodiments, an antibody that
binds to BACE1 has a dissociation constant (Kd) of .ltoreq.1 .mu.M,
.ltoreq.100 nM, .ltoreq.10 nM, .ltoreq.1 nM, .ltoreq.0.1 nM,
.ltoreq.0.01 nM, or .ltoreq.0.001 nM (e.g. 10.sup.-8M or less, e.g.
from 10.sup.-8M to 10.sup.-13M, e.g., from 10.sup.-9M to 10.sup.-13
M). In certain embodiments, an anti-BACE1 antibody binds to an
epitope of BACE1 that is conserved among BACE1 from different
species and isoforms. In one embodiment, an antibody is provided
that binds to the epitope on BACE1 bound by anti-BACE1 antibody
YW412.8.31. In other embodiments, an antibody is provided that
binds to an exosite within BACE1 located in the catalytic domain of
BACE1. In one embodiment an antibody is provided that competes with
the peptides identified in Kornacker et al., Biochem.
44:11567-11573 (2005), which is incorporated herein by reference in
its entirety, (i.e., Peptides 1, 2, 3, 1-11, 1-10, 1-9, 1-8, 1-7,
1-6, 2-12, 3-12, 4-12, 5-12, 6-12, 7-12, 8-12, 9-12, 10-12, 4, 5,
6, 5-10, 5-9, scrambled, YSA, P6A, Y7A, F8A, I9A, P10A and L11A)
for binding to BACE1. Exemplary BACE1 antibody sequences are
depicted in FIG. 5A-B and FIG. 6A-B. One exemplary antibody herein
comprises the variable domains of the antibody YW412.8.31 (e.g. as
in FIGS. 5A-B).
[0074] A "native sequence" protein herein refers to a protein
comprising the amino acid sequence of a protein found in nature,
including naturally occurring variants of the protein. The term as
used herein includes the protein as isolated from a natural source
thereof or as recombinantly produced.
[0075] The term "antibody" herein is used in the broadest sense and
specifically covers monoclonal antibodies, polyclonal antibodies,
multispecific antibodies (e.g. bispecific antibodies) formed from
at least two intact antibodies, and antibody fragments so long as
they exhibit the desired biological activity.
[0076] "Antibody fragments" herein comprise a portion of an intact
antibody which retains the ability to bind antigen. Examples of
antibody fragments include Fab, Fab', F(ab')2, and Fv fragments;
diabodies; linear antibodies; single-chain antibody molecules; and
multispecific antibodies formed from antibody fragments.
[0077] The term "monoclonal antibody" as used herein refers to an
antibody obtained from a population of substantially homogeneous
antibodies, i.e., the individual antibodies comprising the
population are identical and/or bind the same epitope, except for
possible variants that may arise during production of the
monoclonal antibody, such variants generally being present in minor
amounts. In contrast to polyclonal antibody preparations that
typically include different antibodies directed against different
determinants (epitopes), each monoclonal antibody is directed
against a single determinant on the antigen. In addition to their
specificity, the monoclonal antibodies are advantageous in that
they are uncontaminated by other immunoglobulins. The modifier
"monoclonal" indicates the character of the antibody as being
obtained from a substantially homogeneous population of antibodies,
and is not to be construed as requiring production of the antibody
by any particular method. For example, the monoclonal antibodies to
be used in accordance with the present invention may be made by the
hybridoma method first described by Kohler et al., Nature, 256:495
(1975), or may be made by recombinant DNA methods (see, e.g., U.S.
Pat. No. 4,816,567). The "monoclonal antibodies" may also be
isolated from phage antibody libraries using the techniques
described in Clackson et al., Nature, 352:624-628 (1991) and Marks
et al., J. Mol. Biol., 222:581-597 (1991), for example. Specific
examples of monoclonal antibodies herein include chimeric
antibodies, humanized antibodies, and human antibodies, including
antigen-binding fragments thereof.
[0078] The monoclonal antibodies herein specifically include
"chimeric" antibodies (immunoglobulins) in which a portion of the
heavy and/or light chain is identical with or homologous to
corresponding sequences in antibodies derived from a particular
species or belonging to a particular antibody class or subclass,
while the remainder of the chain(s) is identical with or homologous
to corresponding sequences in antibodies derived from another
species or belonging to another antibody class or subclass, as well
as fragments of such antibodies, so long as they exhibit the
desired biological activity (U.S. Pat. No. 4,816,567; Morrison et
al., Proc. Natl. Acad. Sci. USA, 81:6851-6855 (1984)). Chimeric
antibodies of interest herein include "primatized" antibodies
comprising variable domain antigen-binding sequences derived from a
non-human primate (e.g. Old World Monkey, such as baboon, rhesus or
cynomolgus monkey) and human constant region sequences (U.S. Pat.
No. 5,693,780).
[0079] "Humanized" forms of non-human (e.g., murine) antibodies are
chimeric antibodies that contain minimal sequence derived from
non-human immunoglobulin. For the most part, humanized antibodies
are human immunoglobulins (recipient antibody) in which residues
from a hypervariable region of the recipient are replaced by
residues from a hypervariable region of a non-human species (donor
antibody) such as mouse, rat, rabbit or nonhuman primate having the
desired specificity, affinity, and capacity. In some instances,
framework region (FR) residues of the human immunoglobulin are
replaced by corresponding non-human residues. Furthermore,
humanized antibodies may comprise residues that are not found in
the recipient antibody or in the donor antibody. These
modifications are made to further refine antibody performance. In
general, the humanized antibody will comprise substantially all of
at least one, and typically two, variable domains, in which all or
substantially all of the hypervariable regions correspond to those
of a non-human immunoglobulin and all or substantially all of the
FRs are those of a human immunoglobulin sequence, except for FR
substitution(s) as noted above. The humanized antibody optionally
also will comprise at least a portion of an immunoglobulin constant
region, typically that of a human immunoglobulin. For further
details, see Jones et al., Nature 321:522-525 (1986); Riechmann et
al., Nature 332:323-329 (1988); and Presta, Curr. Op. Struct. Biol.
2:593-596 (1992).
[0080] A "human antibody" herein is one comprising an amino acid
sequence structure that corresponds with the amino acid sequence
structure of an antibody obtainable from a human B-cell, and
includes antigen-binding fragments of human antibodies. Such
antibodies can be identified or made by a variety of techniques,
including, but not limited to: production by transgenic animals
(e.g., mice) that are capable, upon immunization, of producing
human antibodies in the absence of endogenous immunoglobulin
production (see, e.g., Jakobovits et al., Proc. Natl. Acad. Sci.
USA, 90:2551 (1993); Jakobovits et al., Nature, 362:255-258 (1993);
Bruggermann et al., Year in Immuno., 7:33 (1993); and U.S. Pat.
Nos. 5,591,669, 5,589,369 and 5,545,807)); selection from phage
display libraries expressing human antibodies or human antibody
fragments (see, for example, McCafferty et al., Nature 348:552-553
(1990); Johnson et al., Current Opinion in Structural Biology
3:564-571 (1993); Clackson et al., Nature, 352:624-628 (1991);
Marks et al., J. Mol. Biol. 222:581-597 (1991); Griffith et al.,
EMBO J. 12:725-734 (1993); U.S. Pat. Nos. 5,565,332 and 5,573,905);
generation via in vitro activated B cells (see U.S. Pat. Nos.
5,567,610 and 5,229,275); and isolation from human antibody
producing hybridomas.
[0081] A "multispecific antibody" herein is an antibody having
binding specificities for at least two different epitopes.
Exemplary multispecific antibodies may bind both a BBB-R and a
brain antigen. Multispecific antibodies can be prepared as
full-length antibodies or antibody fragments (e.g. F(ab')2
bispecific antibodies). Engineered antibodies with two, three or
more (e.g. four) functional antigen binding sites are also
contemplated (see, e.g., US Appln No. US 2002/0004587 A1, Miller et
al.). Multispecific antibodies can be prepared as full length
antibodies or antibody fragments.
[0082] Antibodies herein include "amino acid sequence variants"
with altered antigen-binding or biological activity. Examples of
such amino acid alterations include antibodies with enhanced
affinity for antigen (e.g. "affinity matured" antibodies), and
antibodies with altered Fc region, if present, e.g. with altered
(increased or diminished) antibody dependent cellular cytotoxicity
(ADCC) and/or complement dependent cytotoxicity (CDC) (see, for
example, WO 00/42072, Presta, L. and WO 99/51642, Iduosogie et
al.); and/or increased or diminished serum half-life (see, for
example, WO00/42072, Presta, L.).
[0083] An "affinity modified variant" has one or more substituted
hypervariable region or framework residues of a parent antibody
(e.g. of a parent chimeric, humanized, or human antibody) that
alter (increase or reduce) affinity. In one embodiment, the
resulting variant(s) selected for further development will have
reduced affinity for the BBB-R according to the present invention.
A convenient way for generating such substitutional variants uses
phage display. Briefly, several hypervariable region sites (e.g.
6-7 sites) are mutated to generate all possible amino substitutions
at each site. The antibody variants thus generated are displayed in
a monovalent fashion from filamentous phage particles as fusions to
the gene III product of M13 packaged within each particle. The
phage-displayed variants are then screened for their biological
activity (e.g. binding affinity). In order to identify candidate
hypervariable region sites for modification, alanine scanning
mutagenesis can be performed to identify hypervariable region
residues contributing significantly to antigen binding.
Alternatively, or additionally, it may be beneficial to analyze a
crystal structure of the antigen-antibody complex to identify
contact points between the antibody and its target. Such contact
residues and neighboring residues are candidates for substitution
according to the techniques elaborated herein. Once such variants
are generated, the panel of variants is subjected to screening and
antibodies with altered affinity may be selected for further
development.
[0084] The antibody herein may be conjugated with a "heterologous
molecule" for example to increase half-life or stability or
otherwise improve the antibody. For example, the antibody may be
linked to one of a variety of non-proteinaceous polymers, e.g.,
polyethylene glycol (PEG), polypropylene glycol, polyoxyalkylenes,
or copolymers of polyethylene glycol and polypropylene glycol.
Antibody fragments, such as Fab', linked to one or more PEG
molecules are an exemplary embodiment of the invention.
[0085] The antibody herein may be a "glycosylation variant" such
that any carbohydrate attached to the Fc region, if present, is
altered. For example, antibodies with a mature carbohydrate
structure that lacks fucose attached to an Fc region of the
antibody are described in US Pat Appl No US 2003/0157108 (Presta,
L.). See also US 2004/0093621 (Kyowa Hakko Kogyo Co., Ltd).
Antibodies with a bisecting N-acetylglucosamine (GlcNAc) in the
carbohydrate attached to an Fc region of the antibody are
referenced in WO 2003/011878, Jean-Mairet et al. and U.S. Pat. No.
6,602,684, Umana et al. Antibodies with at least one galactose
residue in the oligosaccharide attached to an Fc region of the
antibody are reported in WO 1997/30087, Patel et al. See, also, WO
1998/58964 (Raju, S.) and WO 1999/22764 (Raju, S.) concerning
antibodies with altered carbohydrate attached to the Fc region
thereof. See also US 2005/0123546 (Umana et al.) describing
antibodies with modified glycosylation.
[0086] The term "hypervariable region" when used herein refers to
the amino acid residues of an antibody that are responsible for
antigen binding. The hypervariable region comprises amino acid
residues from a "complementarity determining region" or "CDR" (e.g.
residues 24-34 (L1), 50-56 (L2) and 89-97 (L3) in the light chain
variable domain and 31-35 (H1), 50-65 (H2) and 95-102 (H3) in the
heavy chain variable domain; Kabat et al., Sequences of Proteins of
Immunological Interest, 5th Ed. Public Health Service, National
Institutes of Health, Bethesda, Md. (1991)) and/or those residues
from a "hypervariable loop" (e.g. residues 26-32 (L1), 50-52 (L2)
and 91-96 (L3) in the light chain variable domain and 26-32 (H1),
53-55 (H2) and 96-101 (H3) in the heavy chain variable domain;
Chothia and Lesk J. Mol. Biol. 196:901-917 (1987)). "Framework" or
"FR" residues are those variable domain residues other than the
hypervariable region residues as herein defined.
[0087] A "full length antibody" is one which comprises an
antigen-binding variable region as well as a light chain constant
domain (CL) and heavy chain constant domains, CH1, CH2 and CH3. The
constant domains may be native sequence constant domains (e.g.
human native sequence constant domains) or amino acid sequence
variants thereof.
[0088] A "naked antibody" is an antibody (as herein defined) that
is not conjugated to a heterologous molecule, such as a cytotoxic
moiety, polymer, or radiolabel.
[0089] Antibody "effector functions" refer to those biological
activities attributable to the Fc region (a native sequence Fc
region or amino acid sequence variant Fc region) of an antibody.
Examples of antibody effector functions include C1q binding,
complement dependent cytotoxicity (CDC), Fc receptor binding,
antibody-dependent cell-mediated cytotoxicity (ADCC), etc. In one
embodiment, the antibody herein essentially lacks effector
function.
[0090] Depending on the amino acid sequence of the constant domain
of their heavy chains, full length antibodies can be assigned to
different "classes". There are five major classes of full length
antibodies: IgA, IgD, IgE, IgG, and IgM, and several of these may
be further divided into "subclasses" (isotypes), e.g., IgG1, IgG2,
IgG3, IgG4, IgA, and IgA2. The heavy-chain constant domains that
correspond to the different classes of antibodies are called alpha,
delta, epsilon, gamma, and mu, respectively. The subunit structures
and three-dimensional configurations of different classes of
immunoglobulins are well known.
[0091] The term "recombinant antibody", as used herein, refers to
an antibody (e.g. a chimeric, humanized, or human antibody or
antigen-binding fragment thereof) that is expressed by a
recombinant host cell comprising nucleic acid encoding the
antibody. Examples of "host cells" for producing recombinant
antibodies include: (1) mammalian cells, for example, Chinese
Hamster Ovary (CHO), COS, myeloma cells (including Y0 and NS0
cells), baby hamster kidney (BHK), Hela and Vero cells; (2) insect
cells, for example, sf9, sf21 and Tn5; (3) plant cells, for example
plants belonging to the genus Nicotiana (e.g. Nicotiana tabacum);
(4) yeast cells, for example, those belonging to the genus
Saccharomyces (e.g. Saccharomyces cerevisiae) or the genus
Aspergillus (e.g. Aspergillus niger); (5) bacterial cells, for
example Escherichia. coli cells or Bacillus subtilis cells,
etc.
[0092] As used herein, "specifically binding" or "binds
specifically to" refers to an antibody selectively or
preferentially binding to an antigen. The binding affinity is
generally determined using a standard assay, such as Scatchard
analysis, or surface plasmon resonance technique (e.g. using
BIACORE.RTM.).
[0093] An "antibody that binds to the same epitope" as a reference
antibody refers to an antibody that blocks binding of the reference
antibody to its antigen in a competition assay by 50% or more, and
conversely, the reference antibody blocks binding of the antibody
to its antigen in a competition assay by 50% or more. In one
embodiment, an anti-BACE1 antibody binds to the BACE1 epitope bound
by YW412.8.31.
[0094] The term "cytotoxic agent" as used herein refers to a
substance that inhibits or prevents a cellular function and/or
causes cell death or destruction. Cytotoxic agents include, but are
not limited to, radioactive isotopes (e.g., At.sup.211, I.sup.131,
I.sup.125, Y.sup.90, Re.sup.186, Re.sup.188, Sm.sup.153,
Bi.sup.212, P.sup.32, Pb.sup.212 and radioactive isotopes of Lu);
chemotherapeutic agents or drugs (e.g., methotrexate, adriamicin,
vinca alkaloids (vincristine, vinblastine, etoposide), doxorubicin,
melphalan, mitomycin C, chlorambucil, daunorubicin or other
intercalating agents); growth inhibitory agents; enzymes and
fragments thereof such as nucleolytic enzymes; antibiotics; toxins
such as small molecule toxins or enzymatically active toxins of
bacterial, fungal, plant or animal origin, including fragments
and/or variants thereof.
[0095] An "effective amount" of an agent, e.g., a pharmaceutical
formulation, refers to an amount effective, at dosages and for
periods of time necessary, to achieve the desired therapeutic or
prophylactic result.
[0096] The term "Fc region" herein is used to define a C-terminal
region of an immunoglobulin heavy chain that contains at least a
portion of the constant region. The term includes native sequence
Fc regions and variant Fc regions. In one embodiment, a human IgG
heavy chain Fc region extends from Cys226, or from Pro230, to the
carboxyl-terminus of the heavy chain. However, the C-terminal
lysine (Lys447) of the Fc region may or may not be present. Unless
otherwise specified herein, numbering of amino acid residues in the
Fc region or constant region is according to the EU numbering
system, also called the EU index, as described in Kabat et al.,
Sequences of Proteins of Immunological Interest, 5th Ed. Public
Health Service, National Institutes of Health, Bethesda, Md.,
1991.
[0097] "Framework" or "FR" refers to variable domain residues other
than hypervariable region (HVR) residues. The FR of a variable
domain generally consists of four FR domains: FR1, FR2, FR3, and
FR4. Accordingly, the HVR and FR sequences generally appear in the
following sequence in VH (or VL):
FR1-H1(L1)-FR2-H2(L2)-FR3-H3(L3)-FR4.
[0098] An "immunoconjugate" is an antibody conjugated to one or
more heterologous molecule(s), including but not limited to a label
or cytotoxic agent. Optionally such conjugation is via a
linker.
[0099] A "linker" as used herein is a structure that covalently or
non-covalently connects the anti-BBB-R antibody to heterologous
molecule. In certain embodiments, a linker is a peptide. In other
embodiments, a linker is a chemical linker.
[0100] A "label" is a marker coupled with the antibody herein and
used for detection or imaging. Examples of such labels include:
radiolabel, a fluorophore, a chromophore, or an affinity tag. In
one embodiment, the label is a radiolabel used for medical imaging,
for example tc99m or I123, or a spin label for nuclear magnetic
resonance (NMR) imaging (also known as magnetic resonance imaging,
mri), such as iodine-123 again, iodine-131, indium-111,
fluorine-19, carbon-13, nitrogen-15, oxygen-17, gadolinium,
manganese, iron, etc.
[0101] An "individual" or "subject" is a mammal. Mammals include,
but are not limited to, domesticated animals (e.g., cows, sheep,
cats, dogs, and horses), primates (e.g., humans and non-human
primates such as monkeys), rabbits, and rodents (e.g., mice and
rats). In certain embodiments, the individual or subject is a
human.
[0102] An "isolated" antibody is one which has been separated from
a component of its natural environment. In some embodiments, an
antibody is purified to greater than 95% or 99% purity as
determined by, for example, electrophoretic (e.g., SDS-PAGE,
isoelectric focusing (IEF), capillary electrophoresis) or
chromatographic (e.g., ion exchange or reverse phase HPLC). For
review of methods for assessment of antibody purity, see, e.g.,
Flatman et al., J. Chromatogr. B 848:79-87 (2007).
[0103] The term "package insert" is used to refer to instructions
customarily included in commercial packages of therapeutic
products, that contain information about the indications, usage,
dosage, administration, combination therapy, contraindications
and/or warnings concerning the use of such therapeutic
products.
[0104] The term "pharmaceutical formulation" refers to a
preparation which is in such form as to permit the biological
activity of an active ingredient contained therein to be effective,
and which contains no additional components which are unacceptably
toxic to a subject to which the formulation would be
administered.
[0105] A "pharmaceutically acceptable carrier" refers to an
ingredient in a pharmaceutical formulation, other than an active
ingredient, which is nontoxic to a subject., A pharmaceutically
acceptable carrier includes, but is not limited to, a buffer,
excipient, stabilizer, or preservative.
[0106] As used herein, "treatment" (and grammatical variations
thereof such as "treat" or "treating") refers to clinical
intervention in an attempt to alter the natural course of the
individual being treated, and can be performed either for
prophylaxis or during the course of clinical pathology. Desirable
effects of treatment include, but are not limited to, preventing
occurrence or recurrence of disease, alleviation of symptoms,
diminishment of any direct or indirect pathological consequences of
the disease, preventing metastasis, decreasing the rate of disease
progression, amelioration or palliation of the disease state, and
remission or improved prognosis. In some embodiments, antibodies of
the invention are used to delay development of a disease or to slow
the progression of a disease.
II. Compositions and Methods
[0107] II. Production of Anti-BBB-R Antibodies and Conjugates
Thereof
[0108] The methods and articles of manufacture of the present
invention use, or incorporate, an antibody that binds to BBB-R. The
BBB-R antigen to be used for production of, or screening for,
antibodies may be, e.g., a soluble form of or a portion thereof
(e.g. the extracellular domain), containing the desired epitope.
Alternatively, or additionally, cells expressing BBB-R at their
cell surface can be used to generate, or screen for, antibodies.
Other forms of BBB-R useful for generating antibodies will be
apparent to those skilled in the art. Examples of BBB-Rs herein
include transferrin receptor (TfR), insulin receptor, insulin-like
growth factor receptor (IGF-R), low density lipoprotein
receptor-related protein 1 (LRP1) and LRP8 etc, and heparin-binding
epidermal growth factor-like growth factor (HB-EGF).
[0109] According to the present invention, a "low affinity"
anti-BBB-R (e.g. anti-TfR) antibody is selected based on the data
herein demonstrating that such antibodies display improved CNS (for
example, brain) uptake. In order to identify such low affinity
antibodies, various assays for measuring antibody affinity are
available including, without limitation: Scatchard assay and
surface plasmon resonance technique (e.g. using BIACORE.RTM.).
According to one embodiment of the invention, the antibody has an
affinity for the BBB-R antigen (e.g. for TfR) from about 5 nM, or
from about 20 nM, or from about 100 nM, to about 10 .mu.M, or to
about 1 .mu.M, or to about 500 nM. Thus, the affinity may be in the
range from about 5 nM to about 10 .mu.M, or in the range from about
20 nM to about 1 .mu.M, or in the range from about 100 nM to about
500 nM, e.g. as measured by Scatchard analysis or BIACORE.RTM..
[0110] Thus, the invention provides a method of making an antibody
useful for transporting a neurological disorder drug across the
blood-brain barrier comprising selecting an antibody from a panel
of antibodies against a blood-brain barrier receptor (BBB-R)
because it has an affinity for the BBB-R which is in the range from
about 5 nM, or from about 20 nM, or from about 100 nM, to about 10
.mu.M, or to about 1 .mu.M, or to about 500 mM. Thus, the affinity
may be in the range from about 5 nM to about 10 .mu.M or in the
range from about 20 nM to about 1 .mu.M, or in the range from about
100 nM to about 500 nM, e.g. as measured by Scatchard analysis or
BIACORE.RTM.. As will be understood by one of ordinary skill in the
art, conjugating a heterologous molecule/compound to an antibody
will often decrease the affinity of the antibody for its target
due, e.g., to steric hindrance or even to elimination of one
binding arm if the antibody is made multispecific with one or more
arms binding to a different antigen than the antibody's original
target. In one embodiment, a low affinity antibody of the invention
specific for TfR conjugated to BACE1 had a Kd for TfR as measured
by BIACORE of about 30 nM. In another embodiment, a low affinity
antibody of the invention specific for TfR conjugated to BACE1 had
a Kd for TfR as measured by BIACORE of about 600 nM.
[0111] One exemplary assay for evaluating antibody affinity is by
Scatchard analysis. For example, the anti-BBB-R antibody of
interest can be iodinated using the lactoperoxidase method (Bennett
and Horuk, Methods in Enzymology 288 pg. 134-148 (1997)). A
radiolabeled anti-BBB-R antibody is purified from free
.sup.125I--Na by gel filtration using a NAP-5 column and its
specific activity measured. Competition reaction mixtures of 50
.mu.L containing a fixed concentration of iodinated antibody and
decreasing concentrations of serially diluted unlabeled antibody
are placed into 96-well plates. Cells transiently expressing BBB-R
are cultured in growth media, consisting of Dulbecco's modified
eagle's medium (DMEM) (Genentech) supplemented with 10% FBS, 2 mM
L-glutamine and 1.times.penicillin-streptomycin at 37.degree. C. in
5% CO.sub.2. Cells are detached from the dishes using Sigma Cell
Dissociation Solution and washed with binding buffer (DMEM with 1%
bovine serum albumin, 50 mM HEPES, pH 7.2, and 0.2% sodium azide).
The washed cells are added at an approximate density of 200,000
cells in 0.2 mL of binding buffer to the 96-well plates containing
the 50-.mu.L competition reaction mixtures. The final concentration
of the unlabeled antibody in the competition reaction with cells is
varied, starting at 1000 nM and then decreasing by 1:2 fold
dilution for 10 concentrations and including a zero-added,
buffer-only sample. Competition reactions with cells for each
concentration of unlabeled antibody are assayed in triplicate.
Competition reactions with cells are incubated for 2 hours at room
temperature. After the 2-hour incubation, the competition reactions
are transferred to a filter plate and washed four times with
binding buffer to separate free from bound iodinated antibody. The
filters are counted by gamma counter and the binding data are
evaluated using the fitting algorithm of Munson and Rodbard (1980)
to determine the binding affinity of the antibody.
[0112] An exemplary scatchard analysis using the compositions of
the invention may be performed as follows. Anti-TFR.sup.A was
iodinated using the lactoperoxidase method (Bennett and Horuk,
Methods in Enzymology 288 pg. 134-148 (1997)). Radiolabeled
anti-TFR.sup.A was purified from free .sup.125I--Na by gel
filtration using a NAP-5 column; purified anti-TFR.sup.A had a
specific activity of 19.82 .mu.Ci/.mu.g. Competition reaction
mixtures of 50 .mu.L containing a fixed concentration of iodinated
antibody and decreasing concentrations of serially diluted
unlabeled antibody were placed into 96-well plates. The 293 cells
transiently expressing murine TfR were cultured in growth media,
consisting of Dulbecco's modified eagle's medium (DMEM) (Genentech)
supplemented with 10% FBS, 2 mM L-glutamine and
1.times.penicillin-streptomycin at 37.degree. C. in 5% CO.sub.2.
Cells were detached from the dishes using Sigma Cell Dissociation
Solution and washed with binding buffer (DMEM with 1% bovine serum
albumin, 50 mM HEPES, pH 7.2, and 0.2% sodium azide). The washed
cells were added at an approximate density of 200,000 cells in 0.2
mL of binding buffer to the 96-well plates containing the 50-.mu.L
competition reaction mixtures. The final concentration of the
iodinated antibody in each competition reaction with cells was 100
pM (134,000 cpm per 0.25 mL). The final concentration of the
unlabeled antibody in the competition reaction with cells varied,
starting at 1000 nM and then decreasing by 1:2 fold dilution for 10
concentrations and including a zero-added, buffer-only sample.
Competition reactions with cells for each concentration of
unlabeled antibody were assayed in triplicate. Competition
reactions with cells were incubated for 2 hours at room
temperature. After the 2-hour incubation, the competition reactions
were transferred to a Millipore Multiscreen filter plate and washed
four times with binding buffer to separate free from bound
iodinated antibody. The filters were counted on a Wallac Wizard
1470 gamma counter (PerkinElmer Life and Analytical Sciences;
Waltham, Mass.). The binding data were evaluated using New Ligand
software (Genentech), which uses the fitting algorithm of Munson
and Rodbard (1980) to determine the binding affinity of the
antibody.
[0113] An exemplary BIACORE.RTM. analysis using the compositions of
the invention may be performed as follows. Kd was measured using
surface plasmon resonance assays using a BIACORE.RTM.-2000
(BIAcore, Inc., Piscataway, N.J.) at 25.degree. C. using anti-human
Fc kit (BiAcore Inc., Piscataway, N.J.). Briefly, carboxymethylated
dextran biosensor chips (CMS, BIACORE, Inc.) were activated with
N-ethyl-N'-(3-dimethylaminopropyl)-carbodiimide hydrochloride (EDC)
and N-hydroxysuccinimide (NETS) according to the supplier's
instructions. Anti-human Fc antibody was diluted with 10 mM sodium
acetate, pH 4.0, to 50 .mu.g/ml before injection at a flow rate of
5 .mu.l/minute to achieve approximately 10000 response units (RU)
of coupled protein. Following the injection of antibody, 1 M
ethanolamine was injected to block unreacted groups. For kinetics
measurements, anti-TfR antibody variants were injected in HBS-P to
reach about 220 RU, then two-fold serial dilutions of MuTfR-His
(0.61 nM to 157 nM) were injected in HBS-P at 25.degree. C. at a
flow rate of approximately 30 .mu.l/min. Association rates (kon)
and dissociation rates (koff) were calculated using a simple
one-to-one Langmuir binding model (BIACORE.RTM. Evaluation Software
version 3.2) by simultaneously fitting the association and
dissociation sensorgrams. The equilibrium dissociation constant
(Kd) was calculated as the ratio koff/kon. See, e.g., Chen et al.,
J. Mol. Biol. 293:865-881 (1999)
[0114] According to another embodiment, Kd is measured using
surface plasmon resonance assays with a BIACORE.RTM.-2000 device
(BIAcore, Inc., Piscataway, N.J.) at 25.degree. C. using anti-human
Fc kit (BiAcore Inc., Piscataway, N.J.). Briefly, carboxymethylated
dextran biosensor chips (CMS, BIACORE, Inc.) are activated with
N-ethyl-N'-(3-dimethylaminopropyl)-carbodiimide hydrochloride (EDC)
and N-hydroxysuccinimide (NHS) according to the supplier's
instructions. Anti-human Fc antibody is diluted with 10 mM sodium
acetate, pH 4.0, to 50 .mu.g/ml before injection at a flow rate of
5 .mu.l/minute to achieve approximately 10000 response units (RU)
of coupled protein. Following the injection of antibody, 1 M
ethanolamine is injected to block unreacted groups. For kinetics
measurements, anti-BBB-R antibody variants are injected in HBS-P to
reach about 220 RU, then two-fold serial dilutions of BBB-R-His
(0.61 nM to 157 nM) are injected in HBS-P at 25.degree. C. at a
flow rate of approximately 30 .mu.l/min. Association rates (kon)
and dissociation rates (koff) are calculated using a simple
one-to-one Langmuir binding model (BIACORE.RTM. Evaluation Software
version 3.2) by simultaneously fitting the association and
dissociation sensorgrams. The equilibrium dissociation constant
(Kd) is calculated as the ratio koff/kon. See, e.g., Chen et al.,
J. Mol. Biol. 293:865-881 (1999).
[0115] A surrogate measurement for the affinity of one or more
antibodies for the BBB-R is its half maximal inhibitory
concentration (IC50), a measure of how much of the antibody is
needed to inhibit the binding of a known BBB-R ligand to the BBB-R
by 50%. Several methods of determining the IC50 for a given
compound are art-known; a common approach is to perform a
competition binding assay, such as that described herein in the
examples, i.e. with regard to FIG. 2A. In general, a high IC50
indicates that more of the antibody is required to inhibit binding
of the known ligand, and thus that the antibody's affinity for that
ligand is relatively low. Conversely, a low IC50 indicates that
less of the antibody is required to inhibit binding of the known
ligand, and thus that the antibody's affinity for that ligand is
relatively high.
[0116] An exemplary competitive ELISA assay to measure IC50 is one
in which increasing concentrations of anti-TfR or anti-TfR/brain
antigen (i.e., anti-TfR/BACE1, anti-TfR/Abeta and the like) variant
antibodies are used to compete against biotinylated TfR.sup.A for
binding to TfR. The anti-TfR competition ELISA was performed in
Maxisorp plates (Neptune, N.J.) coated with 2.5 .mu.g/ml of
purified murine TfR extracellular domain in PBS at 4.degree. C.
overnight. Plates were washed with PBS/0.05% Tween 20 and blocked
using Superblock blocking buffer in PBS (Thermo Scientific, Hudson,
N.H.). A titration of each individual anti-TfR or anti-TfR/brain
antigen (i.e., anti-TfR/BACE1 or anti-TfR/Abeta) (1:3 serial
dilution) was combined with biotinylated anti-TfR.sup.A (0.5 nM
final concentration) and added to the plate for 1 hour at room
temperature. Plates were washed with PBS/0.05% Tween 20, and
HRP-streptavidin (Southern Biotech, Birmingham) was added to the
plate and incubated for 1 hour at room temperature. Plates were
washed with PBS/0.05% Tween 20, and biotinylated anti-TfR.sup.A
bound to the plate was detected using TMB substrate (BioFX
Laboratories, Owings Mills).
[0117] In one embodiment, the low affinity anti-BBB-R antibody
herein is coupled with a label and/or neurological disorder drug or
imaging agent in order to more efficiently transport the label
and/or drug or imaging agent across the BBB. Such coupling can be
achieved by chemical cross-linkers or by generating fusion proteins
etc.
[0118] Covalent conjugation can either be direct or via a linker.
In certain embodiments, direct conjugation is by construction of a
protein fusion (i.e., by genetic fusion of the two genes encoding
BBB-R antibody and neurological disorder drug and expression as a
single protein). In certain embodiments, direct conjugation is by
formation of a covalent bond between a reactive group on one of the
two portions of the anti-BBB-R antibody and a corresponding group
or acceptor on the neurological drug. In certain embodiments,
direct conjugation is by modification (i.e., genetic modification)
of one of the two molecules to be conjugated to include a reactive
group (as nonlimiting examples, a sulfhydryl group or a carboxyl
group) that forms a covalent attachment to the other molecule to be
conjugated under appropriate conditions. As one nonlimiting
example, a molecule (i.e., an amino acid) with a desired reactive
group (i.e., a cysteine residue) may be introduced into, e.g., the
anti-BBB-R antibody and a disulfide bond formed with the
neurological drug. Methods for covalent conjugation of nucleic
acids to proteins are also known in the art (i.e.,
photocrosslinking, see, e.g., Zatsepin et al. Russ. Chem. Rev. 74:
77-95 (2005)) Non-covalent conjugation can be by any nonconvalent
attachment means, including hydrophobic bonds, ionic bonds,
electrostatic interactions, and the like, as will be readily
understood by one of ordinary skill in the art. Conjugation may
also be performed using a variety of linkers. For example, an
anti-BBB-R antibody and a neurological drug may be conjugated using
a variety of bifunctional protein coupling agents such as
N-succinimidyl-3-(2-pyridyldithio) propionate (SPDP),
succinimidyl-4-(N-maleimidomethyl) cyclohexane-1-carboxylate
(SMCC), iminothiolane (IT), bifunctional derivatives of imidoesters
(such as dimethyl adipimidate HCl), active esters (such as
disuccinimidyl suberate), aldehydes (such as glutaraldehyde),
bis-azido compounds (such as bis (p-azidobenzoyl) hexanediamine),
bis-diazonium derivatives (such as
bis-(p-diazoniumbenzoyl)-ethylenediamine), diisocyanates (such as
toluene 2,6-diisocyanate), and bis-active fluorine compounds (such
as 1,5-difluoro-2,4-dinitrobenzene). Peptide linkers, comprised of
from one to twenty amino acids joined by peptide bonds, may also be
used. In certain such embodiments, the amino acids are selected
from the twenty naturally-occurring amino acids. In certain other
such embodiments, one or more of the amino acids are selected from
glycine, alanine, proline, asparagine, glutamine and lysine. The
linker may be a "cleavable linker" facilitating release of the
neurological drug upon delivery to the brain. For example, an
acid-labile linker, peptidase-sensitive linker, photolabile linker,
dimethyl linker or disulfide-containing linker (Chari et al.,
Cancer Res. 52:127-131 (1992); U.S. Pat. No. 5,208,020) may be
used.
[0119] The invention herein expressly contemplates, but is not
limited to, conjugates prepared with cross-linker reagents
including, but not limited to, BMPS, EMCS, GMBS, HBVS, LC-SMCC,
MBS, MPBH, SBAP, SIA, SIAB, SMCC, SMPB, SMPH, sulfo-EMCS,
sulfo-GMBS, sulfo-KMUS, sulfo-MBS, sulfo-SIAB, sulfo-SMCC, and
sulfo-SMPB, and SVSB (succinimidyl-(4-vinylsulfone)benzoate) which
are commercially available (e.g., from Pierce Biotechnology, Inc.,
Rockford, Ill., U.S.A).
[0120] For a neuropathy disorder, a neurological drug may be
selected that is an analgesic including, but not limited to, a
narcotic/opioid analgesic (i.e., morphine, fentanyl, hydrocodone,
meperidine, methadone, oxymorphone, pentazocine, propoxyphene,
tramadol, codeine and oxycodone), a nonsteroidal anti-inflammatory
drug (NSAID) (i.e., ibuprofen, naproxen, diclofenac, diflunisal,
etodolac, fenoprofen, flurbiprofen, indomethacin, ketorolac,
mefenamic acid, meloxicam, nabumetone, oxaprozin, piroxicam,
sulindac, and tolmetin), a corticosteroid (i.e., cortisone,
prednisone, prednisolone, dexamethasone, methylprednisolone and
triamcinolone), an anti-migraine agent (i.e., sumatriptin,
almotriptan, frovatriptan, sumatriptan, rizatriptan, eletriptan,
zolmitriptan, dihydroergotamine, eletriptan and ergotamine),
acetaminophen, a salicylate (i.e., aspirin, choline salicylate,
magnesium salicylate, diflunisal, and salsalate), a anti-convulsant
(i.e., carbamazepine, clonazepam, gabapentin, lamotrigine,
pregabalin, tiagabine, and topiramate), an anaesthetic (i.e.,
isoflurane, trichloroethylene, halothane, sevoflurane, benzocaine,
chloroprocaine, cocaine, cyclomethycaine, dimethocaine,
propoxycaine, procaine, novocaine, proparacaine, tetracaine,
articaine, bupivacaine, carticaine, cinchocaine, etidocaine,
levobupivacaine, lidocaine, mepivacaine, piperocaine, prilocaine,
ropivacaine, trimecaine, saxitoxin and tetrodotoxin), and a
cox-2-inhibitor (i.e., celecoxib, rofecoxib, and valdecoxib). For a
neuropathy disorder with vertigo involvement, a neurological drug
may be selected that is an anti-vertigo agent including, but not
limited to, meclizine, diphenhydramine, promethazine and diazepam.
For a neuropathy disorder with nausea involvement, a neurological
drug may be selected that is an anti-nausea agent including, but
not limited to, promethazine, chlorpromazine, prochlorperazine,
trimethobenzamide, and metoclopramide. For a neurodegenerative
disease, a neurological drug may be selected that is a growth
hormone or neurotrophic factor; examples include but are not
limited to brain-derived neurotrophic factor (BDNF), nerve growth
factor (NGF), neurotrophin-4/5, fibroblast growth factor (FGF)-2
and other FGFs, neurotrophin (NT)-3, erythropoietin (EPO),
hepatocyte growth factor (HGF), epidermal growth factor (EGF),
transforming growth factor (TGF)-alpha, TGF-beta, vascular
endothelial growth factor (VEGF), interleukin-1 receptor antagonist
(IL-lra), ciliary neurotrophic factor (CNTF), glial-derived
neurotrophic factor (GDNF), neurturin, platelet-derived growth
factor (PDGF), heregulin, neuregulin, artemin, persephin,
interleukins, glial cell line derived neurotrophic factor (GFR),
granulocyte-colony stimulating factor (CSF),
granulocyte-macrophage-CSF, netrins, cardiotrophin-1, hedgehogs,
leukemia inhibitory factor (LIF), midkine, pleiotrophin, bone
morphogenetic proteins (BMPs), netrins, saposins, semaphorins, and
stem cell factor (SCF).
[0121] For cancer, a neurological drug may be selected that is a
chemotherapeutic agent. Examples of chemotherapeutic agents include
alkylating agents such as thiotepa and CYTOXAN.RTM.
cyclosphosphamide; alkyl sulfonates such as busulfan, improsulfan
and piposulfan; aziridines such as benzodopa, carboquone,
meturedopa, and uredopa; ethylenimines and methylamelamines
including altretamine, triethylenemelamine,
trietylenephosphoramide, triethiylenethiophosphor-amide and
trimethylolomelamine; acetogenins (especially bullatacin and
bullatacinone); delta-9-tetrahydrocannabinol (dronabinol,
MARINOL.RTM.); beta-lapachone; lapachol; colchicines; betulinic
acid; a camptothecin (including the synthetic analogue topotecan
(HYCAMTIN.RTM.), CPT-11 (irinotecan, CAMPTOSAR.RTM.),
acetylcamptothecin, scopolectin, and 9-aminocamptothecin);
bryostatin; callystatin; CC-1065 (including its adozelesin,
carzelesin and bizelesin synthetic analogues); podophyllotoxin;
podophyllinic acid; teniposide; cryptophycins (particularly
cryptophycin 1 and cryptophycin 8); dolastatin; duocarmycin
(including the synthetic analogues, KW-2189 and CB1-TM1);
eleutherobin; pancratistatin; a sarcodictyin; spongistatin;
nitrogen mustards such as chlorambucil, chlornaphazine,
cholophosphamide, estramustine, ifosfamide, mechlorethamine,
mechlorethamine oxide hydrochloride, melphalan, novembichin,
phenesterine, prednimustine, trofosfamide, uracil mustard;
nitrosureas such as carmustine, chlorozotocin, fotemustine,
lomustine, nimustine, and ranimnustine; antibiotics such as the
enediyne antibiotics (e. g., calicheamicin, especially
calicheamicin gammall and calicheamicin omegall (see, e.g., Agnew,
Chem Intl. Ed. Engl., 33: 183-186 (1994)); dynemicin, including
dynemicin A; an esperamicin; as well as neocarzinostatin
chromophore and related chromoprotein enediyne antiobiotic
chromophores), aclacinomysins, actinomycin, authramycin, azaserine,
bleomycins, cactinomycin, carabicin, carminomycin, carzinophilin,
chromomycinis, dactinomycin, daunorubicin, detorubicin,
6-diazo-5-oxo-L-norleucine, ADRIAMYCIN.RTM. doxorubicin (including
morpholino-doxorubicin, cyanomorpholino-doxorubicin,
2-pyrrolino-doxorubicin and deoxydoxorubicin), epirubicin,
esorubicin, idarubicin, marcellomycin, mitomycins such as mitomycin
C, mycophenolic acid, nogalamycin, olivomycins, peplomycin,
potfiromycin, puromycin, quelamycin, rodorubicin, streptonigrin,
streptozocin, tubercidin, ubenimex, zinostatin, zorubicin;
anti-metabolites such as methotrexate and 5-fluorouracil (5-FU);
folic acid analogues such as denopterin, methotrexate, pteropterin,
trimetrexate; purine analogs such as fludarabine, 6-mercaptopurine,
thiamiprine, thioguanine; pyrimidine analogs such as ancitabine,
azacitidine, 6-azauridine, carmofur, cytarabine, dideoxyuridine,
doxifluridine, enocitabine, floxuridine; androgens such as
calusterone, dromostanolone propionate, epitiostanol, mepitiostane,
testolactone; anti-adrenals such as aminoglutethimide, mitotane,
trilostane; folic acid replenisher such as frolinic acid;
aceglatone; aldophosphamide glycoside; aminolevulinic acid;
eniluracil; amsacrine; bestrabucil; bisantrene; edatraxate;
defofamine; demecolcine; diaziquone; elfornithine; elliptinium
acetate; an epothilone; etoglucid; gallium nitrate; hydroxyurea;
lentinan; lonidainine; maytansinoids such as maytansine and
ansamitocins; mitoguazone; mitoxantrone; mopidanmol; nitraerine;
pentostatin; phenamet; pirarubicin; losoxantrone; 2-ethylhydrazide;
procarbazine; PSK.RTM. polysaccharide complex (JHS Natural
Products, Eugene, Oreg.); razoxane; rhizoxin; sizofiran;
spirogermanium; tenuazonic acid; triaziquone;
2,2',2''-trichlorotriethylamine; trichothecenes (especially T-2
toxin, verracurin A, roridin A and anguidine); urethan; vindesine
(ELDISINE.RTM., FILDESIN.RTM.); dacarbazine; mannomustine;
mitobronitol; mitolactol; pipobroman; gacytosine; arabinoside
("Ara-C"); thiotepa; taxoids, e.g., TAXOL.RTM. paclitaxel
(Bristol-Myers Squibb Oncology, Princeton, N.J.), ABRAXANE.TM.
Cremophor-free, albumin-engineered nanoparticle formulation of
paclitaxel (American Pharmaceutical Partners, Schaumberg, Ill.),
and TAXOTERE.RTM. doxetaxel (Rhone-Poulenc Rorer, Antony, France);
chloranbucil; gemcitabine (GEMZAR.RTM.); 6-thioguanine;
mercaptopurine; methotrexate; platinum analogs such as cisplatin
and carboplatin; vinblastine (VELBAN.RTM.); platinum; etoposide
(VP-16); ifosfamide; mitoxantrone; vincristine (ONCOVIN.RTM.);
oxaliplatin; leucovovin; vinorelbine (NAVELBINE.RTM.); novantrone;
edatrexate; daunomycin; aminopterin; ibandronate; topoisomerase
inhibitor RFS 2000; difluorometlhylornithine (DMFO); retinoids such
as retinoic acid; capecitabine (XELODA.RTM.); pharmaceutically
acceptable salts, acids or derivatives of any of the above; as well
as combinations of two or more of the above such as CHOP, an
abbreviation for a combined therapy of cyclophosphamide,
doxorubicin, vincristine, and prednisolone, and FOLFOX, an
abbreviation for a treatment regimen with oxaliplatin
(ELOXATIN.TM.) combined with 5-FU and leucovovin.
[0122] Also included in this definition of chemotherapeutic agents
are anti-hormonal agents that act to regulate, reduce, block, or
inhibit the effects of hormones that can promote the growth of
cancer, and are often in the form of systemic, or whole-body
treatment. They may be hormones themselves. Examples include
anti-estrogens and selective estrogen receptor modulators (SERMs),
including, for example, tamoxifen (including NOLVADEX.RTM.
tamoxifen), EVISTA.RTM. raloxifene, droloxifene,
4-hydroxytamoxifen, trioxifene, keoxifene, LY117018, onapristone,
and FARESTON.RTM. toremifene; anti-progesterones; estrogen receptor
down-regulators (ERDs); agents that function to suppress or shut
down the ovaries, for example, leutinizing hormone-releasing
hormone (LHRH) agonists such as LUPRON.RTM. and ELIGARD.RTM.
leuprolide acetate, goserelin acetate, buserelin acetate and
tripterelin; other anti-androgens such as flutamide, nilutamide and
bicalutamide; and aromatase inhibitors that inhibit the enzyme
aromatase, which regulates estrogen production in the adrenal
glands, such as, for example, 4(5)-imidazoles, aminoglutethimide,
MEGASE.RTM. megestrol acetate, AROMASIN.RTM. exemestane,
formestanie, fadrozole, RIVISOR.RTM. vorozole, FEMARA.RTM.
letrozole, and ARIMIDEX.RTM. anastrozole. In addition, such
definition of chemotherapeutic agents includes bisphosphonates such
as clodronate (for example, BONEFOS.RTM. or OSTAC.RTM.),
DIDROCAL.RTM. etidronate, NE-58095, ZOMETA.RTM. zoledronic
acid/zoledronate, FOSAMAX.RTM. alendronate, AREDIA.RTM.
pamidronate, SKELID.RTM. tiludronate, or ACTONEL.RTM. risedronate;
as well as troxacitabine (a 1,3-dioxolane nucleoside cytosine
analog); antisense oligonucleotides, particularly those that
inhibit expression of genes in signaling pathways implicated in
aberrant cell proliferation, such as, for example, PKC-alpha, Raf,
H-Ras, and epidermal growth factor receptor (EGF-R); vaccines such
as THERATOPE.RTM. vaccine and gene therapy vaccines, for example,
ALLOVECTIN.RTM. vaccine, LEUVECTIN.RTM. vaccine, and VAXID.RTM.
vaccine; LURTOTECAN.RTM. topoisomerase 1 inhibitor; ABARELIX.RTM.
rmRH; lapatinib ditosylate (an ErbB-2 and EGFR dual tyrosine kinase
small-molecule inhibitor also known as GW572016); and
pharmaceutically acceptable salts, acids or derivatives of any of
the above.
[0123] Another group of compounds that may be selected as
neurological drugs for cancer treatment or prevention are
anti-cancer immunoglobulins (including, but not limited to,
trastuzumab, bevacizumab, alemtuxumab, cetuximab, gemtuzumab
ozogamicin, ibritumomab tiuxetan, panitumumab and rituximab). In
some instances, antibodies in conjunction with a toxic label may be
used to target and kill desired cells (i.e., cancer cells),
including, but not limited to, tositumomab with a .sup.131I
radiolabel.
[0124] For an ocular disease or disorder, a neurological drug may
be selected that is an anti-angiogenic ophthalmic agent (i.e.,
bevacizumab, ranibizumab and pegaptanib), an ophthalmic glaucoma
agent (i.e., carbachol, epinephrine, demecarium bromide,
apraclonidine, brimonidine, brinzolamide, levobunolol, timolol,
betaxolol, dorzolamide, bimatoprost, carteolol, metipranolol,
dipivefrin, travoprost and latanoprost), a carbonic anhydrase
inhibitor (i.e., methazolamide and acetazolamide), an ophthalmic
antihistamine (i.e., naphazoline, phenylephrine and
tetrahydrozoline), an ocular lubricant, an ophthalmic steroid
(i.e., fluorometholone, prednisolone, loteprednol, dexamethasone,
difluprednate, rimexolone, fluocinolone, medrysone and
triamcinolone), an ophthalmic anesthetic (i.e., lidocaine,
proparacaine and tetracaine), an ophthalmic anti-infective (i.e.,
levofloxacin, gatifloxacin, ciprofloxacin, moxifloxacin,
chloramphenicol, bacitracin/polymyxin b, sulfacetamide, tobramycin,
azithromycin, besifloxacin, norfloxacin, sulfisoxazole, gentamicin,
idoxuridine, erythromycin, natamycin, gramicidin, neomycin,
ofloxacin, trifluridine, ganciclovir, vidarabine), an ophthalmic
anti-inflammatory agent (i.e., nepafenac, ketorolac, flurbiprofen,
suprofen, cyclosporine, triamcinolone, diclofenac and bromfenac),
and an ophthalmic antihistamine or decongestant (i.e., ketotifen,
olopatadine, epinastine, naphazoline, cromolyn, tetrahydrozoline,
pemirolast, bepotastine, naphazoline, phenylephrine, nedocromil,
lodoxamide, phenylephrine, emedastine and azelastine).
[0125] For a seizure disorder, a neurological drug may be selected
that is an anticonvulsant or antiepileptic including, but not
limited to, barbiturate anticonvulsants (i.e., primidone,
metharbital, mephobarbital, allobarbital, amobarbital,
aprobarbital, alphenal, barbital, brallobarbital and
phenobarbital), benzodiazepine anticonvulsants (i.e., diazepam,
clonazepam, and lorazepam), carbamate anticonvulsants (i.e.
felbamate), carbonic anhydrase inhibitor anticonvulsants (i.e.,
acetazolamide, topiramate and zonisamide), dibenzazepine
anticonvulsants (i.e., rufinamide, carbamazepine, and
oxcarbazepine), fatty acid derivative anticonvulsants (i.e.,
divalproex and valproic acid), gamma-aminobutyric acid analogs
(i.e., pregabalin, gabapentin and vigabatrin), gamma-aminobutyric
acid reuptake inhibitors (i.e., tiagabine), gamma-aminobutyric acid
transaminase inhibitors (i.e., vigabatrin), hydantoin
anticonvulsants (i.e. phenytoin, ethotoin, fosphenytoin and
mephenytoin), miscellaneous anticonvulsants (i.e., lacosamide and
magnesium sulfate), progestins (i.e., progesterone),
oxazolidinedione anticonvulsants (i.e., paramethadione and
trimethadione), pyrrolidine anticonvulsants (i.e., levetiracetam),
succinimide anticonvulsants (i.e., ethosuximide and methsuximide),
triazine anticonvulsants (i.e., lamotrigine), and urea
anticonvulsants (i.e., phenacemide and pheneturide).
[0126] For a lysosomal storage disease, a neurological drug may be
selected that is itself or otherwise mimics the activity of the
enzyme that is impaired in the disease. Exemplary recombinant
enzymes for the treatment of lysosomal storage disorders include,
but are not limited to those set forth in e.g., U.S. Patent
Application publication no. 2005/0142141 (i.e.,
alpha-L-iduronidase, iduronate-2-sulphatase, N-sulfatase,
alpha-N-acetylglucosaminidase, N-acetyl-galactosamine-6-sulfatase,
beta-galactosidase, arylsulphatase B, beta-glucuronidase, acid
alpha-glucosidase, glucocerebrosidase, alpha-galactosidase A,
hexosaminidase A, acid sphingomyelinase, beta-galactocerebrosidase,
beta-galactosidase, arylsulfatase A, acid ceramidase,
aspartoacylase, palmitoyl-protein thioesterase 1 and tripeptidyl
amino peptidase 1).
[0127] For amyloidosis, a neurological drug may be selected that
includes, but is not limited to, an antibody or other binding
molecule (including, but not limited to a small molecule, a
peptide, an aptamer, or other protein binder) that specifically
binds to a target selected from: beta secretase, tau, presenilin,
amyloid precursor protein or portions thereof, amyloid beta peptide
or oligomers or fibrils thereof, death receptor 6 (DR6), receptor
for advanced glycation endproducts (RAGE), parkin, and huntingtin;
a cholinesterase inhibitor (i.e., galantamine, donepezil,
rivastigmine and tacrine); an NMDA receptor antagonist (i.e.,
memantine), a monoamine depletor (i.e., tetrabenazine); an ergoloid
mesylate; an anticholinergic antiparkinsonism agent (i.e.,
procyclidine, diphenhydramine, trihexylphenidyl, benztropine,
biperiden and trihexyphenidyl); a dopaminergic antiparkinsonism
agent (i.e., entacapone, selegiline, pramipexole, bromocriptine,
rotigotine, selegiline, ropinirole, rasagiline, apomorphine,
carbidopa, levodopa, pergolide, tolcapone and amantadine); a
tetrabenazine; an anti-inflammatory (including, but not limited to,
a nonsteroidal anti-inflammatory drug (i.e., indomethicin and other
compounds listed above); a hormone (i.e., estrogen, progesterone
and leuprolide); a vitamin (i.e., folate and nicotinamide); a
dimebolin; a homotaurine (i.e., 3-aminopropanesulfonic acid; 3APS);
a serotonin receptor activity modulator (i.e., xaliproden); an, an
interferon, and a glucocorticoid.
[0128] For a viral or microbial disease, a neurological drug may be
selected that includes, but is not limited to, an antiviral
compound (including, but not limited to, an adamantane antiviral
(i.e., rimantadine and amantadine), an antiviral interferon (i.e.,
peginterferon alfa-2b), a chemokine receptor antagonist (i.e.,
maraviroc), an integrase strand transfer inhibitor (i.e.,
raltegravir), a neuraminidase inhibitor (i.e., oseltamivir and
zanamivir), a non-nucleoside reverse transcriptase inhibitor (i.e.,
efavirenz, etravirine, delavirdine and nevirapine), a nucleoside
reverse transcriptase inhibitors (tenofovir, abacavir, lamivudine,
zidovudine, stavudine, entecavir, emtricitabine, adefovir,
zalcitabine, telbivudine and didanosine), a protease inhibitor
(i.e., darunavir, atazanavir, fosamprenavir, tipranavir, ritonavir,
nelfinavir, amprenavir, indinavir and saquinavir), a purine
nucleoside (i.e., valacyclovir, famciclovir, acyclovir, ribavirin,
ganciclovir, valganciclovir and cidofovir), and a miscellaneous
antiviral (i.e., enfuvirtide, foscarnet, palivizumab and
fomivirsen)), an antibiotic (including, but not limited to, an
aminopenicillin (i.e., amoxicillin, ampicillin, oxacillin,
nafcillin, cloxacillin, dicloxacillin, flucoxacillin, temocillin,
azlocillin, carbenicillin, ticarcillin, mezlocillin, piperacillin
and bacampicillin), a cephalosporin (i.e., cefazolin, cephalexin,
cephalothin, cefamandole, ceftriaxone, cefotaxime, cefpodoxime,
ceftazidime, cefadroxil, cephradine, loracarbef, cefotetan,
cefuroxime, cefprozil, cefaclor, and cefoxitin), a carbapenem/penem
(i.e., imipenem, meropenem, ertapenem, faropenem and doripenem), a
monobactam (i.e., aztreonam, tigemonam, norcardicin A and
tabtoxinine-beta-lactam, a beta-lactamase inhibitor (i.e.,
clavulanic acid, tazobactam and sulbactam) in conjunction with
another beta-lactam antibiotic, an aminoglycoside (i.e., amikacin,
gentamicin, kanamycin, neomycin, netilmicin, streptomycin,
tobramycin, and paromomycin), an ansamycin (i.e., geldanamycin and
herbimycin), a carbacephem (i.e., loracarbef), a glycopeptides
(i.e., teicoplanin and vancomycin), a macrolide (i.e.,
azithromycin, clarithromycin, dirithromycin, erythromycin,
roxithromycin, troleandomycin, telithromycin and spectinomycin), a
monobactam (i.e., aztreonam), a quinolone (i.e., ciprofloxacin,
enoxacin, gatifloxacin, levofloxacin, lomefloxacin, moxifloxacin,
norfloxacin, ofloxacin, trovafloxacin, grepafloxacin, sparfloxacin
and temafloxacin), a sulfonamide (i.e., mafenide,
sulfonamidochrysoidine, sulfacetamide, sulfadiazine,
sulfamethizole, sulfanilamide, sulfasalazine, sulfisoxazole,
trimethoprim, trimethoprim and sulfamethoxazole), a tetracycline
(i.e., tetracycline, demeclocycline, doxycycline, minocycline and
oxytetracycline), an antineoplastic or cytotoxic antibiotic (i.e.,
doxorubicin, mitoxantrone, bleomycin, daunorubicin, dactinomycin,
epirubicin, idarubicin, plicamycin, mitomycin, pentostatin and
valrubicin) and a miscellaneous antibacterial compound (i.e.,
bacitracin, colistin and polymyxin B)), an antifungal (i.e.,
metronidazole, nitazoxanide, tinidazole, chloroquine, iodoquinol
and paromomycin), and an antiparasitic (including, but not limited
to, quinine, chloroquine, amodiaquine, pyrimethamine, sulphadoxine,
proguanil, mefloquine, atovaquone, primaquine, artemesinin,
halofantrine, doxycycline, clindamycin, mebendazole, pyrantel
pamoate, thiabendazole, diethylcarbamazine, ivermectin, rifampin,
amphotericin B, melarsoprol, efornithine and albendazole).
[0129] For ischemia, a neurological drug may be selected that
includes, but is not limited to, a thrombolytic (i.e., urokinase,
alteplase, reteplase and tenecteplase), a platelet aggregation
inhibitor (i.e., aspirin, cilostazol, clopidogrel, prasugrel and
dipyridamole), a statin (i.e., lovastatin, pravastatin,
fluvastatin, rosuvastatin, atorvastatin, simvastatin, cerivastatin
and pitavastatin), and a compound to improve blood flow or vascular
flexibility, including, e.g., blood pressure medications.
[0130] For a behavioral disorder, a neurological drug may be
selected from a behavior-modifying compound including, but not
limited to, an atypical antipsychotic (i.e., risperidone,
olanzapine, apripiprazole, quetiapine, paliperidone, asenapine,
clozapine, iloperidone and ziprasidone), a phenothiazine
antipsychotic (i.e., prochlorperazine, chlorpromazine,
fluphenazine, perphenazine, trifluoperazine, thioridazine and
mesoridazine), a thioxanthene (i.e., thiothixene), a miscellaneous
antipsychotic (i.e., pimozide, lithium, molindone, haloperidol and
loxapine), a selective serotonin reuptake inhibitor (i.e.,
citalopram, escitalopram, paroxetine, fluoxetine and sertraline), a
serotonin-norepinephrine reuptake inhibitor (i.e., duloxetine,
venlafaxine, desvenlafaxine, a tricyclic antidepressant (i.e.,
doxepin, clomipramine, amoxapine, nortriptyline, amitriptyline,
trimipramine, imipramine, protriptyline and desipramine), a
tetracyclic antidepressant (i.e., mirtazapine and maprotiline), a
phenylpiperazine antidepressant (i.e., trazodone and nefazodone), a
monoamine oxidase inhibitor (i.e., isocarboxazid, phenelzine,
selegiline and tranylcypromine), a benzodiazepine (i.e.,
alprazolam, estazolam, flurazeptam, clonazepam, lorazepam and
diazepam), a norepinephrine-dopamine reuptake inhibitor (i.e.,
bupropion), a CNS stimulant (i.e., phentermine, diethylpropion,
methamphetamine, dextroamphetamine, amphetamine, methylphenidate,
dexmethylphenidate, lisdexamfetamine, modafinil, pemoline,
phendimetrazine, benzphetamine, phendimetrazine, armodafinil,
diethylpropion, caffeine, atomoxetine, doxapram, and mazindol), an
anxiolytic/sedative/hypnotic (including, but not limited to, a
barbiturate (i.e., secobarbital, phenobarbital and mephobarbital),
a benzodiazepine (as described above), and a miscellaneous
anxiolytic/sedative/hypnotic (i.e. diphenhydramine, sodium oxybate,
zaleplon, hydroxyzine, chloral hydrate, aolpidem, buspirone,
doxepin, eszopiclone, ramelteon, meprobamate and ethclorvynol)), a
secretin (see, e.g., Ratliff-Schaub et al. Autism 9: 256-265
(2005)), an opioid peptide (see, e.g., Cowen et al., J. Neurochem.
89:273-285 (2004)), and a neuropeptide (see, e.g., Hethwa et al.
Am. J. Physiol. 289: E301-305 (2005)).
[0131] For CNS inflammation, a neurological drug may be selected
that addresses the inflammation itself (i.e., a nonsteroidal
anti-inflammatory agent such as ibuprofen or naproxen), or one
which treats the underlying cause of the inflammation (i.e., an
anti-viral or anti-cancer agent).
[0132] According to one embodiment of the invention, the "coupling"
is achieved by generating a multispecific antibody (e.g. a
bispecific antibody). Multispecific antibodies are monoclonal
antibodies that have binding specificities for at least two
different sites. In one embodiment, the multispecific antibody
comprises a first antigen binding site which binds the BBB-R and a
second antigen binding site which binds a brain antigen, such as
beta-secretase 1 (BACE1) or Abeta, and the other brain antigens
disclosed herein.
[0133] An exemplary brain antigen bound by such
multispecific/bispecific antibody is BACE1, and an exemplary
antibody binding thereto is the YW412.8.31 antibody in FIGS. 5a-b
herein.
[0134] In another embodiment, the brain antigen is Abeta, exemplary
such antibodies being described in WO2007068412, WO2008011348,
WO20080156622, and WO2008156621, expressly incorporated herein by
reference, with an exemplary Abeta antibody comprising IgG4
MABT5102A antibody comprising the heavy and light chain amino acid
sequences in FIGS. 7a and 7b, respectively.
[0135] Techniques for making multispecific antibodies include, but
are not limited to, recombinant co-expression of two immunoglobulin
heavy chain-light chain pairs having different specificities (see
Milstein and Cuello, Nature 305: 537 (1983)), WO 93/08829, and
Traunecker et al., EMBO J. 10: 3655 (1991)), and "knob-in-hole"
engineering (see, e.g., U.S. Pat. No. 5,731,168). Multi-specific
antibodies may also be made by engineering electrostatic steering
effects for making antibody Fc-heterodimeric molecules (WO
2009/089004A1); cross-linking two or more antibodies or fragments
(see, e.g., U.S. Pat. No. 4,676,980, and Brennan et al., Science,
229: 81 (1985)); using leucine zippers to produce bi-specific
antibodies (see, e.g., Kostelny et al., J. Immunol.,
148(5):1547-1553 (1992)); using "diabody" technology for making
bispecific antibody fragments (see, e.g., Hollinger et al., Proc.
Natl. Acad. Sci. USA, 90:6444-6448 (1993)); and using single-chain
Fv (sFv) dimers (see, e.g. Gruber et al., J. Immunol., 152:5368
(1994)); and preparing trispecific antibodies as described, e.g.,
in Tutt et al. J. Immunol. 147: 60 (1991).
[0136] Engineered antibodies with three or more functional antigen
binding sites, including "Octopus antibodies" or "dual-variable
domain immunoglobulins" (DVDs) are also included herein (see, e.g.
US 2006/0025576A1, and Wu et al. Nature Biotechnology (2007)).
[0137] The antibody or fragment herein also includes a "Dual Acting
FAb" or "DAF" comprising an antigen binding site that binds to the
BBB-R (e.g.TfR) as well as the brain antigen (e.g. BACE1) (see, US
2008/0069820, for example).
[0138] In one embodiment, the antibody is an antibody fragment,
various such fragments being disclosed above.
[0139] In another embodiment, the antibody is an intact or
full-length antibody. Depending on the amino acid sequence of the
constant domain of their heavy chains, intact antibodies can be
assigned to different classes. There are five major classes of
intact antibodies: IgA, IgD, IgE, IgG, and IgM, and several of
these may be further divided into subclasses (isotypes), e.g.,
IgG1, IgG2, IgG3, IgG4, IgA, and IgA2. The heavy chain constant
domains that correspond to the different classes of antibodies are
called .alpha., .delta., .epsilon., .gamma., and .mu.,
respectively. The subunit structures and three-dimensional
configurations of different classes of immunoglobulins are well
known. In one embodiment, the intact antibody lacks effector
function.
[0140] Techniques for generating antibodies are known and examples
provided above in the definitions section of this document. In one
embodiment, the antibody is a chimeric, humanized, or human
antibody or antigen-binding fragment thereof.
[0141] Various techniques are available for determining binding of
the antibody to the BBB-R. One such assay is an enzyme linked
immunosorbent assay (ELISA) for confirming an ability to bind to
human BBB-R (and brain antigen). According to this assay, plates
coated with antigen (e.g. recombinant sBBB-R) are incubated with a
sample comprising the anti-BBB-R antibody and binding of the
antibody to the antigen of interest is determined.
[0142] In one aspect, an antibody of the invention is tested for
its antigen binding activity, e.g., by known methods such as ELISA,
Western blot, etc.
[0143] Assays for evaluating uptake of systemically administered
antibody and other biological activity of the antibody can be
performed as disclosed in the examples or as known for the
anti-brain antigen antibody of interest.
[0144] Exemplary assays where the multispecific antibody binds
BACE1 shall now be described.
[0145] Competition assays may be used to identify an antibody that
competes with any of the antibodies or Fabs descried herein, for
example, YW412.8, YW412.8.31, YW412.8.30, YW412.8.2, YW412.8.29,
YW412.8.51, Fab12, LC6, LC9, LC10 for binding to BACE1. In certain
embodiments, such a competing antibody binds to the same epitope
(e.g., a linear or a conformational epitope) that is bound by any
of the antibodies or Fabs descried herein, for example, YW412.8,
YW412.8.31, YW412.8.30, YW412.8.2, YW412.8.29, YW412.8.51, Fab12,
LC6, LC9, LC10. Detailed exemplary methods for mapping an epitope
to which an antibody binds are provided in Morris (1996) "Epitope
Mapping Protocols," in Methods in Molecular Biology vol. 66 (Humana
Press, Totowa, N.J.).
[0146] In an exemplary competition assay, immobilized BACE1 is
incubated in a solution comprising a first labeled antibody that
binds to BACE1 (e.g., YW412.8, YW412.8.31, YW412.8.30, YW412.8.2,
YW412.8.29, YW412.8.51, Fab12, LC6, LC9, LC10) and a second
unlabeled antibody that is being tested for its ability to compete
with the first antibody for binding to BACE1. The second antibody
may be present in a hybridoma supernatant. As a control,
immobilized BACE1 is incubated in a solution comprising the first
labeled antibody but not the second unlabeled antibody. After
incubation under conditions permissive for binding of the first
antibody to BACE1, excess unbound antibody is removed, and the
amount of label associated with immobilized BACE1 is measured. If
the amount of label associated with immobilized BACE1 is
substantially reduced in the test sample relative to the control
sample, then that indicates that the second antibody is competing
with the first antibody for binding to BACE1. See Harlow and Lane
(1988) Antibodies: A Laboratory Manual ch.14 (Cold Spring Harbor
Laboratory, Cold Spring Harbor, N.Y.).
[0147] In one aspect, assays are provided for identifying
anti-BACE1 antibodies thereof having biological activity.
Biological activity may include, e.g., inhibition of BACE1 aspartyl
protease activity. Antibodies having such biological activity in
vivo and/or in vitro are also provided, e.g. as evaluated by
homogeneous time-resolved fluorescence HTRF assay or a microfluidic
capillary electrophoretic (MCE) assay using synthetic substrate
peptides, or in vivo in cell lines which express BACE1 substrates
such as APP.
[0148] The antibody (including the multispecific antibody) herein
is optionally recombinantly produced in a host cell transformed
with nucleic acid sequences encoding its heavy and light chains
(e.g. where the host cell has been transformed by one or more
vectors with the nucleic acid therein). The host cell is optionally
a mammalian cell, for example a Chinese Hamster Ovary (CHO)
cell.
[0149] III. Pharmaceutical Formulations
[0150] Therapeutic formulations of the antibodies used in
accordance with the present invention are prepared for storage by
mixing an antibody having the desired degree of purity with
optional pharmaceutically acceptable carriers, excipients or
stabilizers (Remington's Pharmaceutical Sciences 16th edition,
Osol, A. Ed. (1980)), in the form of lyophilized formulations or
aqueous solutions. Acceptable carriers, excipients, or stabilizers
are nontoxic to recipients at the dosages and concentrations
employed, and include buffers such as phosphate, citrate, and other
organic acids; antioxidants including ascorbic acid and methionine;
preservatives (such as octadecyldimethylbenzyl ammonium chloride;
hexamethonium chloride; benzalkonium chloride, benzethonium
chloride; phenol, butyl or benzyl alcohol; alkyl parabens such as
methyl or propyl paraben; catechol; resorcinol; cyclohexanol;
3-pentanol; and m-cresol); low molecular weight (less than about 10
residues) polypeptides; proteins, such as serum albumin, gelatin,
or immunoglobulins; hydrophilic polymers such as
polyvinylpyrrolidone; amino acids such as glycine, glutamine,
asparagine, histidine, arginine, or lysine; monosaccharides,
disaccharides, and other carbohydrates including glucose, mannose,
or dextrins; chelating agents such as EDTA; sugars such as sucrose,
mannitol, trehalose or sorbitol; salt-forming counter-ions such as
sodium; metal complexes (e.g. Zn-protein complexes); and/or
non-ionic surfactants such as TWEEN.TM., PLURONICS.TM. or
polyethylene glycol (PEG).
[0151] The formulation herein may also contain more than one active
compound as necessary, optionally those with complementary
activities that do not adversely affect each other. The type and
effective amounts of such medicaments depend, for example, on the
amount of antibody present in the formulation, and clinical
parameters of the subjects. Exemplary such medicaments are
discussed below.
[0152] The active ingredients may also be entrapped in
microcapsules prepared, for example, by coacervation techniques or
by interfacial polymerization, for example, hydroxymethylcellulose
or gelatin-microcapsules and poly-(methylmethacylate)
microcapsules, respectively, in colloidal drug delivery systems
(for example, liposomes, albumin microspheres, microemulsions,
nano-particles and nanocapsules) or in macroemulsions. Such
techniques are disclosed in Remington's Pharmaceutical Sciences
16th edition, Osol, A. Ed. (1980).
[0153] Sustained-release preparations may be prepared. Suitable
examples of sustained-release preparations include semi-permeable
matrices of solid hydrophobic polymers containing the antibody,
which matrices are in the form of shaped articles, e.g. films, or
microcapsules.
[0154] Examples of sustained-release matrices include polyesters,
hydrogels (for example, poly(2-hydroxyethyl-methacrylate), or
poly(vinylalcohol)), polylactides (U.S. Pat. No. 3,773,919),
copolymers of L-glutamic acid and .gamma. ethyl-L-glutamate,
non-degradable ethylene-vinyl acetate, degradable lactic
acid-glycolic acid copolymers such as the LUPRON DEPOT.TM.
(injectable microspheres composed of lactic acid-glycolic acid
copolymer and leuprolide acetate), and poly-D-(-)-3-hydroxybutyric
acid.
[0155] The formulations to be used for in vivo administration must
be sterile. This is readily accomplished by filtration through
sterile filtration membranes.
[0156] In one embodiment the formulation is isotonic.
[0157] IV. Therapeutic Uses of Anti-BBB-R Antibodies
[0158] The anti-BBB-R antibodies (including multispecific
antibodies comprising them) may be utilized in a variety of in vivo
methods. For example, the invention provides a method of
transporting a therapeutic compound across the blood-brain barrier
comprising exposing the anti-BBB-R antibody coupled to a
therapeutic compound (e.g. a multispecific antibody which binds
both the BBB-R and a brain antigen) to the BBB such that the
antibody transports the therapeutic compound coupled thereto across
the BBB. In another example, the invention provides a method of
transporting a neurological disorder drug across the blood-brain
barrier comprising exposing the anti-BBB-R antibody coupled to a
brain disorder drug (e.g. a multispecific antibody which binds both
the BBB-R and a brain antigen) to the BBB such that the antibody
transports the neurological disorder drug coupled thereto across
the BBB. In one embodiment, the BBB here is in a mammal (e.g. a
human), e.g. one which has a neurological disorder, including,
without limitation: Alzheimer's disease (AD), stroke, dementia,
muscular dystrophy (MD), multiple sclerosis (MS), amyotrophic
lateral sclerosis (ALS), cystic fibrosis, Angelman's syndrome,
Liddle syndrome, Parkinson's disease, Pick's disease, Paget's
disease, cancer, traumatic brain injury, etc.
[0159] In one embodiment, neurological disorder is selected from: a
neuropathy, amyloidosis, cancer (e.g. involving the CNS or brain),
an ocular disease or disorder, a viral or microbial infection,
inflammation (e.g. of the CNS or brain), ischemia,
neurodegenerative disease, seizure, behavioral disorder, lysosomal
storage disease, etc.
[0160] Neuropathy disorders are diseases or abnormalities of the
nervous system characterized by inappropriate or uncontrolled nerve
signaling or lack thereof, and include, but are not limited to,
chronic pain (including nociceptive pain), pain caused by an injury
to body tissues, including cancer-related pain, neuropathic pain
(pain caused by abnormalities in the nerves, spinal cord, or
brain), and psychogenic pain (entirely or mostly related to a
psychological disorder), headache, migraine, neuropathy, and
symptoms and syndromes often accompanying such neuropathy disorders
such as vertigo or nausea.
[0161] Amyloidoses are a group of diseases and disorders associated
with extracellular proteinaceous deposits in the CNS, including,
but not limited to, secondary amyloidosis, age-related amyloidosis,
Alzheimer's Disease (AD), mild cognitive impairment (MCI), Lewy
body dementia, Down's syndrome, hereditary cerebral hemorrhage with
amyloidosis (Dutch type); the Guam Parkinson-Dementia complex,
cerebral amyloid angiopathy, Huntington's disease, progressive
supranuclear palsy, multiple sclerosis; Creutzfeld Jacob disease,
Parkinson's disease, transmissible spongiform encephalopathy,
HIV-related dementia, amyotropic lateral sclerosis (ALS),
inclusion-body myositis (IBM), and ocular diseases relating to
beta-amyloid deposition (i.e., macular degeneration, drusen-related
optic neuropathy, and cataract).
[0162] Cancers of the CNS are characterized by aberrant
proliferation of one or more CNS cell (i.e., a neural cell) and
include, but are not limited to, glioma, glioblastoma multiforme,
meningioma, astrocytoma, acoustic neuroma, chondroma,
oligodendroglioma, medulloblastomas, ganglioglioma, Schwannoma,
neurofibroma, neuroblastoma, and extradural, intramedullary or
intradural tumors.
[0163] Ocular diseases or disorders are diseases or disorders of
the eye, which for the purposes herein is considered a CNS organ
subject to the BBB. Ocular diseases or disorders include, but are
not limited to, disorders of sclera, cornea, iris and ciliary body
(i.e., scleritis, keratitis, corneal ulcer, corneal abrasion, snow
blindness, arc eye, Thygeson's superficial punctate keratopathy,
corneal neovascularisation, Fuchs' dystrophy, keratoconus,
keratoconjunctivitis sicca, iritis and uveitis), disorders of the
lens (i.e., cataract), disorders of choroid and retina (i.e.,
retinal detachment, retinoschisis, hypertensive retinopathy,
diabetic retinopathy, retinopathy, retinopathy of prematurity,
age-related macular degeneration, macular degeneration (wet or
dry), epiretinal membrane, retinitis pigmentosa and macular edema),
glaucoma, floaters, disorders of optic nerve and visual pathways
(i.e., Leber's hereditary optic neuropathy and optic disc drusen),
disorders of ocular muscles/binocular movement
accommodation/refraction (i.e., strabismus, ophthalmoparesis,
progressive external opthalmoplegia, esotropia, exotropia,
hypermetropia, myopia, astigmatism, anisometropia, presbyopia and
ophthalmoplegia), visual disturbances and blindness (i.e.,
amblyopia, Lever's congenital amaurosis, scotoma, color blindness,
achromatopsia, nyctalopia, blindness, river blindness and
micro-opthalmia/coloboma), red eye, Argyll Robertson pupil,
keratomycosis, xerophthalmia and andaniridia.
[0164] Viral or microbial infections of the CNS include, but are
not limited to, infections by viruses (i.e., influenza, HIV,
poliovirus, rubella,), bacteria (i.e., Neisseria sp., Streptococcus
sp., Pseudomonas sp., Proteus sp., E. coli, S. aureus, Pneumococcus
sp., Meningococcus sp., Haemophilus sp., and Mycobacterium
tuberculosis) and other microorganisms such as fungi (i.e., yeast,
Cryptococcus neoformans), parasites (i.e., toxoplasma gondii) or
amoebas resulting in CNS pathophysiologies including, but not
limited to, meningitis, encephalitis, myelitis, vasculitis and
abscess, which can be acute or chronic.
[0165] Inflammation of the CNS is inflammation that is caused by an
injury to the CNS, which can be a physical injury (i.e., due to
accident, surgery, brain trauma, spinal cord injury, concussion) or
an injury due to or related to one or more other diseases or
disorders of the CNS (i.e., abscess, cancer, viral or microbial
infection).
[0166] Ischemia of the CNS, as used herein, refers to a group of
disorders relating to aberrant blood flow or vascular behavior in
the brain or the causes therefor, and includes, but is not limited
to: focal brain ischemia, global brain ischemia, stroke (i.e.,
subarachnoid hemorrhage and intracerebral hemorrhage), and
aneurysm.
[0167] Neurodegenerative diseases are a group of diseases and
disorders associated with neural cell loss of function or death in
the CNS, and include, but are not limited to: adrenoleukodystrophy,
Alexander's disease, Alper's disease, amyotrophic lateral
sclerosis, ataxia telangiectasia, Batten disease, cockayne
syndrome, corticobasal degeneration, degeneration caused by or
associated with an amyloidosis, Friedreich's ataxia, frontotemporal
lobar degeneration, Kennedy's disease, multiple system atrophy,
multiple sclerosis, primary lateral sclerosis, progressive
supranuclear palsy, spinal muscular atrophy, transverse myelitis,
Refsum's disease, and spinocerebellar ataxia.
[0168] Seizure diseases and disorders of the CNS involve
inappropriate and/or abnormal electrical conduction in the CNS, and
include, but are not limited to: epilepsy (i.e., absence seizures,
atonic seizures, benign Rolandic epilepsy, childhood absence,
clonic seizures, complex partial seizures, frontal lobe epilepsy,
febrile seizures, infantile spasms, juvenile myoclonic epilepsy,
juvenile absence epilepsy, Lennox-Gastaut syndrome, Landau-Kleffner
Syndrome, Dravet's syndrome, Otahara syndrome, West syndrome,
myoclonic seizures, mitochondrial disorders, progressive myoclonic
epilepsies, psychogenic seizures, reflex epilepsy, Rasmussen's
Syndrome, simple partial seizures, secondarily generalized
seizures, temporal lobe epilepsy, toniclonic seizures, tonic
seizures, psychomotor seizures, limbic epilepsy, partial-onset
seizures, generalized-onset seizures, status epilepticus, abdominal
epilepsy, akinetic seizures, autonomic seizures, massive bilateral
myoclonus, catamenial epilepsy, drop seizures, emotional seizures,
focal seizures, gelastic seizures, Jacksonian March, Lafora
Disease, motor seizures, multifocal seizures, nocturnal seizures,
photosensitive seizure, pseudo seizures, sensory seizures, subtle
seizures, sylvan seizures, withdrawal seizures, and visual reflex
seizures).
[0169] Behavioral disorders are disorders of the CNS characterized
by aberrant behavior on the part of the afflicted subject and
include, but are not limited to: sleep disorders (i.e., insomnia,
parasomnias, night terrors, circadian rhythm sleep disorders, and
narcolepsy), mood disorders (i.e., depression, suicidal depression,
anxiety, chronic affective disorders, phobias, panic attacks,
obsessive-compulsive disorder, attention deficit hyperactivity
disorder (ADHD), attention deficit disorder (ADD), chronic fatigue
syndrome, agoraphobia, post-traumatic stress disorder, bipolar
disorder), eating disorders (i.e., anorexia or bulimia), psychoses,
developmental behavioral disorders (i.e., autism, Rett's syndrome,
Aspberger's syndrome), personality disorders and psychotic
disorders (i.e., schizophrenia, delusional disorder, and the
like).
[0170] Lysosomal storage disorders are metabolic disorders which
are in some cases associated with the CNS or have CNS-specific
symptoms; such disorders include, but are not limited to: Tay-Sachs
disease, Gaucher's disease, Fabry disease, mucopolysaccharidosis
(types I, II, III, IV, V, VI and VII), glycogen storage disease,
GM1-gangliosidosis, metachromatic leukodystrophy, Farber's disease,
Canavan's leukodystrophy, and neuronal ceroid lipofuscinoses types
1 and 2, Niemann-Pick disease, Pompe disease, and Krabbe's
disease.
[0171] In one aspect, the antibody is used to detect a neurological
disorder before the onset of symptoms and/or to assess the severity
or duration of the disease or disorder. In one aspect, the antibody
permits detection and/or imaging of the neurological disorder,
including imaging by radiography, tomography, or magnetic resonance
imaging (MM).
[0172] In one aspect, a low affinity anti-BBB-R antibody for use as
a medicament is provided. In further aspects, a low affinity
anti-BBB-R antibody for use in treating a neurological disease or
disorder is provided (e.g., Alzheimer's disease). In certain
embodiments, a low affinity anti-BBB-R antibody for use in a method
of treatment is provided. In certain embodiments, the invention
provides a low affinity anti-BBB-R antibody for use in a method of
treating an individual having a neurological disease or disorder
comprising administering to the individual an effective amount of
the anti-BBB-R antibody (optionally coupled to a neurological
disorder drug). In one such embodiment, the method further
comprises administering to the individual an effective amount of at
least one additional therapeutic agent. In further embodiments, the
invention provides an anti-BBB-R antibody for use in reducing or
inhibiting amlyoid plaque formation in a patient at risk or
suffering from a neurological disease or disorder (e.g.,
Alzheimer's disease). An "individual" according to any of the above
embodiments is optionally a human. In certain aspect, the
anti-BBB-R antibody for use in the methods of the invention
improves uptake of the neurological disorder drug with which it is
coupled.
[0173] In a further aspect, the invention provides for the use of a
low affinity anti-BBB-R antibody in the manufacture or preparation
of a medicament. In one embodiment, the medicament is for treatment
of neurological disease or disorder. In a further embodiment, the
medicament is for use in a method of treating neurological disease
or disorder comprising administering to an individual having
neurological disease or disorder an effective amount of the
medicament. In one such embodiment, the method further comprises
administering to the individual an effective amount of at least one
additional therapeutic agent.
[0174] In a further aspect, the invention provides a method for
treating Alzheimer's disease. In one embodiment, the method
comprises administering to an individual having Alzheimer's disease
an effective amount of a multispecific antibody which binds both
BACE1 and TfR. In one such embodiment, the method further comprises
administering to the individual an effective amount of at least one
additional therapeutic agent. An "individual" according to any of
the above embodiments may be a human.
[0175] The anti-BBB-R antibodies of the invention can be used
either alone or in combination with other agents in a therapy. For
instance, the anti-BBB-R antibody of the invention may be
co-administered with at least one additional therapeutic agent. In
certain embodiments, an additional therapeutic agent is a
therapeutic agent effective to treat the same or a different
neurological disorder as the anti-BBB-R antibody is being employed
to treat. Exemplary additional therapeutic agents include, but are
not limited to: the various neurological drugs described above,
cholinesterase inhibitors (such as donepezil, galantamine,
rovastigmine, and tacrine), NMDA receptor antagonists (such as
memantine), amyloid beta peptide aggregation inhibitors,
antioxidants, .gamma.-secretase modulators, nerve growth factor
(NGF) mimics or NGF gene therapy, PPAR.gamma. agonists, HMS-CoA
reductase inhibitors (statins), ampakines, calcium channel
blockers, GABA receptor antagonists, glycogen synthase kinase
inhibitors, intravenous immunoglobulin, muscarinic receptor
agonists, nicrotinic receptor modulators, active or passive amyloid
beta peptide immunization, phosphodiesterase inhibitors, serotonin
receptor antagonists and anti-amyloid beta peptide antibodies. In
certain embodiments, the at least one additional therapeutic agent
is selected for its ability to mitigate one or more side effects of
the neurological drug.
[0176] Such combination therapies noted above encompass combined
administration (where two or more therapeutic agents are included
in the same or separate formulations), and separate administration,
in which case, administration of the antibody of the invention can
occur prior to, simultaneously, and/or following, administration of
the additional therapeutic agent and/or adjuvant. Antibodies of the
invention can also be used in combination with other interventional
therapies such as, but not limited to, radiation therapy,
behavioral therapy, or other therapies known in the art and
appropriate for the neurological disorder to be treated or
prevented.
[0177] The anti-BBB-R antibody of the invention (and any additional
therapeutic agent) can be administered by any suitable means,
including parenteral, intrapulmonary, and intranasal, and, if
desired for local treatment, intralesional administration.
Parenteral infusions include intramuscular, intravenous,
intraarterial, intraperitoneal, or subcutaneous administration.
Dosing can be by any suitable route, e.g. by injections, such as
intravenous or subcutaneous injections, depending in part on
whether the administration is brief or chronic. Various dosing
schedules including but not limited to single or multiple
administrations over various time-points, bolus administration, and
pulse infusion are contemplated herein.
[0178] Lipid-based methods of transporting the antibody or fragment
thereof across the blood-brain barrier include, but are not limited
to, encapsulating the antibody or fragment thereof in liposomes
that are coupled to antibody binding fragments that bind to
receptors on the vascular endothelium of the blood-brain barrier
(see e.g., U.S. Patent Application Publication No. 20020025313),
and coating the antibody or active fragment thereof in low-density
lipoprotein particles (see e.g., U.S. Patent Application
Publication No. 20040204354) or apolipoprotein E (see e.g., U.S.
Patent Application Publication No. 20040131692).
[0179] Antibodies of the invention would be formulated, dosed, and
administered in a fashion consistent with good medical practice.
Factors for consideration in this context include the particular
disorder being treated, the particular mammal being treated, the
clinical condition of the individual patient, the cause of the
disorder, the site of delivery of the agent, the method of
administration, the scheduling of administration, and other factors
known to medical practitioners. The antibody need not be, but is
optionally formulated with one or more agents currently used to
prevent or treat the disorder in question. The effective amount of
such other agents depends on the amount of antibody present in the
formulation, the type of disorder or treatment, and other factors
discussed above. These are generally used in the same dosages and
with administration routes as described herein, or about from 1 to
99% of the dosages described herein, or in any dosage and by any
route that is empirically/clinically determined to be
appropriate.
[0180] For the prevention or treatment of disease, the appropriate
dosage of an antibody of the invention (when used alone or in
combination with one or more other additional therapeutic agents)
will depend on the type of disease to be treated, the type of
antibody, the severity and course of the disease, whether the
antibody is administered for preventive or therapeutic purposes,
previous therapy, the patient's clinical history and response to
the antibody, and the discretion of the attending physician. The
antibody is suitably administered to the patient at one time or
over a series of treatments. Depending on the type and severity of
the disease, about 1 .mu.g/kg to 15 mg/kg (e.g. 0.1 mg/kg-10 mg/kg)
of antibody can be an initial candidate dosage for administration
to the patient, whether, for example, by one or more separate
administrations, or by continuous infusion. One typical daily
dosage might range from about 1 .mu.g/kg to 100 mg/kg or more,
depending on the factors mentioned above. For repeated
administrations over several days or longer, depending on the
condition, the treatment would generally be sustained until a
desired suppression of disease symptoms occurs. One exemplary
dosage of the antibody would be in the range from about 0.05 mg/kg
to about 10 mg/kg. Thus, one or more doses of about 0.5 mg/kg, 2.0
mg/kg, 4.0 mg/kg or 10 mg/kg (or any combination thereof) may be
administered to the patient. Such doses may be administered
intermittently, e.g. every week or every three weeks (e.g. such
that the patient receives from about two to about twenty, or e.g.
about six doses of the antibody). An initial higher loading dose,
followed by one or more lower doses may be administered.
[0181] However, other dosage regimens may be useful. The progress
of this therapy is easily monitored by conventional techniques and
assays.
[0182] It is understood that any of the above formulations or
therapeutic methods may be carried out using an immunoconjugate of
the invention in place of or in addition to an anti-BBB-R
antibody.
[0183] V. Articles of Manufacture
[0184] In another aspect of the invention, an article of
manufacture containing materials useful for the treatment,
prevention and/or diagnosis of the disorders described above is
provided. The article of manufacture comprises a container and a
label or package insert on or associated with the container.
Suitable containers include, for example, bottles, vials, syringes,
IV solution bags, etc. The containers may be formed from a variety
of materials such as glass or plastic. The container holds a
composition which is by itself or combined with another composition
effective for treating, preventing and/or diagnosing the condition
and may have a sterile access port (for example the container may
be an intravenous solution bag or a vial having a stopper
pierceable by a hypodermic injection needle). At least one active
agent in the composition is an antibody of the invention. The label
or package insert indicates that the composition is used for
treating the condition of choice. Moreover, the article of
manufacture may comprise (a) a first container with a composition
contained therein, wherein the composition comprises an antibody of
the invention; and (b) a second container with a composition
contained therein, wherein the composition comprises a further
cytotoxic or otherwise therapeutic agent. The article of
manufacture in this embodiment of the invention may further
comprise a package insert indicating that the compositions can be
used to treat a particular condition. Alternatively, or
additionally, the article of manufacture may further comprise a
second (or third) container comprising a
pharmaceutically-acceptable buffer, such as bacteriostatic water
for injection (BWFI), phosphate-buffered saline, Ringer's solution
and dextrose solution. It may further include other materials
desirable from a commercial and user standpoint, including other
buffers, diluents, filters, needles, and syringes.
[0185] It is understood that any of the above articles of
manufacture may include an immunoconjugate of the invention in
place of or in addition to an anti-BBB-R antibody.
[0186] The article of manufacture optionally further comprises a
package insert with instructions for treating a neurological
disorder in a subject, wherein the instructions indicate that
treatment with the antibody as disclosed herein treats the
neurological disorder, and optionally indicates that the antibody
has improved uptake across the BBB due to its low affinity for the
BBB-R.
III. Examples
[0187] This example evaluated the transferrin receptor (TfR), which
mediates iron transport into the brain via the holo-transferrin
complex (Skarlatos et al. Brain Res 683: 164-171 (1995)). A human
chimeric anti-murine transferrin receptor (anti-TfR.sup.A) antibody
that does not compete with endogenous transferrin binding to TfR
was compared to a human control IgG in a double-labeled experiment
for uptake in wild type mouse brain. A single trace dose
(approximately 50 .mu.g/kg) of [.sup.131I]anti-TfR.sup.A and
[.sup.125I]control IgG was injected into wild type mice
intravenously (i.v.) and brain uptake was measured at 5 min., 0.5,
1, 4, 24, 48, and 72 hours. A significant increase in
[.sup.131I]anti-TfR.sup.A uptake in the brain, measured as a
percentage of injected dose per gram of brain, was observed at all
time points (FIG. 1A). At its peak, 1 hour after injection, there
was a >11-fold difference in [.sup.131I]anti-TfR.sup.A brain
accumulation as compared to [.sup.125I]control IgG (n=6). If
unlabeled anti-TfR.sup.A (4 mg/kg body weight) was also
co-administered, brain accumulation of [.sup.131I]anti-TfR.sup.A
was nearly reduced to the level of control IgG, indicating
specific, target-driven uptake.
[0188] To evaluate whether significant antibody uptake in brain
also occurs at therapeutic dose levels, wild type mice were
administered either anti-TfR.sup.A or control IgG at 20 mg/kg
intravenously (i.v.). Human antibody concentration in the cortex
and serum was determined 1 and 24 hours after injection using a
human Fc sandwich ELISA. Briefly, after the indicated time of
administration, mice were perfused with D-PBS at a rate of 2
ml/min. for 8 minutes. Brains were extracted and the cortex and
hippocampus were isolated, homogenized in 1% NP-40 (Cal-Biochem) in
PBS containing Complete Mini EDTA-free protease inhibitor cocktail
tablets (Roche Diagnostics). Homogenized brain samples were rotated
at 4.degree. C. for 1 hour before centrifugation at 14,000 rpm for
20 minutes. The supernatant was isolated for brain antibody
measurement. Whole blood was collected prior to perfusion in serum
separator microcontainer tubes (BD Diagnostics), allowed to clot
for at least 30 minutes, and spun down at 5,000.times.g for 90
seconds. The supernatant was isolated for serum antibody
measurements. Antibody concentrations in mouse serum and brain
samples were measured by ELISA. NUNC 384-well Maxisorp immunoplates
(Neptune, N.J.) were coated with F(ab')2 fragment of donkey
anti-human IgG, Fc fragment-specific polyclonal antibody (Jackson
ImmunoResearch, West Grove, Pa.) overnight at 4.degree. C. Plates
were blocked with PBS containing 0.5% BSA for 1 hour at 25.degree.
C. Each antibody was used as an internal standard to quantify
respective antibody concentration. Plates were washed with PBS
containing 0.05% Tween-20 using a microplate washer (Bio-Tek
Instruments, Inc., Winooski, Vt.). Standards and samples were
diluted in PBS containing 0.5% BSA, 0.35 M NaCl, 0.25% CHAPS, 5 mM
EDTA, 0.05% Tween-20 and 15 ppm Proclin, and were added to the
microplate for two hours at 25.degree. C. Bound antibody was
detected with horseradish peroxidase-conjugated F(ab')2 goat
anti-human IgG, Fc-specific polyclonal antibody (Jackson
ImmunoResearch), developed using 3,3',5,5'-tetramethyl benzidine
(TMB) (KPL, Inc., Gaithersburg, Md.) and absorbance measured at 450
nm on a Multiskan Ascent reader (Thermo Scientific, Hudson, N.H.).
Concentrations were determined from the standard curve using a
four-parameter non-linear regression program. The assay had lower
limit of quantification (LLOQ) values of 3.12 ng/ml in serum and
15.6 ng/g in brain. Statistical analysis of differences between
experimental groups was performed using a two-tailed unpaired
t-test.
[0189] Compared to control IgG, concentration of anti-TfR.sup.A was
significantly higher in the brain 24 hours after antibody
administration (FIG. 1B, p=0.0002, n=10). Additionally, human IgG
concentration in brain was >2.5-fold higher compared to serum
for anti-TfR.sup.A compared to control IgG at 24 hours (FIG. 1C,
p=0.003, n=10). Together with the radiolabeled trace data, these
results indicate that systemically administered anti-TfR.sup.A can
accumulate in the brain, however the tissue distribution of
antibody in brain remained to be understood.
[0190] To address the distribution of systemically administered
antibodies in brain, wild type mice were injected 20 mg/kg i.v.
with either anti-TfR.sup.A or control IgG, perfused with PBS to
flush out any remaining circulating antibody, and brain sections
were stained with fluorescent anti-human secondary IgG to determine
antibody localization. After 1 hour of circulation, anti-TfR.sup.A
had a pronounced vascular distribution, as indicated by its
co-localization with the basement membrane marker anti-collagen IV
(FIG. 1D, left column). Although less pronounced, control IgG also
localized to the vasculature, indicating that after 1 hour of
exposure, therapeutic dose levels of systemically administered IgG
maintains a vascular distribution (FIG. 1E, left column). However,
there was a marked difference in antibody localization 24 hours
after injection. Anti-TfR.sup.A distribution was no longer
exclusively vascular, but instead, exhibited modest parenchymal
staining (FIG. 1D, right columns). In contrast, control IgG
antibody was largely absent in brain tissue 24 hours after
injection (FIG. 1E, right columns). These results indicate that
when dosed at therapeutically relevant levels, anti-TfR.sup.A may
penetrate the BBB as evidenced by modest parenchymal staining,
however, the bulk of the brain-accumulated antibody was largely
confined to endothelial cells of the BBB.
[0191] Accumulation in the parenchyma requires binding to surface
TfRs expressed on brain endothelial cells as well as dissociation
from the receptor following RMT. Without being bound by any theory,
it was hypothesized that reduced affinity for TfR may facilitate
dissociation after RMT and allow enhanced accumulation in the
parenchyma. Further, an anti-TfR with reduced affinity would be
less efficiently captured and transported in a
concentration-limited environment, such as in the brain, where
anti-TfR concentrations are low. In a clinical setting, however,
serum levels of an anti-TfR therapeutic would still be sufficiently
high to maintain saturation of the receptor in the vascular
lumen.
[0192] To test this prediction, variants of anti-TfR.sup.A were
generated that vary in their binding affinity for TfR. These
variants were tested in a competition ELISA assay (FIG. 2A);
anti-TfR.sup.A had the strongest affinity and lowest IC50 of any of
the tested antibodies for TfR, and each of anti-TfR.sup.B,C,D had
successively lower affinity and higher IC50. Later, variant
anti-TfR.sup.E was generated and tested in the same assay along
with anti-TfR.sup.A,B,C,D variants; as shown in FIG. 2A, it was
substantially less able to compete for binding to TfR than any of
the other tested anti-TfR antibodies, and it had a corresponding
high IC50 value (Table 2).
TABLE-US-00002 TABLE 2 IC50 measurements for anti-TfR antibodies
Antibody IC50 (nM) Standard deviation Anti-TfR.sup.A 1.7 0.1
Anti-TfR.sup.B 6.9 0.4 Anti-TfR.sup.C 65 12 Anti-TfR.sup.D 111 16
Anti-TfR.sup.E >5 .times. 10.sup.4 --
[0193] These variants were tested in both a non-TfR saturating
(trace dosing) and TfR saturating (therapeutic dosing) environment.
Trace levels of [.sup.125I]anti-TfR.sup.A,
[.sup.125I]anti-TfR.sup.B, [.sup.125I]anti-TfR.sup.C,
[.sup.125I]anti-TfR.sup.D and [.sup.125I]anti-TfR.sup.E (which vary
in affinity for TfR, with the affinity of
anti-TfR.sup.A>affinity of anti-TfR.sup.B>affinity of
anti-TfR.sup.C>affinity of anti-TfR.sup.D>affinity of
anti-TfR.sup.E) were injected i.v. into mice and brain uptake was
measured 1, 4, or 24 hours after injection. This assay was
performed originally with [.sup.125I]anti-TfR.sup.A,
[.sup.125I]anti-TfR.sup.B, [.sup.125I]anti-TfR.sup.C, and
[.sup.125I]anti-TfR.sup.D, and later repeated upon the construction
of [.sup.125I]anti-TfR.sup.E, the results of which are shown in
FIG. 2B. Consistent with the proposed model, trace dose levels of
lower affinity anti-TfR antibodies resulted in less uptake in brain
compared to higher affinity variants (FIG. 2B). In striking
contrast to trace dosing, however, brain uptake of these same
lower-affinity variants at therapeutic levels (20 mg/kg assessed at
1 and 24 hours) exhibited increased brain uptake at 24 hours as
affinity was lowered, while no significant difference in uptake was
observed at 1 hour (FIG. 2C). These data support the hypothesis
that a lower affinity RMT antibody would exhibit decreased
transport under limiting concentrations while transport under
saturating conditions would be unaffected.
[0194] Thus, the following model is proposed: compared to a high
affinity antibody, fewer low affinity antibodies bind to receptors
on the luminal side of the vasculature under non-saturating
concentrations, leading to lower endothelial uptake (FIG. 2D, left
panels). At a higher therapeutic dose, however, luminal receptors
would be saturated regardless of affinity resulting in similar
endothelial uptake (FIG. 2D, right panels). Under these conditions,
lower affinity RMT antibodies can achieve greater brain
accumulation by 1) maximizing dissociation from the RMT target
facilitating release into the brain, and 2) reducing the likelihood
of efflux out of the brain as concentrations are limited on the
parenchymal side of the BBB. Thus in a therapeutic setting, a lower
affinity antibody for an RMT target is surprisingly advantageous
for parenchymal accumulation.
[0195] To evaluate the localization of these variants exhibiting
increased brain uptake, mice were dosed i.v. with 20 mg/kg of
either the high affinity anti-TfR.sup.A or the lower affinity
variants anti-After 24 hours, animals were PBS-perfused and brain
sections were co-stained for human IgG and the neuronal marker NeuN
(FIG. 2E). As observed before, high affinity anti-TfR.sup.A treated
animals had mostly vascular staining with low levels of parenchymal
signal (FIG. 2E, top row). However, the lower affinity
anti-TfR.sup.B,C,D had noticeably more pronounced cellular staining
not depicting cortical blood vessels (FIG. 2E, data for
anti-TfR.sup.B,C,D). Furthermore, co-localized staining with NeuN
indicated a redistribution of antibody from the vasculature to
neurons. This is especially pronounced in a representative higher
magnification image of anti-TfR.sup.D variant (FIG. 2F). Together
with the brain uptake data, these results indicate that a
significantly higher brain accumulation of antibody can be achieved
by lowering the affinity of anti-TfR for TfR, and that lower
affinity antibodies such as anti-TfR.sup.D selectively distributed
to neurons.
[0196] Transport of anti-TfR antibodies across the BBB was further
established when evaluating a bispecific antibody
(anti-TfR.sup.A/BACE1) that binds both TfR and the amyloid
precursor protein (APP) cleavage enzyme, beta secretase (BACE1)
(FIG. 3A). The high affinity anti-TfR.sup.A was used to engineer
the TfR binding arm of the bispecific using standard `knob in hole`
bispecific antibody construction technology (see, e.g., Ridgway et
al., Protein Eng. (1996) 9(7): 617-621). In addition to the knob
and hole mutations in the Fc for anti-TfR (hole) and anti-BACE1
(knob), the anti-TfR arm of the antibody comprised a mutation in
the Fc region that abrogated glycosylation (N297G). The knob and
hole half-antibodies were purified separately and annealed to
generate an aglycosylated bispecific IgG in vitro. The binding
affinity of the anti-TfR.sup.A/BACE1 antibody to TfR was
considerably reduced compared to the parental anti-TfR.sup.A due to
the loss of bivalent binding (FIG. 3B). BACE1 is expressed
primarily on neurons in the CNS and is considered to be the primary
contributor of beta amyloid (A.beta..sub.1-40) formation via APP
cleavage (Vassar et al., Science 286:735-741 (1999)). An antibody
to BACE1 has been described as an effective means to inhibit BACE1
activity, and may reduce A.beta..sub.1-40 production in vivo.
Inhibition of BACE1 by anti-TfR/BACE1 was examined in a HEK293 cell
line stably expressing APP. Compared to anti-BACE1, the bispecific
antibody had both similar efficacy and potency in inhibiting
A.beta..sub.1-40 production, suggesting that the anti-TfR/BACE1 is
a fully functional large molecule inhibitor of BACE1 activity (FIG.
3C).
[0197] Based on this model, this lower affinity bispecific would be
expected to be a more favorable candidate for increased uptake
compared to the anti-TfR alone. To investigate the brain
accumulation of the bispecific antibody, trace doses of
[.sup.125I]anti-TfR.sup.A/BACE1 were compared to
[.sup.125I]anti-TfR.sup.A and [.sup.125I]anti-BACE1 and brain
uptake was evaluated at 30 min., 6, 24, and 48 hours after i.v.
injection. Significantly higher brain uptake was observed with
[.sup.125I]anti-TfR/BACE1 compared to [.sup.125I]anti-BACE1 at all
time points (FIG. 3d, n=4). Consistent with the affinity
hypothesis, brain uptake of this non-saturating trace dose of
[.sup.125I]anti-TfR.sup.A was much greater than that of the lower
affinity [.sup.125I]anti-TfR.sup.A/BACE1. To assess antibody
accumulation at therapeutic dose levels, mice were injected i.v.
with anti-TfR.sup.A/BACE1 or anti-BACE1 at 20 mg/kg and brain
uptake of antibody was determined after 1, 12, 24, and 48 hours.
Compared to the monospecific anti-BACE1, administration of the
bispecific anti-TfR.sup.A/BACE1 resulted in a significantly higher
brain uptake at all time points (FIG. 3E). As predicted by the
affinity model, the extent of uptake was significantly greater than
the higher affinity anti-TfR.sup.A alone (compare FIGS. 3E to 1B).
Peak accumulation was achieved at 24 hours after injection,
reaching concentrations of .about.20 nM and remained elevated 48
hours after injection, even as peripheral levels of antibody
cleared to .about.12% of its concentration at 1 hour. Enhanced
uptake by the bispecific is dramatically apparent when comparing
the average percent of antibody in the brain versus the serum (FIG.
3F).
[0198] To determine localization of anti-TfR.sup.A/BACE1 after
systemic administration, mice were PBS-perfused 24 hours after
injection, and antibody distribution was visualized with anti-human
fluorescent secondary (FIG. 3G). Similar to the lower affinity
anti-TfR antibody localization, there was substantial staining of
the parenchyma in addition to vascular staining. Parenchymal
co-localization with NeuN indicated that these antibodies were
localized to the neuronal population. In contrast, animals injected
with control IgG showed a complete lack of both vascular and
parenchymal staining. Together, these data indicate that the
bispecific anti-TfR.sup.A/BACE1 traverses across the BBB and can
significantly accumulate in the brain parenchyma.
[0199] To assess the efficacy of anti-TfR.sup.A/BACE1 on
A.beta..sub.1-40 production in vivo, wild type mice were
administered a single 25 mg/kg or 50 mg/kg dose of control IgG,
anti-BACE1, or anti-TfR/BACE1. Based on the observation that brain
antibody uptake peaks 24 hours after injection (see FIG. 3E), brain
and plasma A.beta..sub.1-40 levels were determined at 24 and 48
hours after i.v. antibody administration. At 25 mg/kg,
anti-TfR.sup.A/BACE1 was able to significantly reduce brain
A.beta..sub.1-40 levels compared to control IgG both after 24
(p=0.001, n=10) and 48 (p=0.0003, n=10) hours post-injection, while
anti-BACE1 had no effect on A.beta..sub.1-40 reduction (FIG. 4A).
At 50 mg/kg, anti-TfR.sup.A/BACE1 had a even more dramatic effect
on reducing brain A.beta..sub.1-40 at both time points compared to
control IgG (FIG. 3B, p<0.0001, n=10 for both 24 and 48 hr).
Administration of anti-BACE1 at this dose also significantly
reduced brain A.beta..sub.1-40 levels compared to control
(p<0.0001, n=10 for 24 hr; p=0.006, n=10 for 48 hr), though to a
significantly lesser extent than the bispecific
anti-TfR.sup.A/BACE1 (p<0.0001, n=10 for both 24 and 48 hours).
Notably, the ability of the bispecific to reduce A.beta..sub.1-40
was 2- to 3-fold greater than anti-BACE1 for all time points and
doses measured. The maximal effect of anti-TfR.sup.A/BACE1 was
achieved 48 hours after injection at 50 mg/kg, with a 50.0.+-.1.9%
reduction in brain A.beta..sub.1-40 compared to control IgG (FIG.
4E). Significant reductions in peripheral A.beta..sub.1-40 was also
observed at both doses and time points for anti-TfR.sup.A/BACE1
(FIG. 4C-D). Treatment with anti-BACE1 resulted in a reduction in
peripheral A.beta..sub.1-40 only at the 24 hour time point (p=0.01
for 25 mg/kg, p=0.002 for 50 mg/kg; n=10 for each). These data
confirm that antibodies engineered to cross the BBB can be
pharmacodynamically efficacious. Furthermore, the increase in brain
penetrance of the bispecific renders it more potent BACE1 inhibitor
drug by significantly reducing brain A.beta..sub.1-40 levels.
[0200] At therapeutic doses of 20 mg/kg, however, BBB penetrance
and entry into the non-vascular portions of the CNS was enhanced in
the anti-TfR.sup.E-treated animals relative to the anti-TfR.sup.A
or anti-TfR.sup.D-treated animals (FIG. 8B). Notably,
anti-TfR.sup.D achieved a higher initial concentration in the
brain, which steadily decreased after day 2; anti-TfR.sup.E, on the
other hand, retained a consistently high level of brain exposure
over the tested 8 day period. Relatedly, anti-TfR.sup.E
concentration in the serum decreased the least of all of the
anti-TfR antibodies over the assessed period (FIG. 8A). In all,
this data indicates that generally a lower affinity for TfR
surprisingly reduces serum clearance and increases brain exposure,
but that at some threshold the lower affinity begins to impair the
maximum brain exposure obtainable with the antibody. In this
example, an optimum would seem to be found between the affinities
of antibodies anti-TfR.sup.D and anti-TfR.sup.E for transferrin
receptor.
[0201] Importantly, these data highlight several causative
mechanisms behind increasing uptake of an antibody into the CNS
using a lower-affinity antibody approach. First, high affinity
anti-TfR antibodies (e.g., anti-TfR.sup.A, FIG. 1D) limit brain
uptake by quickly saturating the TfR in the brain vasculature, thus
reducing the total amount of antibody taken up into the brain and
also restricting its distribution to the vasculature. Strikingly,
lowering affinity (e.g., anti-TfR.sup.B-E, and
anti-TfR.sup.A,D,E/BACE1, FIGS. 2C, 2E, 2F, 3E-G and 9C) improves
brain uptake and distribution, with a robust shift observed in
localization from the vasculature to neurons and associated
neuropil. Second, the lower affinity of the antibody for TfR is
proposed to impair the ability of the antibody to return to the
vascular side of the BBB via TfR from the CNS side of the membrane
because the overall affinity of the antibody for TfR is low and the
local concentration of the antibody on the CNS side of the BBB is
non-saturating due to the rapid dispersal of the antibody into the
CNS compartment (see, e.g., FIGS. 1D, 2E and 2F). Third, in vivo,
antibodies with less affinity for TfR are not cleared from the
system as efficiently as those with greater affinity for TfR (see
FIGS. 8A and 9B), and thus remain at higher circulating
concentrations than their higher-affinity counterparts. This is
advantageous because the circulating antibody levels of the
lower-affinity antibody are sustained at therapeutic levels for a
longer period of time than the higher-affinity antibody, which
subsequently improves uptake of antibody in brain for longer period
of time (compare anti-TfR.sup.A/BACE1 to anti-TfR.sup.D/BACE1 in
FIG. 9C). Furthermore, this improvement in both plasma and brain
exposure may reduce the frequency of dosing in the clinic, which
would have potential benefit not only for patient compliance and
convenience but also in lessening any potential side effects or
off-target effects of the antibody and/or of a therapeutic compound
coupled thereto.
[0202] Further studies were performed to assess whether further
lessening the affinity of the bispecific anti-TfR.sup.A/BACE1
antibody could further improve its BBB and parenchymal penetrance.
Two further bispecific antibodies were constructed:
anti-TfR.sup.D/BACE1 and anti-TfR.sup.E/BACE1, using the same
construction methodology employed for the anti-TfR.sup.A/BACE1
antibody. Competition ELISA assays were performed (FIG. 9A) and the
resulting IC50s were as follows:
TABLE-US-00003 TABLE 3 IC50/affinity measurements for
anti-TfR/BACE1 antibodies Antibody IC50 Kd (Biacore) (nM)
Anti-TfR.sup.A/BACE1 15 nM 33.3 .+-. 1.7 Anti-TfR.sup.D/BACE1 1.6
.mu.M 630 .+-. 50 Anti-TfR.sup.E/BACE1 >50 .mu.M N.D.
[0203] Surface plasmon resonance measurements of Kd were also made
for the binding between each bispecific antibody and TfR. The
BIACORE.RTM. analysis in Table 3 was performed as follows. Kd was
measured using surface plasmon resonance assays using a
BIACORE.RTM.-T-100 (BIAcore, Inc., Piscataway, N.J.) at 25.degree.
C. using penta-His Ab capture (Qiagen, Valencia, Calif.). Briefly,
carboxymethylated dextran biosensor chips (CMS, BIACORE, Inc.) were
activated with N-ethyl-N'-(3-dimethylaminopropyl)-carbodiimide
hydrochloride (EDC) and N-hydroxysuccinimide (NHS) according to the
supplier's instructions. Penta-His antibody was diluted with 100 mM
sodium acetate, pH 4.0, to 50 .mu.g/ml before injection at a flow
rate of 5 .mu.l/minute to achieve approximately 10000 response
units (RU) of coupled protein. Following the injection of antibody,
1 M ethanolamine was injected to block unreacted groups. For
kinetics measurements, MuTfR-His was injected in FIBS-P to reach
about 50 RU, then two-fold serial dilutions of anti-TfR.sup.A/BACE1
(1.95 nM to 1000 nM) or anti-TfR.sup.D/BACE1 (9.75 nM to 5000 nM)
were injected in HBS-P at 25.degree. C. at a flow rate of
approximately 30 .mu.l/min. Association rates (kon) and
dissociation rates (koff) were calculated using a simple one-to-one
Langmuir binding model (BIACORE.RTM. Evaluation Software version
3.2) by simultaneously fitting the association and dissociation
sensorgrams. The equilibrium dissociation constant (Kd) was
calculated as the ratio koff/kon. See, e.g., Chen et al., J. Mol.
Biol. 293:865-881 (1999). The affinity of anti-TfR.sup.E/BACE1 was
too weak to be determined by surface plasmon resonance.
[0204] As shown in FIG. 9A and Tables 2 and 3, the bispecific
anti-TfR.sup.A/BACE1 and anti-TfR.sup.D/BACE1 antibodies bound
markedly less well to TfR than the corresponding monospecific
anti-TfR.sup.A and anti-TfR.sup.D (compare FIG. 9A to FIG. 2A). For
anti-TfR.sup.E/BACE1, the partial binding curves for the bispecific
and monospecific also suggest that the bispecific
anti-TfR.sup.E/BACE1 has a much higher IC50 than the corresponding
monospecific anti-TfR.sup.E.
[0205] These antibodies were tested in the same in vivo
A.beta..sub.1-40 production assay described above. Briefly, 6-8
week old wild type C57Bl/6 mice were administered via i.v. tail
vein injection a single 50 mg/kg dose of control IgG, monospecific
anti-BACE1, or anti-TfR.sup.A/BACE1, anti-TfR.sup.D/BACE1, or
anti-TfR.sup.E/BACE1, 6 mice per antibody treatment per timepoint,
for a total of 180 mice treated. Brain and plasma A.beta..sub.1-40
levels were determined at 1, 2, 4, 6, 8, and 10 days after i.v.
antibody administration (FIGS. 9B-9E). The concentration of
bispecific antibodies found in the brain (FIG. 9C) at the earliest
time point was greatest with anti-TfR.sup.A/BACE1 and
anti-TfR.sup.D/BACE1, each of which had concentrations of more than
twice the concentration achieved by anti-TfR.sup.E/BACE1 at the 1
day time point. However, the anti-TfR.sup.A/BACE1 brain
concentration levels returned to control levels by day 6, and the
anti-TfR.sup.D/BACE1 levels did so by day 10. In contrast, the
lowest affinity bispecific antibody anti-TfR.sup.E/BACE1 had a much
lower relative dropoff in brain antibody concentration as compared
to anti-TfR.sup.A/BACE1 and anti-TfR.sup.D/BACE1, in keeping with
the proposed model that a lower affinity for anti-TfR leads to a
reduced ability for the antibody to be exported from the
parenchymal space. The levels of Abeta1-40 in the brain (FIG. 9E)
were reduced in roughly the same proportion expected by the
observed concentrations of bispecific antibody in the brain:
anti-TfR.sup.A/BACE1 and anti-TfR.sup.D/BACE1 had similarly reduced
levels of observed brain Abeta1-40 at the earliest time points
(days 1-2), which either rapidly increased at subsequent time
points (anti-TfR.sup.A/BACE1) or more moderately increased at
subsequent time points (anti-TfR.sup.D/BACE1), consistent with the
observed decreases in brain concentration of each of these
antibodies (FIG. 9C). Notably, while the anti-TfR.sup.E/BACE1
antibody treatment resulted in a relatively more modest reduction
in brain Abeta1-40 levels than that observed with the other
bispecific antibodies, this reduction was consistent across all
timepoints (FIG. 9E).
[0206] Plasma measurements (FIG. 9B) showed that
anti-TfR.sup.A/BACE1 was cleared by day 4, while
anti-TfR.sup.D/BACE1 persisted at relatively low levels across all
time points, and levels of anti-TfR.sup.E/BACE1 remained similar to
controls across all time points. Consistent with this finding,
observed plasma Abeta1-40 levels (FIG. 9D) were similarly reduced
from control anti-gD levels at all time points with each of
anti-TfR.sup.D/BACE1, anti-TfR.sup.E/BACE1 and anti-BACE1.
Anti-TfR.sup.A/BACE1 showed similar reductions at the 1, 2 and
4-day time points, rapidly returning to control levels at later
time points, in keeping with the observed disappearance of the
antibody from the plasma.
[0207] These results again demonstrate that bispecific
anti-TfR/BACE1 antibodies effectively cross the BBB and inhibit
BACE1 activity in a mammalian in vivo system. They also suggest
that an affinity for TfR between that of the anti-TFR.sup.D/BACE1
and the anti-TfR.sup.E/BACE1 may provide an optimal combination of
persistence and activity in the parenchyma/brain. It is noted,
however that for each brain target, the potency of the bispecific
arm specific for that target will dictate how much of the
anti-TfR/target bispecific antibody must be present in the CNS side
of the BBB in order to achieve the desired results, and thus what
degree of affinity of the anti-TfR for TfR must be used in the
bispecific to obtain that concentration. This invention provides a
means to determine and design the bispecific antibody to achieve
such target levels in the CNS after administration on the
nonprivileged side of the BBB.
[0208] These results were confirmed and extended using another
anti-TfR bispecific antibody, anti-TfR/Abeta, that binds both TfR
and amyloid beta. Three bispecific variants were prepared:
anti-TfR.sup.A/Abeta, anti-TfR.sup.D/Abeta and
anti-TfR.sup.E/Abeta, using the same methods as used for the
preparation of the anti-TfR/BACE1 bispecific above. Abeta is the
main substituent of amyloid plaques, which are believed to be
involved in the development of AD. Inhibition of plaque formation
by Abeta binding and removal, in either its free or oligomerized
state, may inhibit the development or progression of AD. The
pharmacokinetic properties of each of these bispecific antibodies
were assessed.
[0209] A single 50 mg/kg dose of control IgG, monospecific
anti-Abeta antibody, or each bispecific antibody was injected i.p.
into 8-16 week old wild type C57BL/6J mice or mice expressing both
human presenilin 2 and human amyloid precursor protein (PS2APP).
Due to a limited number of transgenic animals, only two of the
bispecific variants (anti-TfR.sup.D/Abeta and anti-TfR.sup.E/Abeta)
were assayed in the PS2APP mice. Four to six replicate mice were
dosed in each treatment group. The mice were sacrificed after 24
hours and drug levels measured in both the brain and plasma, as
with the anti-TfR/BACE1 bispecific studies. Prior to sacrifice,
blood was also collected 6 hours post-dose for an early evaluation
of plasma antibody concentrations. Plasma measurements of antibody
concentration (FIGS. 10A and 11A) showed that all antibodies were
present at similar levels at 6 hours post-dose. However, control
monospecific anti-Abeta levels were reduced compared to control IgG
by 24 hours. This is similar to previous observations for this
anti-Abeta molecule. At 24 hours, anti-TfR.sup.A/Abeta showed
similar antibody levels in the periphery as anti-Abeta, whereas
anti-TfR.sup.D/Abeta and anti-TfR.sup.E/Abeta showed slightly
elevated levels, intermediate between anti-Abeta and control
IgG.
[0210] The concentration of bispecific antibodies found in the
brain was increased compared to both control IgG and anti-Abeta
(FIGS. 10B and 11B). As compared to anti-Abeta,
anti-TfR.sup.A/Abeta had concentrations 12-fold higher,
anti-TfR.sup.D/Abeta had concentrations 8- to 15-fold higher, and
anti-TfR.sup.E/Abeta had concentrations 4- to 5-fold higher. The
increase in brain uptake of the anti-TfR.sup.A,D,E/Abeta antibodies
compared to anti-Abeta was even greater than the increases seen for
the anti-TfR.sup.A,D,E/BACE bispecific antibodies compared to
anti-BACE1. This is likely due to the decreased peripheral exposure
of anti-Abeta compared to control IgG 24 hours after dosing, which
resulted in lower levels of anti-Abeta in brain as compared to
control IgG.
[0211] These findings are the first demonstration that large
molecule antibodies administered at therapeutically relevant doses
can traverse the BBB and produce significant and sustained brain
uptake. Furthermore, these results demonstrating an inverse
relationship between antibody affinity and extent of brain uptake
furthers understanding of RMT dynamics. This novel insight can be
applied to a variety of other potential RMT targets to provide a
more effective strategy for antibody drug delivery into the CNS.
Additionally, these in vivo results demonstrate that a bispecific
antibody can greatly improve the potency of a promising
anti-amyloidogenic therapeutic by significantly increasing brain
penetrance of the targeting antibody drug. This could be highly
advantageous, as enhanced drug delivery would translate to less
potential side effects due to lower therapeutic dosing required.
More generally, this technology has vast potential to be applied to
therapeutics for a wide range of CNS diseases and represents an
improved approach to provide safer antibody drugs.
[0212] Although the foregoing invention has been described in some
detail by way of illustration and example for purposes of clarity
of understanding, the descriptions and examples should not be
construed as limiting the scope of the invention. The disclosures
of all patent and scientific literature cited herein are expressly
incorporated in their entirety by reference.
Sequence CWU 1
1
151108PRTArtificial sequencesequence is synthesized 1Asp Ile Gln
Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val 1 5 10 15Gly Asp
Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Asp Val Ser 20 25 30Thr Ala
Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys 35 40 45Leu Leu
Ile Tyr Ser Ala Ser Phe Leu Tyr Ser Gly Val Pro Ser 50 55 60Arg Phe
Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile 65 70 75Ser Ser
Leu Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln 80 85 90Ser Tyr
Thr Thr Pro Pro Thr Phe Gly Gln Gly Thr Lys Val Glu 95 100 105Ile
Lys Arg2108PRTArtificial sequencesequence is synthesized 2Asp Ile
Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val 1 5 10 15Gly
Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Asp Val Ser 20 25 30Thr
Ala Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys 35 40 45Leu
Leu Ile Tyr Ser Ala Ser Phe Leu Tyr Ser Gly Val Pro Ser 50 55 60Arg
Phe Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile 65 70 75Ser
Ser Leu Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln 80 85 90Phe
Pro Thr Tyr Leu Pro Thr Phe Gly Gln Gly Thr Lys Val Glu 95 100
105Ile Lys Arg3108PRTArtificial sequencesequence is synthesized
3Asp Ile Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val 1 5 10
15Gly Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Asp Val Ser 20 25
30Thr Ala Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys 35 40
45Leu Leu Ile Tyr Ser Ala Ser Phe Leu Tyr Ser Gly Val Pro Ser 50 55
60Arg Phe Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile 65 70
75Ser Ser Leu Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln 80 85
90Gly Tyr Asn Asp Pro Pro Thr Phe Gly Gln Gly Thr Lys Val Glu 95
100 105Ile Lys Arg4108PRTArtificial sequencesequence is synthesized
4Asp Ile Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val 1 5 10
15Gly Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Asp Val Ser 20 25
30Thr Ala Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys 35 40
45Leu Leu Ile Tyr Ser Ala Ser Phe Leu Tyr Ser Gly Val Pro Ser 50 55
60Arg Phe Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile 65 70
75Ser Ser Leu Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln 80 85
90Ser Ser Thr Asp Pro Thr Thr Phe Gly Gln Gly Thr Lys Val Glu 95
100 105Ile Lys Arg5108PRTArtificial sequencesequence is synthesized
5Asp Ile Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val 1 5 10
15Gly Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Val Val Ala 20 25
30Asn Ser Leu Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys 35 40
45Leu Leu Ile Tyr Leu Ala Ser Phe Leu Tyr Ser Gly Val Pro Ser 50 55
60Arg Phe Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile 65 70
75Ser Ser Leu Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln 80 85
90Asp Ala Thr Ser Pro Pro Thr Phe Gly Gln Gly Thr Lys Val Glu 95
100 105Ile Lys Arg6108PRTArtificial sequencesequence is synthesized
6Asp Ile Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val 1 5 10
15Gly Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Asp Val Ser 20 25
30Thr Ala Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys 35 40
45Leu Leu Ile Tyr Ser Ala Ser Phe Leu Tyr Ser Gly Val Pro Ser 50 55
60Arg Phe Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile 65 70
75Ser Ser Leu Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln 80 85
90Tyr Ala Thr Asp Pro Pro Thr Phe Gly Gln Gly Thr Lys Val Glu 95
100 105Ile Lys Arg7119PRTArtificial sequencesequence is synthesized
7Glu Val Gln Leu Val Glu Ser Gly Gly Gly Leu Val Gln Pro Gly 1 5 10
15Gly Ser Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe Thr Phe Ser 20 25
30Gly Tyr Ala Ile His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu 35 40
45Glu Trp Val Gly Trp Ile Ser Pro Ala Gly Gly Ser Thr Asp Tyr 50 55
60Ala Asp Ser Val Lys Gly Arg Phe Thr Ile Ser Ala Asp Thr Ser 65 70
75Lys Asn Thr Ala Tyr Leu Gln Met Asn Ser Leu Arg Ala Glu Asp 80 85
90Thr Ala Val Tyr Tyr Cys Ala Arg Gly Pro Phe Ser Pro Trp Val 95
100 105Met Asp Tyr Trp Gly Gln Gly Thr Leu Val Thr Val Ser Ser 110
115 8119PRTArtificial sequencesequence is synthesized 8Glu Val Gln
Leu Val Glu Ser Gly Gly Gly Leu Val Gln Pro Gly 1 5 10 15Gly Ser
Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe Thr Phe Leu 20 25 30Gly Tyr
Gly Ile His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu 35 40 45Glu Trp
Val Gly Trp Ile Ser Pro Ala Gly Gly Ser Thr Asp Tyr 50 55 60Ala Asp
Ser Val Lys Gly Arg Phe Thr Ile Ser Ala Asp Thr Ser 65 70 75Lys Asn
Thr Ala Tyr Leu Gln Met Asn Ser Leu Arg Ala Glu Asp 80 85 90Thr Ala
Val Tyr Tyr Cys Ala Arg Gly Pro Phe Ser Pro Trp Val 95 100 105Met
Asp Tyr Trp Gly Gln Gly Thr Leu Val Thr Val Ser Ser 110 115
9108PRTArtificial sequencesequence is synthesized 9Asp Ile Gln Met
Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val 1 5 10 15Gly Asp Arg
Val Thr Ile Thr Cys Arg Ala Ser Gln Ser Val Ser 20 25 30Ser Ala Val
Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys 35 40 45Leu Leu Ile
Tyr Ser Ala Ser Ser Leu Tyr Ser Gly Val Pro Ser 50 55 60Arg Phe Ser
Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile 65 70 75Ser Ser Leu
Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln 80 85 90Tyr Ser Tyr
Ser Pro Phe Thr Phe Gly Gln Gly Thr Lys Val Glu 95 100 105Ile Lys
Arg10108PRTArtificial sequencesequence is synthesized 10Asp Ile Gln
Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val 1 5 10 15Gly Asp
Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Ser Val Ser 20 25 30Ser Ala
Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys 35 40 45Leu Leu
Ile Ser Trp Ala Ser Trp Leu Tyr Ser Gly Val Pro Ser 50 55 60Arg Phe
Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile 65 70 75Ser Ser
Leu Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln 80 85 90Tyr Ser
Tyr Ser Pro Phe Thr Phe Gly Gln Gly Thr Lys Val Glu 95 100 105Ile
Lys Arg11108PRTArtificial sequencesequence is synthesized 11Asp Ile
Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val 1 5 10 15Gly
Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Ser Val Ser 20 25 30Ser
Ala Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys 35 40 45Leu
Leu Ile Trp Tyr Ala Ser Trp Leu Tyr Ser Gly Val Pro Ser 50 55 60Arg
Phe Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile 65 70 75Ser
Ser Leu Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln 80 85 90Tyr
Ser Tyr Ser Pro Phe Thr Phe Gly Gln Gly Thr Lys Val Glu 95 100
105Ile Lys Arg12108PRTArtificial sequencesequence is synthesized
12Asp Ile Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val 1 5
10 15Gly Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Ser Val Ser 20
25 30Ser Ala Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys 35
40 45Leu Leu Ile Trp Trp Ala Ser Ser Leu Tyr Ser Gly Val Pro Ser 50
55 60Arg Phe Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile 65
70 75Ser Ser Leu Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln 80
85 90Tyr Ser Tyr Ser Pro Phe Thr Phe Gly Gln Gly Thr Lys Val Glu 95
100 105Ile Lys Arg13126PRTArtificial sequencesequence is
synthesized 13Glu Val Gln Leu Val Glu Ser Gly Gly Gly Leu Val Gln
Pro Gly 1 5 10 15Gly Ser Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe
Asn Phe Tyr 20 25 30Tyr Ser Ser Ile His Trp Val Arg Gln Ala Pro Gly
Lys Gly Leu 35 40 45Glu Trp Val Ala Ser Ile Ser Pro Tyr Ser Gly Tyr
Thr Ser Tyr 50 55 60Ala Asp Ser Val Lys Gly Arg Phe Thr Ile Ser Ala
Asp Thr Ser 65 70 75Lys Asn Thr Ala Tyr Leu Gln Met Asn Ser Leu Arg
Ala Glu Asp 80 85 90Thr Ala Val Tyr Tyr Cys Ala Arg Gln Pro Thr His
Tyr Tyr Tyr 95 100 105Tyr Ala Lys Gly Tyr Lys Ala Met Asp Tyr Trp
Gly Gln Gly Thr 110 115 120Leu Val Thr Val Ser Ser 125
14438PRTArtificial sequencesequence is synthesized 14Glu Val Gln
Leu Val Glu Ser Gly Gly Gly Leu Val Gln Pro Gly 1 5 10 15Gly Ser
Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe Thr Phe Ser 20 25 30Ser Tyr
Gly Met Ser Trp Val Arg Gln Ala Pro Gly Lys Gly Leu 35 40 45Glu Leu
Val Ala Ser Ile Asn Ser Asn Gly Gly Ser Thr Tyr Tyr 50 55 60Pro Asp
Ser Val Lys Gly Arg Phe Thr Ile Ser Arg Asp Asn Ala 65 70 75Lys Asn
Ser Leu Tyr Leu Gln Met Asn Ser Leu Arg Ala Glu Asp 80 85 90Thr Ala
Val Tyr Tyr Cys Ala Ser Gly Asp Tyr Trp Gly Gln Gly 95 100 105Thr
Thr Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val 110 115
120Phe Pro Leu Ala Pro Cys Ser Arg Ser Thr Ser Glu Ser Thr Ala 125
130 135Ala Leu Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val Thr
140 145 150Val Ser Trp Asn Ser Gly Ala Leu Thr Ser Gly Val His Thr
Phe 155 160 165Pro Ala Val Leu Gln Ser Ser Gly Leu Tyr Ser Leu Ser
Ser Val 170 175 180Val Thr Val Pro Ser Ser Ser Leu Gly Thr Lys Thr
Tyr Thr Cys 185 190 195Asn Val Asp His Lys Pro Ser Asn Thr Lys Val
Asp Lys Arg Val 200 205 210Glu Ser Lys Tyr Gly Pro Pro Cys Pro Pro
Cys Pro Ala Pro Glu 215 220 225Phe Leu Gly Gly Pro Ser Val Phe Leu
Phe Pro Pro Lys Pro Lys 230 235 240Asp Thr Leu Met Ile Ser Arg Thr
Pro Glu Val Thr Cys Val Val 245 250 255Val Asp Val Ser Gln Glu Asp
Pro Glu Val Gln Phe Asn Trp Tyr 260 265 270Val Asp Gly Val Glu Val
His Asn Ala Lys Thr Lys Pro Arg Glu 275 280 285Glu Gln Phe Asn Ser
Thr Tyr Arg Val Val Ser Val Leu Thr Val 290 295 300Leu His Gln Asp
Trp Leu Asn Gly Lys Glu Tyr Lys Cys Lys Val 305 310 315Ser Asn Lys
Gly Leu Pro Ser Ser Ile Glu Lys Thr Ile Ser Lys 320 325 330Ala Lys
Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr Leu Pro Pro 335 340 345Ser
Gln Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr Cys Leu 350 355
360Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu Trp Glu Ser 365
370 375Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr Pro Pro Val Leu
380 385 390Asp Ser Asp Gly Ser Phe Phe Leu Tyr Ser Arg Leu Thr Val
Asp 395 400 405Lys Ser Arg Trp Gln Glu Gly Asn Val Phe Ser Cys Ser
Val Met 410 415 420His Glu Ala Leu His Asn His Tyr Thr Gln Lys Ser
Leu Ser Leu 425 430 435Ser Leu Gly15219PRTArtificial
sequencesequence is synthesized 15Asp Ile Val Met Thr Gln Ser Pro
Leu Ser Leu Pro Val Thr Pro 1 5 10 15Gly Glu Pro Ala Ser Ile Ser
Cys Arg Ser Ser Gln Ser Leu Val 20 25 30Tyr Ser Asn Gly Asp Thr Tyr
Leu His Trp Tyr Leu Gln Lys Pro 35 40 45Gly Gln Ser Pro Gln Leu Leu
Ile Tyr Lys Val Ser Asn Arg Phe 50 55 60Ser Gly Val Pro Asp Arg Phe
Ser Gly Ser Gly Ser Gly Thr Asp 65 70 75Phe Thr Leu Lys Ile Ser Arg
Val Glu Ala Glu Asp Val Gly Val 80 85 90Tyr Tyr Cys Ser Gln Ser Thr
His Val Pro Trp Thr Phe Gly Gln 95 100 105Gly Thr Lys Val Glu Ile
Lys Arg Thr Val Ala Ala Pro Ser Val 110 115 120Phe Ile Phe Pro Pro
Ser Asp Glu Gln Leu Lys Ser Gly Thr Ala 125 130 135Ser Val Val Cys
Leu Leu Asn Asn Phe Tyr Pro Arg Glu Ala Lys 140 145 150Val Gln Trp
Lys Val Asp Asn Ala Leu Gln Ser Gly Asn Ser Gln 155 160 165Glu Ser
Val Thr Glu Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu 170 175 180Ser
Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His Lys 185 190
195Val Tyr Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser Pro Val 200
205 210Thr Lys Ser Phe Asn Arg Gly Glu Cys 215
* * * * *