U.S. patent application number 16/212732 was filed with the patent office on 2019-05-09 for cytotoxic anti-lag-3 monoclonal antibody and its use in the treatment or prevention of organ transplant rejection and autoimmune disease.
The applicant listed for this patent is IMMUTEP, INSERM INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICALE. Invention is credited to Thomas HAUDEBOURG, Frederic TRIEBEL, Bernard VANHOVE.
Application Number | 20190135916 16/212732 |
Document ID | / |
Family ID | 43756814 |
Filed Date | 2019-05-09 |
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United States Patent
Application |
20190135916 |
Kind Code |
A1 |
HAUDEBOURG; Thomas ; et
al. |
May 9, 2019 |
CYTOTOXIC ANTI-LAG-3 MONOCLONAL ANTIBODY AND ITS USE IN THE
TREATMENT OR PREVENTION OF ORGAN TRANSPLANT REJECTION AND
AUTOIMMUNE DISEASE
Abstract
Cytotoxic anti-LAG-3 monoclonal antibodies or fragments thereof
causing depletion of LAG-3+ activated T cells are described, as are
related pharmaceuticals and methods of treating. Also described are
related nucleic acid and protein sequences.
Inventors: |
HAUDEBOURG; Thomas; (Nantes,
FR) ; TRIEBEL; Frederic; (Chatenay-Malabry, FR)
; VANHOVE; Bernard; (Reze, FR) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
IMMUTEP
INSERM INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE
MEDICALE |
Orsay
Paris |
|
FR
FR |
|
|
Family ID: |
43756814 |
Appl. No.: |
16/212732 |
Filed: |
December 7, 2018 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14970926 |
Dec 16, 2015 |
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16212732 |
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12823795 |
Jun 25, 2010 |
9244059 |
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14970926 |
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12598128 |
Mar 19, 2010 |
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PCT/IB2008/001072 |
Apr 30, 2008 |
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12823795 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61K 2039/505 20130101;
C07K 2317/734 20130101; C07K 2317/92 20130101; A61P 7/06 20180101;
C07K 2317/24 20130101; C07K 16/2803 20130101; G01N 33/505 20130101;
A61P 37/06 20180101; C07K 2317/732 20130101; C07K 2317/565
20130101; A61P 37/00 20180101; G01N 2333/70503 20130101 |
International
Class: |
C07K 16/28 20060101
C07K016/28; G01N 33/50 20060101 G01N033/50 |
Foreign Application Data
Date |
Code |
Application Number |
Apr 30, 2007 |
EP |
07290545.8 |
Apr 30, 2008 |
EP |
08750865.1 |
Claims
1. A method of treating a T-cell mediated autoimmune disease in a
mammal, the method comprising: administering to the mammal a
therapeutically effective amount of a cytotoxic anti-LAG-3
monoclonal antibody or a biologically active fragment thereof
causing depletion of LAG-3 activated T cells, wherein the
monoclonal antibody or biologically active fragment thereof
comprises an Fc fragment from human IgG1, human IgM, or mouse IgG2a
and an Fab fragment that binds LAG-3 protein, and wherein the
antibody or fragment thereof is capable of depleting LAG-3+
activated T cells in a complement dependent cytotoxicity (CDC)
assay, or in an antibody-dependent cell cytotoxicity (ADCC) assay,
or both.
2. The method of claim 1, wherein the monoclonal antibody or the
biologically active fragment thereof comprises a light chain
variable region comprising a CDR-L1 having the amino acid sequence
as set forth in SEQ ID NO:17, a CDR-L2 having the amino acid
sequence of FAS, and a CDR-L3 having the amino acid sequence as set
forth in SEQ ID NO:18 and a heavy chain variable region comprising
a CDR-H1 having the amino acid sequence as set forth in SEQ ID
NO:19, a CDR-H2 having the amino acid sequence as set forth in SEQ
ID NO:20, and a CDR-H3 having the amino acid sequence as set forth
in SEQ ID NO:21.
3. The method of claim 1, wherein the monoclonal antibody or the
biologically active fragment thereof comprises a light chain kappa
region as set forth in amino acids 21 to 240 of SEQ ID NO:13 and a
heavy chain gamma region as set forth in amino acids 20 to 465 of
SEQ ID NO:16.
4. The method of claim 1, wherein the monoclonal antibody or the
biologically active fragment thereof comprises a kappa light chain
variable region polypeptide encoded by a nucleic acid molecule as
set forth in SEQ ID NO: 8 and a gamma heavy chain variable region
polypeptide encoded by a nucleic acid molecule as set forth in SEQ
ID NO: 10.
5. The method of claim 4, wherein the monoclonal antibody or the
biologically active fragment thereof comprises two polypeptides
having the following amino acid sequences: TABLE-US-00004 (SEQ ID
NO: 9) QSPKLLVYFASTRDSGVPDRFIGSGSGTDFTLTISSVQAE
DLADYFCLQHFGTPPTFGGGTKLEIKR; and (SEQ ID NO: 11)
QVQLKESGPGLVAPSQSLSITCTVSGFSLTAYGVNWVRQ
PPGKGLEWLGMIWDDGSTDYNSALKSRLSISKDNSKSQV
FLKMNSLQTDDTARYYCAREGDVAFDYWGQGTTLTVSS.
6. The method of claim 1, wherein the T-cell mediated autoimmune
disease is selected from the group consisting of: autoimmune
hemolytic anemia, autoimmune thrombocytopenia purpura,
Goodpasture's syndrome, pemphigus vulgaris, acute rheumatic fever,
mixed essential cryoglobulinemia, systemic lupus erythematosus,
insulin-dependent diabetes mellitus, rheumatoid arthritis, Grave's
disease, Hashimoto's thyroiditis, myasthenia gravis, psoriasis and
multiple sclerosis.
7. The method of claim 1, wherein the T-cell mediated autoimmune
disease is psoriasis.
8. The method of claim 1, wherein the T-cell mediated autoimmune
disease is rheumatoid arthritis.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application is a Divisional of U.S. application Ser.
No. 14/970,926, filed Dec. 16, 2015 (pending), which is a
Continuation of U.S. application Ser. No. 12/823,795 (now U.S. Pat.
No. 9,244,059), filed Jun. 25, 2010, which is a
Continuation-in-part of U.S. application Ser. No. 12/598,128
(pending), filed Mar. 19, 2010 as a National Stage entry of
International Application No. PCT/IB2008/001072, filed Apr. 30,
2008, which claims priority to European Patent Application Nos.
08750865.1, filed Apr. 30, 2008 and 07290545.8, filed Apr. 30,
2007, the disclosures of which are incorporated by reference in
their entirety.
SEQUENCE LISTING
[0002] The instant application contains a Sequence Listing which
has been submitted electronically in ASCII format and is hereby
incorporated by reference in its entirety. Said ASCII copy, created
on Dec. 7, 2018, is named LB64510-1D1 US SEQ LIST and is 21.3 KB in
size.
I--FIELD OF THE INVENTION
[0003] The present invention is in the field of immunotherapy. More
specifically, it relates to the treatment or prevention of organ
transplant rejection or for treating autoimmune disease. The
invention relates to molecule binding to LAG-3 protein and causing
depletion of LAG-3.sup.+ activated T cells. More specifically, it
relates to cytotoxic LAG-3-specific monoclonal antibody or fragment
thereof.
II--BACKGROUND
[0004] Lymphocyte activation gene-3 (LAG-3, CD223) is upregulated
during the early stages of T-cell activation. The present invention
is based on the analysis of the effects of cytotoxic antibodies
against LAG-3 in acute cardiac allograft rejection (in vivo animal
studies) and in in vitro experiments where selected LAG-3
monoclonal antibodies are efficient at low doses (<0.1 .mu.g/ml)
at depleting LAG-3.sup.+ activated effector T cells.
[0005] Selectively depleting activated T lymphocytes might
represent an immunosuppressive induction treatment able to result
in the development of regulatory cells supporting a long-term
survival of allogeneic organs in mice and primates (1). This has
actually been demonstrated with anti-CD40L antibodies that deplete
in vivo activated T cells through a Fc-dependent mechanism (2).
However, anti-CD40L antibodies also target activated platelets in
humans and affect the stability of arterial thrombi (3). Therefore
the development of monoclonal antibodies to other molecules
specific for T-cell activation has catalyzed attempts to achieve
immunosuppression. One such molecule is LAG-3, which engages Class
II on dendritic cells (DC) with a high affinity, enabling DC to
become activated (4-6). The LAG-3 protein is expressed in vivo in
activated CD4.sup.+ and CD8.sup.+ lymphocytes residing in inflamed
secondary lymphoid organs or tissues but not in spleen, thymus or
blood (7). In addition, LAG-3 can function as a negative regulator
of activated human CD4 and CD8 T cells by inhibiting early events
in primary activation (8).
III--SUMMARY OF THE INVENTION
[0006] The invention provides a molecule binding to LAG-3 protein
and causing depletion of LAG-3.sup.+ activated T cells. Said
depletion can be measured by changes in peripheral blood lymphocyte
numbers, in a tissue or an organ.
[0007] In a preferred embodiment the molecule binding to LAG-3
protein is a cytotoxic anti-LAG-3 monoclonal antibody or fragment
thereof causing depletion of LAG-3.sup.+ activated T cells, said
antibody comprising an Fc fragment from the human IgGI or IgM (or
mouse IgG2a) subclass and an Fab fragment which binds LAG-3
protein, said antibody exhibiting a complement-dependent
cytotoxicity (CDC) and/or an antibody dependent cell cytotoxicity
activity (ADCC).
[0008] In one embodiment, the anti-LAG-3 monoclonal antibody is
IMP731 or a biologically active fragment thereof.
[0009] Another aspect of the invention is a method of depleting
LAG-3.sup.+ activated T cells in a mammal, the method comprising
administering monoclonal antibody IMP731 or a biologically active
fragment thereof to said mammal.
[0010] Another embodiment of the invention is a pharmaceutical
composition comprising monoclonal antibody IMP731 or a biologically
active fragment thereof.
[0011] Another embodiment of the invention is a method of treating
diseases associated with LAG-3.sup.+ activated T cells in a
subject, the method comprising administering an effective amount of
a pharmaceutical composition comprising monoclonal antibody IMP731
or a biologically active fragment thereof to said subject. Such
disease may be an auto-immune disease. Exemplary auto-immune
diseases include autoimmune hemolytic anemia, autoimmune
thrombocytopenia purpura, Goodpasture's syndrome, pemphigus
vulgaris, acute rheumatic fever, mixed essential cryoglobulinemia,
systemic lupus erythematosus, insulin-dependent diabetes mellitus,
rheumatoid arthritis, Grave's disease, Hashimoto's thyroiditis,
myasthenia gravis, psoriasis and multiple sclerosis.
[0012] The present invention further provides a method for treating
or preventing organ transplant rejection or for treating
auto-immune disease. Said method comprises the administration, to a
mammalian subject, of a therapeutically effective amount of a
cytotoxic anti-LAG-3 monoclonal antibody or fragment thereof. In
one embodiment, the monoclonal antibody is IMP731.
[0013] Another embodiment of the invention is directed to an
isolated nucleic acid molecule comprising a nucleic acid sequence
encoding the kappa region of IMP731 or a biologically active
fragment thereof.
[0014] Another embodiment is directed to a polypeptide encoded by a
nucleic acid molecule comprising a nucleic acid sequence encoding
the kappa region of IMP731 or a biologically active fragment
thereof.
[0015] Another embodiment is directed to an isolated nucleic acid
molecule comprising a nucleic acid sequence encoding the gamma
region of IMP731 or a biologically active fragment thereof.
[0016] Another embodiment is directed to a polypeptide encoded by
nucleic acid molecule comprising a nucleic acid sequence encoding
the gamma region of IMP731 or a biologically active fragment
thereof.
[0017] Another embodiment is directed to an antibody that binds
LAG-3 protein and depletes LAG-3.sup.+ activated T cells and
comprises a light chain variable region comprising the 3 CDRs in
FIG. 22 and a heavy chain variable region comprising the 3 CDR's in
FIG. 23.
[0018] Another embodiment of the invention is directed to a method
of identifying a molecule that binds LAG-3 protein and may deplete
LAG-3.sup.+ activated T cells, the method comprising providing an
assay in which a candidate molecule and IMP371 compete for binding
on an LAG-3 protein, wherein when said candidate blocks IMP371 from
binding said LAG-3 protein, said candidate is identified as a
molecule that binds LAG-3 protein and may deplete LAG-3.sup.+
activated T cells.
[0019] Another embodiment of the invention is directed to a method
of assessing a candidate molecule for cytotoxicity on LAG-3.sup.+
activated T cells, the method comprising incubating T-cells in a
CMV peptide containing medium with the candidate molecule and under
the same conditions, incubating T-cells in a CMV peptide containing
medium without the candidate molecule and comparing the percentage
of T cells expressing an activation marker with the candidate
molecule against the percentage of T cells expressing an activation
markers without the candidate molecule, wherein a reduction in the
percentage of activated T-cells with the candidate molecule
indicates the cytotoxicity of the candidate molecule on LAG-3.sup.+
activated T cells.
IV--DESCRIPTION OF THE FIGURES
[0020] FIG. 1: LAG-3 mRNA expression in cardiac allograft (A), in
the spleen (B) and in lymph nodes (C). Expression of LAG-3 mRNA in
heart grafts at day 5 was measured by quantitative RT-PCR and
compared with housekeeping HPRT transcripts expression. Rejection:
allograft without treatment. Syngenic: isograft. Tolerant:
allograft in recipients receiving a tolerogenic (CsA+anti-CD28
antibodies) treatment. **: p<0.05 for syngenic and tolerant vs.
rejection.
[0021] FIG. 2: Characterization of anti-LAG-3 antibodies in a
complement-dependent cytotoxicity assay. ConA-stimulated target
cells were labeled with .sup.51Cr and mixed with rabbit complement
and anti-LAG-3 (full line) or preimmune (dotted line) serum at the
indicated dilution. % cytotoxic activity is calculated as follows:
(CPM of the assay-spontaneous CPM release)/maximum released CPM
obtained after cell lysis.
[0022] FIG. 3: In vitro depleting activity of anti-LAG-3
antibodies. T cells from the spleen were activated for 48 h with
Con A to induce expression of LAG-3 and labeled with CFSE. 10.sup.5
cells were injected i.v. to recipients that had been irradiated
(4.5 Gy) 3 days before. Twenty-four hours after injection,
recipients were sacrificed and the presence of CD4.sup.+ cells in
the CD8.sup.+ and CD8' compartments of the spleen analyzed by flow
cytometry.
[0023] FIG. 4: Heart graft survival after anti-LAG-3 antibodies
administration. Lew.IA recipients of fully allogeneic (class I and
II mismatch) Lew.1W hearts were treated by injections on days 0 and
3 of 200 .mu.l (dashed line) or 600 .mu.l (full line) rabbit
anti-LAG-3 serum or of 600 .mu.l pre-immune serum (dotted line).
Graft survival was evaluated by daily evaluation of heartbeat.
P<0.002 for 600 .mu.l rabbit anti-LAG-3 serum vs. pre-immune
serum.
[0024] FIG. 5: Analysis of Graft infiltrating cells (GICs). GICs
were extracted from cardiac allografts on day 5 from
control-treated or anti-LAG-3 antibodies treated recipients. Cells
were counted and analyzed by flow cytometry for the expression of
LAG-3. White bars: total number of GICs. Black bars: LAG-3.sup.+
GICs measured by flow cytometry (p<0.01). Total RNA was also
extracted from GICs and messenger for INF.gamma. were quantified by
qPCR, relative to HPRT expression level (dashed bars;
p<0.05).
[0025] FIG. 6: Comparison of A9H12 binding with the reference LAG-3
specific 17B4 mAb on LAG-3.sup.+ CHO and activated human T
cells.
[0026] A) hLAG-3-transfected CHO were dissociated from culture
plastic using Versene buffer containing cation-chelating agent,
incubated with indicated concentrations of A9H12 or
[0027] 17B4 mAbs for 30 min at 40 C, washed and then incubated with
a FITC-conjugated goat anti-mouse IgG+M (H+L) secondary antibody (5
.mu.g/ml, Coulter Inc.) for 30 minutes at 4.degree. C. After
washing, cells were analysed by flow cytometry using a
FACSCanto.TM. (BD Biosciences) and means of fluorescence intensity
were plotted as a function of antibody concentration.
[0028] B) PBMCs from a healthy volunteer were stimulated for 2 days
with SEB (1 .mu.g/ml, Sigma Aldrich) to induce the expression of
LAG-3 on T cells. PBMCs were stained as above. Data represent a
weighted percentage, calculated as the percentage of LAG-3.sup.+
cells in PBMCs x mean of fluorescence intensity of the LAG-3.sup.+
cells, plotted as a function of antibody concentration.
[0029] FIG. 7: Complement-Dependent Cytotoxicity induced by A9H12
LAG-3 mAb.
[0030] A) hLAG-3-transfected and wild type CHO cells were labelled
with FITC-conjugated anti-LAG-3 mAb (17B4) and the expression of
LAG-3 on cell surface was analysed by flow cytometry using a
FACSCanto.TM.. The histogram plots represent the mean fluorescence
intensity of wt CHO (gray) and LAG-3.sup.+ CHO (dark).
[0031] B) hLAG-3-transfected and wt CHO cells were washed in
complete medium (MEM supplemented with 10% heat inactivated Foetal
Calf Serum, FCS) and incubated with 0.1 .mu.g/ml of A9H12 LAG-3 mAb
or mIgG2a isotype-control mAb (Southern Biotechnologies) in
complete medium for 30 min at 4.degree. C. Cells were then washed
and incubated in complete medium (-Complement) or in MEM
supplemented with 10% of freshly resuspended rabbit serum
(Cerdalane Inc.) (+Complement) for 1 hour at 37.degree. C. After
washing, cells were stained with 7-AAD (Coulter Inc.) for 15
minutes at room temperature and immediately analysed by flow
cytometry to determine the percentage of 7-AAD-positive cells
corresponding to dead cells. Data represent the percentage of dead
cells in each condition on hLAG-3-transfected and wt CHO cells as
indicated.
[0032] C) LAG-3.sup.+ CHO cells were incubated with indicated
concentrations of A9H12 LAG-3 mAb for 30 min at 4.degree. C. and
then incubated with MEM supplemented with 25% rabbit serum for 1
hour at 37.degree. C. After washing, cells were stained with 7-AAD
(Coulter Inc.) and analysed by flow cytometry. The percentage of
specific cytotoxicity is calculated according to the following
formula
(Sample Death-Spontaneous Death).times.100
(Maximal Death-Spontaneous Death)
[0033] where Sample Death is the percentage of 7-AAD-positive cells
in each condition, Spontaneous Death, the percentage of
7-AAD-positive cells without mAb and Maximal Death, the percentage
of 7-AAD-positive cells with 10 .mu.g/ml mAb.
[0034] D) LAG-3.sup.+ CHO cells were incubated with 0.1 .mu.g/ml
A9H12, 17B4 or 31G11 LAG-3 mAb or with their corresponding isotype
controls (IgG2a, IgG1 or IgM, respectively) for 30 min at 4.degree.
C. and then incubated with MEM supplemented with 25% rabbit serum
for 1 hour at 37.degree. C. Specific cytotoxicity was determined as
above with a Maximal Death corresponding to 10 .mu.g/ml A9H12 (left
panel) and 0.1 .mu.g/ml A9H12 (right panel).
[0035] E) PBMCs were stimulated with SEB (1 .mu.g/ml) to induce
LAG-3 expression on T cells and then used as target cells in the
CDC assay in the presence of A9H12 or 31 G11 LAG-3 mAb or their
isotype controls. After staining cells with fluorochrome-conjugated
CD3, CD4, CD8, CD25 and 17B4, the percentage of 7-AAD-positive
cells was analysed on the indicated T cell subpopulations. Data
represent the percentage of dead cells in each population (with
spontaneous death in the absence of mAb being subtracted).
[0036] FIG. 8: Antibody-Dependent Cell-mediated Cytotoxicity
induced by A9H12 LAG-3 mAb
[0037] A) Effector cells (PBMCs) were stimulated with IL-2 (100
IU/ml, BD Biosciences) for 1 day. Target cells (hLAG-3-transfected
CHO cells) were labelled with CFSE (a fluorescent vital dye) and
incubated with 1 .mu.g/ml A9H12, mIgG2a, 17B4 or mIgGI for 20 min
at room temperature. Effector cells and target cells were then
mixed at indicated E:T ratios (E:T, Effector:Target) and incubated
for 16 hours at 37.degree. C. Non-adherent and adherent cells were
harvested using Versene reagent, stained with 7-AAD and immediately
analysed by flow cytometry to determine the percentage of
7-AAD-positive cells in the CFSE-positive population. Data
represent the percentage of dead cells, with the non-specific cell
death in the presence of the isotype control being subtracted.
[0038] B) CFSE-labelled wild-type or LAG-3.sup.+ CHO target cells
were incubated with indicated concentrations of A9H12 or mIgG2a and
IL-2-stimulated PBMCs were added at a 50:1 E:T ratio and incubated
for 16 hours at 37.degree. C. Cell death was analysed as above and
data represent the percentage of dead cells in CFSE-positive cells
in the presence of A9H12 or its isotype-matched IgG2a control
mAb.
[0039] FIG. 9: Incidence of arthritis (percentage of mice that
developed CIA)
[0040] Male DBA/1 mice (n=22) were injected i.d. with bovine type
II collagen (200 .mu.g) emulsified in CFA containing 250 lug M.
tuberculosis.
[0041] FIG. 10: Construction of the chimeric IMP731 therapeutic
antibody.
[0042] FIG. 11: Expression plasmids for the light (panel A) and
heavy (panel B) IMP731 chains.
[0043] FIG. 12: Final bi-cistronic plasmid construction used for
the stable transfection of CHO cells.
[0044] FIG. 13: IMP731 binding on LAG-3.sup.+ CHO and activated
human T cells.
[0045] A) hLAG-3-transfected CHO were dissociated from culture
plastic using VERSENE.TM. buffer containing cation-chelating agent,
incubated with indicated concentrations of IMP731 Ab or its isotype
control hIgG1 (Chemicon) for 30 min at 4.degree. C., washed and
then incubated with a FITC-conjugated F(ab)'2 goat anti-human IgG1
secondary antibody (5 .mu.g/ml, SBA) for 30 minutes at 4.degree. C.
After washing, cells were analysed by flow cytometry using a
FACSCanto.TM. (BD Biosciences) and the means of fluorescence
intensity were plotted as a function of antibody concentration.
[0046] B) PBMCs from a healthy volunteer were stimulated for 2 days
with SEB (1 .mu.g/ml, Sigma Aldrich) to induce the expression of
LAG-3 on T cells. PBMCs were stained as above. Data represent a
weighted percentage, calculated as the percentage of LAG-3.sup.+
cells in PBMCs x mean of fluorescence intensity of the LAG-3.sup.+
cells, plotted as a function of antibody concentration.
[0047] FIG. 14: Complement-Dependent Cytotoxicity induced by IMP731
LAG-3 mAb
[0048] hLAG-3-transfected CHO cells were incubated with 1 .mu.g/ml
of IMP731 Ab or hIgGI isotype-control mAb (Chemicon) in complete
medium (MEM supplemented with 10% heat inactivated Foetal Calf
Serum, FCS) for 30 min at 4.degree. C. Cells were then washed and
incubated in complete medium (without Complement) or in MEM
supplemented with 25% of freshly resuspended rabbit serum
(Cerdalane Inc.) (with Complement) for 1 hour at 37.degree. C.
After washing, cells were stained with 7-AAD (BD Biosciences) for
15 minutes at room temperature and immediately analysed by flow
cytometry to determine the percentage of 7-AAD-positive cells
corresponding to dead cells. Data represent the percentage of dead
cells in each condition as indicated.
[0049] FIG. 15: Antibody-Dependent Cell-mediated Cytotoxicity
induced by IMP731.
[0050] A) Effector cells (PBMCs) were stimulated with IL-2 (100
IU/ml, BD Biosciences) for 1 day. Target cells (hLAG-3-transfected
CHO cells) were labelled with CFSE (a fluorescent vital dye) and
incubated with 1 .mu.g/ml IMP731 or hIgGI for 10 min at room
temperature. Effector cells and target cells were then mixed at
indicated E:T ratios (E:T, Effector:Target) and incubated for 16
hours at 37.degree. C. Cells were stained with 7-AAD and
immediately analysed by flow cytometry to determine the percentage
of 7-AAD-positive cells in the CFSE-positive population. Data
represent the percentage of dead cells.
[0051] B) CFSE-labelled LAG-3.sup.+ CHO target cells were incubated
with indicated concentrations of IMP731 or hIgGI and
IL-2-stimulated PBMCs were added at a 50:1 E:T ratio and incubated
for 16 hours at 37.degree. C. Cell death was analysed as above in
CFSE-positive population. The percentage of specific cytotoxicity,
calculated according to the following formula
(Sample Death-Spontaneous Death).times.100
(Maximal Death-Spontaneous Death)
[0052] where Sample Death is the percentage of 7-AAD-positive cells
in each condition, Spontaneous Death, the percentage of
7-AAD-positive cells without Ab and Maximal Death, the percentage
of 7-AAD-positive cells with 1 .mu.g/ml IMP731
[0053] C) Effector cells (PBMCs) were stimulated with IL-2 (100
IU/ml, BD Biosciences) for 1 day. Target cells (hLAG-3.sup.+ CHO
cells or hLAG-3-CHO cells) were labelled with CFSE (a fluorescent
vital dye) and incubated with 1 .mu.g/ml IMP731 or hIgGI for 10 min
at room temperature. Effector cells and target cells were then
mixed at indicated E:T ratios (E:T, Effector:Target) and incubated
for 16 hours at 37.degree. C. Cells were stained with 7-AAD and
immediately analysed by flow cytometry to determine the percentage
of 7-AAD-positive cells in the CFSE-positive population. Data
represent the percentage of dead cells.
[0054] FIG. 16 depicts ADCC activity of IMP731 using CMV
peptides-activated human T cells. This ADCC assay was performed
with PBMCs from a CMV-positive human donor stimulated with a CMV
peptide pool. Various concentrations of IMP731 or human igG1 were
added for 4 hr. Then, the cells were phenotyped to evaluate the
percentage of activated T cells remaining. The dose-dependent
decrease of the percentage of activated CD8.sup.+ (panel A, left)
or CD4.sup.+ (panel A, right) T cells expressing LAG-3 induced by
IMP731 versus its isotype-matched hIgG1 control) is presented.
Panel B presents the percentage of CD3.sup.+ CD8.sup.+ and
CD3.sup.+ CD4.sup.+ cells expressing CD25 and/or LAG-3 with
10-ng/ml of IMP731 or hIgG1.
[0055] FIG. 17 depicts the pharmacokinetics of IMP731 injected into
3 baboons (0.1 mg/kg).
[0056] FIG. 18 depicts DTH reaction as a model for psoriasis
inflammation in baboon. Two BCG vaccines were injected before the
5.sup.th DTH to test the long-term IMP731 depletion effect on
tuberculin-specific memory T cells.
[0057] FIG. 19 depicts the size of the DTH reaction of three
baboons to a full (1:1 dilution) or a suboptimal tuberculin dose
(1/50 dilution). Open symbols show the first reference DTH, dark
symbols the subsequent DTH performed after i.v. injection of 0.1
mg/kg of IMP731. IDR means intra-dermal reaction.
[0058] FIG. 20 are DNA and amino acid sequences for the light chain
kappa region of IMP731, including the variable region sequences and
the amino acid sequences for CDR-L1, -L2 and -L3. FIG. 20 discloses
SEQ ID NOS 12-13, 8, 14 and 17-19, respectively, in order of
appearance.
[0059] FIG. 21 are DNA and amino acid sequences for the heavy chain
gamma region of IMP731, including the variable region sequences and
the amino acid sequences for CDR-H1, -H2 and -H3. FIG. 21 discloses
SEQ ID NOS 15, 16, 10, 11 and 19-21, respectively, in order of
appearance.
[0060] FIG. 22 shows the characterization of variable and signal
peptide sequences of the kappa chain from IMP731 recombinant
antibody. FR, Framework; CDR, Complementarity Determining Region.
FIG. 22 discloses SEQ ID NOS 22-23, 8 and 14, respectively, in
order of appearance.
[0061] FIG. 23 shows the characterization of variable and signal
peptide sequences of the gamma chain from the IMP731 recombinant
antibody. FR, Framework; CDR, Complementarity Determining Region.
FIG. 23 discloses SEQ ID NOS 24-25, 10 and 11, respectively, in
order of appearance.
V--DETAILED DESCRIPTION
[0062] The present invention provides molecules binding to LAG-3
protein and causing depletion of LAG-3.sup.+ activated T cells.
Said depletion can be measured by changes in peripheral blood
lymphocyte numbers, a tissue or an organ.
[0063] The present invention relates preferably to human LAG-3
protein (hLAG-3 also named hereafter LAG-3). In a preferred
embodiment the molecule binding to LAG-3 protein is a cytotoxic
anti-LAG-3 monoclonal antibody or fragment thereof causing
depletion of LAG-3.sup.+ activated T cells, said antibody
comprising an Fc fragment from the human IgGI or IgM (or mouse
IgG2a) subclass and an Fab fragment which binds LAG-3 protein, said
antibody exhibiting a complement-dependent cytotoxicity (CDC)
and/or an antibody dependent-cell cytotoxicity activity (ADCC).
[0064] Lymphocyte activation gene-3 (LAG-3, CD223) is up-regulated
during the early stages of T-cell activation. The present invention
is based on the analysis of the effects of cytotoxic antibodies
against LAG-3 in acute cardiac allograft rejection and in
rheumatoid arthritis (in vivo animal studies) and in in vitro
experiments where selected LAG-3 monoclonal antibodies are
efficient at low doses (<0.1 .mu.g/ml) at depleting LAG-3.sup.+
activated effector T cells.
[0065] Fully vascularized heterotopic allogeneic heart
transplantation was performed in rats across a full-MHC mismatch
barrier (LEW.1W into LEW.1A). Recipients received two injections
(day 0 and 3) of antibodies directed to the extraloop domain of
LAG-3 or control antibodies. Graft survival, histology, mRNA
transcripts and alloreactivity of lymphocytes were tested.
[0066] It was first noted that LAG-3 mRNA molecules accumulate in
cardiac allografts undergoing rejection, but not in peripheral
lymphoid organs. Administration of anti-LAG-3 antibodies inhibited
graft infiltration by effectors mononuclear cells and prolonged
allograft survival from 6 days in control antibodies-treated
recipients to a median of 27 days.
[0067] It was found that cells expressing LAG-3 infiltrate rejected
heart allografts and that targeting LAG-3 using cytotoxic
antibodies as induction monotherapy delays acute rejection by
reducing graft infiltration by T cells and monocytes.
[0068] Experiments showing that short courses of CD40L antibody
therapy could achieve long-term graft survival in mice and primates
have been initially interpreted as an effect of costimulation
blockade. However, Monk et al. (2) showed that much of the efficacy
of anti-CD40L therapy derives not from costimulation blockade, but
from destruction of activated T cells. The outcome is a selective
purging of potentially aggressive T cells that have experienced
antigen.
[0069] Collagen-induced arthritis (CIA) is a well-described animal
model for rheumatoid arthritis. Collagen-induced arthritis is an
autoimmune disease inducible in rats, mice and primates by
immunization with heterologous type II collagen. The resulting
joint pathology resembles rheumatoid arthritis with synovial
proliferation, cell infiltration, cartilage erosion and bone
resorption in the most severe cases (12).
[0070] Using particular immunization protocols, early studies have
established a hierarchy of responsiveness to CIA linked to the H-2
haplotype, with H-2.sup.q (e. g. DBA/1 mice) being the most and
H-2.sup.b (e.g. C57BL/6 mice) amongst the least responsive strains.
However, some studies have shown that responsiveness to CIA may be
less restricted by the MHC class II than previously thought and may
be just as dependent on immunization conditions (13). The variety
of type II collagen (CII) from different species and the
preparation of complete Freund's adjuvant (CFA) with different
concentrations of Mycobacterium tuberculosis were important
parameters for arthritis development. Inglis et al. have shown that
chicken, but not bovine, CII was capable of inducing disease in
C57BL/6 mice, with an incidence of 50% to 75%. This is in contrast
to DBA/1 mice, in which bovine, mouse and chicken CII all induced
disease, with an incidence of 80% to 100%. The phenotype of
arthritis was milder in C57BL/6 mice than in DBA/1 mice, with less
swelling and a more gradual increase in clinical score (14).
Moreover, male mice are frequently preferred for CIA studies, as
the incidence of arthritis is somewhat higher in male than in
female mice.
[0071] In mice, CIA is induced by an i.d. injection of type II
collagen (CII) in the presence of CFA, usually followed by an i.p.
boost injection of CII, without adjuvant, 21 days later. However,
there are reported variations for almost every aspect of the
immunization procedure and even in the highly susceptible DBA/1
strain the time of onset, severity and incidence of CIA can be
variable (13, 15).
[0072] Therapeutic antibodies for the treatment of auto-immune
diseases have already been described, like the TNFa mAbs in
rheumatoid arthritis. By definition, LAG-3 (Lymphocyte Activation
Gene-3) is a marker for recently activated effector T cells.
Depleting these effector LAG-3.sup.+ T cells will lead to targeted
immunosuppression (i.e. only activated T cells are suppressed, not
all T cells as with corticoids or cyclosporin). This very specific
immunosuppression should lead to higher therapeutic indices
compared to classical immunosuppressive agents or to therapeutic
antibodies (e.g. HUMIRA.TM., REMICADE.TM.) or soluble receptors
(e.g. ENBREL.TM.) blocking TNFa. Thus, LAG-3 is a promising target
available for a therapeutic depleting mAb approach to eliminate
auto-reactive activated effector T cells.
[0073] Molecules that bind to LAG-3 protein and cause depletion of
LAG-3+ activated T cells, according to the present invention,
include antibodies (mono or polyclonal, preferably monoclonal) and
fragment thereof, peptides and organic small molecules.
[0074] Cytotoxic anti-LAG-3 monoclonal antibody or fragment thereof
according to the present invention causes depletion of more than
30% preferably more than 50% of LAG-3+ activated T cells.
[0075] Cytotoxic anti-LAG-3 monoclonal antibody or fragment thereof
according to the invention comprises antibodies with a murine IgG2a
or a human IgGI Fc region giving strong CDC or ADCC properties.
[0076] Cytotoxic anti-LAG-3 monoclonal antibody or fragment thereof
according to the present invention exhibits (i) more than 50% of
maximal CDC activity at a mAb concentration of less than 0.1
.mu.g/ml and/or (ii) more than 50% of maximal ADCC activity at a
mAb concentration of less than 0.1 .mu.g/ml.
[0077] Cytotoxic anti-LAG-3 monoclonal antibody or fragment
thereof, which suppresses a DTH reaction in a mammal after a single
dose of 0.1 mg/kg.
[0078] Molecules binding to LAG-3 protein and more particularly
cytotoxic anti-LAG-3 monoclonal antibody, causing depletion of
LAG-3+ activated T cells and antibody, can be produced by methods
well known to those skilled in the art.
[0079] Antibodies generated against CD223 polypeptides can be
obtained by administering, in particular by direct injection, CD223
polypeptides to an animal, preferably a non-human. The antibody so
obtained will then bind the CD223 polypeptides itself. In this
manner, even a sequence encoding only a fragment of the CD223
polypeptide can be used to generate antibodies binding the whole
native CD223 polypeptide.
[0080] For preparation of monoclonal antibodies, any technique
which provides antibodies produced by continuous cell line cultures
can be used. Examples include the hybridoma technique (9), the
trioma technique, the human B-cell hybridoma technique (10).
[0081] Techniques described for the production of single chain
antibodies (U.S. Pat. No. 4,946,778) can be readily used to produce
single chain antibodies to CD223 polypeptides. Also, transgenic
mice may be used to express humanized antibodies to immunogenic
CD223 polypeptides.
[0082] An antibody of the present invention includes intact
antibodies, an antibody fragment, a humanized antibody, a
conjugate, a fusion protein or a bi-specific antibody that contains
a V.sub.H-V.sub.L pair where the CDRs form the antigen binding
site. The invention also includes antibodies in which the
Complementarity Determining Regions (CDRs) of one of the antibodies
of the invention, such as those set forth in FIGS. 22 and 23, are
transferred from the native framework (FR) to a different FR. The
antibody of the invention could be produced recombinantly,
according to methods known in the art.
[0083] For instance, a first monoclonal antibody according to the
present invention, called A9H12, is produced by the hybridoma
deposited at the CNCM on Apr. 27, 2007 under the access number CNCM
I-3755.
[0084] A second monoclonal antibody according to the present
invention, called 31G11, is produced by the hybridoma deposited at
the CNCM on Apr. 27, 2007 under the access number CNCM I-3756.
[0085] A third monoclonal antibody according to the present
invention, called IMP731, is produced by chimerization of
monoclonal antibody A9H12 with human IgG1 Fc region, as described
and characterized in Examples 4, 5 and 6.
[0086] The antibodies of the present invention include those that
have the same CDRs as the above antibodies (A9H12, 31G11 or IMP731)
but have differences due to glycosylation patterns or post
translational modifications.
[0087] The invention is also directed to the use of a cytotoxic
anti-LAG-3 monoclonal antibody or fragment thereof for the
manufacture of a medicament for treating or preventing organ
transplant rejection or for treating autoimmune disease.
[0088] Biologically active fragments of the monoclonal antibodies
of the present invention exhibit some or all of the biological
activities of the monoclonal antibody. For example, biologically
active fragments of IMP731 exhibit the same high binding affinity
as IMP731, as assessed in a standard assay such as a BIACORE.TM.
analysis. Biological activity may also be assessed by other in
vitro or in vivo assays, which are known to the skilled artisan and
which are used to assess and characterize the monoclonal antibodies
of the invention. One such assay assesses DTH reaction in baboons.
Another in vitro assay is the ADCC bioassay described in Example 5
and FIG. 16 and related description. In one embodiment, the
invention relates to the ADCC assay described in Example 5 and in
FIG. 16 and to the use of such assay in identifying depleting LAG-3
antibodies or fragments thereof that have an EC50 of less than 5
ng/ml.
[0089] The present invention also relates to an antibody other than
IMP731 which comprises the kappa or gamma regions of IMP731 and
which has the same biological activity as IMP731. In another
embodiment, the invention relates to antibodies or fragments
thereof that compete with IMP731 in binding LAG-3 protein and in
causing depletion of LAG-3.sup.+ activated T cells.
[0090] The nucleic acid sequences encoding the kappa and gamma
regions of IMP 731 are set forth in FIGS. 20 and 21, respectively.
The present invention includes these nucleic acid sequences and
biologically active fragments and mutations thereof and nucleic
acid molecules comprising these nucleic acid sequences, vectors
comprising these nucleic acid molecules, cells comprising such
vectors and pharmaceuticals comprising the nucleic acid molecules
of the invention. The present invention also is directed to the
polypeptides encoded by the nucleic acid molecules of the invention
and particularly to polypeptides represented by the amino acid
sequences set forth in FIGS. 20 and 21, and also polypeptides
comprising such amino acid sequences and biologically active
fragments and mutations of such amino acid sequences. In one
embodiment, the invention is directed to molecules comprising the
CDRs set forth in FIGS. 20 and 21 and further characterized in
FIGS. 22 and 23 and to molecules comprising such CDRs that may have
minor amino acid differences from the native sequences, wherein
such molecules have an EC50 of less than 5 ng/ml in the ADCC
bioassay using CMV-stimulated human CD4 and CD8 T cells.
[0091] The present invention further provides a method for treating
or preventing organ transplant rejection or for treating autoimmune
disease. Said method comprises the administration to a mammalian
subject a therapeutically effective amount of a cytotoxic
anti-LAG-3 monoclonal antibody or fragment thereof.
[0092] Organ transplant rejection refers to the graft of an organ
in an allogenic host. It may be useful for treating organisms
suffering from conditions resulting in an abnormally high T-cell
population or deleterious T-cell activity, for example graft
rejection mediated by host T-cells, graft vs. host disease and
T-cell mediated autoimmune and inflammatory diseases such as
rheumatoid arthritis, type 1 diabetes, muscular sclerosis, etc. The
methods of the invention may be applied to any organism which
contains T-cells that express CD223. This includes, but is not
limited to, any mammal and particularly includes humans and
mice.
[0093] Auto-immune diseases are diseases in which the subject's own
immune system reacts against the subject cells. Auto-immune disease
which are amenable to treatments according to the present invention
include autoimmune hemolytic anemia, autoimmune thrombocytopenia
purpura, Goodpasture's syndrome, pemphigus vulgaris, acute
rheumatic fever, mixed essential cryoglobulinemia, systemic lupus
erythematosus, insulin-dependent diabetes mellitus, rheumatoid
arthritis, Grave's disease, Hashimoto's thyroiditis, myasthenia
gravis, psoriasis and multiple sclerosis.
[0094] A method for depleting LAG-3.sup.+ activated T cells from a
sample from a patient according to the present invention comprises
reacting the sample with an antibody composition comprising an
antibody described above.
[0095] A pharmaceutical composition according to the present
invention comprises from 0.1 to 300 mg per dose, preferably from
0.5 to 30 mg per dose, and more preferably from 5 to 10 mg per
dose, of a cytotoxic monoclonal antibody described above and one or
more pharmaceutically acceptable carriers, adjuvants and/or
diluents for administration to a mammal. In another embodiment, the
pharmaceutical composition according to the invention comprises
from 0.01 to 30 mg per kg, preferably from 0.1 to 3 mg per kg, and
more preferably from 0.5 to 1 mg per kg of the cytotoxic monoclonal
antibody described above. One of skill in the art would understand
that the pharmaceutical compositions of the invention could be
adjusted to contain amounts of the cytotoxic monoclonal antibody
that would vary depending upon the health, age, weight, and
condition of the subject being treated.
[0096] The pharmaceutical compositions of the present invention may
be specially formulated for administration in solid or liquid form
according to methods well known to the skilled artisan. Suitable
carriers, for instance, vehicles, adjuvants, excipients and
diluents are well known to the skilled artisan. Suitable
formulations include formulations for oral, aerosol, parenteral,
subcutaneous, transdermal, transmucosal, intestinal,
intramedullary, intravenous, intranasal, intraocular, intravenous
and interperitoneal administration or injection are exemplary and
are not intended to be limiting. Techniques for formulating the
pharmaceuticals of the present invention may be found in
Remington's Pharmaceutical Sciences 18.sup.th ed. Mack Publishing
Co., Easton, Pa. (1990).
[0097] The pharmaceutical compositions of the invention may contain
the cytotoxic monoclonal antibody of the invention in combination
with one or more other therapeutic agents.
[0098] The following examples further illustrate the invention but
should not be construed as limiting the scope of the invention.
Example 1: LAG-3-Positive Cells Targeted with Cytotoxic
Antibodies
[0099] Material and Methods
[0100] Animals and Transplantations
[0101] Eight- to 12-week-old male Lewis. IW (LEW. 1W, haplotype
RT.sup.u) and Lewis. IA (LEW. 1A, haplotype RT1.sup.a) congeneic
rats (Centre d'Elevage Janvier, Le Genest-Saint-Isle, France),
differed in their entire MHC region. Heterotopic LEW.IW heart
transplantation was performed as previously described (11). Graft
survival was evaluated by palpation through the abdominal wall.
[0102] Anti-LAG-3 Antibodies
[0103] A synthetic peptide corresponding to the extraloop domain of
the rat LAG-3 protein (NCBI accession nb DQ438937; peptide
DQPASIPALDLLQGMPSTRRHPPHR) (SEQ ID NO. 1) was linked to ovalbumin
and used to immunise two rabbits. Pre-immune and immune sera,
collected on day 63 after the 4th immunisation, were assayed by
ELISA on immunogen and peptide and by flow cytometry on Con-A
activated rat spleen cells. Pre-immune sera were negative in both
assays. Pooled immune sera presented a titer (dilution for 50%
signal) of 1/60000 by ELISA and of 1/1000 by FRCS, and presented a
specificity for activated T cells.
[0104] Complement-Dependent Cytotoxicity Assay
[0105] Complement-mediated antibody-dependent cytotoxicity was
tested using rabbit sera against Lewis 1A T cells in a .sup.51Cr
release assay. A total of 2.times.10.sup.6 Lewis 1A T cells were
labelled with 30 .mu.Ci of .sup.51Cr for 90 min at 37.degree. C. in
RPMI (GIBCO) with 10% FCS. After three washes, T cells were
distributed in 96 V-bottomed plates and incubated with rabbit
complement and serial dilutions of heat-inactivated rabbit serum.
After 4 h at 37.degree. C., .sup.51Cr release was measured in the
supernatants using a scintillation counter. Specific cytotoxicity
was calculated according to the following formula: (experimental
release-spontaneous release).times.100/(maximum release-spontaneous
release).
[0106] In Vivo Antibody-Induced Cytotoxicity
[0107] Cytotoxic activity of anti-LAG-3 antibodies against
LAG-3.sup.+ cells was evaluated in vivo. ConA-activated (48 h)
LEW.1W splenocytes were labelled with the CFSE and transferred
(10.sup.8 cells) into irradiated (4.5 Gy, day -3) LEW.IA
recipients, together with anti-LAG-3 antibodies. On day 1,
recipients were sacrificed and the presence of CFSE-positive cells
evaluated by flow cytometry in lymphoid organs and in the
blood.
[0108] Immunostaining
[0109] Graft samples were embedded in Tissue Tek (OCT Compound,
Torrance, Calif., USA), snap-frozen in liquid nitrogen, cut into 5
.mu.m sections and fixed in acetone. Endogenous biotin activity was
blocked using the Dako biotin blocking system (Dako, Trappes,
France). Sections were then labelled by a three-step indirect
immunoperoxidase revelation. The area of each
immunoperoxidase-labeled tissue section infiltrated by cells was
determined by quantitative morphometric analysis. Positively
stained cells on each slide were counted by morphometric analysis
using point counting analysis (14) with a 121-intersection squared
grid in the eyepiece of the microscope. Briefly, the percentage of
the area of each graft section occupied by cells of a particular
antigenic specificity (area infiltrate) was calculated as follows:
[number of positive cells under grid intersection/(total number of
grid intersections=121)].times.100. The graft sections were
examined at a magnification of .times.400. The accuracy of the
technique is proportional to the number of points counted. Thus, to
maintain a SE of <100, 15 fields were counted for each labeled
section. Results are expressed as the percentage of the area of the
tissue section infiltrated by leukocytes (determined with OX1, OX30
labeling) and the phenotypic composition of the infiltrate and
subpopulations which are related to the percentage of total
leukocytes and are expressed as the percentage of leukocytes.
[0110] Graft Infiltrating Cell Extraction Staining
[0111] Dilacerated hearts were digested with collagenase D (2
mg/ml; Boehringer Mannheim) for 10 min at 37.degree. C. Cells were
then collected by extraction through a stainless steel mesh. The
resulting suspension was then clarified by Ficoll isolation.
[0112] Quantitative RT-PCR
[0113] Real-time quantitative PCR was performed in an Applied
Biosystems GENAMP.TM. 7700 Sequence Detection System using SYBR.TM.
Green PCR Core Reagents (Applied Biosystems, Foster City, Calif.).
The following oligonucleotides were used in this study: rat LAG-3:
upper primer is 5'-ATATGAATTCACAGAGGAGATGAGGCAG-3' (SEQ ID NO. 2)
and lower primer is 5'-ATATGAATTCTCCTGGTCAGAGCTGCCT-3' (SEQ ID NO.
3) Rat INFg: upper primer is 5'-TGGATGCTATGGAAGGAAAGA-3' (SEQ ID
NO. 4) and lower primer is 5'-GATTCTGGTGACAGCTGGTG-3' (SEQ ID NO.
5) Rat HPRT: upper primer is 5'-CCTTGGTCAAGCAGTACAGCC-3' (SEQ ID
NO. 6) and lower primer is 5'-TTCGCTGATGACACAAACATGA-3' (SEQ ID NO.
7) A constant amount of cDNA corresponding to the reverse
transcription of 100 .mu.g of total RNA was amplified in 25 MI of
PCR mix containing 300 nM of each primer; 200 .mu.M dATP, dGTP,
dCTP; 400 .mu.M dUTP; 3 mM MgCl.sub.2; 0.25 U of
uracyl-N-glycosylase; 0.625 U of AmpliTaq Gold DNA polymerase. The
mix was subjected to 40 cycles of amplification. The real-time PCR
data were plotted as the .DELTA.R.sub.n, fluorescence signal vs.
the cycle number. The .DELTA.R.sub.n values were calculated by the
Applied Biosystems 7700 sequence detection software using the
formula: .DELTA.R.sub.n=(R.sub.n.sup.+)-(R.sub.n.sup.-), where
R.sub.n.sup.+ is the fluorescence signal of the product at any
given time, R.sub.n.sup.- is the mean fluorescence signal during
cycles 3-13 and referred to as the baseline. The Ct value is
defined as the cycle number at which the .DELTA.R.sub.n crosses a
threshold. The threshold is set above the background fluorescence
to intersect the exponential portion of the amplification curve of
a positive reaction. The Ct is inversely proportional to the log
amount of template within the PCR.
[0114] Statistical Analyses
[0115] Statistical significance was evaluated using a Mann-Whitney
test for the comparison of two groups. Graft survival was evaluated
by Kaplan-Meier analysis using the log rank test.
[0116] Results
[0117] LAG-3 mRNA expression in rejected allograft and lymphoid
organs LAG-3 is expressed by activated T cells in inflamed lymphoid
organs and tissues (7). In order to see if LAG-3 is also expressed
in rejected allografts, hearts grafts from LEW.1W to LEW.IA rat
recipients were analyzed on day 5 (rejection occurring on day 6).
Messenger RNA for LAG-3 was analyzed and compared with allografts
receiving a tolerance-inducing regiment (anti-CD28 antibodies+CSA,
as described (16)) and with isografts. Rejected allografts
presented a 7-fold and a 25-fold accumulation of LAG-3 mRNA as
compared with tolerated and syngeneic grafts, respectively (FIG.
1A). Such an accumulation was not detected in lymph nodes (FIG. 1B)
or in the spleen of rejecting recipients (FIG. 1C).
[0118] Mechanism of Action of Anti-LAG-3 Antibodies
[0119] Anti-LAG-3 antibodies were produced in rabbits by
immunization with a synthetic peptide from the extra-loop of LAG-3
Ig-like N-terminal domain, involved in the interaction of LAG-3
with Class II (ref PNAS Huard 1997). Post-immune serum, as well as
the IgG fraction, stained <1% of rat spleen cells and 400 of rat
spleen cells activated for 48 h with ConA, PMA+ionomycin or PHA.
Pre-immune serum was negative (data not shown). In order to
characterize the effect of anti-LAG-3 antibodies on LAG-3.sup.+
cells, complement and ADCC-dependent cytotoxicity was assayed in
vitro. Fifteen % of ConA-activated spleen cells were lysed in the
complement-dependent cytotoxicity assay (FIG. 2). Given that only
400 of the ConA-activated target cells expressed LAG-3, this assay
revealed that about 37% of the LAG-3.sup.+ spleen cells present in
the preparation were lysed in vitro as a result of complement
activation.
[0120] In vivo, the depleting activity of anti-LAG-3 antibodies was
estimated by measuring the fate of CFSE-labeled activated T cells
adoptively transferred to irradiated rat recipients. One day after
the injection of therapeutic doses of anti-LAG-3 immune serum, only
half the amount of CFSE.sup.+/CD4.sup.+ and CFSE.sup.+/CD8.sup.+
cells could be recovered from the spleen, as compared with similar
injections of pre-immune serum (FIG. 3).
[0121] Anti-LAG-3 Antibodies Delay Heart Allograft Rejection
[0122] From preliminary pharmacokinetic observations, we
established that two i.v. injections of 600 .mu.l of anti-LAG-3
rabbit serum on days 0 and 3 resulted in the maintenance of
anti-LAG-3 binding activity in recipient's serum for at least 2
weeks. This treatment delayed cardiac allograft rejection from 6
days in untreated and control-treated recipients to a median of 27
days. All recipients, however, eventually rejected their graft
within 10 weeks (FIG. 4). On day 5, grafts from control-treated
recipients were heavily infiltrated by activated T cells and this
infiltrate was less important in anti-LAG-3 treated recipients.
Infiltration by CD25.sup.+ cells and NK cells, however, was not
modified by the treatment. Since our anti-LAG-3 antibodies do not
recognize LAG-3 in immunohistology, LAG-3 expression by graft
infiltrating cells (GICs) was analyzed by flow cytometry after
extraction. An average of 8.5 10.sup.6.+-.0.76 GICs could be
recovered from control rejected grafts. From heart allografts from
anti-LAG-3 treated recipients, only 3.16.+-.0.44 10.sup.6 GICs
could be recovered (n=3; p<0.005). GICs contained 41.17.+-.1%
LAG-3.sup.+ cells in controls (i.e. 3.5 10.sup.6 cells) versus
22.2.+-.0.9% in treated animals (i.e. 0.7 10.sup.6 cells; n=3;
p<0.0005; FIG. 5). Analysis of mRNA transcript reinforced these
observations that infiltration of heart graft by mononuclear cells
was reduced since we measured four times less INF.gamma. mRNA
molecules in treated grafts (FIG. 5).
[0123] Anti-LAG-3 Antibodies Inhibit Ongoing Acute Heart Allograft
Delay Rejection
[0124] In order to investigate whether anti-LAG-3 antibodies might
serve as a treatment of an ongoing acute allograft rejection, we
grafted LEW.1W hearts into LEW.1A allogenic recipients that we
maintained untreated over 3 or 4 days. At that time, recipients
received an injection of 600 microliter of control or anti-LAG-3
rabbit serum. Control-treated recipients rejected the allografts on
day 5 whereas anti-LAG-3 antibodies-treated recipients rejected
only on day 11 (Table 1).
TABLE-US-00001 TABLE 1 Treatment Day of rejection Median survival
Control serum on day 3 5, 5, 5 5 Control serum on day 4 5, 5, 5 5
Anti-LAG-3 serum on day 3 12, 13, 9 12 (p < 0.05 vs. control)
Anti-LAG-3 serum on day 4 10, 13, 13, 19 12.5 (p < 0.05 vs.
control)
[0125] Table 1: Heart graft recipients were treated on day 3 or 4
with control or anti-LAG-3 antibodies. Rejection was monitored by
daily heart palpation.
Example 2: Generation of New High Affinity hLAG-3 mAbs
[0126] Material and Methods
[0127] Mice were immunized 3 times with hLAG-3-transfected CHO
cells (10.sup.7 cells, intra-peritoneal injection), followed by a
boost i.v. injection with 10 .mu.g IMP321, the clinical-grade
hLAG-31 g recombinant protein. Three days after the boost,
splenocytes were fused with the X63.AG8653 fusion partner to yield
hybridoma cells. Supernatants from hybridomas were screened for
their specific binding (FACS analysis) on hLAG-3-transfected CHO
versus wild type (wt) CHO cells.
[0128] One murine IgG2a antibody (580.1E MM H12, called A9H12) was
selected, subcloned to yield a stable cell line and further
characterized for its potency to deplete LAG-3.sup.+ cells through
CDC (complement-dependent cytotoxicity) and ADCC
(antibody-dependent cell-mediated cytotoxicity), given that the
murine IgG2a Pc region is known to be the most efficient Fc isotype
in mice at delivering these activities, even on heterologous cells
(i.e. CHO cells or human PBMCs). Similarly, a second IgM antibody
(31G11E8, called 31 G11) was also selected.
[0129] Results
[0130] Dose-dependent binding of A9H12 was first compared to the
reference LAG-3-specific 17B4 mAb on hLAG-3-transfected CHO cells
and on LAG-3.sup.+ in vitro activated human T cells (FIG. 6). A9H12
displayed a greater binding than the reference 17B4 mAb on both
cell types. For instance, significant binding of A9H12 to activated
human T cells was observed with a concentration as low as 0.01
.mu.g/ml.
[0131] For CDC testing, the target cells used in this assay were
LAG-3.sup.+ CHO cells compared to wt CHO cells (FIG. 7A). Both
types of cells were incubated for 1 hour at 37.degree. C. with
either A9H12, its murine isotype-matched IgG2a negative control
mAb, 31G11, its murine isotype-matched IgM negative control or the
reference 17B4 (IgGI) mAb and rabbit serum containing active
complement. Cell viability was then assessed using
7-Amino-Actinomycin D (7-AAD), a fluorescent dye labelling cells
which have lost their membranous integrity, a phenomenon which
appeared rapidly after death. The percentage of 7-AAD-positive CHO
cells (i.e. dead target cells) was determined by flow cytometry
analysis. A9H12 displayed a potent and specific cytotoxic activity
in this CDC assay, killing only LAG-3.sup.+ CHO cells in the
presence of complement (FIG. 7B). The anti-LAG-3 Ab was titered
down to determine the efficacy of the antibody to activate CDC at
low concentration of antibody. A9H12 efficiently induced
LAG-3.sup.+ CHO cells killing at a concentration as low as 0.01
.mu.g/ml (FIG. 7C). The IgGI 17B4 antibody was also tested in this
assay and had no effect (FIG. 7D, left panel), showing that not all
LAG-3 mAbs could induce cytotoxicity in this bioassay. As observed
with A9H12, the second 31G11 LAG-3-specific mAb also induced
LAG-3.sup.+ CHO cells killing (FIG. 7D, right panel).
[0132] The CDC bioassay was also performed on PBMCs stimulated with
the superantigen SEB. The cytotoxicity of A9H12 and 31G11 were
analysed on both activated (namely CD25.sup.+/LAG-3.sup.+ cells)
and non-activated (namely CD25.sup.-/LAG-3.sup.- cells) CD4.sup.+
helper T and CD8.sup.+ cytotoxic T cells. Only activated CD4.sup.+
and CD8.sup.+ T cells were specifically killed by A9H12 and 31G11
(FIG. 7E), showing that activated human T cells are susceptible to
A9H12- or 31G11-specific killing in the presence of complement.
[0133] For ADCC testing, PMBCs were stimulated for one day with
IL-2 to serve as effector cells and LAG-3.sup.+ CHO cells were
labelled with the vital dye CFSE to serve as target cells. In the
presence of A9H12, PBMCs were able to kill a significant percentage
of LAG-3.sup.+ CHO cells and this effect was increased with the
number of effector cells (FIG. 8A). In the presence of 17B4, only a
small percentage of target cells was killed even at a high E:T
ratio (FIG. 8A), showing that not all LAG-3 mAbs could induce
cytotoxicity in this bioassay. The A9H12 LAG-3 mAb was titered down
to determine the efficacy of the antibody to induce ADCC at low
concentration of antibody. A9H12 efficiently induced LAG-3.sup.+
CHO cells killing at a concentration as low as 0.01 .mu.g/ml (FIG.
8B).
Example 3: Testing Depleting LAG-3 Antibodies in a Collagen-Induced
Arthritis Mouse Model
[0134] Material and Methods
[0135] Animals and Materials
[0136] Male DBA/1 (H-2.sup.q) mice, 8-10 weeks old, were obtained
from Janvier Laboratories. All animal experiments were performed
according to local guidelines. BovineCII (joint cartilage) was
purchased from BioCol. Incomplete Freund's adjuvant was provided by
Sigma. Heat-killed M. tuberculosis H37Ra was purchased from Difco
Laboratories.
[0137] Induction of Collagen-Induced Arthritis (CIA)
[0138] The induction and assessment of CIA were performed as
previously described in two publications (13, 15). Complete
Freund's adjuvant was prepared by mixing 100 mg heat-killed
Mycobacterium tuberculosis in 13.3 ml IFA (final concentration 7.5
mg/ml). Bovine CII was dissolved at 3 mg/ml in 10 mm acetic acid
overnight at 4.degree. C. An emulsion was formed by mixing 2
volumes of CII with 1 volume of CFA. The CII solution and the
emulsion with CFA were always freshly prepared. Male DBA/1 mice
were intra-dermally injected at the base of the tail with a total
of 100 .mu.l of emulsion containing 200 .mu.g CII and 250 .mu.g M.
tuberculosis on day 1 (D1). The injection was repeated at day 21
(D21). As control, three mice were injected with the emulsion of
CFA without CII.
[0139] Clinical Assessment of Arthritis
[0140] Mice were examined for signs of arthritis three times a week
from day 22. The disease severity was determined with the following
scoring system for each limb: score 0=normal; score 1=swelling of
footpad or joint; score 2=swelling of footpad and 1 or 2 joints;
score 3=swelling of footpad and 3 or 4 joints; score 4=swelling of
footpad and all joints. Each paw was graded, and the 4 scores were
summed so that the maximum possible score was 16 per mouse.
Incidence was expressed as the percentage of mice with an arthritis
score .gtoreq.1.
[0141] Results
[0142] CIA was induced by i.d. injections of bovine type II
collagen (CII) emulsified in CFA containing 250 .mu.g M.
tuberculosis. After one injection, 4 out of 22 mice had developed
arthritis at D21. Two weeks after the second injection, at D35,
80-90% of the mice had developed clinical signs of arthritis (FIG.
9). The mice exhibited clinical scores covering the full range of
responses from 1 to 16 with some limbs showing severe swelling of
the footpad, ankle/wrist joint and digits (Table 2). None of the
control animals (injected with CFA without CII) developed signs of
arthritis (data not shown).
TABLE-US-00002 TABLE 2 Days Mean SEM 25 2.2 0.9 27 2.7 0.8 29 5.7
1.0 32 9.2 1.5 34 10.5 1.5 36 10.9 1.6 39 10.8 1.7 41 10.9 1.6 43
11.2 1.5 46 11.7 1.3 53 13.1 1.2 55 13.3 1.1
[0143] Table 2: Mean clinical scores (.+-.SEM) over 55 days. Male
DBA/1 mice (n=10) were injected i.d. with bovine type II collagen
(200 mg) emulsified in CFA containing 250 mg M. tuberculosis at D1
and D21.
[0144] Our results show that with the CIA protocol used, it is
possible to obtain a high percentage (80-90%) of mice developing
signs of arthritis. This experimental protocol provides a model to
evaluate the therapeutic effect of depleting LAG-3 antibodies
(specific for mouse LAG-3) in auto-immune diseases.
[0145] 200 .mu.g of the depleting LAG-3 mAb (A9H12 or 31 G11) are
injected i.p. or i.v. on day 15 and 25. Both a significant decrease
in arthritis incidence and a significant lowering of mean clinical
scores are involved.
Example 4: Complement-Dependent Cytotoxicity (CDC) and
Antibody-Dependent Cell-Mediated Cytotoxicity (ADCC) Induced by
IMP731
[0146] Materials and Methods
[0147] A new murine mAb with depleting properties, A9H12, has been
shown to recognize also baboon and macaque monkey LAG-3.sup.+ cells
with high avidity and had been chosen as our lead depleting
therapeutic mAb (ImmuTune IMP731).
[0148] A9H12 has been chimerized with a human IgG1 Fc region using
standard genetic engineering and PCR protocols, to give CDC
(complement-dependent cytotoxicity) and ADCC (antibody-dependent
cell cytotoxicity) properties.
[0149] The A9H12 VH and VL cDNA sequences derived from A9H12
hybridoma cell mRNA were fused upstream of the human
CH1-hinge-CH2-CH3 IgGI domains and Ckappa chains, respectively
(FIG. 10).
[0150] The two light and heavy IMP731 chimeric chains were
independently cloned into separate expression plasmids (FIG. 11
panel A and B, respectively) under the control of the PGK (or
SRalpha in another construction, not shown) promoter. These 2
plasmids were co-transfected (transitory transfection) together
into CHO cells and IMP731 was purified from the culture supernatant
at day 2 or 3 by using protein A column affinity capture and
elution at pH 3. After neutralisation with Tris-HCl the purified
IMP731 antibody was tested in CDC and ADCC experiments for its
ability to kill LAG-3.sup.+ target cells.
[0151] The two IMP731 light and heavy chains were then cloned
together with the PGK (or SRalpha, not shown) promoter in a
head-to-tail situation for coordinated expression of the two IMP731
chains from the same integration site (FIG. 12). This bi-cistronic
IMP731 expression plasmid was used for stable transfection and
selection of high-productivity (e.g. more than 20 picogramme IMP731
protein per million CHO-S cells per day) CHO-S cells using
increasing concentrations of hygromycine in serum-free medium.
[0152] The DNA and protein sequences for the kappa region of IMP731
are set forth in FIG. 20 and the DNA and protein sequences for the
gamma region of IMP731 are set forth in FIG. 21.
[0153] Results
[0154] Dose-dependent binding of IMP731 was first assessed on
hLAG-3-transfected CHO cells (FIG. 13A) and on LAG-3.sup.+ in vitro
activated human T cells (FIG. 13B). IMP731 displayed a significant
binding on both cell types with a concentration as low as 0.01
.mu.g/ml for activated T cells.
[0155] For complement dependent cytotoxicity (CDC) testing, the
target cells used in this assay were LAG-3.sup.+ CHO cells (FIG.
14). Cells were incubated either with IMP731 or its human
isotype-matched IgGI negative control and then with rabbit serum
containing active complement for 1 hour at 37.degree. C. Cell
viability was then assessed using 7-Amino-Actinomycin D (7-AAD).
7-AAD is a fluorescent dye labelling cells which have lost their
membranous integrity, a phenomenon which appeared rapidly after
death. The percentage of 7-AAD-positive CHO cells (i.e. dead target
cells) was determined by flow cytometry analysis. IMP731 displayed
a potent and specific cytotoxic activity in this CDC assay, killing
only LAG-3.sup.+ CHO cells in the presence of complement (FIG.
14).
[0156] For antibody-dependent cell-mediated cytotoxicity (ADCC)
testing, PBMCs were stimulated for one day with IL-2 to serve as
effector cells and LAG-3.sup.+ CHO cells were labelled with the
vital dye CFSE to serve as target cells. In the presence of IMP731,
PBMCs were able to kill a high percentage of LAG-3.sup.+ CHO cells
(FIG. 15A). IMP731 LAG-3 Ab was titered down to determine the
efficacy of the antibody in inducing ADCC at low concentration of
antibody. IMP731 significantly induced LAG-3.sup.+ CHO cells
killing at a concentration as low as 0.01 .mu.g/ml (FIG. 15B).
LAG-3.sup.+ but not LAG-3-cells were killed by the addition of
IMP731 in this assay (FIG. 15C).
[0157] It appeared that binding and functional activities of IMP731
were similar to the parental A9H12 murine mAb produced by hybridoma
cells. For instance, IMP731 has the same high affinity as the
parent antibody, as assessed by BIACORE.TM. analysis.
TABLE-US-00003 Antibodies: ka (1/Ms) kd (1/s) KD (M) Chi2 A9H12
1.72 .times. 10.sup.6 1.43 .times. 10.sup.-3 8.29 .times.
10.sup.-10 8.65 IMP731 (chimeric 2.03 .times. 10.sup.6 1.12 .times.
10.sup.-3 5.51 .times. 10.sup.-10 11.4 A9H12)
Example 5: Antibody-Dependent Cellular Cytotoxicity (ADCC) of
LAG-3.sup.+ Human T Cells Activated by a Recall Antigen Peptide
Pool Using the IMP731 Therapeutic Antibody
[0158] Introduction
[0159] More than 80% of the population is cytomegalovirus (CMV)
seropositive and more than 50% has a high frequency of circulating
CMV-reactive T cells that can be analyzed in short-term in vitro
assays in response to a CMV protein recall antigen. This is
therefore a convenient setting in which to analyze IMP731-dependent
antibody-dependent cellular cytotoxicity (ADCC) on subsets of
antigen-specific T cells physiologically activated through
peptide-dependent T-cell receptor triggering, using defined
synthetic peptides (i.e. no antigenic contaminants) from the
sequence of a CMV protein.
[0160] In addition, this experimental setting mimics closely the
situation encountered in auto-immune diseases where circulating
antigen-specific T cells are periodically stimulated by auto-immune
recall antigens. For example in the case of psoriasis, the recall
antigens are skin antigens that are presented to the immune system
in the form of MHC-class I- and class II-restricted peptides.
[0161] Purpose
[0162] To assess the potency of IMP731 in killing activated
antigen-specific human T cells stimulated with a CMV peptide pool
and thus to estimate the lowest dose likely to have a
pharmacological effect in man.
[0163] Experimental Design
[0164] PBMCs from CMV-positive donors were thawed, washed in
complete RPMI 1640 supplemented with 10% FCS and seeded at
10.sup.6/ml in 24-well plate (1.75 ml/well) in the presence of a
CMV peptide pool (BD Biosciences). The CMV peptide pool consists of
a mix of 138 15-mers with 11 amino acid overlaps spanning the
entire sequence of the pp65 protein (CMV AD169 strain). This
peptide pool will induce MHC class II-restricted CD4
peptide-specific T cell activation and proliferation but will also
activate MHC class I restricted CD8 peptide-specific T cells
through the internalization and processing of 15-mers into 9-mers.
Together the entire T cell repertoire specific for the pp65 protein
will be activated. The final concentration of each peptide was
0.875 .mu.g/ml. The cells were incubated at 37.degree. C. for 5
days. As CD8 T cells proliferate more rapidly than CD4 T cells,
there will always be more CD8 than CD4 activated T cells at day
5.
[0165] For ADCC testing, the cells were seeded in a 96-well
U-bottom plate (180 .mu.l/well, containing 150-175.times.10.sup.3
cells/well) in the CMV peptide-containing medium and 20 .mu.l of
10.times. dilutions of IMP731 or its isotype-matched control (human
IgG1, Chemicon) were added. After 4 hr at 37.degree. C., the cells
were stained with CD3-PE, CD4-PE-Cy7, CD8-APC-Cy7, CD25-APC (all
from BD Biosciences) and FITC-conjugated anti-LAG-3 mAb (17B4
antibody, 1 .mu.g/point) for 30 min at 4.degree. C. After
centrifuging, the cells were suspended for 15 min at room
temperature in culture medium containing 2.5 .mu.l 7-AAD (viability
dye), before FACS analysis. After exclusion of dead cells based on
size/granularity and 7-AAD staining, the percentages of LAG-3.sup.+
and CD25.sup.+ (another T cell activation marker) in the CD3.sup.+
CD4.sup.+ and the CD3.sup.+ CD8.sup.+ cells populations were
analyzed.
[0166] Results
[0167] The stimulation of PBMCs with the CMV peptide pool induced
the expression of the activation marker CD25 and LAG-3 (see FIG.
16) on a variable percentage of CD8.sup.+ T cells (from 3 to 12% of
T cells, 2 blood donors tested in different experiments) and
CD4.sup.+ T cells (lower percentages). In the presence of IMP731,
the percentage of activated CD8.sup.+ and CD4.sup.+ T cells was
dramatically reduced. A 70% reduction in the number of LAG-3.sup.+
cells was observed both in the CD4 and the CD8 subsets at a 10
ng/ml IMP731 concentration (see FIG. 16, panel A). Similar results
have been obtained at least twice in two donors. Additionally, the
half maximal effective concentration (EC50) was found to be
1.+-.0.4 ng/ml for CD4.sup.+ T cells and 0.7.+-.0.4 ng/ml for
CD8.sup.+ T cells (mean.+-.sd of 5 experiments).
[0168] The observed effect is not due to a competition between
IMP731 and the anti-LAG-3 17B4-FITC reagent since the binding of
17B4-FITC is not inhibited by a 3-fold excess of IMP731 (not
shown). A putative internalization of the membrane LAG-3 induced by
IMP731 was also excluded because the disappearance of activated T
cells was also observed with an anti-CD25 antibody (see FIG. 16B).
Note that half of CD2.sup.5 cells are LAG-3- (in the CD4 subset,
these cells are the natural Tregs) and are therefore not depleted.
The depletion of CD25.sup.+ cells versus LAG-3.sup.+ cells is also
minimized by the fact that many LAG-3.sup.+ cells are CD25.sup.-
(not shown).
CONCLUSIONS
[0169] IMP731 efficiently induced cell-mediated cytotoxicity of
activated antigen-specific CD4 and CD8 human T cells at very low
doses (1-10 ng/ml). From previous work we know that a concentration
of 30 ng/ml IMP731 was measured at t=116 hr in the baboon injected
with 0.1 mg/kg IMP731 (experiment showing a long-term suppression
of DTH reaction). Therefore the concentration in the first few
hours must have been much higher.
[0170] Based on this information, it is believed that a starting
dose in human in the planned Phase Ia trial of 0.01 mg/kg could be
pharmacologically active. It is possible that even such a very low
dose could lead to >10 ng/ml serum concentration levels for a
few hours and therefore be sufficient to deplete LAG-3.sup.+ T
cells in patients.
Example 6: IMP731 DTH Studies in Baboons
[0171] IMP731 has been shown to be immunosuppressive after a single
i.v. low dose (0.1 mg/kg) injection on a skin antigen-specific
reaction (DTH) in baboon. This test is used as a surrogate in vivo
assay for psoriasis inflammation. By continuing the DTH testing for
five months after the injection of IMP731 it was possible to show
that the immunosuppression was long-lasting corresponding to the
"Campath Effect".
[0172] The choice of psoriasis as an initial indication is
supported by the work showing that psoriatic skin is massively
infiltrated with LAG-3.sup.+ T cells compared to normal skin. The
following describes the work which led to these results and
conclusions.
[0173] IMP731 Suppresses DTH Reaction in Baboons
[0174] The half-life in 3 baboons injected (i.v.) with 0.1 mg/kg
IMP731 showed similar pharmacokinetic profiles with the following
elimination half-life: 16, 21 and 31 hours (FIG. 17).
[0175] Delayed Type Hypersensitivity (DTH) reaction is an
established model for skin inflammation (16-18). To assess the
potency of IMP731 on skin tissue and their draining lymph nodes in
baboons as a surrogate assay for the treatment of psoriasis
lesions, 3 baboons were immunized with tuberculin and then their
reactivity was assessed in a tuberculin-specific DTH reaction (see
protocol in FIG. 18). In a DTH reaction the erythema (the reddened
area of skin) measurement reflects an antigen-specific CD4 and CD8
T cell response over time.
[0176] Even a single dose as low as 0.1 mg/kg IMP731 is
immunosuppressive as shown for Baboon #3 (FIG. 19) where the DTH is
abrogated at a suboptimal dose (1:50 dilution) of tuberculin and is
still inhibited in time and intensity at an optimal dose (1:1
dilution) of tuberculin. The relevance of the DTH results is clear.
Both psoriasis and DTH are caused by antigen-specific LAG-3.sup.+
activated T cells in the skin.
[0177] Decrease in LAG-3.sup.+ T Cells in Lymph Nodes
[0178] To quantify the systemic deletion of circulating LAG-3.sup.+
T cells following injection of IMP731, the number of LAG-3.sup.+ T
cells in the DTH site draining lymph nodes 3 days after the
tuberculin injection was analyzed. The mean percentage of live
LAG-3.sup.+ cells in these immune-reactive lymph nodes was 3.5% for
the first DTH and only 0.7% for the second DTH. This clearly
indicates that IMP731 had killed 80% of LAG-3.sup.+ cells in the
antigen-reactive lymph node at day 3. This mechanism of action
explains why the immunosuppressive effect on the DTH is
long-lasting (see below).
[0179] IMP731 Still Suppresses DTH Reaction in Baboons Five Months
after Injection
[0180] This immunosuppressive effect is sustained over time as a
third, fourth and fifth DTH reaction performed up to five months
after the IMP731 injection is still inhibited (FIG. 19). This
clearly shows that the effect of antigen-specific immunosuppression
is still as potent five months after the injection of IMP731. This
effect is made even more striking by the fact that, whereas IMP731
can easily be detected in the blood in the few days following
injection, two months later there are no detectable antibodies
remaining.
[0181] IMP731 Suppresses DTH Reaction for Five Months Even after
Two Booster Immunizations
[0182] This long duration of immunosuppressive effect was tested to
determine whether it might be due to the deletion of
tuberculin-specific memory T cells at the time of IMP731 injection.
This is a possibility because CD45.sup.+ memory T cells (in both
CD4 and CD8 subsets) are LAG-3.sup.+ in human. If so, the DTH would
be suppressed following booster immunization. Accordingly, baboon
#3 was injected with two BCG vaccines before performing the
5.sup.th DTH (FIG. 18). Remarkably, the DTH was still totally
negative (FIG. 19).
[0183] It is established that memory T cells may take up to a year
to recover from deletion in human (the "Campath Effect") (19).
Therefore, it is likely that psoriasis patients can be treated with
a low dose (e.g. 0.1 mg/kg) IMP731, which could be effective at
deleting the activated memory T cells.
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[0203] All references, including publications, patent applications
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if each were individually and specifically indicated to be
incorporated by reference and were set forth in its entirety
herein.
Sequence CWU 1
1
25125PRTRattus norvegicus 1Asp Gln Pro Ala Ser Ile Pro Ala Leu Asp
Leu Leu Gln Gly Met Pro1 5 10 15Ser Thr Arg Arg His Pro Pro His Arg
20 25228DNAArtificial SequenceDescription of Artificial Sequence
Synthetic primer 2atatgaattc acagaggaga tgaggcag 28328DNAArtificial
SequenceDescription of Artificial Sequence Synthetic primer
3atatgaattc tcctggtcag agctgcct 28421DNAArtificial
SequenceDescription of Artificial Sequence Synthetic primer
4tggatgctat ggaaggaaag a 21520DNAArtificial SequenceDescription of
Artificial Sequence Synthetic primer 5gattctggtg acagctggtg
20621DNAArtificial SequenceDescription of Artificial Sequence
Synthetic primer 6ccttggtcaa gcagtacagc c 21722DNAArtificial
SequenceDescription of Artificial Sequence Synthetic primer
7ttcgctgatg acacaaacat ga 228342DNAArtificial SequenceDescription
of Artificial Sequence Synthetic polynucleotideCDS(1)..(342) 8gac
att gtg atg aca cag tct ccc tcc tcc ctg gct gtg tca gta gga 48Asp
Ile Val Met Thr Gln Ser Pro Ser Ser Leu Ala Val Ser Val Gly1 5 10
15cag aag gtc act atg agc tgc aag tcc agt cag agc ctt tta aat ggt
96Gln Lys Val Thr Met Ser Cys Lys Ser Ser Gln Ser Leu Leu Asn Gly
20 25 30agc aat caa aag aac tac ttg gcc tgg tac cag cag aaa cca gga
cag 144Ser Asn Gln Lys Asn Tyr Leu Ala Trp Tyr Gln Gln Lys Pro Gly
Gln 35 40 45tct cct aaa ctt ctg gta tac ttt gca tcc act agg gat tct
ggg gtc 192Ser Pro Lys Leu Leu Val Tyr Phe Ala Ser Thr Arg Asp Ser
Gly Val 50 55 60cct gat cgc ttc ata ggc agt gga tct ggg aca gat ttc
act ctt acc 240Pro Asp Arg Phe Ile Gly Ser Gly Ser Gly Thr Asp Phe
Thr Leu Thr65 70 75 80atc agc agt gtg cag gct gaa gac ctg gca gat
tac ttc tgt ctg caa 288Ile Ser Ser Val Gln Ala Glu Asp Leu Ala Asp
Tyr Phe Cys Leu Gln 85 90 95cat ttt ggc act cct ccg acg ttc ggt gga
ggc acc aaa ctg gaa atc 336His Phe Gly Thr Pro Pro Thr Phe Gly Gly
Gly Thr Lys Leu Glu Ile 100 105 110aaa cgg 342Lys
Arg967PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 9Gln Ser Pro Lys Leu Leu Val Tyr Phe Ala Ser
Thr Arg Asp Ser Gly1 5 10 15Val Pro Asp Arg Phe Ile Gly Ser Gly Ser
Gly Thr Asp Phe Thr Leu 20 25 30Thr Ile Ser Ser Val Gln Ala Glu Asp
Leu Ala Asp Tyr Phe Cys Leu 35 40 45Gln His Phe Gly Thr Pro Pro Thr
Phe Gly Gly Gly Thr Lys Leu Glu 50 55 60Ile Lys
Arg6510348DNAArtificial SequenceDescription of Artificial Sequence
Synthetic polynucleotideCDS(1)..(348) 10cag gtg cag ctg aag gag tca
ggt cct ggc ctg gtg gcg ccc tca cag 48Gln Val Gln Leu Lys Glu Ser
Gly Pro Gly Leu Val Ala Pro Ser Gln1 5 10 15agc ctg tcc atc aca tgc
acc gtc tca ggg ttc tca tta acc gcc tat 96Ser Leu Ser Ile Thr Cys
Thr Val Ser Gly Phe Ser Leu Thr Ala Tyr 20 25 30ggt gta aac tgg gtt
cgc cag cct cca gga aag ggt ctg gag tgg ctg 144Gly Val Asn Trp Val
Arg Gln Pro Pro Gly Lys Gly Leu Glu Trp Leu 35 40 45gga atg ata tgg
gat gat gga agc aca gac tat aat tca gct ctc aaa 192Gly Met Ile Trp
Asp Asp Gly Ser Thr Asp Tyr Asn Ser Ala Leu Lys 50 55 60tcc aga ctg
agc atc agt aag gac aac tcc aag agc caa gtt ttc tta 240Ser Arg Leu
Ser Ile Ser Lys Asp Asn Ser Lys Ser Gln Val Phe Leu65 70 75 80aaa
atg aac agt ctg caa act gat gac aca gcc agg tac tac tgt gcc 288Lys
Met Asn Ser Leu Gln Thr Asp Asp Thr Ala Arg Tyr Tyr Cys Ala 85 90
95aga gaa ggg gac gta gcc ttt gac tac tgg ggc caa ggc acc act ctc
336Arg Glu Gly Asp Val Ala Phe Asp Tyr Trp Gly Gln Gly Thr Thr Leu
100 105 110aca gtc tcc tca 348Thr Val Ser Ser 11511116PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
11Gln Val Gln Leu Lys Glu Ser Gly Pro Gly Leu Val Ala Pro Ser Gln1
5 10 15Ser Leu Ser Ile Thr Cys Thr Val Ser Gly Phe Ser Leu Thr Ala
Tyr 20 25 30Gly Val Asn Trp Val Arg Gln Pro Pro Gly Lys Gly Leu Glu
Trp Leu 35 40 45Gly Met Ile Trp Asp Asp Gly Ser Thr Asp Tyr Asn Ser
Ala Leu Lys 50 55 60Ser Arg Leu Ser Ile Ser Lys Asp Asn Ser Lys Ser
Gln Val Phe Leu65 70 75 80Lys Met Asn Ser Leu Gln Thr Asp Asp Thr
Ala Arg Tyr Tyr Cys Ala 85 90 95Arg Glu Gly Asp Val Ala Phe Asp Tyr
Trp Gly Gln Gly Thr Thr Leu 100 105 110Thr Val Ser Ser
11512723DNAArtificial SequenceDescription of Artificial Sequence
Synthetic polynucleotide 12atggaatcac agacccaggt cctcatgttt
cttctgctct gggtatctgg tgcctgtgca 60gacattgtga tgacacagtc tccctcctcc
ctggctgtgt cagtaggaca gaaggtcact 120atgagctgca agtccagtca
gagcctttta aatggtagca atcaaaagaa ctacttggcc 180tggtaccagc
agaaaccagg acagtctcct aaacttctgg tatactttgc atccactagg
240gattctgggg tccctgatcg cttcataggc agtggatctg ggacagattt
cactcttacc 300atcagcagtg tgcaggctga agacctggca gattacttct
gtctgcaaca ttttggcact 360cctccgacgt tcggtggagg caccaaactg
gaaatcaaac ggaccgtggc tgcaccatct 420gtcttcatct tcccgccatc
tgatgagcag ttgaaatctg gaactgcctc tgttgtgtgc 480ctgctgaata
acttctatcc cagagaggcc aaagtacagt ggaaggtgga taacgccctc
540caatcgggta actcccagga gagtgtcaca gagcaggaca gcaaggacag
cacctacagc 600ctcagcagca ccctgacgct gagcaaagca gactacgaga
aacacaaagt ctacgcctgc 660gaagtcaccc atcagggcct gagttcgccc
gtcacaaaga gcttcaacag gggagagtgt 720taa 72313240PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
13Met Glu Ser Gln Thr Gln Val Leu Met Phe Leu Leu Leu Trp Val Ser1
5 10 15Gly Ala Cys Ala Asp Ile Val Met Thr Gln Ser Pro Ser Ser Leu
Ala 20 25 30Val Ser Val Gly Gln Lys Val Thr Met Ser Cys Lys Ser Ser
Gln Ser 35 40 45Leu Leu Asn Gly Ser Asn Gln Lys Asn Tyr Leu Ala Trp
Tyr Gln Gln 50 55 60Lys Pro Gly Gln Ser Pro Lys Leu Leu Val Tyr Phe
Ala Ser Thr Arg65 70 75 80Asp Ser Gly Val Pro Asp Arg Phe Ile Gly
Ser Gly Ser Gly Thr Asp 85 90 95Phe Thr Leu Thr Ile Ser Ser Val Gln
Ala Glu Asp Leu Ala Asp Tyr 100 105 110Phe Cys Leu Gln His Phe Gly
Thr Pro Pro Thr Phe Gly Gly Gly Thr 115 120 125Lys Leu Glu Ile Lys
Arg Thr Val Ala Ala Pro Ser Val Phe Ile Phe 130 135 140Pro Pro Ser
Asp Glu Gln Leu Lys Ser Gly Thr Ala Ser Val Val Cys145 150 155
160Leu Leu Asn Asn Phe Tyr Pro Arg Glu Ala Lys Val Gln Trp Lys Val
165 170 175Asp Asn Ala Leu Gln Ser Gly Asn Ser Gln Glu Ser Val Thr
Glu Gln 180 185 190Asp Ser Lys Asp Ser Thr Tyr Ser Leu Ser Ser Thr
Leu Thr Leu Ser 195 200 205Lys Ala Asp Tyr Glu Lys His Lys Val Tyr
Ala Cys Glu Val Thr His 210 215 220Gln Gly Leu Ser Ser Pro Val Thr
Lys Ser Phe Asn Arg Gly Glu Cys225 230 235 24014114PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
14Asp Ile Val Met Thr Gln Ser Pro Ser Ser Leu Ala Val Ser Val Gly1
5 10 15Gln Lys Val Thr Met Ser Cys Lys Ser Ser Gln Ser Leu Leu Asn
Gly 20 25 30Ser Asn Gln Lys Asn Tyr Leu Ala Trp Tyr Gln Gln Lys Pro
Gly Gln 35 40 45Ser Pro Lys Leu Leu Val Tyr Phe Ala Ser Thr Arg Asp
Ser Gly Val 50 55 60Pro Asp Arg Phe Ile Gly Ser Gly Ser Gly Thr Asp
Phe Thr Leu Thr65 70 75 80Ile Ser Ser Val Gln Ala Glu Asp Leu Ala
Asp Tyr Phe Cys Leu Gln 85 90 95His Phe Gly Thr Pro Pro Thr Phe Gly
Gly Gly Thr Lys Leu Glu Ile 100 105 110Lys Arg151398DNAArtificial
SequenceDescription of Artificial Sequence Synthetic polynucleotide
15atggctgtct tggggctgct cttctgcctg gtaacattcc caagctgtat cctttcccag
60gtgcagctga aggagtcagg tcctggcctg gtggcgccct cacagagcct gtccatcaca
120tgcaccgtct cagggttctc attaaccgcc tatggtgtaa actgggttcg
ccagcctcca 180ggaaagggtc tggagtggct gggaatgata tgggatgatg
gaagcacaga ctataattca 240gctctcaaat ccagactgag catcagtaag
gacaactcca agagccaagt tttcttaaaa 300atgaacagtc tgcaaactga
tgacacagcc aggtactact gtgccagaga aggggacgta 360gcctttgact
actggggcca aggcaccact ctcacagtct cctcagctag caccaagggc
420ccatcggtct tccccctggc accctcctcc aagagcacct ctgggggcac
agcggccctg 480ggctgcctgg tcaaggacta cttccccgaa ccggtgacgg
tgtcgtggaa ctcaggcgcc 540ctgaccagcg gcgtgcacac cttcccggct
gtcctacagt cctcaggact ctactccctc 600agcagcgtgg tgaccgtgcc
ctccagcagc ttgggcaccc agacctacat ctgcaacgtg 660aatcacaagc
ccagcaacac caaggtggac aagaaagttg agcccaaatc ttgtgacaaa
720actcacacat gcccaccgtg cccagcacct gaactcctgg ggggaccgtc
agtcttcctc 780ttccccccaa aacccaagga caccctcatg atctcccgga
cccctgaggt cacatgcgtg 840gtggtggacg tgagccacga agaccctgag
gtcaagttca actggtacgt ggacggcgtg 900gaggtgcata atgccaagac
aaagccgcgg gaggagcagt acaacagcac gtaccgtgtg 960gtcagcgtcc
tcaccgtcct gcaccaggac tggctgaatg gcaaggagta caagtgcaag
1020gtctccaaca aagccctccc agcccccatc gagaaaacca tctccaaagc
caaagggcag 1080ccccgagaac cacaggtgta caccctgccc ccatcccggg
atgagctgac caagaaccag 1140gtcagcctga cctgcctggt caaaggcttc
tatcccagcg acatcgccgt ggagtgggag 1200agcaatgggc agccggagaa
caactacaag accacgcctc ccgtgctgga ctccgacggc 1260tccttcttcc
tctacagcaa gctcaccgtg gacaagagca ggtggcagca ggggaacgtc
1320ttctcatgct ccgtgatgca tgaggctctg cacaaccact acacgcagaa
gagcctctcc 1380ctgtctccgg gtaaataa 139816465PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
16Met Ala Val Leu Gly Leu Leu Phe Cys Leu Val Thr Phe Pro Ser Cys1
5 10 15Ile Leu Ser Gln Val Gln Leu Lys Glu Ser Gly Pro Gly Leu Val
Ala 20 25 30Pro Ser Gln Ser Leu Ser Ile Thr Cys Thr Val Ser Gly Phe
Ser Leu 35 40 45Thr Ala Tyr Gly Val Asn Trp Val Arg Gln Pro Pro Gly
Lys Gly Leu 50 55 60Glu Trp Leu Gly Met Ile Trp Asp Asp Gly Ser Thr
Asp Tyr Asn Ser65 70 75 80Ala Leu Lys Ser Arg Leu Ser Ile Ser Lys
Asp Asn Ser Lys Ser Gln 85 90 95Val Phe Leu Lys Met Asn Ser Leu Gln
Thr Asp Asp Thr Ala Arg Tyr 100 105 110Tyr Cys Ala Arg Glu Gly Asp
Val Ala Phe Asp Tyr Trp Gly Gln Gly 115 120 125Thr Thr Leu Thr Val
Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe 130 135 140Pro Leu Ala
Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala Ala Leu145 150 155
160Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val Thr Val Ser Trp
165 170 175Asn Ser Gly Ala Leu Thr Ser Gly Val His Thr Phe Pro Ala
Val Leu 180 185 190Gln Ser Ser Gly Leu Tyr Ser Leu Ser Ser Val Val
Thr Val Pro Ser 195 200 205Ser Ser Leu Gly Thr Gln Thr Tyr Ile Cys
Asn Val Asn His Lys Pro 210 215 220Ser Asn Thr Lys Val Asp Lys Lys
Val Glu Pro Lys Ser Cys Asp Lys225 230 235 240Thr His Thr Cys Pro
Pro Cys Pro Ala Pro Glu Leu Leu Gly Gly Pro 245 250 255Ser Val Phe
Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile Ser 260 265 270Arg
Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser His Glu Asp 275 280
285Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly Val Glu Val His Asn
290 295 300Ala Lys Thr Lys Pro Arg Glu Glu Gln Tyr Asn Ser Thr Tyr
Arg Val305 310 315 320Val Ser Val Leu Thr Val Leu His Gln Asp Trp
Leu Asn Gly Lys Glu 325 330 335Tyr Lys Cys Lys Val Ser Asn Lys Ala
Leu Pro Ala Pro Ile Glu Lys 340 345 350Thr Ile Ser Lys Ala Lys Gly
Gln Pro Arg Glu Pro Gln Val Tyr Thr 355 360 365Leu Pro Pro Ser Arg
Asp Glu Leu Thr Lys Asn Gln Val Ser Leu Thr 370 375 380Cys Leu Val
Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu Trp Glu385 390 395
400Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr Pro Pro Val Leu
405 410 415Asp Ser Asp Gly Ser Phe Phe Leu Tyr Ser Lys Leu Thr Val
Asp Lys 420 425 430Ser Arg Trp Gln Gln Gly Asn Val Phe Ser Cys Ser
Val Met His Glu 435 440 445Ala Leu His Asn His Tyr Thr Gln Lys Ser
Leu Ser Leu Ser Pro Gly 450 455 460Lys4651712PRTArtificial
SequenceDescription of Artificial Sequence Synthetic peptide 17Gln
Ser Leu Leu Asn Gly Ser Asn Gln Lys Asn Tyr1 5 10189PRTArtificial
SequenceDescription of Artificial Sequence Synthetic peptide 18Leu
Gln His Phe Gly Thr Pro Pro Thr1 5198PRTArtificial
SequenceDescription of Artificial Sequence Synthetic peptide 19Gly
Phe Ser Leu Thr Ala Tyr Gly1 5207PRTArtificial SequenceDescription
of Artificial Sequence Synthetic peptide 20Ile Trp Asp Asp Gly Ser
Thr1 52110PRTArtificial SequenceDescription of Artificial Sequence
Synthetic peptide 21Ala Arg Glu Gly Asp Val Ala Phe Asp Tyr1 5
102260DNAArtificial SequenceDescription of Artificial Sequence
Synthetic oligonucleotideCDS(1)..(60) 22atg gaa tca cag acc cag gtc
ctc atg ttt ctt ctg ctc tgg gta tct 48Met Glu Ser Gln Thr Gln Val
Leu Met Phe Leu Leu Leu Trp Val Ser1 5 10 15ggt gcc tgt gca 60Gly
Ala Cys Ala 202320PRTArtificial SequenceDescription of Artificial
Sequence Synthetic peptide 23Met Glu Ser Gln Thr Gln Val Leu Met
Phe Leu Leu Leu Trp Val Ser1 5 10 15Gly Ala Cys Ala
202457DNAArtificial SequenceDescription of Artificial Sequence
Synthetic oligonucleotideCDS(1)..(57) 24atg gct gtc ttg ggg ctg ctc
ttc tgc ctg gta aca ttc cca agc tgt 48Met Ala Val Leu Gly Leu Leu
Phe Cys Leu Val Thr Phe Pro Ser Cys1 5 10 15atc ctt tcc 57Ile Leu
Ser2519PRTArtificial SequenceDescription of Artificial Sequence
Synthetic peptide 25Met Ala Val Leu Gly Leu Leu Phe Cys Leu Val Thr
Phe Pro Ser Cys1 5 10 15Ile Leu Ser
* * * * *