U.S. patent application number 16/296825 was filed with the patent office on 2019-09-19 for use of anti-il-36r antibodies for treatment of generalized pustular psoriasis.
The applicant listed for this patent is Boehringer Ingelheim International GmbH. Invention is credited to Janine Lamar, Steven John Padula, Christian Thoma.
Application Number | 20190284285 16/296825 |
Document ID | / |
Family ID | 65904556 |
Filed Date | 2019-09-19 |
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United States Patent
Application |
20190284285 |
Kind Code |
A1 |
Thoma; Christian ; et
al. |
September 19, 2019 |
USE OF ANTI-IL-36R ANTIBODIES FOR TREATMENT OF GENERALIZED PUSTULAR
PSORIASIS
Abstract
The present invention relates to the treatment of or alleviation
of signs and symptoms of an acute phase flare-up of generalized
pustular psoriasis (GPP) with anti-IL36R antibodies.
Inventors: |
Thoma; Christian; (Biberach
an der Riss, DE) ; Padula; Steven John; (Wiesbaden,
DE) ; Lamar; Janine; (Ingelheim am Rhein,
DE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Boehringer Ingelheim International GmbH |
Ingelheim am Rhein |
|
DE |
|
|
Family ID: |
65904556 |
Appl. No.: |
16/296825 |
Filed: |
March 8, 2019 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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62729518 |
Sep 11, 2018 |
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|
62699274 |
Jul 17, 2018 |
|
|
|
62683720 |
Jun 12, 2018 |
|
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62642641 |
Mar 14, 2018 |
|
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
C07K 2317/76 20130101;
A61K 2039/54 20130101; C07K 16/2866 20130101; C07K 2317/24
20130101; A61P 17/06 20180101; A61K 2039/505 20130101; C07K 2317/92
20130101 |
International
Class: |
C07K 16/28 20060101
C07K016/28; A61P 17/06 20060101 A61P017/06 |
Claims
1-38. (canceled)
39. A method of treating generalized pustular psoriasis (GPP) in a
patient, said method comprising administering or having
administered to the patient a therapeutically effective amount of
an anti-IL-36R antibody, wherein the anti-IL-36R antibody is
administered in one or more intravenous doses comprising 210 mg,
300 mg, 350 mg, 450 mg, 600 mg, 700 mg, 750 mg, 800 mg, 850 mg or
900 mg of the anti-IL-36R antibody, wherein the anti-IL-36R
antibody comprises: (i) a light chain variable region comprising
the amino acid sequence of SEQ ID NO: 77; and a heavy chain
variable region comprising the amino acid sequence of SEQ ID NO:
87; or (ii) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or (iii) a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 77; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 89; or (iv) a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 87; or (v) a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 88; or (vi) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 89; or (vii) a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 85; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 100; or (viii) a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
85; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO:101; or (ix) a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 86; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 100; or (x) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 86; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO:101.
40. The method of claim 39, wherein the anti-IL-36R antibody is
administered in one intravenous dose of 700 mg.
41. The method of claim 39, wherein the anti-IL-36R antibody is
administered in one intravenous dose of 750 mg.
42. The method of claim 39, wherein the anti-IL-36R antibody is
administered in one intravenous dose of 800 mg.
43. The method of claim 39, wherein the anti-IL-36R antibody is
administered in one intravenous dose of 850 mg.
44. The method of claim 39, wherein the anti-IL-36R antibody is
administered in one intravenous dose of 900 mg.
45. The method of claim 39, wherein 1, 2 or 3 intravenous doses
is/are administered.
46. The method of claim 45, wherein 2 or 3 intravenous doses are
administered at 4 to 12 weeks intervals.
47. A method of treating generalized pustular psoriasis (GPP) in a
patient, said method comprising administering or having
administered to the patient a therapeutically effective amount of
an anti-IL-36R antibody, wherein the anti-IL-36R antibody is
administered in one intravenous dose of about 10 mg per kilogram of
body weight of the patient, wherein the anti-IL-36R antibody
comprises: (i) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or (ii) a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 77; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 88; or (iii) a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
77; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 89; or (iv) a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 87; or (v) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or (vi) a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 80; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 89; or (vii) a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
85; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 100; or (viii) a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 85; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO:101; or (ix) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 86; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 100; or (x) a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 86; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO:101.
Description
RELATED APPLICATIONS
[0001] This application claims priority to U.S. Provisional Patent
Application Nos. 62/642,641 (filed Mar. 14, 2018), 62/683,720
(filed Jun. 12, 2018), 62/699,274 (filed Jul. 17, 2018) and
62/729,518 (filed Sep. 11, 2018), the entire content of each of
which is hereby incorporated herein by reference as though fully
set forth herein.
SEQUENCE LISTING
[0002] The instant application contains a Sequence Listing which
has been submitted in ASCII format via EFS-Web and is hereby
incorporated by reference in its entirety. Said ASCII copy, created
on Mar. 5, 2019, is named 09-0683-US-4-2019-03-08-SL.txt and is
146,018 bytes in size.
TECHNICAL FIELD OF THE INVENTION
[0003] The present invention relates to methods and compositions
for treatment of generalized pustular psoriasis (GPP). More
specifically, the invention relates to administration of an
interleukin-36 receptor (IL-36R) antibody to a subject with
GPP.
BACKGROUND
[0004] GPP is a severe skin disease characterized by the repeated
occurrence of acute flares caused by systemic inflammation
affecting the skin and internal organs. The classic presentation of
acute GPP was first described as a recurrent pustular form of
psoriasis by von Zumbusch in 1909. While GPP and plaque psoriasis
can occur at the same time in an individual patient, GPP is
distinct from plaque psoriasis in clinical presentation,
pathophysiology, histopathology, response to therapies,
epidemiology and genetics.
[0005] Therefore, it is very critical to differentiate GPP from
plaque or erythrodermic psoriasis with secondary pustulation. The
clinical presentation of GPP is quite different from psoriasis
vulgaris (PV) in its' episodic nature, often with normal appearing
skin between very acute and severe disease flares. GPP is
clinically characterized by the preponderance of pustules as the
primary lesion on an erythematous base rather than red plaques
covered with silvery scales representing the primary lesion of
typical plaque psoriasis. In addition, the histopathological
hallmarks of GPP are distinct spongiform pustules of Kogoj located
in the subcorneal portion of the epidermis. GPP may be associated
with systemic symptoms (fever, increased CRP and neutrophilia) and
severe extra-cutaneous organ manifestations (liver, kidney failure,
CV shock). While patients with GPP may have pre-existing or
co-existing PV, it is possible to clinically distinguish patients
with primary plaque disease (PV) who have a secondary pustular
component from patients who have primary pustular disease (GPP)
with a concomitant plaque component, based on the sequence of
manifestations (primary lesion pustule rather than plaque) and the
localization of a GPP pustule on an erythematous base rather than a
PsO plaque.
[0006] As descriptions for GPP are discordant among standard
dermatology textbooks, the European Rare And Severe Psoriasis
Expert Network (ERASPEN) has defined consensus criteria that
include as key diagnosis criteria for acute GPP the presence of
primary, sterile, macroscopically visible pustules on non-acral
skin (excluding cases where pustulation is restricted to psoriatic
plaques), with or without systemic inflammation, with or without
plaque-type psoriasis, either relapsing (>1 episode) or
persistent (>3 months).
[0007] Chronic GPP describes the state in between disease flares
that may be characterized by the complete absence of symptoms or
the persistence of residual skin symptoms such as erythema and
scaling and minor pustulation.
[0008] Current treatment options for controlling acute GPP and
subcutaneous of response are limited and do not provide sustained
efficacy. No treatments are currently approved for GPP in the US
and EU, though retinoids, cyclosporine or methotrexate are being
recommended. Although these treatments are described to be
"remarkably effective or effective" in 70-84% of patients (J Am
Acad Dermatol. 2012; 67(2):279-88) these data are based on a
retrospective cohort study from Japan without clearly defined
endpoints (Japanese Journal of Dermatology. 2010; 120(4):815-39).
Furthermore, these treatments cannot be used long-term due to side
effects and contraindications (retinoids: teratogenicity, hair
loss; cyclosporine: excessive hair growth, renal toxicity; MTX:
liver toxicity).
[0009] Biologics (mostly TNF inhibitors, occasionally IL-1 or IL-17
inhibitors) are increasingly used to treat more severe, extensive
or treatment resistant patients with GPP, based on small published
case series. However, these drugs are also associated with
limitations in efficacy (incomplete and delayed responses are
frequent) and safety as well as contraindications (infusion
reactions, tuberculosis, cardiovascular disease). Thus, a need
exists in the art for novel targeted therapies for the treatment
and/or prevention of GPP.
SUMMARY OF THE INVENTION
[0010] The present invention addresses the above need by providing
biotherapeutics, in particular antibodies, which bind to IL-36R and
provide therapeutic or prophylactic therapy for acute and/or
chronic GPP and the associated signs and symptoms such as GPP
flares.
[0011] In a first aspect, the present invention relates to a method
of treating generalized pustular psoriasis (GPP) in a patient, said
method including administering or having administered to the
patient a therapeutically effective amount of an anti-IL-36R
antibody.
[0012] In a second aspect, the present invention relates to a
method of treating moderate to severe GPP in a patient, including
administering or having administered to the patient a
therapeutically effective amount of an anti-IL-36R antibody.
[0013] In a third aspect, the present invention relates to a method
of reducing or alleviating signs and symptoms of an acute phase
flare-up of GPP in a patient, said method including administering
or having administered to the patient a therapeutically effective
amount of an anti-IL-36R antibody.
[0014] In a forth aspect, the present invention relates to a method
of reducing the severity and duration of GPP flares, said method
comprising including administering or having administered to the
patient a therapeutically effective amount of an anti-IL-36R
antibody.
[0015] In a fifth aspect, the present invention relates to a method
of treating a skin disorder associated with acute GPP, said method
including administering or having administered to the patient a
therapeutically effective amount of an anti-IL-36R antibody.
[0016] In one embodiment related to any of aspects first to fifth,
the anti-IL-36R antibody includes: a) a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 26 (L-CDR1); the
amino acid sequence of SEQ ID NO: 35, 102, 103, 104, 105 106 or 140
(L-CDR2); the amino acid sequence of SEQ ID NO: 44 (L-CDR3); and b)
a heavy chain variable region comprising the amino acid sequence of
SEQ ID NO: 53 (H-CDR1); the amino acid sequence of SEQ ID NO: 62,
108, 109, 110 or 111 (H-CDR2); the amino acid sequence of SEQ ID
NO: 72 (H-CDR3).
[0017] In one embodiment related to any of aspects first to fifth,
the anti-IL-36R antibody includes:
[0018] I. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 102 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0019] II. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 103 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0020] III. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 104 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0021] IV. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 105 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0022] V. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 106 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0023] VI. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 140 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0024] In one embodiment related to any of aspects first to fifth,
the anti-IL-36R antibody includes:
[0025] (i) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or
[0026] (ii) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or
[0027] (iii) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 89; or
[0028] (iv) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or
[0029] (v) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or
[0030] (vi) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 89; or
[0031] (vii) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 85; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 100; or
[0032] (viii) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 85; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO:101; or
[0033] (ix) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 86; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 100; or
[0034] (x) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 86; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO:101.
[0035] In one embodiment related to any of aspects first to fifth,
the anti-IL-36R antibody includes:
[0036] i. a light chain comprising the amino acid sequence of SEQ
ID NO: 115; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 125; or
[0037] ii. a light chain comprising the amino acid sequence of SEQ
ID NO: 115; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 126; or
[0038] iii. a light chain comprising the amino acid sequence of SEQ
ID NO: 115; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 127; or
[0039] iv. a light chain comprising the amino acid sequence of SEQ
ID NO: 118; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 125; or
[0040] v. a light chain comprising the amino acid sequence of SEQ
ID NO: 118; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 126; or
[0041] vi. a light chain comprising the amino acid sequence of SEQ
ID NO: 118; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 127; or
[0042] vii. a light chain comprising the amino acid sequence of SEQ
ID NO: 123; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 138; or
[0043] viii. a light chain comprising the amino acid sequence of
SEQ ID NO: 123; and a heavy chain comprising the amino acid
sequence of SEQ ID NO: 139; or
[0044] ix. a light chain comprising the amino acid sequence of SEQ
ID NO: 124; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 138.
[0045] In one embodiment related to any of aspects first to fifth,
the anti-IL-36R antibody is administered in one or more intravenous
dose(s). In a related embodiment, each of the one or more
intravenous dose(s) includes 210 mg, 300 mg, 350 mg, 450 mg, 600
mg, 700 mg, 750 mg, 800 mg, 900 mg of said anti-IL-36R
antibody.
[0046] In another embodiment related to any of aspects first to
fifth, the anti-IL-36R antibody is administered in one intravenous
dose. In another embodiment related to any of the above aspects,
the anti-IL-36R is administered in one intravenous dose of about 10
mg per kilogram of body weight of the patient. In another
embodiment related to any of the above aspects, the anti-IL-36R
antibody is administered in one intravenous dose of 210 mg. In
another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 300
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 350
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 450
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 600
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 700
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 750
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 800
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 850
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 900
mg.
[0047] In another embodiment related to any of aspects first to
fifth, 1, 2 or 3 intravenous dose(s) is/are administered. In
another embodiment related to any of the above aspects, 2 or 3
intravenous doses are administered at 2, 4, 6, 8, 10 or 12 weeks
intervals.
[0048] In another embodiment related to any of the above
embodiments or aspects first to fifth, the administration results
in one or more of the following efficacy endpoints:
[0049] (a) Generalized Pustular Psoriasis Global Assessment (GPPGA)
score of 0 or 1 at Week 1;
[0050] (b) GPPGA pustulation subscore of 0 indicating no visible
pustules at Week 1;
[0051] (c) Psoriasis Area and Severity Index for Generalized
Pustular Psoriasis (GPPASI) 75 at Week 4;
[0052] (d) Change from baseline in Pain Visual Analog Scale (VAS)
score at Week 4;
[0053] (e) Change from baseline in Psoriasis Symptom Scale (PSS)
score at Week 4;
[0054] (f) Change from baseline in Functional Assessment of Chronic
Illness Therapy (FACIT) Fatigue score at Week 4;
[0055] (g) GPPGA 0 or 1 at Week 4;
[0056] (h) GPPGA pustulation subscore of 0 indicating no visible
pustules at Week 4;
[0057] (i) GPPASI 50 at Week 1 and 4; or
[0058] (j) Change in GPPASI pustule, erythema or scaling severity
subscore from baseline at Week 1 and 4.
[0059] In another embodiment related to the above embodiment,
proportion of patients with a response to the administration is
statistically significantly higher as compared to patients on
placebo for one or more of end points (a)-(j).
[0060] In a sixth aspect, the present invention relates to a method
of preventing the recurrence of GPP flares in a patient treated
with one or more intravenous dose(s) of the anti-IL-36R antibody
according to any of aspects first to fifth or the above
embodiments, said method including administering to the patient a
prophylactically effective amount of the anti-IL-36R antibody in
one or more subcutaneous doses.
[0061] In a seventh aspect, the present invention relates to a
method of achieving a Generalized Pustular Psoriasis Global
Assessment (GPPGA) score of 0 in a patient treated with one or more
intravenous dose(s) of the anti-IL-36R antibody according to any of
aspects first to fifth or the above embodiments, said method
including administering to the patient an effective amount of the
anti-IL-36R antibody in one or more subcutaneous doses.
[0062] In an eight aspect, the present invention relates to a
method of achieving a complete resolution of GPP symptoms in a
patient treated with one or more intravenous dose(s) of the
anti-IL-36R antibody according to any of aspects first to fifth or
the above embodiments, said method comprising administering to the
patient an effective amount of the anti-IL-36R antibody in one or
more subcutaneous doses; wherein the GPP symptoms comprise postule,
erythema, or scaling and the complete resolution comprises a GPPGA
score of 0.
[0063] In one embodiment related to any of aspects sixth to eight,
each of the one or more subcutaneous doses includes 150 mg, 225 mg,
300 mg, 450 mg or 600 mg of said anti-IL-36R antibody.
[0064] In one embodiment related to any of aspects sixth to eight
or the related embodiment(s), 1, 2, 3 or more subcutaneous doses
are administered to the patient and wherein a first subcutaneous
dose is administered after the last intravenous dose.
[0065] In one embodiment related to any of aspects sixth to eight
or the related embodiment(s), the first subcutaneous dose is
administered 2 to 8 weeks, 4 to 6 weeks, 2 weeks, 4 weeks, 6 weeks
or 8 weeks, after the last intravenous dose is administered and the
second subcutaneous dose is administered 4, 6, 8, 10 or 12 weeks
after said first subcutaneous dose is administered.
[0066] In one embodiment related to any of aspects sixth to eight
or the related embodiment(s), at least 10%, 20%, 30%, 40%, 50%,
60%, 70% or 80% of the patients remain in clinical remission as
measured by a GPPGA score of 0 or 1 at Week 12, 24, 36, 48, 60 or
72 of the treatment.
[0067] In one embodiment related to any of aspects sixth to eight
or the related embodiment(s), at least 10%, 20%, 30%, 40%, 50%,
60%, 70% or 80% of the patients remain in clinical remission as
measured by a change in GPPASI from baseline at Week 12, 24, 36,
48, 60 or 72 of the treatment.
[0068] In one embodiment related to any of aspects sixth to eight
or the related embodiment(s), at least 10%, 20%, 30%, 40%, 50%,
60%, 70% or 80% of the patients remain in clinical remission as
measured by a change in GPPASI pustule, erythema or scaling
severity subscore from baseline at Week 12, 24, 36, 48, 60 or 72 of
the treatment. In a related embodiment, proportion of patients with
a response to the administration is statistically significantly
higher as compared to patients on placebo for any of the end points
recited.
[0069] In a ninth aspect, the present invention relates to a method
of treating GPP in a patient, including administering to the
patient a therapeutically effective amount of one or more
intravenous dose(s) of the anti-IL-36R antibody, according to
aspects first to fifth and their related embodiments, followed by
one or more subcutaneous dose(s) of the anti-IL-36R antibody.
[0070] In one embodiment relating to aspect ninth, 1 or 2 or 3
intravenous dose(s) of the anti-IL-36R antibody is/are followed by
1 or 2 or 3 subcutaneous dose(s) of the anti-IL-36R antibody.
[0071] In one embodiment relating to aspect ninth, 1 intravenous
dose of the anti-IL-36R antibody is followed by 1 or 2 or 3
subcutaneous doss(s) of the anti-IL-36R antibody.
[0072] In one embodiment relating to aspect ninth, 2 intravenous
doses of the anti-IL-36R antibody are followed by 1 or 2 or 3
subcutaneous doss(s) of the anti-IL-36R antibody.
[0073] In one embodiment relating to aspect ninth, 3 intravenous
doses of the anti-IL-36R antibody are followed by 1 or 2 or 3
subcutaneous doss(s) of the anti-IL-36R antibody.
[0074] In one embodiment relating to aspect ninth and its related
embodiment, each of the one or more intravenous dose(s) includes
210 mg, 300 mg, 350 mg, 450 mg, 600 mg, 700 mg, 750 mg, 800 mg, 850
mg or 900 mg of the anti-IL-36R antibody and each of the one or
more subcutaneous dose(s) includes 150 mg, 225 mg, 300 mg, 450 mg,
or 600 mg of the anti-IL-36R antibody. In a related embodiment, the
intravenous doses are administered at 2, 4, 6, 8, 10 or 12 weeks
intervals, the subcutaneous doses are administered at 4, 6, 8, 10
or 12 weeks intervals, and the first subcutaneous dose is
administered 2 to 8 weeks, 4 to 6 weeks, 2 weeks, 4 weeks, 6 weeks
or 8 weeks after the last intravenous dose is administered.
[0075] In an embodiment relating to any of the above aspects, the
intravenous dose(s) may be followed by one or more subcutaneous
dose(s).
[0076] In an embodiment relating to any of the above aspects, the
anti-IL-36R antibody or an antigen binding fragment thereof
(disclosed herein) is present in a stable pharmaceutical
formulation (as described in co-pending U.S. provisional
application No. 62/815,405, filed Mar. 8, 2019, the entire content
of which is hereby incorporated herein by reference in its
entirety) for administration to a mammal or patient according to
any one of the aspects of the present invention.
[0077] In one embodiment, the method of treatment according to any
of the aspects described herein, includes administering to the
mammal or patient a therapeutic amount of a stable pharmaceutical
formulation comprising from about 20 mg/mL to about 150 mg/mL of an
anti-IL-36R antibody (disclosed herein), about 20 mM to about 80 mM
of a pharmaceutically acceptable buffer (e.g., acetate buffer),
about 100 mM to about 250 mM of a pharmaceutically acceptable
tonicifying agent (e.g., sucrose), about 0 mM to about 80 mM of a
pharmaceutically acceptable stabilizing agent (e.g., arginine) or a
pharmaceutically acceptable salt thereof, about 0 to about 150 mM
of a pharmaceutically acceptable salt (e.g., sodium chloride), and
a pharmaceutically acceptable surfactant (e.g., polysorbate 20) in
an amount about 0 g/L to about 1.5 g/L, wherein the generalized
pustular psoriasis (GPP) in the patient is treated, or the moderate
to severe GPP in the patient is treated, or the signs and symptoms
of an acute phase flare-up of GPP in the patient is reduced or
alleviated, or the severity and duration of GPP flares in the
patient is reduced, or the skin disorder associated with acute GPP
in the patient is treated, or the GPP flares in a patient is
prevented or inhibited, or the Generalized Pustular Psoriasis
Global Assessment (GPPGA) score of 0 in the patient is achieved, or
the complete resolution of GPP symptoms in the patient is achieved,
In a related embodiment, the stable pharmaceutical formulation is
an aqueous pharmaceutical formulation. In a related embodiment, the
pH of the aqueous pharmaceutical formulation is about 5 to about 7.
In a related embodiment, the pharmaceutical formulation is for an
intravenous administration to the mammal or patient. In a related
embodiment, the pharmaceutical formulation is for a subcutaneous
administration to the mammal or patient. In a related embodiment,
the pharmaceutical formulation for an intravenous administration
comprises an anti-IL-36R antibody in an amount of about 60 mg/mL.
In a related embodiment, the pharmaceutical formulation for a
subcutaneous administration comprises an anti-IL-36R antibody in an
amount of about 150 mg/mL.
[0078] In a tenth aspect, the present invention relates to a method
of treating GPP in a patient, including
[0079] (a) obtaining a biological sample from said patient, wherein
the biological sample is obtained from source including lesional
skin or whole blood;
[0080] (b) determining the gene express profile of one or more of
genes;
[0081] (c) administering to the patient an effective amount of the
anti-IL-36R antibody according to any embodiments relating to
aspects first to fifth.
[0082] In one embodiment relating to aspect tenth, the one or more
of genes are IL12B, IL1B, IL6, CXCL1, IL23A, TNF, IL17C, IL24 or
IL1B in lesional skin, and IL1B, S100A9, S100A12, S100A8, MMP25,
MMP9 or CD177 in whole blood.
[0083] Additional features and advantages of the present invention
will be set forth in the description below, and in part will be
apparent from the description, or may be learned by practice of the
subject technology. It is to be understood that both the foregoing
general description and the following detailed description are
exemplary and explanatory and are intended to provide further
explanation of the present invention as claimed.
BRIEF DESCRIPTION OF THE DRAWINGS
[0084] The accompanying drawings, which are included to provide
further understanding of the present invention and are incorporated
in and constitute a part of this specification, illustrate aspects
of the subject technology and together with the description serve
to explain the principles of the present invention.
[0085] FIG. 1 shows changes in clinical responses with an
anti-IL-36R antibody of the present invention treatment through
Week 20; Panel A shows the percentage of patients in whom a
Generalized Pustular Psoriasis Physician Global Assessment (GPPGA)
score of 0 (clear) or 1 (almost clear) was achieved; Panel B shows
the percent change from baseline in Generalized Pustular Psoriasis
Area and Severity Index (GPPASI); and Panel C shows the percentage
of patients in whom pustule clearance (based upon the GPPASI
pustule component severity score) was achieved. Analysis includes
all patients with at least one available post-baseline value. One
patient received methotrexate post Week 4 for treatment of "pain"
and therefore data for Weeks 12 and 20 have been excluded (set to
non-response for GPPGA and pustule clearance). By Week 1, two of
the three patients with an IL36RN mutation achieved GPPGA 0 or 1;
by Week 4, all three patients achieved GPPGA 0 or 1. * At Week 2,
GPPGA score for one patient was missing.
[0086] FIG. 2 shows GPPASI 50/75/90 response rates through Week 20.
In this figure, the proportion of patients who achieved a decrease
of more than 50%, 75%, or 90% in the Generalized Pustular Psoriasis
Area and Severity Index (GPPASI 50, 75, or 90) is shown over time.
Analysis includes all patients with at least one available
post-baseline value. One patient received methotrexate post Week 4
for treatment of "pain" and therefore data for Weeks 12 and 20 have
are set to non-response.
[0087] FIG. 3 shows GPPASI subscores through Week 20. In this
figure, individual and mean percent change in Generalized Pustular
Psoriasis Area and Severity Index (GPPASI) severity subscores for
Pustules (panel A), erythema (panel B), and scaling (panel C) are
shown. Analysis includes all patients with at least one available
post-baseline value. One patient received methotrexate post Week 4
for treatment of "pain" and therefore data for Weeks 12 and 20 have
been excluded.
[0088] FIG. 4 shows change from baseline in FACIT-F through Week 4.
Mean (SD) change from baseline in FACIT-F score over time is shown.
Analysis includes all patients with at least one available
post-baseline value. FACIT-F=Functional Assessment of Chronic
Illness Therapy-Fatigue; SD=Standard deviation.
[0089] FIG. 5 shows change from baseline in Pain-VAS through Week
4. Mean (SD) change from baseline in Pain-VAS over time is shown.
Analysis includes all patients with at least one available
post-baseline value. SD=Standard deviation; VAS=Visual analogue
scale. *N=6.
[0090] FIG. 6 shows change from baseline in PSS through Week 4.
Mean (SD) change from baseline in PSS over time is shown. Analysis
includes all patients with at least one available post-baseline
value. PSS=Psoriasis symptom scale; SD=Standard deviation.
[0091] FIG. 7 shows change from baseline in CRP through Week 4.
Mean (SD) change from baseline in CRP over time is shown.
CRP=C-reactive protein; SD=Standard deviation.
[0092] FIG. 8 shows absolute neutrophil count through Week 4.
Absolute neutrophil count over time is shown. Analysis includes all
patients with at least one available post-baseline value.
SD=Standard deviation.
[0093] FIG. 9 shows the study design as discussed in Example 2.
DETAILED DESCRIPTION OF THE INVENTION
[0094] In the following detailed description, numerous specific
details are set forth to provide a full understanding of the
present invention. It will be apparent, however, to one ordinarily
skilled in the art that the subject technology may be practiced
without some of these specific details. In other instances,
well-known structures and techniques have not been shown in detail
so as not to obscure the present invention.
[0095] A phrase such as "an aspect" does not imply that such aspect
is essential to the present invention or that such aspect applies
to all configurations of the subject technology. A disclosure
relating to an aspect may apply to all configurations, or one or
more configurations. An aspect may provide one or more examples of
the disclosure. A phrase such as "an aspect" may refer to one or
more aspects and vice versa. A phrase such as "an embodiment" does
not imply that such embodiment is essential to the subject
technology or that such embodiment applies to all configurations of
the subject technology. A disclosure relating to an embodiment may
apply to all embodiments, or one or more embodiments. An embodiment
may provide one or more examples of the disclosure.
[0096] The inventors have surprisingly discovered inter alia that
the interleukin-36 pathway inhibition with a single dose of a
humanized anti-interleukin-36R (anti-IL-36R) monoclonal antibody of
the present invention resulted in the rapid and sustained remission
of clinical symptoms in patients with acute generalized pustular
psoriasis and that no recurrence of GPP flares were observed in 20
weeks after the single dose administration.
[0097] The invention therefore relates to compositions and methods
for treating and/or prophylaxis of GPP and its signs and symptoms.
More specifically, the invention relates to compositions and
methods for treating and/or prophylaxis of moderate to severe GPP,
acute GPP, chronic GPP, and/or GPP flares in a mammal with an
anti-IL36R antibody or an antigen-binding fragment thereof of the
present invention. The compositions and methods include
administering to the mammal a therapeutically effective amount of
an anti-IL-36R antibody or an antigen-binding fragment thereof,
wherein the anti-IL-36R antibody is administered in one intravenous
dose. In an embodiment, the anti-IL-36R antibody is administered in
one or more intravenous doses which is/are optionally followed by
one or more subcutaneous doses.
[0098] Without wishing to be bound by this theory it is believed
that anti-IL-36R antibodies or antigen-binding fragments thereof
bind to human anti-IL-36R and thus interfere with the binding of
IL-36 agonists, and in doing so block at least partially the
signaling cascade from the IL-36R to inflammatory mediators. The
anti-IL36R antibodies of the present invention are disclosed in
U.S. Pat. No. 9,023,995 or WO2013/074569, the entire content of
each of which is incorporated herein by reference.
[0099] Acute GPP flares of varying severity occur in most patients
and may be idiopathic or triggered by external stimuli, such as
infection, corticosteroid use or withdrawal, stress or pregnancy.
Moderate or severe GPP flares cause significant morbidity and
mortality due to tender, painful skin lesions, extreme fatigue,
high fever, peripheral blood neutrophilia and acute phase response
and sepsis. The acute phase is associated with a mean duration of
hospitalization of 10 days (range 3-44 days). The observed
mortality rate of 7% reported in a retrospective study with 102 GPP
cases seen in a tertiary hospital in Johor, Malaysia is likely an
underestimate as not all GPP patients were included in the study.
Mortality rates are also likely underestimated due to lack of
identifying the cause of death as GPP and are largely driven by
infectious complications and extra-cutaneous organ manifestations
such as renal, hepatic, respiratory and cardiac failure. After
responding to treatment or spontaneous flare cessation, it is
estimated that up to 50% of patients may suffer from chronic GPP
characterized by persistent erythema and scaling that may also
include joint symptoms.
[0100] Based on the limitations described above, current
therapeutic options are not suitable for life-long treatment and do
not provide sustained responses in most patients. Therefore, there
is a high need to develop (i) a highly effective treatment with
rapid onset of action for patients presenting with an acute GPP
flare; and (ii) to develop an effective treatment of chronic GPP,
which reliably prevents the occurrence of flares and is safe and
tolerable for lifelong treatment.
[0101] The classic presentation of GPP flares as described by von
Zumbusch is strongly correlated with polymorphisms in the IL36-R
signaling pathway. Individuals with loss-of-function mutations of
the IL36RN gene which encodes an endogenous IL36R antagonist
(IL-36RN) have dramatically higher incidence of GPP, indicating
that uncontrolled upregulation of IL36 signaling due to defective
IL36RN antagonism leads to the inflammatory episodes observed in
GPP. Genetic human studies have demonstrated the occurrence of GPP
clusters in families with a loss of function mutation in IL36RN,
which results in uncontrolled IL36R signaling. Mutations in other
genes linked to the IL36 pathway such as CARD14 also lead to GPP. A
recently published gene expression study indicates sustained
activation of IL-1 and IL-36 in GPP, inducing neutrophil chemokine
expression, infiltration, and pustule formation, suggesting that
the IL-1/IL-36 inflammatory axis is a potent driver of disease
pathology in GPP. Moreover, a recent meta-analysis investigated 233
published GPP cases. They found that 49 (21.0%) of 233 cases
carried recessive IL36RN alleles. Those 49 recessive IL36RN alleles
defined a GPP phenotype characterized by early onset and high risk
of systemic inflammation.
[0102] IL36R is a cell surface receptor involved in inflammatory
responses in skin and gut. It is a novel member of the IL1R family
that forms a heterodimeric complex with the IL1R accessory protein.
The heterodimeric IL36R system with stimulating (IL36.alpha.,
IL36.beta., IL36.gamma.) and inhibitory ligands (IL36Ra) shares a
number of structural and functional similarities to other members
of the IL1/IL1R family, such as IL1, IL18 and IL33 (R17-3602). All
IL1 family members (IL1.alpha., IL1.beta., IL18, IL36.alpha.,
IL36.beta., IL36.gamma., and IL38) signal through a unique, cognate
receptor protein which, upon ligand binding, recruits the common
IL1 RacP subunit and activates NFkB and MAP kinase pathways in
receptor-positive cell types. In human skin tissues, IL36R is
expressed in keratinocytes, dermal fibroblasts and infiltrating
myeloid cells. IL36R activation in skin tissue drives the
production of inflammatory mediators (e.g. CCL20, MIP-1.beta.,
TNF-.alpha., IL12, IL17, IL23, TGF-.beta.) and modulates the
expression of tissue remodeling genes (e.g. MMPs, TGF-.beta.).
Therefore, the link between GPP and mutations in the IL36RN is
somewhat analogous to the well-established neonatal onset of
sterile multifocal osteomyelitis, periostitis, and pustulosis
caused by absence of interleukin-1-receptor antagonist. In this
case, absence of the receptor antagonist allows unopposed action of
interleukin-1, resulting in life-threatening systemic inflammation
with skin and bone involvement. These clinical features responded
to empirical treatment with the recombinant interleukin-1-receptor
antagonist anakinra.
I. Definitions
[0103] The term "about" shall generally mean an acceptable degree
of error or variation for the quantity measured given the nature or
precision of the measurements. Typical, exemplary degrees of error
or variation are within 5% or within 3% or within 1% of a given
value or range of values. For example, the expression of "about
100" includes 105 and 95 or 103 and 97 or 101 and 99, and all
values in between (e.g., 95.1, 95.2, etc. for range of 95-105; or
97.1, 97.2, etc. for the range of 97-103; 99.1, 99.2, etc. for the
range of 99-101). Numerical quantities given herein are
approximates unless stated otherwise, meaning that the term "about"
can be inferred when not expressly stated.
[0104] A "pharmaceutical formulation" or "formulation" refers to
the process but also the product of a process in which an active
drug or agent is combined with chemical substances to produce a
final medicinal or drug product, the final formulation therefore
refers to medicinal products such as liquids, powders or
compositions. Therefore, in one embodiment, a pharmaceutical
formulation is a pharmaceutical composition.
[0105] A "pharmaceutical composition" refers in this context to a
liquid or powder preparation which is in such form as to permit the
biological activity of the active ingredient(s) to be unequivocally
effective, and which contains no additional components which are
significantly toxic to the subjects to which the composition would
be administered. Such compositions are sterile. A "powder" refers
to a freeze-dried or lyophilized or a spray-dried pharmaceutical
composition for parenteral use. The powder is reconstituted or
dissolved typically in water. Lyophilisation is a low temperature
dehydration process which involves freezing the product, lowering
pressure, then removing the ice by sublimation. Freeze drying
results in a high quality product because of the low temperature
used in processing. For a well-developed lyophilized formulation,
the shape and appearance of the product is maintained over time and
the quality of the rehydrated product is excellent. Spray drying is
another method of producing a dry powder from a liquid or slurry by
rapidly drying with a hot gas and with the goal of achieving a
consistent particle size distribution.
[0106] As used herein, the terms "intravenous dose", "subcutaneous
dose" refer to the temporal sequence of administration of the
anti-IL-36R antibody. Thus, the "intravenous dose" is the dose
which is administered at the beginning of the treatment regimen
(also referred to as the "baseline dose"); it may also be referred
to as an "initial dose" or "induction dose." The "subcutaneous
dose" is the dose which is administered after the intravenous dose,
which may also be referred to as a "subsequent dose" or
"maintenance dose." The intravenous, subcutaneous doses may all
contain the same amount of anti-IL-36R antibody or an antigen
binding fragment thereof, but generally may differ from one another
in terms of the amount of the antibody administered or the
frequency of administration. In an embodiment, the intravenous dose
is equal or larger than the subcutaneous dose. An "intravenous
dose" which may be interchangeably referred to as an "initial dose"
or "induction dose" can be a single dose or, alternatively, a set
of doses. The subcutaneous dose which may also be referred to as a
"subsequent dose" or "maintenance dose" can be a single dose or,
alternatively, a set of doses for administration.
[0107] In certain embodiments, the amount of the anti-IL-36R
antibody contained in the induction/initial/intravenous and
maintenance/subsequent/subcutaneous doses varies from one another
during the course of treatment. In certain embodiments, the one or
more initial/induction/intravenous doses each comprise a first
amount of the antibody or antigen-binding fragment thereof and the
one or more maintenance/subsequent/subcutaneous doses each comprise
a second amount of the antibody or antigen-binding fragment
thereof. In some embodiments, the first amount of antibody or
fragment thereof is 1.5.times., 2.times., 2.5.times., 3.times.,
3.5.times., 4.times., or 5.times. the second or subsequent amount
of the antibody or antigen-binding fragment thereof. In certain
embodiments, one or more (e.g., 1, 2, 3, 4, or 5 or more) initial
doses are administered at the beginning of the treatment regimen as
"loading doses" or "leading doses" followed by subsequent doses
that are administered on a less frequent basis (e.g., "maintenance
doses"). In one embodiment, the intravenous dose, the induction
dose or the initial dose is about 210 mg, 300 mg, 350 mg, 450 mg,
600 mg, 700 mg, 750 mg, 800 mg, 850 mg or 900 mg of the anti-IL-36R
antibody. In one embodiment, the subcutaneous dose, the maintenance
dose or the subsequent dose is about 150, 225 mg or 300 mg. In
another embodiment, the subcutaneous dose or maintenance or
subsequent dose is administered at least two weeks following the
intravenous, induction or initial dose.
[0108] As used herein "buffer" refers to a buffered solution that
resists changes in pH by the action of its acid-base conjugate
components. The "pH" herein refers to the acidity or basicity of
the composition at room temperature. Standard methods to measure
the pH of a composition are known to the skilled in the art.
Typically, measuring pH consists of calibrating the instrument,
placing the electrodes in a well-mixed sample, and then reading the
pH directly from the pH meter. The exemplary buffers of the present
invention include acetate, citrate, histidine, succinate, phosphate
and Tris.
[0109] As used herein, the term "tonicifying agent" or "tonicity
agent" or "tonicifyer" refers to substances providing an osmotic
pressure equivalent to that of serum in the body including salts
(e.g. sodium chloride, potassium chloride, magnesium chloride) or
sugars (e.g. sucrose, trehalose, sorbitol, magnesium sulfate
(MgSO.sub.4), glycerol, mannitol or dextrose). In addition, sugars
present in the solution act as a cryoprotectant for the protein
which allows the drug substance to be frozen without damage. This
permits shipment in the frozen form and long-term storage of the
drug substance prior to the filling of drug product. The exemplary
tonicifying agents of the present invention include sodium
chloride, potassium chloride, magnesium chloride (salts) and/or
sucrose, trehalose, sorbitol, magnesium sulfate (MgSO.sub.4),
glycerol, mannitol or dextrose (sugars).
[0110] As used herein, the term "stabilizer" or "stabilizing agent"
refers to substances contributing to the stability of the active
ingredient in a pharmaceutical formulation. The exemplary
stabilizing agents of the present invention include arginine,
histidine, glycine, cysteine, proline, methionine, lysine, or
pharmaceutically acceptable salts thereof.
[0111] As used herein, the term "surfactant" refers to substances
which tend to reduce the surface tension of a liquid in which they
are dissolved. The exemplary surfactants of the present invention
include poloxamer 188, polysorbate 20, polysorbate 40, polysorbate
60 or polysorbate 80.
[0112] The terms, "antibody", "anti-IL-36R antibody", "humanized
anti-IL-36R antibody", "humanized anti-IL-36R epitope antibody",
and "variant humanized anti-IL-36R epitope antibody" specifically
encompass monoclonal antibodies (including full length monoclonal
antibodies), polyclonal antibodies, multispecific antibodies (e.g.,
bispecific antibodies), antibodies with minor modifications such as
N- and/or C-terminal truncation, and antibody fragments such as
variable domains and other portions of antibodies that exhibit a
desired biological activity, e.g., IL-36R binding.
[0113] The term "monoclonal antibody" (mAb) refers to an antibody
that is highly specific, being directed against a single antigenic
determinant, an "epitope". Therefore, the modifier "monoclonal" is
indicative of antibodies directed to the identical epitope and is
not to be construed as requiring production of the antibody by any
particular method. It should be understood that monoclonal
antibodies can be made by any technique or methodology known in the
art; including e.g., the hybridoma method (Kohler et al., 1975,
Nature 256:495), or recombinant DNA methods known in the art (see,
e.g., U.S. Pat. No. 4,816,567), or methods of isolation of
monoclonal recombinantly produced using phage antibody libraries,
using techniques described in Clackson et al., 1991, Nature 352:
624-628, and Marks et al., 1991, J. Mol. Biol. 222: 581-597.
[0114] The term "monomer" refers to a homogenous form of an
antibody. For example, for a full-length antibody, monomer means a
monomeric antibody having two identical heavy chains and two
identical light chains.
[0115] Chimeric antibodies consist of the heavy and light chain
variable regions of an antibody from one species (e.g., a non-human
mammal such as a mouse) and the heavy and light chain constant
regions of another species (e.g., human) antibody and can be
obtained by linking the DNA sequences encoding the variable regions
of the antibody from the first species (e.g., mouse) to the DNA
sequences for the constant regions of the antibody from the second
(e.g. human) species and transforming a host with an expression
vector containing the linked sequences to allow it to produce a
chimeric antibody. Alternatively, the chimeric antibody also could
be one in which one or more regions or domains of the heavy and/or
light chain is identical with, homologous to, or a variant of the
corresponding sequence in a monoclonal antibody from another
immunoglobulin class or isotype, or from a consensus or germline
sequence. Chimeric antibodies can include fragments of such
antibodies, provided that the antibody fragment exhibits the
desired biological activity of its parent antibody, for example
binding to the same epitope (see, e.g., U.S. Pat. No. 4,816,567;
and Morrison et al., 1984, Proc. Natl. Acad. Sci. USA 81:
6851-6855).
[0116] The terms, "antibody fragment", "anti-IL-36R antibody
fragment", "anti-IL-36R epitope antibody fragment", "humanized
anti-IL-36R antibody fragment", "humanized anti-IL-36R epitope
antibody fragment", "variant humanized anti-IL-36R epitope antibody
fragment" refer to a portion of a full length anti-IL-36R antibody,
in which a variable region or a functional capability is retained,
for example, specific IL-36R epitope binding. Examples of antibody
fragments include, but are not limited to, a Fab, Fab',
F(ab').sub.2, Fd, Fv, scFv and scFv-Fc fragment, a diabody, a
linear antibody, a single-chain antibody, a minibody, a diabody
formed from antibody fragments, and multispecific antibodies formed
from antibody fragments.
[0117] The term "intravenous infusion" refers to introduction of an
agent into the vein of an animal or human patient over a period of
time greater than approximately 15 minutes, generally between
approximately 30 to 90 minutes.
[0118] The term "intravenous bolus" or "intravenous push" refers to
drug administration into a vein of an animal or human such that the
body receives the drug in approximately 15 minutes or less,
generally 5 minutes or less.
[0119] The term "subcutaneous administration" refers to
introduction of an agent under the skin of an animal or human
patient, preferable within a pocket between the skin and underlying
tissue, by relatively slow, sustained delivery from a drug
receptacle. Pinching or drawing the skin up and away from
underlying tissue may create the pocket.
[0120] The term "subcutaneous infusion" refers to introduction of a
drug under the skin of an animal or human patient, preferably
within a pocket between the skin and underlying tissue, by
relatively slow, sustained delivery from a drug receptacle for a
period of time including, but not limited to, 30 minutes or less,
or 90 minutes or less. Optionally, the infusion may be made by
subcutaneous implantation of a drug delivery pump implanted under
the skin of the animal or human patient, wherein the pump delivers
a predetermined amount of drug for a predetermined period of time,
such as 30 minutes, 90 minutes, or a time period spanning the
length of the treatment regimen.
[0121] The term "subcutaneous bolus" refers to drug administration
beneath the skin of an animal or human patient, where bolus drug
delivery is less than approximately 15 minutes; in another aspect,
less than 5 minutes, and in still another aspect, less than 60
seconds. In yet even another aspect, administration is within a
pocket between the skin and underlying tissue, where the pocket may
be created by pinching or drawing the skin up and away from
underlying tissue.
[0122] The term "mammal" for purposes of treatment refers to any
animal classified as a mammal, including humans, domesticated and
farm animals, and zoo, sports, or pet animals, such as dogs,
horses, cats, cows, and the like. Preferably, the mammal is
human.
[0123] The terms "treatment" and "therapy" and the like, as used
herein, are meant to include therapeutic as well as prophylactic,
or suppressive measures for a disease or disorder leading to any
clinically desirable or beneficial effect, including but not
limited to alleviation or relief of one or more symptoms,
regression, slowing or cessation of progression of the disease or
disorder. Thus, for example, the term treatment includes the
administration of an agent prior to or following the onset of a
symptom of a disease or disorder thereby preventing or removing one
or more signs of the disease or disorder. As another example, the
term includes the administration of an agent after clinical
manifestation of the disease to combat the symptoms of the disease.
Further, administration of an agent after onset and after clinical
symptoms have developed where administration affects clinical
parameters of the disease or disorder, such as the degree of tissue
injury or the amount or extent of metastasis, whether or not the
treatment leads to amelioration of the disease, comprises
"treatment" or "therapy" as used herein. Moreover, as long as the
compositions of the invention either alone or in combination with
another therapeutic agent alleviate or ameliorate at least one
symptom of a disorder being treated as compared to that symptom in
the absence of use of the humanized anti-IL-36R antibody
composition, the result should be considered an effective treatment
of the underlying disorder regardless of whether all the symptoms
of the disorder are alleviated or not.
[0124] The term "therapeutically effective amount" is used to refer
to an amount of an active agent that relieves or ameliorates one or
more of the symptoms of the disorder being treated. In another
aspect, the therapeutically effective amount refers to a target
serum concentration that has been shown to be effective in, for
example, slowing disease progression. Efficacy can be measured in
conventional ways, depending on the condition to be treated.
[0125] The term "prophylactically effective amount" is used to
refer to an amount effective, at dosages and for periods of time
necessary, to achieve the desired prophylactic result. Typically, a
prophylactic dose is used in subjects prior to the onset of a GPP
flare and/or prior to the onset of symptoms of GPP such as to
prevent or inhibit the occurrence of acute flares. In an
embodiment, a subcutaneous dose as contemplated herein is a
prophylactic dose that is used in a patient with acute GPP, after
the intravenous dose, to prevent a possible recurrence of the GPP
flares in the patient.
[0126] 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,
administration, contraindications and/or warnings concerning the
use of such therapeutic products.
II. Antibodies
[0127] The anti-IL36R antibodies of the present invention are
disclosed in U.S. Pat. No. 9,023,995 or WO2013/074569, the entire
content of each of which is incorporated herein by reference.
[0128] In one aspect, described and disclosed herein are
anti-IL-36R antibodies, in particular humanized anti-IL-36R
antibodies, and compositions and articles of manufacture comprising
one or more anti-IL-36R antibody, in particular one or more
humanized anti-IL-36R antibody of the present invention. Also
described are binding agents that include an antigen-binding
fragment of an anti-IL-36 antibody, in particular a humanized
anti-IL-36R antibody.
[0129] Mode of Action
[0130] an anti-IL-36R antibody of the present invention is a
humanized antagonistic monoclonal IgG1 antibody that blocks human
IL36R signaling. Binding of an anti-IL-36R antibody of the present
invention to IL36R is anticipated to prevent the subsequent
activation of IL36R by cognate ligands (IL36 .alpha., .beta. and
.gamma.) and downstream activation of pro-inflammatory and
pro-fibrotic pathways with the aim to reduce epithelial
cell/fibroblast/immune cell-mediated inflammation and interrupt the
inflammatory response that drives pathogenic cytokine production in
generalized pustular psoriasis (GPP). As provided herein, an
anti-IL-36R antibody of the present invention has been tested and
proved to be effective in treating patients with acute Generalized
Pustular Psoriasis (GPP), a severe inflammatory skin disease driven
by uncontrolled IL36 activity.
[0131] IL-36R is also known as IL-1RL2 and IL-1Rrp2. It has been
reported that agonistic IL-36 ligands (.alpha., .beta., or .gamma.)
initiate the signaling cascade by engaging the IL-36 receptor which
then forms a heterodimer with the IL-1 receptor accessory protein
(IL-1RAcP). IL-36 antagonist ligands (IL-36RA/IL1F5, IL-38/ILF10)
inhibit the signaling cascade.
[0132] Variable regions and CDRs of representative antibodies of
the present invention are disclosed below:
Anti-IL-36R Mouse Antibody Sequences
[0133] Variable regions and CDRs of representative mouse lead
antibodies of the present invention (mouse leads) are shown
below:
TABLE-US-00001 Light Chain Variable Region (VK) Amino Acid
Sequences >33D10B12vK Protein (antibody 33D10) (SEQ ID NO: 1)
QIVLTQSPAIMSASLGERVTMTCTASSSVSSSYLHWYQKKPGSSPKLWVYSTSNLASGVPVRF
SGSGSGTSYSLTISSMEAEDAATYYCHQHHRSPVTFGSGTKLEMK >172C8B12 vK
protein (antibody 172C8) (SEQ ID NO: 2)
DIQMTQSPASQSASLGESVTFTCLASQTIGTWLAWYQQRPGKSPQLLIYAATSLADGVPSRFS
GSGSGTQFSFNIRSLQAEDFASYYCQQVYTTPLTFGGGTKLEIK >67E7E8 vK protein
(antibody 67E7) (SEQ ID NO: 3)
DIQMTQSPASQSASLGESVTFTCLASQTIGTWLGWYQQKPGKSPQLLIYRSTTLADGVPSRFS
GSGSGTKFSFKISSLQAADFASYYCQQLYSAPYTFGGGTKLEIR >78C8D1 vK Protein
(antibody 78C8) (SEQ ID NO: 4)
DVLLTQTPLSLPVSLGDQASISCRSSQNIVHSNGNTYLQWYLQKPGQSPKLLIYKVSNRFSGVP
DRFSGSGSGTDFTLKISRVEAEDLGVYYCFQGSHVPFTFGAGTKLELK >81A1D1 vK
Protein (antibody 81A1) (SEQ ID NO: 5)
DIQMTQTTSSLSASLGDRVTISCRASQDIYKYLNWYQQKPDGTLKLLIYYTSGLHSGVPSRFSG
SGSGTDFSLTISNLEPEDIATYFCQQDSKFPWTFGGDTKLEIK >81B4E11 vK Protein
(antibody 81B4) (SEQ ID NO: 6)
QIVLTQSPAIMSASLGERVTMTCTASSSVSSSYFHWYQQKPGSSPKLWIYRTSNLASGVPGRF
SGSGSGTSYSLTISSMEAEDAATYYCHQFHRSPLTFGAGTKLELK >73C5C10 vK
protein (antibody 73C5) (SEQ ID NO: 7)
DIVMTQSQKFLSTSVGVRVSVTCKASQDVGTNVLWYQQKIGQSPKPLIYSASYRHSGVPDRFT
GSGSGTDFTLIISNVQSEDLAEYFCQQYSRYPLTFGPGTKLELK >73F6F8 vK protein
(antibody 73F6) (SEQ ID NO: 8)
DIVMTQSQKFLSTSVGVRVSVTCKASQDVGTNVLWYQQKIGQSPKALIYSASYRHSGVPDRFT
GSGSGTDFTLIITNVQSEDLAEYFCQQYSRYPLTFGPGTKLELK >76E10E8 vK protein
(antibody 76E10) (SEQ ID NO: 9)
DIVMTQSQKFMSATVGGRVNITCKASQNVGRAVAWYQQKPGQSPKLLTHSASNRYTGVPDRF
TGSGSGTDFTLTITNMQSEDLADYFCQQYSSYPLTFGAGTKLDLK >89A12B8 vK
protein (antibody 89A12) (SEQ ID NO: 10)
DIQMTQSPASQSASLGESVTFSCLASQTIGTWLGWYQQKPGKSPQLLIYRATSLADGVPSRFS
GSGSGTNFSFKISSLQAEDLASYYCQQLYSGPYTFGGGTKLEIR Heavy Chain Variable
Region (VH) Amino Acid Sequences >33D10B12vH Protein (antibody
33D10) (SEQ ID NO: 11)
QVQLQQSGTELLKPGASVKLSCKASGNTVTSYWMHWVKQRPGQGLEWIGEILPSTGRTNYNE
NFKGKAMLTVDKSSSTAYMQLSSLASEDSAVYYCTIVYFGNPWFAYWGQGTLVTVSA
>172C8B12 vH protein (antibody 172C8) (SEQ ID NO: 12)
EVQLQQSGPELVKPGASVKLSCKASGYTFTDNYMNWVRQSHGKSLEWIGRVNPSNGDTKYN
QNFKGKATLTVDKSLSTAYMQLNGLTSEDSAVYYCGRTKNFYSSYSYDDAMDYWGQGTSVTV SS
>67E7E8 vH protein (antibody 67E7) (SEQ ID NO: 13)
EVQLQQSGAEFVRPGASVKFSCTASGFNIKDDYIHWVRQRPEQGLEWVGRIDPANGNTKYAP
KFQDKATITADTSSNTAYLQLSSLTSEDTAVYYCAKSFPNNYYSYDDAFAYWGQGTLVTVSA
>78C8D1 vH Protein (antibody 78C8) (SEQ ID NO: 14)
QVQLKESGPVLVAPSQSLSITCTVSGFSLTKFGVHWIRQTPGKGLEWLGVIWAGGPTNYNSAL
MSRLTISKDISQSQVFLRIDSLQTDDTAMYYCAKQIYYSTLVDYWGQGTSVTVSS >81A1D1
vH Protein (antibody 81A1) (SEQ ID NO: 15)
QVQLKESGPGLVAPSQSLFITCTVSGFSLSSYEINWVRQVPGKGLEWLGVIWTGITTNYNSALI
SRLSISKDNSKSLVFLKMNSLQTDDTAIYYCARGTGTGFYYAMDYWGQGTSVTVSS
>81B4E11 vH Protein (antibody 81B4) (SEQ ID NO: 16)
QVQLQQPGADFVRPGASMRLSCKASGYSFTSSWIHWVKQRPGQGLEWIGEINPGNVRTNYN
ENFRNKATLTVDKSSTTAYMQLRSLTSADSAVYYCTVVFYGEPYFPYWGQGTLVTVSA
>73C5C10 vH Protein (antibody 73C5) (SEQ ID NO: 17)
QVQLKESGPGLVAPSQSLSITCTVSGFSLTNYAVHWVRQFPGKGLEWLGVIWSDGSTDFNAP
FKSRLSINKDNSKSQVFFKMNSLQIDDTAIYYCARKGGYSGSWFAYWGQGTLVTVSA
>73F6F8 vH protein (antibody 73F6) (SEQ ID NO: 18)
QVQLKESGPGLVAPSQSLSITCTVSGFSLTNYAVHWVRQFPGKGLEWLGVIWSDGSTDYNAP
FKSRLSINKDNSKSQVFFKMNSLQTDDTAIYYCARKGGYSGSWFAYWGQGTLVTVSA
>76E10E8 vH protein (antibody 76E10) (SEQ ID NO: 19)
QVQLKESGPVLVAPSQSLSITCTVSGFSLTNYGVHWVRQPPGKGLEWLGVIWPVGSTNYNSA
LMSRLSIHKDNSKSQVFLRMNSLQTDDTAIYYCAKMDWDDFFDYWGQGTTLTVSS >89A12B8
vH Protein (antibody 89A12) (SEQ ID NO: 20)
EVQLQQSGAELVRPGASVRLSCTASGFNIKDDYIHWVRQRPKQGLEWLGRIDPANGNTKYDP
RFQDKATITADTSSNTAYLHLSSLTSEDTAVYYCAKSFPDNYYSYDDAFAYWGQGTLVTVSA
Light chain CDR-1 (L-CDR1) Amino Acid Sequences >33D10G1 L-CDR1
(SEQ ID NO: 21) TASSSVSSSYLH >172C8B12 L-CDR1 (SEQ ID NO: 22)
LASQTIGTWLA >67E7E8 L-CDR1 (SEQ ID NO: 23) LASQTIGTWLG
>78C8D1 L-CDR1 (SEQ ID NO: 24) RSSQNIVHSNGNTYLQ >81A1D1
L-CDR1 (SEQ ID NO: 25) RASQDIYKYLN >81B4E11 L-CDR1 (SEQ ID NO:
26) TASSSVSSSYFH >73C5C10 L-CDR1 (SEQ ID NO: 27) KASQDVGTNVL
>73F6F8 L-CDR1 (SEQ ID NO: 27) KASQDVGTNVL >76E10E8 L-CDR1
(SEQ ID NO: 28) KASQNVGRAVA >89A12B8 L-CDR1 (SEQ ID NO: 29)
LASQTIGTWLG Light chain CDR-2 (L-CDR2) Amino Acid Sequences
>33D10B12 L-CDR2 (SEQ ID NO: 30) STSNLAS >172C8B12 L-CDR2
(SEQ ID NO: 31) AATSLAD >67E7E8 L-CDR2 (SEQ ID NO: 32) RSTTLAD
>78C8D1 L-CDR2 (SEQ ID NO: 33) KVSNRFS >81A1D1 L-CDR2 (SEQ ID
NO: 34) YTSGLHS >81B4E11 L-CDR2 (SEQ ID NO: 35) RTSNLAS
>73C5C10 L-CDR2 (SEQ ID NO: 36) SASYRHS >73F6F8 L-CDR2 (SEQ
ID NO: 36) SASYRHS >76E10E8 L-CDR2 (SEQ ID NO: 37) SASNRYT
>89A12B8 L-CDR2 (SEQ ID NO: 38) RATSLAD Light chain CDR-3
(L-CDR3) Amino Acid Sequences >33D10B12 L-CDR3 (SEQ ID NO: 39)
HQHHRSPVT >172C8B12 L-CDR3 (SEQ ID NO: 40) QQVYTTPLT >67E7E8
L-CDR3 (SEQ ID NO: 41) QQLYSAPYT >78C8D1 L-CDR3 (SEQ ID NO: 42)
FQGSHVPFT >81A1D1 L-CDR3 (SEQ ID NO: 43) QQDSKFPWT >81B4E11
L-CDR3 (SEQ ID NO: 44) HQFHRSPLT >73C5C10 L-CDR3 (SEQ ID NO: 45)
QQYSRYPLT >73F6F8 L-CDR3 (SEQ ID NO: 45) QQYSRYPLT >76E10E8
L-CDR3 (SEQ ID NO: 46) QQYSSYPLT >89A12B8 L-CDR3 (SEQ ID NO: 47)
QQLYSGPYT Heavy chain CDR-1 (H-CDR1) Amino Acid Sequences
>33D10B12 H-CDR1 (SEQ ID NO: 48)
GNTVTSYWMH >172C8B12 H-CDR1 (SEQ ID NO: 49) GYTFTDNYMN
>67E7E8 H-CDR1 (SEQ ID NO: 50) GFNIKDDYIH >78C8D1 H-CDR1 (SEQ
ID NO: 51) GFSLTKFGVH >81A1D1 H-CDR1 (SEQ ID NO: 52) GFSLSSYEIN
>81B4E11 H-CDR1 (SEQ ID NO: 53) GYSFTSSWIH >73C5C10 H-CDR1
(SEQ ID NO: 54) GFSLTNYAVH >73F6F8 H-CDR1 (SEQ ID NO: 54)
GFSLTNYAVH >76E10E8 H-CDR1 (SEQ ID NO: 55) GFSLTNYGVH
>89A12B8 H-CDR1 (SEQ ID NO: 56) GFNIKDDYIH Heavy chain CDR-2
(H-CDR2) Amino Acid Sequences >33D10B12 H-CDR2 (SEQ ID NO: 57)
EILPSTGRTNYNENFKG >172C8B12 H-CDR2 (SEQ ID NO: 58)
RVNPSNGDTKYNQNFKG >67E7E8 H-CDR2 (SEQ ID NO: 59)
RIDPANGNTKYAPKFQD >78C8D1 H-CDR2 (SEQ ID NO: 60)
VIWAGGPTNYNSALMS >81A1D1 H-CDR2 (SEQ ID NO: 61) VIWTGITTNYNSALIS
>81B4E11 H-CDR2 (SEQ ID NO: 62) EINPGNVRTNYNENF >73C5C10
H-CDR2 (SEQ ID NO: 63) VIWSDGSTDFNAPFKS >73F6F8 H-CDR2 (SEQ ID
NO: 64) VIWSDGSTDYNAPFKS >76E10E8 H-CDR2 (SEQ ID NO: 65)
VIWPVGSTNYNSALMS >89A12B8 H-CDR2 (SEQ ID NO: 66)
RIDPANGNTKYDPRFQD Heavy chain CDR-3 (H-CDR3) Amino Acid Sequences
>33D10B12 H-CDR3 (SEQ ID NO: 67) VYFGNPWFAY >172C8B12 H-CDR3
(SEQ ID NO: 68) TKNFYSSYSYDDAMDY >67E7E8 H-CDR3 (SEQ ID NO: 69)
SFPNNYYSYDDAFAY >78C8D1 H-CDR3 (SEQ ID NO: 70) QIYYSTLVDY
>81A1D1 H-CDR3 (SEQ ID NO: 71) GTGTGFYYAMDY >81B4E11 H-CDR3
(SEQ ID NO: 72) VFYGEPYFPY >73C5C10 H-CDR3 (SEQ ID NO: 73)
KGGYSGSWFAY >73F6F8 H-CDR3 (SEQ ID NO: 73) KGGYSGSWFAY
>76E10E8 H-CDR3 (SEQ ID NO: 74) MDWDDFFDY >89A12B8 H-CDR3
(SEQ ID NO: 75) SFPDNYYSYDDAFAY
Anti-IL-36R Mouse CDR Sequences
A Summary of the CDR Sequences of the Lead Mouse Antibodies is
Shown Below:
TABLE-US-00002 [0134] H-CDR L-CDR Antibody Sequences Sequences
33D10 GNTVTSYWMH TASSSVSSSYLH (H-CDR1) (L-CDR1) SEQ ID No: 48 SEQ
ID No: 21 EILPSTGRTNYNENFKG STSNLAS (H-CDR2) (L-CDR2) SEQ ID No: 57
SEQ ID No: 30 VYFGNPWFAY HQHHRSPVT (H-CDR3) (L-CDR3) SEQ ID No: 67
SEQ ID No: 39 172C8 GYTFTDNYMN LASQTIGTWLA (H-CDR1) (L-CDR1) SEQ ID
No: 49 SEQ ID No: 22 RVNPSNGDTKYNQNFKG AATSLAD (H-CDR2) (L-CDR2)
SEQ ID No: 58 SEQ ID No: 31 TKNFYSSYSYDDAMDY QQVYTTPLT (H-CDR3)
(L-CDR3) SEQ ID No: 68 SEQ ID No: 40 67E7 GFNIKDDYIH LASQTIGTWLG
(H-CDR1) (L-CDR1) SEQ ID No: 50 SEQ ID No: 23 RIDPANGNTKYAPKFQD
RSTTLAD (H-CDR2) (L-CDR2) SEQ ID No: 59 SEQ ID No: 32
SFPNNYYSYDDAFAY QQLYSAPYT (H-CDR3) (L-CDR3) SEQ ID No: 69 SEQ ID
No: 41 78C8 GFSLTKFGVH RSSQNIVHSNGNTYLQ (H-CDR1) (L-CDR1) SEQ ID
No: 51 SEQ ID No: 24 VIWAGGPTNYNSALMS KVSNRFS (H-CDR2) (L-CDR2) SEQ
ID No: 60 SEQ ID No: 33 QIYYSTLVDY FQGSHVPFT (H-CDR3) (L-CDR3) SEQ
ID No: 70 SEQ ID No: 42 81A1 GFSLSSYEIN RASQDIYKYLN (H-CDR1)
(L-CDR1) SEQ ID No: 52 SEQ ID No: 25 VIWTGITTNYNSALIS YTSGLHS
(H-CDR2) (L-CDR2) SEQ ID No: 61 SEQ ID No: 34 GTGTGFYYAMDY
QQDSKFPWT (H-CDR3) (L-CDR3) SEQ ID No: 71 SEQ ID No: 43 81B4
GYSFTSSWIH TASSSVSSSYFH (H-CDR1) (L-CDR1) SEQ ID No: 53 SEQ ID No:
26 EINPGNVRTNYNENF RTSNLAS (H-CDR2) (L-CDR2) SEQ ID No: 62 SEQ ID
No: 35 VFYGEPYFPY HQFHRSPLT (H-CDR3) (L-CDR3) SEQ ID No: 72 SEQ ID
No: 44 73C5 GFSLTNYAVH KASQDVGTNVL (H-CDR1) (L-CDR1) SEQ ID No: 54
SEQ ID No: 27 VIWSDGSTDFNAPFKS SASYRHS (H-CDR2) (L-CDR2) SEQ ID No:
63 SEQ ID No: 36 KGGYSGSWFAY QQYSRYPLT (H-CDR3) (L-CDR3) SEQ ID No:
73 SEQ ID No: 45 73F6 GFSLTNYAVH KASQDVGTNVL (H-CDR1) (L-CDR1) SEQ
ID No: 54 SEQ ID No: 27 VIWSDGSTDYNAPFKS SASYRHS (H-CDR2) (L-CDR2)
SEQ ID No: 64 SEQ ID No: 36 KGGYSGSWFAY QQYSRYPLT (H-CDR3) (L-CDR3)
SEQ ID No: 73 SEQ ID No: 45 76E10 GFSLTNYGVH KASQNVGRAVA (H-CDR1)
(L-CDR1) SEQ ID No: 55 SEQ ID No: 28 VIWPVGSTNYNSALMS SASNRYT
(H-CDR2) (L-CDR2) SEQ ID No: 65 SEQ ID No: 37 MDWDDFFDY QQYSSYPLT
(H-CDR3) (L-CDR3) SEQ ID No: 74 SEQ ID No: 46 89A12 GFNIKDDYIH
LASQTIGTWLG (H-CDR1) (L-CDR1) SEQ ID No: 56 SEQ ID No: 29
RIDPANGNTKYDPRFQD RATSLAD (H-CDR2) (L-CDR2) SEQ ID No: 66 SEQ ID
No: 38 SFPDNYYSYDDAFAY QQLYSGPYT (H-CDR3) (L-CDR3) SEQ ID No: 75
SEQ ID No: 47
Anti-IL-36R Humanized Antibody Sequences
[0135] Human framework sequences were selected for the mouse leads
based on the framework homology, CDR structure, conserved canonical
residues, conserved interface packing residues and other parameters
to produce humanized variable regions (see Example 5).
[0136] Representative humanized variable regions derived from
antibodies 81B4 and 73C5 are shown below.
TABLE-US-00003 Light Chain Variable Region (VK) Amino Acid
Sequences >81B4vK32_3 vK protein
EIVLTQSPGTLSLSPGERATMSCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSTLASGI
PDRFSGSGSGTDFTLTISRLEPEDAATYYCHQFHRSPLTFGQGTKLEIK (SEQ ID NO: 76)
>81B4vK32_105 vK protein
EIVLTQSPGTLSLSPGERATMSCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSILASGV
PDRFSGSGSGTDFTLTISRLEPEDFATYYCHQFHRSPLTFGQGTKLEIK (SEQ ID NO: 77)
>81B4vK32_116 vK protein
EIVLTQSPGTLSLSPGERATMSCTASSSVSSSYFHWYQQKPGQAPRLWIYRTSRLASG
VPDRFSGSGSGTDFTLTISRLEPEDAATYYCHQFHRSPLTFGQGTKLEIK (SEQ ID NO: 78)
>81B4vK32_127 vK protein
EIVLTQSPGTLSLSPGERATMTCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSRLASG
VPDRFSGSGSGTDFTLTISRLEPEDFAVYYCHQFHRSPLTFGQGTKLEIK (SEQ ID NO: 79)
>81B4vK32_138 vK protein
QIVLTQSPGTLSLSPGERATMTCTASSSVSSSYFHWYQQKPGQAPRLWIYRTSRLAS
GVPDRFSGSGSGTDFTLTISRLEPEDAATYYCHQFHRSPLTFGAGTKLEIK (SEQ ID NO: 80)
>81B4vK32_140 vK protein
QIVLTQSPGTLSLSPGERVTMSCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSQLASG
IPDRFSGSGSGTDFTLTISRLEPEDAATYYCHQFHRSPLTFGQGTKLEIK (SEQ ID NO: 81)
>81B4vK32_141 vK protein
QIVLTQSPGTLSLSPGERATMTCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSKLASG
VPDRFSGSGSGTDFTLTISRLEPEDFATYYCHQFHRSPLTFGQGTKLEIK (SEQ ID NO: 82)
>81B4vK32_147 vK protein
EIVLTQSPGTLSLSPGERATMSCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSHLASGI
PGRFSGSGSGTDFTLTISRLEPEDAAVYYCHQFHRSPLTFGQGTKLEIK (SEQ ID NO: 83)
>73C5vK39_2 vK protein
EIVMTQSPATLSVSPGVRATLSCKASQDVGTNVLWYQQKPGQAPRPLIYSASYRHSGI
PDRFSGSGSGTEFTLTISSLQSEDFAEYFCQQYSRYPLTFGQGTKLEIK (SEQ ID NO: 84)
>73C5vK39_7 vK protein
EIVMTQSPATLSVSPGVRATLSCKASQDVGTNVLWYQQKPGQAPRPLIYSASYRHSGI
PDRFSGSGSGTEFTLTISSLQSEDFAVYYCQQYSRYPLTFGQGTKLEIK (SEQ ID NO: 85)
>73C5vK39_15 vK protein
EIVMTQSPATLSVSPGVRATLSCKASQDVGTNVLWYQQKPGQAPRPLIYSASYRHSGI
PARFSGSGSGTEFTLTISSLQSEDFAEYYCQQYSRYPLTFGQGTKLEIK (SEQ ID NO: 86)
Heavy Chain Variable Region (VH) Amino Acid Sequences
>81B4vH33_49 vH Protein
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQAPGQGLEWIGEINPGNV
RTNYNENFRNKATMTVDTSISTAYMELSRLRSDDTAVYYCAVVFYGEPYFPYWGQGT LVTVSS
(SEQ ID NO: 87) >81B4vH33_85T vH Protein
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQRPGQGLEWIGEINPGNV
RTNYNENFRNRVTMTVDTSISTAYMELSRLRSDDTAVYYCTVVFYGEPYFPYWGQGT LVTVSS
(SEQ ID NO: 88) >81B4vH33_90 vH Protein
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVKQAPGQGLEWMGEINPGNV
RTNYNENFRNKVTMTVDTSISTAYMELSRLRSDDTAVYYCTVVFYGEPYFPYWGQGT LVTVSS
(SEQ ID NO: 89) >81B4vH33_93 vH Protein
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQRPGQGLEWMGEINPGNV
RTNYNENFRNRATLTRDTSISTAYMELSRLRSDDTAVYYCAVVFYGEPYFPYWGQGTL VTVSS
(SEQ ID NO: 90) >81B4vH50_22 vH Protein
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQRPGQGLEWMGEILPGVV
RTNYNENFRNKVTMTVDTSISTAYMELSRLRSDDTAVYYCTVVFYGEPYFPYWGQGT LVTVSS
(SEQ ID NO: 91) >81B4vH50_30 vH Protein
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQRPGQGLEWIGEINPGAV
RTNYNENFRNRVTMTVDTSISTAYMELSRLRSDDTAVYYCTVVFYGEPYFPYWGQGT LVTVSS
(SEQ ID NO: 92) >81B4vH51_13 vH Protein
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQAPGQGLEWIGEINPGLVR
TNYNENFRNKVTMTVDTSISTAYMELSRLRSDDTAVYYCAVVFYGEPYFPYWGQGTL VTVSS
(SEQ ID NO: 93) >81B4vH51_15 vH Protein
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQAPGQGLEWIGEINPGAVR
TNYNENFRNKVTMTVDTSISTAYMELSRLRSDDTAVYYCAVVFYGEPYFPYWGQGTL VTVSS
(SEQ ID NO: 94) >81B4vH52_83 vH Protein
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQAPGQGLEWIGEINPGSVR
TNYNENFRNKATMTVDTSISTAYMELSRLRSDDTAVYYCAVVFYGEPYFPYWGQGTL VTVSS
(SEQ ID NO: 95) >73C5vH46_4 vH Protein
QVQLQESGPGLVKPSETLSITCTVSGFSLTDYAVHWIRQPPGKGLEWIGVIWSDGSTD
YNAPFKSRVTINKDTSKSQVSFKMSSVQAADTAVYYCARKGGYSGSWFAYWGQGTL VTVSS (SEQ
ID NO: 96) >73C5vH46_19 vH Protein
QVQLQESGPGLVKPSETLSITCTVSGFSLTDYAVHWIRQPPGKGLEWIGVIWSDGSTD
YNAPFKSRVTISKDTSKNQVSLKMNSLTTDDTAVYYCARKGGYSGSWFAYWGQGTLV TVSS (SEQ
ID NO: 97) >73C5vH46_40 vH Protein
QVQLQESGPGLVKPSETLSITCTVSGFSLTDYAVHWIRQPPGKGLEWIGVIWSDGSTD
YNAPFKSRVTISKDNSKSQVSLKMNSVTVADTAVYYCARKGGYSGSWFAYWGQGTL VTVSS (SEQ
ID NO: 98) >73C5vH47_65 vH Protein
QVQLQESGPGLVKPSETLSITCTVSGFSLTDYAVHWVRQPPGKGLEWIGVIWSDGST
DYNAPFKSRVTISKDTSKNQVSFKLSSVTVDDTAVYYCARKGGYSGSWFAYWGQGTL VTVSS
(SEQ ID NO: 99) >73C5vH47_77 vH Protein
QVQLQESGPGLVAPSETLSLTCTVSGFSLTDYAVHWIRQFPGKGLEWIGVIWSDGSTD
FNAPFKSRVTISKDTSKNQVSFKLSSVTTDDTAVYYCARKGGYSGSWFAYWGQGTLV TVSS (SEQ
ID NO: 100) >73C5vH58_91 vH Protein
QVQLQESGPGLVKPSETLSITCTVSGFSLTDYAVHWIRQPPGKGLEWIGVIWSDGSTD
YNAPFKSRVTISKDNSKSQVSFKMSSVTADDTAVYYCARKGGYSGSWFAYWGQGTL VTVSS (SEQ
ID NO: 101)
[0137] The CDR sequences from the humanized variable regions
derived from antibodies 81B4 and 73C5 shown above are depicted
below.
TABLE-US-00004 L-CDR1 Amino Acid Sequences >81B4vK32_3 L-CDR1
TASSSVSSSYFH (SEQ ID NO: 26) >81B4vK32_105 L-CDR1 TASSSVSSSYFH
(SEQ ID NO: 26) >81B4vK32_116 L-CDR1 TASSSVSSSYFH (SEQ ID NO:
26) >81B4vK32_127 L-CDR1 TASSSVSSSYFH (SEQ ID NO: 26)
>81B4vK32_138 L-CDR1 TASSSVSSSYFH (SEQ ID NO: 26) >81
B4vK32_140 L-CDR1 TASSSVSSSYFH (SEQ ID NO: 26) >81B4vK32_141
L-CDR1 TASSSVSSSYFH (SEQ ID NO: 26) >81B4vK32_147 L-CDR1
TASSSVSSSYFH (SEQ ID NO: 26) >73C5vK39_2 L-CDR1 KASQDVGTNVL (SEQ
ID NO: 27) >73C5vK39_7 L-CDR1 KASQDVGTNVL (SEQ ID NO: 27)
>73C5vK39_15 L-CDR1 KASQDVGTNVL (SEQ ID NO: 27) L-CDR2 Amino
Acid Sequences >81B4vK32_3 L-CDR2 (SEQ ID 102) RTSTLAS
>81B4vK32_105 L-CDR2 (SEQ ID 103) RTSILAS >81B4vK32_116
L-CDR2 (SEQ ID 104) RTSRLAS >81B4vK32_127 L-CDR2 (SEQ ID 104)
RTSRLAS >81B4vK32_138 L-CDR2 (SEQ ID 104) RTSRLAS
>81B4vK32_140 L-CDR2 (SEQ ID 105) RTSQLAS >81B4vK32_141
L-CDR2 (SEQ ID 106) RTSKLAS >81B4vK32_147 L-CDR2 (SEQ ID 140)
RTSHLAS >73C5vK39_2 L-CDR2 SASYRHS (SEQ ID NO: 36)
>73C5vK39_7 L-CDR2 SASYRHS (SEQ ID NO: 36) >73C5vK39_15
L-CDR2 SASYRHS (SEQ ID NO: 36) L-CDR3 Amino Acid Sequences
>81B4vK32_3 L-CDR3 HQFHRSPLT (SEQ ID NO: 44) >81B4vK32_105
L-CDR3 HQFHRSPLT (SEQ ID NO: 44) >81B4vK32_116 L-CDR3 HQFHRSPLT
(SEQ ID NO: 44) >81B4vK32_127 L-CDR3 HQFHRSPLT (SEQ ID NO: 44)
>81B4vK32_138 L-CDR3 HQFHRSPLT (SEQ ID NO: 44) >81B4vK32_140
L-CDR3 HQFHRSPLT (SEQ ID NO: 44) >81B4vK32_141 L-CDR3 HQFHRSPLT
(SEQ ID NO: 44) >81B4vK32_147 L-CDR3 HQFHRSPLT (SEQ ID NO: 44)
>73C5vK39_2 L-CDR3 QQYSRYPLT (SEQ ID NO: 45) >73C5vK39_7
L-CDR3 QQYSRYPLT (SEQ ID NO: 45) >73C5vK39_15 L-CDR3 QQYSRYPLT
(SEQ ID NO: 45) H-CDR1 Amino Acid Sequences >81B4vH33_49 H-CDR1
GYSFTSSWIH (SEQ ID NO: 53) >81B4vH33_85T H-CDR1 GYSFTSSWIH (SEQ
ID NO: 53) >81B4vH33_90 H-CDR1 GYSFTSSWIH (SEQ ID NO: 53)
>81B4vH33_93 H-CDR1 GYSFTSSWIH (SEQ ID NO: 53) >81B4vH50_22
H-CDR1 GYSFTSSWIH (SEQ ID NO: 53) >81B4vH50_30 H-CDR1 GYSFTSSWIH
(SEQ ID NO: 53) >81B4vH51_13 H-CDR1 GYSFTSSWIH (SEQ ID NO: 53)
>81B4vH51_15 H-CDR1 GYSFTSSWIH (SEQ ID NO: 53) >81B4vH52_83
H-CDR1 GYSFTSSWIH (SEQ ID NO: 53) >73C5vH46_4 H-CDR1 GFSLTDYAVH
(SEQ ID NO: 107) >73C5vH46_19 H-CDR1 GFSLTDYAVH (SEQ ID NO: 107)
>73C5vH46_40 H-CDR1 GFSLTDYAVH (SEQ ID NO: 107) >73C5vH47_65
H-CDR1 GFSLTDYAVH (SEQ ID NO: 107) >73C5vH47 77 H-CDR1
GFSLTDYAVH (SEQ ID NO: 107) >73C5vH58_91 H-CDR1 GFSLTDYAVH (SEQ
ID NO: 107) H-CDR2 Amino Acid Sequences >81B4vH33_49 H-CDR2
EINPGNVRTNYNENF (SEQ ID NO: 62) >81B4vH33_85T H-CDR2
EINPGNVRTNYNENF (SEQ ID NO: 62) >81B4vH33_90 H-CDR2
EINPGNVRTNYNENF (SEQ ID NO: 62) >81B4vH33_93 H-CDR2
EINPGNVRTNYNENF (SEQ ID NO: 62) >81B4vH50_22 H-CDR2
EILPGVVRTNYNENF (SEQ ID NO: 108) >81B4vH50_30 H-CDR2
EINPGAVRTNYNENF (SEQ ID NO: 109) >81B4vH51_13 H-CDR2
EINPGLVRTNYNENF (SEQ ID NO: 110) >81B4vH51_15 H-CDR2
EINPGAVRTNYNENF (SEQ ID NO: 109) >81B4vH52_83 H-CDR2
EINPGSVRTNYNENF (SEQ ID NO: 111) >73C5vH46_4 H-CDR2
VIWSDGSTDYNAPFKS (SEQ ID NO: 64) >73C5vH46_19 H-CDR2
VIWSDGSTDYNAPFKS (SEQ ID NO: 64) >73C5vH46_40 H-CDR2
VIWSDGSTDYNAPFKS (SEQ ID NO: 64) >73C5vH47_65 H-CDR2
VIWSDGSTDYNAPFKS (SEQ ID NO: 64) >73C5vH47_77 H-CDR2
VIWSDGSTDFNAPFKS (SEQ ID NO: 63) >73C5vH58_91 H-CDR2
VIWSDGSTDYNAPFKS (SEQ ID NO: 64) H-CDR3 Amino Acid Sequences
>81B4vH33_49 H-CDR3 VFYGEPYFPY (SEQ ID NO: 72) >81B4vH33_85T
H-CDR3 VFYGEPYFPY (SEQ ID NO: 72) >81B4vH33_90 H-CDR3 VFYGEPYFPY
(SEQ ID NO: 72) >81B4vH33_93 H-CDR3 VFYGEPYFPY (SEQ ID NO: 72)
>81B4vH50_22 H-CDR3 VFYGEPYFPY (SEQ ID NO: 72) >81B4vH50_30
H-CDR3 VFYGEPYFPY (SEQ ID NO: 72) >81B4vH51_13 H-CDR3 VFYGEPYFPY
(SEQ ID NO: 72) >81B4vH51_15 H-CDR3 VFYGEPYFPY (SEQ ID NO: 72)
>81B4vH52_83 H-CDR3 VFYGEPYFPY (SEQ ID NO: 72) >73C5vH46_4
H-CDR3 KGGYSGSWFAY (SEQ ID NO: 73) >73C5vH46_19 H-CDR3
KGGYSGSWFAY (SEQ ID NO: 73) >73C5vH46_40 H-CDR3 KGGYSGSWFAY (SEQ
ID NO: 73) >73C5vH47_65 H-CDR3 KGGYSGSWFAY (SEQ ID NO: 73)
>73C5vH47_77 H-CDR3 KGGYSGSWFAY (SEQ ID NO: 73) >73C5vH58_91
H-CDR3 KGGYSGSWFAY (SEQ ID NO: 73)
[0138] In one aspect, a variable region of the present invention is
linked to a constant region. For example, a variable region of the
present invention is linked to a constant region shown below to
form a heavy chain or a light chain of an antibody.
TABLE-US-00005 Heavy Chain Constant region linked downstream of a
humanized variable heavy region:
ASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGV
HTFPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEP
KSCDKTHTCPPCPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVS
HEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGK
EYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSREEMTKNQVSLTC
LVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRW
QQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 112) Light Chain
Constant region linked downstream of a humanized variable light
region: RTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSG
NSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEVTHQGLSSPVTK SFNRGEC (SEQ ID
NO: 113)
[0139] Representative light chain and heavy chain sequences of the
present invention are shown below (humanized variable regions
derived from antibodies 81B4 and 73C5 linked to constant
regions).
TABLE-US-00006 Light Chain Amino Acid Sequences >81B4vK32_3
Light Chain
EIVLTQSPGTLSLSPGERATMSCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSTLASGI
PDRFSGSGSGTDFTLTISRLEPEDAATYYCHQFHRSPLTFGQGTKLEIKRTVAAPSVFI
FPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYS
LSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 114)
>81B4vK32_105 Light Chain
EIVLTQSPGTLSLSPGERATMSCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSILASGV
PDRFSGSGSGTDFTLTISRLEPEDFATYYCHQFHRSPLTFGQGTKLEIKRTVAAPSVFIF
PPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYSL
SSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 115)
>81B4vK32_116 Light Chain
EIVLTQSPGTLSLSPGERATMSCTASSSVSSSYFHWYQQKPGQAPRLWIYRTSRLASG
VPDRFSGSGSGTDFTLTISRLEPEDAATYYCHQFHRSPLTFGQGTKLEIKRTVAAPSVF
IFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTY
SLSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 116)
>81B4vK32_127 Light Chain
EIVLTQSPGTLSLSPGERATMTCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSRLASG
VPDRFSGSGSGTDFTLTISRLEPEDFAVYYCHQFHRSPLTFGQGTKLEIKRTVAAPSVF
IFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTY
SLSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 117)
>81B4vK32_138 Light Chain
QIVLTQSPGTLSLSPGERATMTCTASSSVSSSYFHWYQQKPGQAPRLWIYRTSRLAS
GVPDRFSGSGSGTDFTLTISRLEPEDAATYYCHQFHRSPLTFGAGTKLEIKRTVAAPSV
FIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDST
YSLSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 118)
>81B4vK32_140 Light Chain
QIVLTQSPGTLSLSPGERVTMSCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSQLASG
IPDRFSGSGSGTDFTLTISRLEPEDAATYYCHQFHRSPLTFGQGTKLEIKRTVAAPSVFI
FPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYS
LSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 119)
>81B4vK32_141 Light Chain
QIVLTQSPGTLSLSPGERATMTCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSKLASG
VPDRFSGSGSGTDFTLTISRLEPEDFATYYCHQFHRSPLTFGQGTKLEIKRTVAAPSVF
IFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTY
SLSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 120)
>81B4vK32_147 Light Chain
EIVLTQSPGTLSLSPGERATMSCTASSSVSSSYFHWYQQKPGQAPRLLIYRTSHLASGI
PGRFSGSGSGTDFTLTISRLEPEDAAVYYCHQFHRSPLTFGQGTKLEIKRTVAAPSVFI
FPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYS
LSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 121)
>73C5vK39_2 Light Chain
EIVMTQSPATLSVSPGVRATLSCKASQDVGTNVLWYQQKPGQAPRPLIYSASYRHSGI
PDRFSGSGSGTEFTLTISSLQSEDFAEYFCQQYSRYPLTFGQGTKLEIKRTVAAPSVFI
FPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYS
LSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 122)
>73C5vK39_7 Light Chain
EIVMTQSPATLSVSPGVRATLSCKASQDVGTNVLWYQQKPGQAPRPLIYSASYRHSGI
PDRFSGSGSGTEFTLTISSLOSEDFAVYYCQQYSRYPLTFGQGTKLEIKRTVAAPSVFI
FPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYS
LSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 123)
>73C5vK39_15 Light Chain
EIVMTQSPATLSVSPGVRATLSCKASQDVGTNVLWYQQKPGQAPRPLIYSASYRHSGI
PARFSGSGSGTEFTLTISSLQSEDFAEYYCQQYSRYPLTFGQGTKLEIKRTVAAPSVFI
FPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYS
LSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC (SEQ ID NO: 124) Heavy
Chain Amino Acid Sequences >81B4vH33_49 Heavy Chain
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQAPGQGLEWIGEINPGNV
RTNYNENFRNKATMTVDTSISTAYMELSRLRSDDTAVYYCAVVFYGEPYFPYWGQGT
LVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHT
FPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCP
PCPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEV
HNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQ
PREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLD
SDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 125)
>81B4vH33_85T Heavy Chain
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQRPGQGLEWIGEINPGNV
RTNYNENFRNRVTMTVDTSISTAYMELSRLRSDDTAVYYCTVVFYGEPYFPYWGQGT
LVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHT
FPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCP
PCPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEV
HNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQ
PREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLD
SDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 126)
>81B4vH33_90 Heavy Chain
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVKQAPGQGLEWMGEINPGNV
RTNYNENFRNKVTMTVDTSISTAYMELSRLRSDDTAVYYCTVVFYGEPYFPYWGQGT
LVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHT
FPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCP
PCPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEV
HNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQ
PREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLD
SDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 127)
>81B4vH33_93 Heavy Chain
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQRPGQGLEWMGEINPGNV
RTNYNENFRNRATLTRDTSISTAYMELSRLRSDDTAVYYCAVVFYGEPYFPYWGQGTL
VTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTF
PAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPP
CPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVH
NAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQP
REPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDS
DGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 128)
>81B4vH50_22 Heavy Chain
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQRPGQGLEWMGEILPGVV
RTNYNENFRNKVTMTVDTSISTAYMELSRLRSDDTAVYYCTVVFYGEPYFPYWGQGT
LVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHT
FPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCP
PCPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEV
HNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQ
PREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLD
SDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 129)
>81B4vH50_30 Heavy Chain
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQRPGQGLEWIGEINPGAV
RTNYNENFRNRVTMTVDTSISTAYMELSRLRSDDTAVYYCTVVFYGEPYFPYWGQGT
LVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHT
FPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCP
PCPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEV
HNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQ
PREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLD
SDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 130)
>81B4vH51_13 Heavy Chain
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQAPGQGLEWIGEINPGLVR
TNYNENFRNKVTMTVDTSISTAYMELSRLRSDDTAVYYCAVVFYGEPYFPYWGQGTL
VTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTF
PAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPP
CPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVH
NAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQP
REPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDS
DGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 131)
>81B4vH51_15 Heavy Chain
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQAPGQGLEWIGEINPGAVR
TNYNENFRNKVTMTVDTSISTAYMELSRLRSDDTAVYYCAVVFYGEPYFPYWGQGTL
VTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTF
PAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPP
CPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVH
NAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQP
REPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDS
DGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 132)
>81B4vH52_83 Heavy Chain
QVQLVQSGAEVKKPGASVKVSCKASGYSFTSSWIHWVRQAPGQGLEWIGEINPGSVR
TNYNENFRNKATMTVDTSISTAYMELSRLRSDDTAVYYCAVVFYGEPYFPYWGQGTL
VTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTF
PAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPP
CPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVH
NAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQP
REPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDS
DGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 133)
>73C5vH46_4 Heavy Chain
QVQLQESGPGLVKPSETLSITCTVSGFSLTDYAVHWIRQPPGKGLEWIGVIWSDGSTD
YNAPFKSRVTINKDTSKSQVSFKMSSVQAADTAVYYCARKGGYSGSWFAYWGQGTL
VTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTF
PAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPP
CPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVH
NAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQP
REPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDS
DGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 134)
>73C5vH46_19 Heavy Chain
QVQLQESGPGLVKPSETLSITCTVSGFSLTDYAVHWIRQPPGKGLEWIGVIWSDGSTD
YNAPFKSRVTISKDTSKNQVSLKMNSLTTDDTAVYYCARKGGYSGSWFAYWGQGTLV
TVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFP
AVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPPC
PAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHN
AKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPR
EPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSD
GSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 135)
>73C5vH46_40 Heavy Chain
QVQLQESGPGLVKPSETLSITCTVSGFSLTDYAVHWIRQPPGKGLEWIGVIWSDGSTD
YNAPFKSRVTISKDNSKSQVSLKMNSVTVADTAVYYCARKGGYSGSWFAYWGQGTL
VTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTF
PAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPP
CPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVH
NAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQP
REPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDS
DGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 136)
>73C5vH47_65 Heavy Chain
QVQLQESGPGLVKPSETLSITCTVSGFSLTDYAVHWVRQPPGKGLEWIGVIWSDGST
DYNAPFKSRVTISKDTSKNQVSFKLSSVTVDDTAVYYCARKGGYSGSWFAYWGQGTL
VTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTF
PAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPP
CPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVH
NAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQP
REPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDS
DGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 137)
>73C5vH47_77 Heavy Chain
QVQLQESGPGLVAPSETLSLTCTVSGFSLTDYAVHWIRQFPGKGLEWIGVIWSDGSTD
FNAPFKSRVTISKDTSKNQVSFKLSSVTTDDTAVYYCARKGGYSGSWFAYWGQGTLV
TVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFP
AVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPPC
PAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHN
AKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPR
EPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSD
GSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO: 138)
>73C5vH58_91 Heavy Chain
QVQLQESGPGLVKPSETLSITCTVSGFSLTDYAVHWIRQPPGKGLEWIGVIWSDGSTD
YNAPFKSRVTISKDNSKSQVSFKMSSVTADDTAVYYCARKGGYSGSWFAYWGQGTL
VTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTF
PAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPP
CPAPEAAGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVH
NAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQP
REPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDS
DGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK (SEQ ID NO:
139)
[0140] The CDRs listed above are defined using the Chothia
numbering system (Al-Lazikani et al., (1997) JMB 273, 927-948).
[0141] In one aspect, an antibody of the present invention
comprises 3 light chain CDRs and 3 heavy chain CDRs, for example as
set forth above.
[0142] In one aspect, an antibody of the present invention
comprises a light chain and a heavy chain variable region as set
forth above. In one aspect, a light chain variable region of the
invention is fused to a light chain constant region, for example a
kappa or lambda constant region. In one aspect, a heavy chain
variable region of the invention is fused to a heavy chain constant
region, for example IgA, IgD, IgE, IgG or IgM, in particular,
IgG.sub.1, IgG.sub.2, IgG.sub.3 or IgG.sub.4.
[0143] The present invention provides an anti-IL-36R antibody
comprising a light chain comprising the amino acid sequence of SEQ
ID NO: 115; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 125 (Antibody B1).
[0144] The present invention provides an anti-IL-36R antibody
comprising a light chain comprising the amino acid sequence of SEQ
ID NO: 115; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 126 (Antibody B2).
[0145] The present invention provides an anti-IL-36R antibody
comprising a light chain comprising the amino acid sequence of SEQ
ID NO: 115; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 127 (Antibody B3).
[0146] The present invention provides an anti-IL-36R antibody
comprising a light chain comprising the amino acid sequence of SEQ
ID NO: 118; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 125 (Antibody B4).
[0147] The present invention provides an anti-IL-36R antibody
comprising a light chain comprising the amino acid sequence of SEQ
ID NO: 118; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 126 (Antibody B5).
[0148] The present invention provides an anti-IL-36R antibody
comprising a light chain comprising the amino acid sequence of SEQ
ID NO: 118; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 127 Antibody B6).
[0149] The present invention provides an anti-IL-36R antibody
comprising a light chain comprising the amino acid sequence of SEQ
ID NO: 123; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 138 (Antibody C3).
[0150] The present invention provides an anti-IL-36R antibody
comprising a light chain comprising the amino acid sequence of SEQ
ID NO: 123; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 139 (Antibody C2).
[0151] The present invention provides an anti-IL-36R antibody
comprising a light chain comprising the amino acid sequence of SEQ
ID NO: 124; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 138 (Antibody C1)
Representative antibodies of the present invention are shown
below.
TABLE-US-00007 TABLE B Antibody Light Chain Sequences Heavy Chain
Sequences B1 EIVLTQSPGTLSLSPGERATMSCT QVQLVQSGAEVKKPGASVKVSCKASGY
ASSSVSSSYFHWYQQKPGQAPR SFTSSWIHWVRQAPGQGLEWIGEINPGN
LLIYRTSILASGVPDRFSGSGSGT VRTNYNENFRNKATMTVDTSISTAYMEL
DFTLTISRLEPEDFATYYCHQFHR SRLRSDDTAVYYCAVVFYGEPYFPYWG
SPLTFGQGTKLEIKRTVAAPSVFIF QGTLVTVSSASTKGPSVFPLAPSSKSTS
PPSDEQLKSGTASVVCLLNNFYP GGTAALGCLVKDYFPEPVTVSWNSGALT
REAKVQWKVDNALQSGNSQESV SGVHTFPAVLQSSGLYSLSSVVTVPSSS
TEQDSKDSTYSLSSTLTLSKADYE LGTQTYICNVNHKPSNTKVDKRVEPKSC
KHKVYACEVTHQGLSSPVTKSFN DKTHTCPPCPAPEAAGGPSVFLFPPKPK RGEC (SEQ ID
NO: 115) DTLMISRTPEVTCVVVDVSHEDPEVKFN WYVDGVEVHNAKTKPREEQYNSTYRVV
SVLTVLHQDWLNGKEYKCKVSNKALPAP IEKTISKAKGQPREPQVYTLPPSREEMTK
NQVSLTCLVKGFYPSDIAVEWESNGQPE NNYKTTPPVLDSDGSFFLYSKLTVDKSR
WQQGNVFSCSVMHEALHNHYTQKSLSL SPGK (SEQ ID NO: 125) B2
EIVLTQSPGTLSLSPGERATMSCT QVQLVQSGAEVKKPGASVKVSCKASGY
ASSSVSSSYFHWYQQKPGQAPR SFTSSWIHWVRQRPGQGLEWIGEINPG
LLIYRTSILASGVPDRFSGSGSGT NVRTNYNENFRNRVTMTVDTSISTAYME
DFTLTISRLEPEDFATYYCHQFHR LSRLRSDDTAVYYCTVVFYGEPYFPYWG
SPLTFGQGTKLEIKRTVAAPSVFIF QGTLVTVSSASTKGPSVFPLAPSSKSTS
PPSDEQLKSGTASVVCLLNNFYP GGTAALGCLVKDYFPEPVTVSWNSGALT
REAKVQWKVDNALQSGNSQESV SGVHTFPAVLQSSGLYSLSSVVTVPSSS
TEQDSKDSTYSLSSTLTLSKADYE LGTQTYICNVNHKPSNTKVDKRVEPKSC
KHKVYACEVTHQGLSSPVTKSFN DKTHTCPPCPAPEAAGGPSVFLFPPKPK RGEC (SEQ ID
NO: 115) DTLMISRTPEVTCVVVDVSHEDPEVKFN WYVDGVEVHNAKTKPREEQYNSTYRVV
SVLTVLHQDWLNGKEYKCKVSNKALPAP IEKTISKAKGQPREPQVYTLPPSREEMTK
NQVSLTCLVKGFYPSDIAVEWESNGQPE NNYKTTPPVLDSDGSFFLYSKLTVDKSR
WQQGNVFSCSVMHEALHNHYTQKSLSL SPGK (SEQ ID NO: 126) B3
EIVLTQSPGTLSLSPGERATMSCT QVQLVQSGAEVKKPGASVKVSCKASGY
ASSSVSSSYFHWYQQKPGQAPR SFTSSWIHWVKQAPGQGLEWMGEINPG
LLIYRTSILASGVPDRFSGSGSGT NVRTNYNENFRNKVTMTVDTSISTAYME
DFTLTISRLEPEDFATYYCHQFHR LSRLRSDDTAVYYCTVVFYGEPYFPYWG
SPLTFGQGTKLEIKRTVAAPSVFIF QGTLVTVSSASTKGPSVFPLAPSSKSTS
PPSDEQLKSGTASVVCLLNNFYP GGTAALGCLVKDYFPEPVTVSWNSGALT
REAKVQWKVDNALQSGNSQESV SGVHTFPAVLQSSGLYSLSSVVTVPSSS
TEQDSKDSTYSLSSTLTLSKADYE LGTQTYICNVNHKPSNTKVDKRVEPKSC
KHKVYACEVTHQGLSSPVTKSFN DKTHTCPPCPAPEAAGGPSVFLFPPKPK RGEC (SEQ ID
NO: 115) DTLMISRTPEVTCVVVDVSHEDPEVKFN WYVDGVEVHNAKTKPREEQYNSTYRVV
SVLTVLHQDWLNGKEYKCKVSNKALPAP IEKTISKAKGQPREPQVYTLPPSREEMTK
NQVSLTCLVKGFYPSDIAVEWESNGQPE NNYKTTPPVLDSDGSFFLYSKLTVDKSR
WQQGNVFSCSVMHEALHNHYTQKSLSL SPGK (SEQ ID NO: 127) B4
QIVLTQSPGTLSLSPGERATMTCT QVQLVQSGAEVKKPGASVKVSCKASGY
ASSSVSSSYFHWYQQKPGQAPR SFTSSWIHWVRQAPGQGLEWIGEINPGN
LWIYRTSRLASGVPDRFSGSGSG VRTNYNENFRNKATMTVDTSISTAYMEL
TDFTLTISRLEPEDAATYYCHQFH SRLRSDDTAVYYCAVVFYGEPYFPYWG
RSPLTFGAGTKLEIKRTVAAPSVFI QGTLVTVSSASTKGPSVFPLAPSSKSTS
FPPSDEQLKSGTASVVCLLNNFYP GGTAALGCLVKDYFPEPVTVSWNSGALT
REAKVQWKVDNALQSGNSQESV SGVHTFPAVLQSSGLYSLSSVVTVPSSS
TEQDSKDSTYSLSSTLTLSKADYE LGTQTYICNVNHKPSNTKVDKRVEPKSC
KHKVYACEVTHQGLSSPVTKSFN DKTHTCPPCPAPEAAGGPSVFLFPPKPK RGEC (SEQ ID
NO: 118) DTLMISRTPEVTCVVVDVSHEDPEVKFN WYVDGVEVHNAKTKPREEQYNSTYRVV
SVLTVLHQDWLNGKEYKCKVSNKALPAP IEKTISKAKGQPREPQVYTLPPSREEMTK
NQVSLTCLVKGFYPSDIAVEWESNGQPE NNYKTTPPVLDSDGSFFLYSKLTVDKSR
WQQGNVFSCSVMHEALHNHYTQKSLSL SPGK (SEQ ID NO: 125) B5
QIVLTQSPGTLSLSPGERATMTCT QVQLVQSGAEVKKPGASVKVSCKASGY
ASSSVSSSYFHWYQQKPGQAPR SFTSSWIHWVRQRPGQGLEWIGEINPG
LWIYRTSRLASGVPDRFSGSGSG NVRTNYNENFRNRVTMTVDTSISTAYME
TDFTLTISRLEPEDAATYYCHQFH LSRLRSDDTAVYYCTVVFYGEPYFPYWG
RSPLTFGAGTKLEIKRTVAAPSVFI QGTLVTVSSASTKGPSVFPLAPSSKSTS
FPPSDEQLKSGTASVVCLLNNFYP GGTAALGCLVKDYFPEPVTVSWNSGALT
REAKVQWKVDNALQSGNSQESV SGVHTFPAVLQSSGLYSLSSVVTVPSSS
TEQDSKDSTYSLSSTLTLSKADYE LGTQTYICNVNHKPSNTKVDKRVEPKSC
KHKVYACEVTHQGLSSPVTKSFN DKTHTCPPCPAPEAAGGPSVFLFPPKPK RGEC (SEQ ID
NO: 118) DTLMISRTPEVTCVVVDVSHEDPEVKFN WYVDGVEVHNAKTKPREEQYNSTYRVV
SVLTVLHQDWLNGKEYKCKVSNKALPAP IEKTISKAKGQPREPQVYTLPPSREEMTK
NQVSLTCLVKGFYPSDIAVEWESNGQPE NNYKTTPPVLDSDGSFFLYSKLTVDKSR
WQQGNVFSCSVMHEALHNHYTQKSLSL SPGK (SEQ ID NO: 126) B6
QIVLTQSPGTLSLSPGERATMTCT QVQLVQSGAEVKKPGASVKVSCKASGY
ASSSVSSSYFHWYQQKPGQAPR SFTSSWIHWVKQAPGQGLEWMGEINPG
LWIYRTSRLASGVPDRFSGSGSG NVRTNYNENFRNKVTMTVDTSISTAYME
TDFTLTISRLEPEDAATYYCHQFH LSRLRSDDTAVYYCTVVFYGEPYFPYWG
RSPLTFGAGTKLEIKRTVAAPSVFI QGTLVTVSSASTKGPSVFPLAPSSKSTS
FPPSDEQLKSGTASVVCLLNNFYP GGTAALGCLVKDYFPEPVTVSWNSGALT
REAKVQWKVDNALQSGNSQESV SGVHTFPAVLQSSGLYSLSSVVTVPSSS
TEQDSKDSTYSLSSTLTLSKADYE LGTQTYICNVNHKPSNTKVDKRVEPKSC
KHKVYACEVTHQGLSSPVTKSFN DKTHTCPPCPAPEAAGGPSVFLFPPKPK RGEC (SEQ ID
NO: 118) DTLMISRTPEVTCVVVDVSHEDPEVKFN WYVDGVEVHNAKTKPREEQYNSTYRVV
SVLTVLHQDWLNGKEYKCKVSNKALPAP IEKTISKAKGQPREPQVYTLPPSREEMTK
NQVSLTCLVKGFYPSDIAVEWESNGQPE NNYKTTPPVLDSDGSFFLYSKLTVDKSR
WQQGNVFSCSVMHEALHNHYTQKSLSL SPGK (SEQ ID NO: 127)
TABLE-US-00008 TABLE C Antibody Light Chain Sequences Heavy Chain
Sequences C1 EIVMTQSPATLSVSPGVRATLSCK QVQLQESGPGLVAPSETLSLTCTVSGFS
ASQDVGTNVLWYQQKPGQAPRP LTDYAVHWIRQFPGKGLEWIGVIWSDGS
LIYSASYRHSGIPARFSGSGSGTE TDFNAPFKSRVTISKDTSKNQVSFKLSSV
FTLTISSLQSEDFAEYYCQQYSRY TTDDTAVYYCARKGGYSGSWFAYWGQ
PLTFGQGTKLEIKRTVAAPSVFIFP GTLVTVSSASTKGPSVFPLAPSSKSTSG
PSDEQLKSGTASVVCLLNNFYPR GTAALGCLVKDYFPEPVTVSWNSGALTS
EAKVQWKVDNALQSGNSQESVT GVHTFPAVLQSSGLYSLSSVVTVPSSSL
EQDSKDSTYSLSSTLTLSKADYEK GTQTYICNVNHKPSNTKVDKRVEPKSCD
HKVYACEVTHQGLSSPVTKSFNR KTHTCPPCPAPEAAGGPSVFLFPPKPKD GEC (SEQ ID
NO: 124) TLMISRTPEVTCVVVDVSHEDPEVKFNW YVDGVEVHNAKTKPREEQYNSTYRVVS
VLTVLHQDWLNGKEYKCKVSNKALPAPI EKTISKAKGQPREPQVYTLPPSREEMTK
NQVSLTCLVKGFYPSDIAVEWESNGQPE NNYKTTPPVLDSDGSFFLYSKLTVDKSR
WQQGNVFSCSVMHEALHNHYTQKSLSL SPGK (SEQ ID NO: 138) C2
EIVMTQSPATLSVSPGVRATLSCK QVQLQESGPGLVKPSETLSITCTVSGFSL
ASQDVGTNVLWYQQKPGQAPRP TDYAVHWIRQPPGKGLEWIGVIWSDGST
LIYSASYRHSGIPDRFSGSGSGTE DYNAPFKSRVTISKDNSKSQVSFKMSSV
FTLTISSLQSEDFAVYYCQQYSRY TADDTAVYYCARKGGYSGSWFAYWGQ
PLTFGQGTKLEIKRTVAAPSVFIFP GTLVTVSSASTKGPSVFPLAPSSKSTSG
PSDEQLKSGTASVVCLLNNFYPR GTAALGCLVKDYFPEPVTVSWNSGALTS
EAKVQWKVDNALQSGNSQESVT GVHTFPAVLQSSGLYSLSSVVTVPSSSL
EQDSKDSTYSLSSTLTLSKADYEK GTQTYICNVNHKPSNTKVDKRVEPKSCD
HKVYACEVTHQGLSSPVTKSFNR KTHTCPPCPAPEAAGGPSVFLFPPKPKD GEC (SEQ ID
NO: 123) TLMISRTPEVTCVVVDVSHEDPEVKFNW YVDGVEVHNAKTKPREEQYNSTYRVVS
VLTVLHQDWLNGKEYKCKVSNKALPAPI EKTISKAKGQPREPQVYTLPPSREEMTK
NQVSLTCLVKGFYPSDIAVEWESNGQPE NNYKTTPPVLDSDGSFFLYSKLTVDKSR
WQQGNVFSCSVMHEALHNHYTQKSLSL SPGK (SEQ ID NO: 139) C3
EIVMTQSPATLSVSPGVRATLSCK QVQLQESGPGLVAPSETLSLTCTVSGFS
ASQDVGTNVLWYQQKPGQAPRP LTDYAVHWIRQFPGKGLEWIGVIWSDGS
LIYSASYRHSGIPDRFSGSGSGTE TDFNAPFKSRVTISKDTSKNQVSFKLSSV
FTLTISSLQSEDFAVYYCQQYSRY TTDDTAVYYCARKGGYSGSWFAYWGQ
PLTFGQGTKLEIKRTVAAPSVFIFP GTLVTVSSASTKGPSVFPLAPSSKSTSG
PSDEQLKSGTASVVCLLNNFYPR GTAALGCLVKDYFPEPVTVSWNSGALTS
EAKVQWKVDNALQSGNSQESVT GVHTFPAVLQSSGLYSLSSVVTVPSSSL
EQDSKDSTYSLSSTLTLSKADYEK GTQTYICNVNHKPSNTKVDKRVEPKSCD
HKVYACEVTHQGLSSPVTKSFNR KTHTCPPCPAPEAAGGPSVFLFPPKPKD GEC (SEQ ID
NO: 123) TLMISRTPEVTCVVVDVSHEDPEVKFNW YVDGVEVHNAKTKPREEQYNSTYRVVS
VLTVLHQDWLNGKEYKCKVSNKALPAPI EKTISKAKGQPREPQVYTLPPSREEMTK
NQVSLTCLVKGFYPSDIAVEWESNGQPE NNYKTTPPVLDSDGSFFLYSKLTVDKSR
WQQGNVFSCSVMHEALHNHYTQKSLSL SPGK (SEQ ID NO: 138)
[0152] In some aspects, the humanized antibody displays blocking
activity, whereby it decreases the binding of IL-36 ligand to IL-36
receptor by at least 45%, by at least 50%, by at least 55%, by at
least 60%, by at least 65%, by at least 70%, by at least 75%, by at
least 80%, by at least 85%, by at least 90%, or by at least 95%.
The ability of an antibody to block binding of IL-36 ligand to the
IL-36 receptor can be measured using competitive binding assays
known in the art. Alternatively, the blocking activity of an
antibody can be measured by assessing the biological effects of
IL-36, such as the production of IL-8, IL-6, and GM-CSF to
determine if signaling mediated by the IL-36 receptor is
inhibited.
[0153] In a further aspect, the present invention provides a
humanized anti-IL-36R antibody having favorable biophysical
properties. In one aspect, a humanized anti-IL-36R antibody of the
present invention is present in at least 90% monomer form, or in at
least 92% monomer form, or in at least 95% monomer form in a
buffer. In a further aspect, a humanized anti-IL-36R antibody of
the present invention remains in at least 90% monomer form, or in
at least 92% monomer form, or in at least 95% monomer form in a
buffer for one month or for four months.
[0154] In one aspect, a humanized antibody of the present invention
is Antibody B1, Antibody B2, Antibody B3, Antibody B4, Antibody B5,
Antibody B6, Antibody C1, Antibody C2, or Antibody C3. Accordingly,
in one embodiment, a humanized antibody of the present invention
comprises the light chain sequence of SEQ ID NO:115 and the heavy
chain sequence of SEQ ID NO:125 (Antibody B1). In another
embodiment, a humanized antibody of the present invention comprises
the light chain sequence of SEQ ID NO:115 and the heavy chain
sequence of SEQ ID NO:126 (Antibody B2). In another embodiment, a
humanized antibody of the present invention comprises the light
chain sequence of SEQ ID NO:115 and the heavy chain sequence of SEQ
ID NO:127 (Antibody B3). In another embodiment, a humanized
antibody of the present invention comprises the light chain
sequence of SEQ ID NO:118 and the heavy chain sequence of SEQ ID
NO:125 (Antibody B4). In another embodiment, a humanized antibody
of the present invention comprises the light chain sequence of SEQ
ID NO:118 and the heavy chain sequence of SEQ ID NO:126 (Antibody
B5). In another embodiment, a humanized antibody of the present
invention comprises the light chain sequence of SEQ ID NO:118 and
the heavy chain sequence of SEQ ID NO:127 (Antibody B6). In another
embodiment, a humanized antibody of the present invention comprises
the light chain sequence of SEQ ID NO:124 and the heavy chain
sequence of SEQ ID NO:138 (Antibody C1). In another embodiment, a
humanized antibody of the present invention comprises the light
chain sequence of SEQ ID NO:123 and the heavy chain sequence of SEQ
ID NO:139 (Antibody C2). In another embodiment, a humanized
antibody of the present invention comprises the light chain
sequence of SEQ ID NO:123 and the heavy chain sequence of SEQ ID
NO:138 (Antibody C3).
[0155] In a further embodiment, a humanized antibody of the present
invention consists of the light chain sequence of SEQ ID NO:115 and
the heavy chain sequence of SEQ ID NO:125 (Antibody B1). In another
embodiment, a humanized antibody of the present invention consists
of the light chain sequence of SEQ ID NO:115 and the heavy chain
sequence of SEQ ID NO:126 (Antibody B2). In another embodiment, a
humanized antibody of the present invention consists of the light
chain sequence of SEQ ID NO:115 and the heavy chain sequence of SEQ
ID NO:127 (Antibody B3). In another embodiment, a humanized
antibody of the present invention consists of the light chain
sequence of SEQ ID NO:118 and the heavy chain sequence of SEQ ID
NO:125 (Antibody B4). In another embodiment, a humanized antibody
of the present invention consists of the light chain sequence of
SEQ ID NO:118 and the heavy chain sequence of SEQ ID NO:126
(Antibody B5). In another embodiment, a humanized antibody of the
present invention consists of the light chain sequence of SEQ ID
NO:118 and the heavy chain sequence of SEQ ID NO:127 (Antibody B6).
In another embodiment, a humanized antibody of the present
invention consists of the light chain sequence of SEQ ID NO:124 and
the heavy chain sequence of SEQ ID NO:138 (Antibody C1). In another
embodiment, a humanized antibody of the present invention consists
of the light chain sequence of SEQ ID NO:123 and the heavy chain
sequence of SEQ ID NO:139 (Antibody C2). In another embodiment, a
humanized antibody of the present invention consists of the light
chain sequence of SEQ ID NO:123 and the heavy chain sequence of SEQ
ID NO:138 (Antibody C3).
[0156] In some embodiments, the humanized anti-IL-36R antibodies,
including antigen-binding fragments thereof, such as heavy and
light chain variable regions, comprise an amino acid sequence of
the residues derived from Antibody B1, Antibody B2, Antibody B3,
Antibody B4, Antibody B5, Antibody B6, Antibody C1, Antibody C2, or
Antibody C3.
[0157] In a further embodiment, the present invention provides an
anti-IL-36R antibody or antigen-binding fragment thereof that
competitively binds to human anti-IL-36R with an antibody of the
present invention, for example Antibody B1, Antibody B2, Antibody
B3, Antibody B4, Antibody B5, Antibody B6, Antibody C1, Antibody C2
or Antibody C3 described herein. The ability of an antibody or
antigen-binding fragment to competitively bind to IL-36R can be
measured using competitive binding assays known in the art.
[0158] The humanized anti-IL-36R antibodies optionally include
specific amino acid substitutions in the consensus or germline
framework regions. The specific substitution of amino acid residues
in these framework positions can improve various aspects of
antibody performance including binding affinity and/or stability,
over that demonstrated in humanized antibodies formed by "direct
swap" of CDRs or HVLs into the human germline framework
regions.
[0159] In some embodiments, the present invention describes other
monoclonal antibodies with a light chain variable region having the
amino acid sequence set forth in any one of SEQ ID NO:1-10. In some
embodiments, the present invention describes other monoclonal
antibodies with a heavy chain variable region having the amino acid
sequence set forth in any one of SEQ ID NO:11-20. Placing such CDRs
into FRs of the human consensus heavy and light chain variable
domains will yield useful humanized antibodies of the present
invention.
[0160] In particular, the present invention provides monoclonal
antibodies with the combinations of light chain variable and heavy
chain variable regions of SEQ ID NO:1/11, 2/12, 3/13, 4/14, 5/15,
6/16, 7/17, 8/18, 9/19, 10/20. Such variable regions can be
combined with human constant regions.
[0161] In some embodiments, the present invention describes other
humanized antibodies with light chain variable region sequences
having the amino acid sequence set forth in any one of SEQ ID
NO:76-86. In some embodiments, the present invention describes
other humanized antibodies with heavy chain variable region
sequences having the amino acid sequence set forth in any one of
SEQ ID NO:87-101. In particular, the present invention provides
monoclonal antibodies with the combinations of light chain variable
and heavy chain variable regions of SEQ ID NO: 77/89, 80/88, 80/89,
77/87, 77/88, 80/87, 86/100, 85/101, 85/100. Such variable regions
can be combined with human constant regions.
[0162] In a further embodiment, the present invention relates to an
anti-IL-36R antibody or antigen-binding fragment thereof comprising
a humanized light chain variable domain comprising the CDRs of SEQ
ID NO:77 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain light chain amino acid sequence of SEQ ID NO:77
and a humanized heavy chain variable domain comprising the CDRs of
SEQ ID NO:89 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain heavy chain amino acid sequence of SEQ ID
NO:89. In one embodiment, the anti-IL-36R antibody is a humanized
monoclonal antibody.
[0163] In a further embodiment, the present invention relates to an
anti-IL-36R antibody or antigen-binding fragment thereof comprising
a humanized light chain variable domain comprising the CDRs of SEQ
ID NO:80 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain light chain amino acid sequence of SEQ ID NO:80
and a humanized heavy chain variable domain comprising the CDRs of
SEQ ID NO:88 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain heavy chain amino acid sequence of SEQ ID
NO:88. In one embodiment, the anti-IL-36R antibody is a humanized
monoclonal antibody.
[0164] In a further embodiment, the present invention relates to an
anti-IL-36R antibody or antigen-binding fragment thereof comprising
a humanized light chain variable domain comprising the CDRs of SEQ
ID NO:80 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain light chain amino acid sequence of SEQ ID NO:80
and a humanized heavy chain variable domain comprising the CDRs of
SEQ ID NO:89 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain heavy chain amino acid sequence of SEQ ID
NO:89. In one embodiment, the anti-IL-36R antibody is a humanized
monoclonal antibody.
[0165] In a further embodiment, the present invention relates to an
anti-IL-36R antibody or antigen-binding fragment thereof comprising
a humanized light chain variable domain comprising the CDRs of SEQ
ID NO:77 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain light chain amino acid sequence of SEQ ID NO:77
and a humanized heavy chain variable domain comprising the CDRs of
SEQ ID NO:87 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain heavy chain amino acid sequence of SEQ ID
NO:87. In one embodiment, the anti-IL-36R antibody is a humanized
monoclonal antibody.
[0166] In a further embodiment, the present invention relates to an
anti-IL-36R antibody or antigen-binding fragment thereof comprising
a humanized light chain variable domain comprising the CDRs of SEQ
ID NO:77 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain light chain amino acid sequence of SEQ ID NO:77
and a humanized heavy chain variable domain comprising the CDRs of
SEQ ID NO:88 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain heavy chain amino acid sequence of SEQ ID
NO:88. In one embodiment, the anti-IL-36R antibody is a humanized
monoclonal antibody.
[0167] In a further embodiment, the present invention relates to an
anti-IL-36R antibody or antigen-binding fragment thereof comprising
a humanized light chain variable domain comprising the CDRs of SEQ
ID NO:80 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain light chain amino acid sequence of SEQ ID NO:80
and a humanized heavy chain variable domain comprising the CDRs of
SEQ ID NO:87 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain heavy chain amino acid sequence of SEQ ID
NO:87. In one embodiment, the anti-IL-36R antibody is a humanized
monoclonal antibody.
[0168] In a further embodiment, the present invention relates to an
anti-IL-36R antibody or antigen-binding fragment thereof comprising
a humanized light chain variable domain comprising the CDRs of SEQ
ID NO:86 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain light chain amino acid sequence of SEQ ID NO:86
and a humanized heavy chain variable domain comprising the CDRs of
SEQ ID NO:100 and framework regions having an amino acid sequence
at least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain heavy chain amino acid sequence of SEQ ID
NO:100. In one embodiment, the anti-IL-36R antibody is a humanized
monoclonal antibody.
[0169] In a further embodiment, the present invention relates to an
anti-IL-36R antibody or antigen-binding fragment thereof comprising
a humanized light chain variable domain comprising the CDRs of SEQ
ID NO:85 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain light chain amino acid sequence of SEQ ID NO:85
and a humanized heavy chain variable domain comprising the CDRs of
SEQ ID NO:101 and framework regions having an amino acid sequence
at least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain heavy chain amino acid sequence of SEQ ID
NO:101. In one embodiment, the anti-IL-36R antibody is a humanized
monoclonal antibody.
[0170] In a further embodiment, the present invention relates to an
anti-IL-36R antibody or antigen-binding fragment thereof comprising
a humanized light chain variable domain comprising the CDRs of SEQ
ID NO:85 and framework regions having an amino acid sequence at
least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain light chain amino acid sequence of SEQ ID NO:85
and a humanized heavy chain variable domain comprising the CDRs of
SEQ ID NO:100 and framework regions having an amino acid sequence
at least 90% identical, at least 93% identical or at least 95%
identical to the amino acid sequence of the framework regions of
the variable domain heavy chain amino acid sequence of SEQ ID
NO:100. In one embodiment, the anti-IL-36R antibody is a humanized
monoclonal antibody.
[0171] In some specific embodiments, the humanized anti-IL-36R
antibodies disclosed herein comprise at least a heavy or a light
chain variable domain comprising the CDRs or HVLs of the murine
monoclonal antibodies or humanized antibodies as disclosed herein
and the FRs of the human germline heavy and light chain variable
domains.
[0172] In one further aspect, the present invention provides an
anti-IL-36R antibody or antigen-binding fragment thereof comprising
a light chain CDR1 (L-CDR1) sequence of any one of SEQ ID NO:21-29;
a light chain CDR2 (L-CDR2) sequence of any one of SEQ ID NO:30-38;
a light chain CDR3 (L-CDR3) sequence of any one of SEQ ID NO:39-47;
a heavy chain CDR1 (H-CDR1) sequence of any one of SEQ ID NO:48-56;
a heavy chain CDR2 (H-CDR2) sequence of any one of SEQ ID NO:57-66;
and a heavy chain CDR3 (H-CDR3) sequence of any one of SEQ ID
NO:67-75. In one aspect, the anti-IL-36R antibody or
antigen-binding fragment thereof comprises a light chain variable
region comprising a L-CDR1 listed above, a L-CDR2 listed above and
a L-CDR3 listed above, and a heavy chain variable region comprising
a H-CDR1 listed above, a H-CDR2 listed above and a H-CDR3 listed
above.
[0173] In a further aspect, the present invention provides an
anti-IL-36R antibody or antigen-binding fragment thereof
comprising: [0174] a) a L-CDR1, a L-CDR2, a L-CDR3, a H-CDR1, a
H-CDR2 and a H-CDR3 sequence of SEQ ID NO:21, 30, 39, 48, 57 and
67, respectively; or [0175] b) a L-CDR1, a L-CDR2, a L-CDR3, a
H-CDR1, a H-CDR2 and a H-CDR3 sequence of SEQ ID NO:22, 31, 40, 49,
58 and 68, respectively; or [0176] c) a L-CDR1, a L-CDR2, a L-CDR3,
a H-CDR1, a H-CDR2 and a H-CDR3 sequence of SEQ ID NO:23, 32, 41,
50, 59 and 69, respectively; or [0177] d) a L-CDR1, a L-CDR2, a
L-CDR3, a H-CDR1, a H-CDR2 and a H-CDR3 sequence of SEQ ID NO:24,
33, 42, 51, 60 and 70, respectively; or [0178] e) a L-CDR1, a
L-CDR2, a L-CDR3, a H-CDR1, a H-CDR2 and a H-CDR3 sequence of SEQ
ID NO:25, 34, 43, 52, 61 and 71, respectively; or [0179] f) a
L-CDR1, a L-CDR2, a L-CDR3, a H-CDR1, a H-CDR2 and a H-CDR3
sequence of SEQ ID NO:26, 35, 44, 53, 62 and 72, respectively; or
[0180] g) a L-CDR1, a L-CDR2, a L-CDR3, a H-CDR1, a H-CDR2 and a
H-CDR3 sequence of SEQ ID NO:27, 36, 45, 54, 63 and 73,
respectively; or [0181] h) a L-CDR1, a L-CDR2, a L-CDR3, a H-CDR1,
a H-CDR2 and a H-CDR3 sequence of SEQ ID NO:27, 36, 45, 54, 64 and
74, respectively; or [0182] i) a L-CDR1, a L-CDR2, a L-CDR3, a
H-CDR1, a H-CDR2 and a H-CDR3 sequence of SEQ ID NO:27, 36, 45, 54,
64 and 73, respectively; or [0183] j) a L-CDR1, a L-CDR2, a L-CDR3,
a H-CDR1, a H-CDR2 and a H-CDR3 sequence of SEQ ID NO:28, 37, 46,
55, 65 and 74, respectively; or [0184] k) a L-CDR1, a L-CDR2, a
L-CDR3, a H-CDR1, a H-CDR2 and a H-CDR3 sequence of SEQ ID NO:29,
38, 47, 56, 66 and 75, respectively.
[0185] In a further aspect, the present invention provides an
anti-IL-36R antibody or antigen-binding fragment thereof
comprising: [0186] a) a L-CDR1, a L-CDR2, a L-CDR3, a H-CDR1, a
H-CDR2 and a H-CDR3 sequence of SEQ ID NO:26, 103, 44, 53, 62 and
72, respectively; or [0187] b) a L-CDR1, a L-CDR2, a L-CDR3, a
H-CDR1, a H-CDR2 and a H-CDR3 sequence of SEQ ID NO:26, 104, 44,
53, 62 and 72, respectively; or [0188] c) a L-CDR1, a L-CDR2, a
L-CDR3, a H-CDR1, a H-CDR2 and a H-CDR3 sequence of SEQ ID NO:27,
36, 45, 107, 63 and 73, respectively; or [0189] d) a L-CDR1, a
L-CDR2, a L-CDR3, a H-CDR1, a H-CDR2 and a H-CDR3 sequence of SEQ
ID NO:27, 36, 45, 107, 64 or 73, respectively.
[0190] In one aspect, the anti-IL-36R antibody or antigen-binding
fragment thereof comprises a light chain variable region comprising
a L-CDR1, L-CDR2 and L-CDR3 combination listed above, and a heavy
chain variable region comprising a H-CDR1, H-CDR2 and H-CDR3
combination listed above.
[0191] In specific embodiments, it is contemplated that chimeric
antibodies with switched CDR regions (i.e., for example switching
one or two CDRs of one of the mouse antibodies or humanized
antibody derived therefrom with the analogous CDR from another
mouse antibody or humanized antibody derived therefrom) between
these exemplary immunoglobulins may yield useful antibodies.
[0192] In certain embodiments, the humanized anti-IL-36R antibody
is an antibody fragment. Various antibody fragments have been
generally discussed above and there are techniques that have been
developed for the production of antibody fragments. Fragments can
be derived via proteolytic digestion of intact antibodies (see,
e.g., Morimoto et al., 1992, Journal of Biochemical and Biophysical
Methods 24:107-117; and Brennan et al., 1985, Science 229:81).
Alternatively, the fragments can be produced directly in
recombinant host cells. For example, Fab'-SH fragments can be
directly recovered from E. coli and chemically coupled to form
F(ab').sub.2 fragments (see, e.g., Carter et al., 1992,
Bio/Technology 10:163-167). By another approach, F(ab').sub.2
fragments can be isolated directly from recombinant host cell
culture. Other techniques for the production of antibody fragments
will be apparent to the skilled practitioner. Accordingly, in one
aspect, the present invention provides antibody fragments
comprising the CDRs described herein, in particular one of the
combinations of L-CDR1, L-CDR2, L-CDR3, H-CDR1, H-CDR2 and H-CDR3
described herein. In a further aspect, the present invention
provides antibody fragments comprising the variable regions
described herein, for example one of the combinations of light
chain variable regions and heavy chain variable regions described
herein.
[0193] Certain embodiments include an F(ab').sub.2 fragment of a
humanized anti-IL-36R antibody comprise a light chain sequence of
any of SEQ ID NO: 115 or 118 in combination with a heavy chain
sequence of SEQ ID NO: 125, 126 or 127. Such embodiments can
include an intact antibody comprising such an F(ab')2.
[0194] Certain embodiments include an F(ab').sub.2 fragment of a
humanized anti-IL-36R antibody comprise a light chain sequence of
any of SEQ ID NO: 123 or 124 in combination with a heavy chain
sequence of SEQ ID NO: 138 or 139. Such embodiments can include an
intact antibody comprising such an F(ab').sub.2.
[0195] In some embodiments, the antibody or antibody fragment
includes a constant region that mediates effector function. The
constant region can provide antibody-dependent cellular
cytotoxicity (ADCC), antibody-dependent cellular phagocytosis
(ADCP) and/or complement-dependent cytotoxicity (CDC) responses
against an anti-IL-36R expressing target cell. The effector
domain(s) can be, for example, an Fc region of an Ig molecule.
[0196] The effector domain of an antibody can be from any suitable
vertebrate animal species and isotypes. The isotypes from different
animal species differ in the abilities to mediate effector
functions. For example, the ability of human immunoglobulin to
mediate CDC and ADCC/ADCP is generally in the order of
IgM.apprxeq.IgG.sub.1.apprxeq.IgG.sub.3>IgG.sub.2>IgG.sub.4
and IgG.sub.1.apprxeq.IgG.sub.3>IgG.sub.2/IgM/IgG.sub.4,
respectively. Murine immunoglobulins mediate CDC and ADCC/ADCP
generally in the order of murine
IgM.apprxeq.IgG.sub.3>>IgG.sub.2b>IgG.sub.2a>>Ig-
G.sub.1 and IgG.sub.2b>IgG.sub.2a>IgG.sub.1>>IgG.sub.3,
respectively. In another example, murine IgG.sub.2a mediates ADCC
while both murine IgG.sub.2a and IgM mediate CDC.
III. Pharmaceutical Doses and Administration
[0197] Anti-IL-36R antibodies of the present invention are
typically administered to a patient as a pharmaceutical composition
in which the antagonist is admixed with a pharmaceutically
acceptable carrier or excipient, see, e. g., Remington's
Pharmaceutical Sciences and US. Pharmacopeia: National Formulary,
Mack Publishing Company, Easton, Pa. (1984). The pharmaceutical
composition may be formulated in any manner suitable for the
intended route of administration. Examples of pharmaceutical
formulations include lyophilized powders, slurries, aqueous
solutions, suspensions and sustained release formulations (see, e.
g., Hardman et al. (2001) Goodman and Gilman's The Pharmacological
Basis of Therapeutics, McGraw-Hill, New York, N.Y.; Gennaro (2000)
Remington: The Science and Practice of Pharmacy, Lippincott,
Williams, and Wilkins, New York, N.Y.; Avis et al. (eds.) (1993)
Pharmaceutical Dosage Forms: Parenteral Medications, Marcel Dekker,
NY; Lieberman et al. (eds.) (1990) Pharmaceutical Dosage Forms:
Tablets, Marcel Dekker, NY; Lieberman et al. (eds.) (1990)
Pharmaceutical Dosage Forms: Disperse Systems, Marcel Dekker, NY;
Weiner and Kotkoskie (2000) Excipient Toxicity and Safety, Marcel
Dekker, Inc., New York, N.Y.). Suitable routes of administration
include intravenous injection (including intraarterial injection)
and subcutaneous injection.
[0198] In a first aspect, the present invention relates to a method
of treating generalized pustular psoriasis (GPP) in a patient, said
method including administering or having administered to the
patient a therapeutically effective amount of an anti-IL-36R
antibody.
[0199] In a second aspect, the present invention relates to a
method of treating moderate to severe GPP in a patient, including
administering or having administered to the patient a
therapeutically effective amount of an anti-IL-36R antibody.
[0200] In a third aspect, the present invention relates to a method
of reducing or alleviating signs and symptoms of an acute phase
flare-up of GPP in a patient, said method including administering
or having administered to the patient a therapeutically effective
amount of an anti-IL-36R antibody.
[0201] In a forth aspect, the present invention relates to a method
of reducing the severity and duration of GPP flares, said method
comprising including administering or having administered to the
patient a therapeutically effective amount of an anti-IL-36R
antibody.
[0202] In a fifth aspect, the present invention relates to a method
of treating a skin disorder associated with acute GPP, said method
including administering or having administered to the patient a
therapeutically effective amount of an anti-IL-36R antibody.
[0203] In one embodiment related to any of aspects first to fifth,
the anti-IL-36R antibody includes: a) a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 26 (L-CDR1); the
amino acid sequence of SEQ ID NO: 35, 102, 103, 104, 105 106 or 140
(L-CDR2); the amino acid sequence of SEQ ID NO: 44 (L-CDR3); and b)
a heavy chain variable region comprising the amino acid sequence of
SEQ ID NO: 53 (H-CDR1); the amino acid sequence of SEQ ID NO: 62,
108, 109, 110 or 111 (H-CDR2); the amino acid sequence of SEQ ID
NO: 72 (H-CDR3).
[0204] In one embodiment related to any of aspects first to fifth,
the anti-IL-36R antibody includes:
[0205] I. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 102 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0206] II. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 103 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0207] III. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 104 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0208] IV. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 105 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0209] V. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 106 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0210] VI. a) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 26 (L-CDR1); the amino acid sequence of
SEQ ID NO: 140 (L-CDR2); the amino acid sequence of SEQ ID NO: 44
(L-CDR3); and b) a heavy chain variable region comprising the amino
acid sequence of SEQ ID NO: 53 (H-CDR1); the amino acid sequence of
SEQ ID NO: 62, 108, 109, 110 or 111 (H-CDR2); the amino acid
sequence of SEQ ID NO: 72 (H-CDR3).
[0211] In one embodiment related to any of aspects first to fifth,
the anti-IL-36R antibody includes:
[0212] (i) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or
[0213] (ii) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or
[0214] (iii) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 89; or
[0215] (iv) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or
[0216] (v) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or
[0217] (vi) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 89; or
[0218] (vii) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 85; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 100; or
[0219] (viii) a light chain variable region comprising the amino
acid sequence of SEQ ID NO: 85; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO:101; or
[0220] (ix) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 86; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 100; or
[0221] (x) a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 86; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO:101.
[0222] In one embodiment related to any of aspects first to fifth,
the anti-IL-36R antibody includes:
[0223] i. a light chain comprising the amino acid sequence of SEQ
ID NO: 115; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 125; or
[0224] ii. a light chain comprising the amino acid sequence of SEQ
ID NO: 115; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 126; or
[0225] iii. a light chain comprising the amino acid sequence of SEQ
ID NO: 115; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 127; or
[0226] iv. a light chain comprising the amino acid sequence of SEQ
ID NO: 118; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 125; or
[0227] v. a light chain comprising the amino acid sequence of SEQ
ID NO: 118; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 126; or
[0228] vi. a light chain comprising the amino acid sequence of SEQ
ID NO: 118; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 127; or
[0229] vii. a light chain comprising the amino acid sequence of SEQ
ID NO: 123; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 138; or
[0230] viii. a light chain comprising the amino acid sequence of
SEQ ID NO: 123; and a heavy chain comprising the amino acid
sequence of SEQ ID NO: 139; or
[0231] ix. a light chain comprising the amino acid sequence of SEQ
ID NO: 124; and a heavy chain comprising the amino acid sequence of
SEQ ID NO: 138.
[0232] In one embodiment related to any of aspects first to fifth,
the anti-IL-36R antibody is administered in one or more intravenous
dose(s). In a related embodiment, each of the one or more
intravenous dose(s) includes 210 mg, 300 mg, 350 mg, 450 mg, 600
mg, 700 mg, 750 mg, 800 mg, 900 mg of said anti-IL-36R
antibody.
[0233] In another embodiment related to any of aspects first to
fifth, the anti-IL-36R antibody is administered in one intravenous
dose. In another embodiment related to any of the above aspects,
the anti-IL-36R is administered in one intravenous dose of about 10
mg per kilogram of body weight of the patient. In another
embodiment related to any of the above aspects, the anti-IL-36R
antibody is administered in one intravenous dose of 210 mg. In
another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 300
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 350
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 450
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 600
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 700
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 750
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 800
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 850
mg. In another embodiment related to any of the above aspects, the
anti-IL-36R antibody is administered in one intravenous dose of 900
mg.
[0234] Representative examples of doses and dose regimens according
to the present invention are disclosed in Table 1. Although, doses
900 mg and 750 mg have been exemplified, similar dose regimens
equally apply to doses 210 mg, 300 mg, 350 mg, 450 mg, 600 mg, 700
mg and 800 mg.
TABLE-US-00009 TABLE 1 Doses and Dose Regimens Optional Intravenous
Frequency of Frequency of Subcutaneous Frequency of Frequency of
dose intravenous intravenous dose subcutaneous subcutaneous (mg)
doses administration (mg) doses administration 900 1 Single 150 0
-- 900 1 Single 150 1 -- 900 1 Single 150 2 At 4, 6, 8, 10 or 12
weeks intervals 900 1 Single 150 3 At 4, 6, 8, 10 or 12 weeks
intervals 900 1 Single 225 0 -- 900 1 Single 225 1 -- 900 1 Single
225 2 At 4, 6, 8, 10 or 12 weeks intervals 900 1 Single 225 3 At 4,
6, 8, 10 or 12 weeks intervals 900 1 Single 300 0 -- 900 1 Single
300 1 -- 900 1 Single 300 2 At 4, 6, 8, 10 or 12 weeks intervals
900 1 Single 300 3 At 4, 6, 8, 10 or 12 weeks intervals 900 2 At 2,
4, 6, 8, 10 or 12 150 0 -- weeks intervals 900 2 At 2, 4, 6, 8, 10
or 12 150 1 -- weeks intervals 900 2 At 2, 4, 6, 8, 10 or 12 150 2
At 4, 6, 8, 10 or weeks intervals 12 weeks intervals 900 2 At 2, 4,
6, 8, 10 or 12 150 3 At 4, 6, 8, 10 or weeks intervals 12 weeks
intervals 900 2 At 2, 4, 6, 8, 10 or 12 225 0 -- weeks intervals
900 2 At 2, 4, 6, 8, 10 or 12 225 1 -- weeks intervals 900 2 At 2,
4, 6, 8, 10 or 12 225 2 At 4, 6, 8, 10 or weeks intervals 12 weeks
intervals 900 2 At 2, 4, 6, 8, 10 or 12 225 3 At 4, 6, 8, 10 or
weeks intervals 12 weeks intervals 900 2 At 2, 4, 6, 8, 10 or 12
300 0 -- weeks intervals 900 2 At 2, 4, 6, 8, 10 or 12 300 1 --
weeks intervals 900 2 At 2, 4, 6, 8, 10 or 12 300 2 At 4, 6, 8, 10
or weeks intervals 12 weeks intervals 900 2 At 2, 4, 6, 8, 10 or 12
300 3 At 4, 6, 8, 10 or weeks intervals 12 weeks intervals 900 3 At
2, 4, 6, 8, 10 or 12 150 0 -- weeks intervals 900 3 At 2, 4, 6, 8,
10 or 12 150 1 -- weeks intervals 900 3 At 2, 4, 6, 8, 10 or 12 150
2 At 4, 6, 8, 10 or weeks intervals 12 weeks intervals 900 3 At 2,
4, 6, 8, 10 or 12 150 3 At 4, 6, 8, 10 or weeks intervals 12 weeks
intervals 900 3 At 2, 4, 6, 8, 10 or 12 225 0 -- weeks intervals
900 3 At 2, 4, 6, 8, 10 or 12 225 1 -- weeks intervals 900 3 At 2,
4, 6, 8, 10 or 12 225 2 At 4, 6, 8, 10 or weeks intervals 12 weeks
intervals 900 3 At 2, 4, 6, 8, 10 or 12 225 3 At 4, 6, 8, 10 or
weeks intervals 12 weeks intervals 900 3 At 2, 4, 6, 8, 10 or 12
300 0 -- weeks intervals 900 3 At 2, 4, 6, 8, 10 or 12 300 1 --
weeks intervals 900 3 At 2, 4, 6, 8, 10 or 12 300 2 At 4, 6, 8, 10
or weeks intervals 12 weeks intervals 900 3 At 2, 4, 6, 8, 10 or 12
300 3 At 4, 6, 8, 10 or weeks intervals 12 weeks intervals 750 1
Single 150 0 -- 750 1 Single 150 1 -- 750 1 Single 150 2 At 4, 6,
8, 10 or 12 weeks intervals 750 1 Single 150 3 At 4, 6, 8, 10 or 12
weeks intervals 750 1 Single 225 0 -- 750 1 Single 225 1 -- 750 1
Single 225 2 At 4, 6, 8, 10 or 12 weeks intervals 750 1 Single 225
3 At 4, 6, 8, 10 or 12 weeks intervals 750 1 Single 300 0 -- 750 1
Single 300 1 -- 750 1 Single 300 2 At 4, 6, 8, 10 or 12 weeks
intervals 750 1 Single 300 3 At 4, 6, 8, 10 or 12 weeks intervals
750 2 At 2, 4, 6, 8, 10 or 12 150 0 -- weeks intervals 750 2 At 2,
4, 6, 8, 10 or 12 150 1 -- weeks intervals 750 2 At 2, 4, 6, 8, 10
or 12 150 2 At 4, 6, 8, 10 or weeks intervals 12 weeks intervals
750 2 At 2, 4, 6, 8, 10 or 12 150 3 At 4, 6, 8, 10 or weeks
intervals 12 weeks intervals 750 2 At 2, 4, 6, 8, 10 or 12 225 0 --
weeks intervals 750 2 At 2, 4, 6, 8, 10 or 12 225 1 -- weeks
intervals 750 2 At 2, 4, 6, 8, 10 or 12 225 2 At 4, 6, 8, 10 or
weeks intervals 12 weeks intervals 750 2 At 2, 4, 6, 8, 10 or 12
225 3 At 4, 6, 8, 10 or weeks intervals 12 weeks intervals 750 2 At
2, 4, 6, 8, 10 or 12 300 0 -- weeks intervals 750 2 At 2, 4, 6, 8,
10 or 12 300 1 -- weeks intervals 750 2 At 2, 4, 6, 8, 10 or 12 300
2 At 4, 6, 8, 10 or weeks intervals 12 weeks intervals 750 2 At 2,
4, 6, 8, 10 or 12 300 3 At 4, 6, 8, 10 or weeks intervals 12 weeks
intervals 750 3 At 2, 4, 6, 8, 10 or 12 150 0 -- weeks intervals
750 3 At 2, 4, 6, 8, 10 or 12 150 1 -- weeks intervals 750 3 At 2,
4, 6, 8, 10 or 12 150 2 At 4, 6, 8, 10 or weeks intervals 12 weeks
intervals 750 3 At 2, 4, 6, 8, 10 or 12 150 3 At 4, 6, 8, 10 or
weeks intervals 12 weeks intervals 750 3 At 2, 4, 6, 8, 10 or 12
225 0 -- weeks intervals 750 3 At 2, 4, 6, 8, 10 or 12 225 1 --
weeks intervals 750 3 At 2, 4, 6, 8, 10 or 12 225 2 At 4, 6, 8, 10
or weeks intervals 12 weeks intervals 750 3 At 2, 4, 6, 8, 10 or 12
225 3 At 4, 6, 8, 10 or weeks intervals 12 weeks intervals 750 3 At
2, 4, 6, 8, 10 or 12 300 0 -- weeks intervals 750 3 At 2, 4, 6, 8,
10 or 12 300 1 -- weeks intervals 750 3 At 2, 4, 6, 8, 10 or 12 300
2 At 4, 6, 8, 10 or weeks intervals 12 weeks intervals 750 3 At 2,
4, 6, 8, 10 or 12 300 3 At 4, 6, 8, 10 or weeks intervals 12 weeks
intervals
[0235] In one embodiment, 1, 2 or 3 intravenous dose(s) is/are
administered to the patient in a dose regimen listed in Table
1.
[0236] In an embodiment relating to any of the above aspects, the
mammal or the patient is evaluated for improved Clinical Remission
as defined by: (a) Generalized Pustular Psoriasis Global Assessment
(GPPGA) score of 0 or 1 at Week 1; (b) GPPGA pustulation subscore
of 0 indicating no visible pustules at Week 1; (c) Psoriasis Area
and Severity Index for Generalized Pustular Psoriasis (GPPASI) 75
at Week 4; (d) Change from baseline in Pain Visual Analog Scale
(VAS) score at Week 4; (e) Change from baseline in Psoriasis
Symptom Scale (PSS) score at Week 4; (f) Change from baseline in
Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue
score at Week 4; (g) GPPGA 0 or 1 at Week 4; (h) GPPGA pustulation
subscore of 0 indicating no visible pustules at Week 4; (i) GPPASI
50 at Week 1 and 4; or (j) Change in GPPASI pustule, erythema or
scaling severity subscore from baseline at Week 1 and 4. In a
related embodiment, proportion of patients with a response to the
administration is statistically significantly higher as compared to
patients on placebo for any of the end points recited.
[0237] In one embodiment, the present invention relates to a method
of treating generalized pustular psoriasis (GPP), a method of
treating moderate to severe GPP, a method of reducing or
alleviating signs and symptoms of an acute phase flare-up of GPP, a
method of reducing the severity and duration of GPP flares, or a
method of treating a skin disorder associated with acute GPP in a
patient, said method(s) including administering or having
administered to the patient a therapeutically effective amount of
an anti-IL-36R antibody of the present invention in one or more
intravenous dose(s) of 210 mg, 300 mg, 350 mg, 450 mg, 600 mg, 700
mg, 750 mg, 800 mg or 900 mg each, wherein more than one
intravenous doses are administered at 2, 4, 6, 8, 10 or 12 weeks
intervals.
[0238] In one embodiment, the present invention relates to a method
of treating generalized pustular psoriasis (GPP), a method of
treating moderate to severe GPP, a method of reducing or
alleviating signs and symptoms of an acute phase flare-up of GPP, a
method of reducing the severity and duration of GPP flares, or a
method of treating a skin disorder associated with acute GPP in a
patient, said method(s) including administering or having
administered to the patient a therapeutically effective amount of
an anti-IL-36R antibody of the present invention in one intravenous
dose of 900 mg.
[0239] the present invention relates to a method of treating
generalized pustular psoriasis (GPP), a method of treating moderate
to severe GPP, a method of reducing or alleviating signs and
symptoms of an acute phase flare-up of GPP, a method of reducing
the severity and duration of GPP flares, or a method of treating a
skin disorder associated with acute GPP in a patient, said
method(s) including administering or having administered to the
patient a therapeutically effective amount of an anti-IL-36R
antibody of the present invention in 1, 2 or 3 intravenous dose(s)
of 210 mg, 300 mg, 350 mg, 450 mg, 600 mg, 700 mg, 750 mg, 800 mg
or 900 mg each, wherein 2 or 3 intravenous doses are administered
at 2, 4, 6, 8, 10 or 12 weeks intervals.
[0240] In a sixth aspect, the present invention relates to a method
of preventing the recurrence of GPP flares in a patient treated
with one or more intravenous dose(s) of the anti-IL-36R antibody
according to any of aspects first to fifth or the above
embodiments, said method including administering to the patient a
prophylactically effective amount of the anti-IL-36R antibody in
one or more subcutaneous doses.
[0241] In a seventh aspect, the present invention relates to a
method of achieving a Generalized Pustular Psoriasis Global
Assessment (GPPGA) score of 0 in a patient treated with one or more
intravenous dose(s) of the anti-IL-36R antibody according to any of
aspects first to fifth or the above embodiments, said method
including administering to the patient an effective amount of the
anti-IL-36R antibody in one or more subcutaneous doses.
[0242] In an eight aspect, the present invention relates to a
method of achieving a complete resolution of GPP symptoms in a
patient treated with one or more intravenous dose(s) of the
anti-IL-36R antibody according to any of aspects first to fifth or
the above embodiments, said method comprising administering to the
patient an effective amount of the anti-IL-36R antibody in one or
more subcutaneous doses; wherein the GPP symptoms comprise postule,
erythema, or scaling and the complete resolution comprises a GPPGA
score of 0.
[0243] In one embodiment related to any of aspects sixth to eight,
each of the one or more subcutaneous doses includes 150 mg, 225 mg,
300 mg, 450 mg or 600 mg of said anti-IL-36R antibody.
[0244] In one embodiment related to any of aspects sixth to eight
or the related embodiment(s), 1, 2, 3 or more subcutaneous doses
are administered to the patient and wherein a first subcutaneous
dose is administered after the last intravenous dose.
[0245] In one embodiment related to any of aspects sixth to eight
or the related embodiment(s), the first subcutaneous dose is
administered 2 to 8 weeks, 4 to 6 weeks, 2 weeks, 4 weeks, 6 weeks
or 8 weeks, after the last intravenous dose is administered and the
second subcutaneous dose is administered 4, 6, 8, 10 or 12 weeks
after said first subcutaneous dose is administered.
[0246] In one embodiment, the present invention relates to a method
of preventing the recurrence of GPP flares in a patient treated
with one or more intravenous dose(s) of the anti-IL-36R antibody of
the present invention, said method including administering to the
patient a prophylactically effective amount of the anti-IL-36R
antibody in one or more subcutaneous doses of 225 mg, 300 mg, 450
mg or 600 mg each of said anti-IL-36R antibody, wherein more than
one subcutaneous doses are administered at 4, 6, 8 10 or 12 weeks
intervals.
[0247] In one embodiment, the present invention relates to a method
of achieving a Generalized Pustular Psoriasis Global Assessment
(GPPGA) score of 0 or a method of achieving a complete resolution
of GPP symptoms in a patient treated with one or more intravenous
dose(s) of the anti-IL-36R antibody of the present invention, said
method including administering to the patient an effective amount
of the anti-IL-36R antibody in one or more subcutaneous doses of
225 mg, 300 mg, 450 mg or 600 mg each of said anti-IL-36R antibody,
wherein more than one subcutaneous doses are administered at 4, 6,
8 10 or 12 weeks intervals, and wherein the GPP symptoms comprise
postule, erythema, or scaling and the complete resolution comprises
a GPPGA score of 0.
[0248] In one embodiment, the present invention relates to a method
of achieving a Generalized Pustular Psoriasis Global Assessment
(GPPGA) score of 0 or a method of achieving a complete resolution
of GPP symptoms in a patient treated with one or more intravenous
dose(s) of the anti-IL-36R antibody of the present invention, said
method including administering to the patient an effective amount
of the anti-IL-36R antibody in 1, 2, 3 subcutaneous doses of 225
mg, 300 mg, 450 mg or 600 mg each of the anti-IL-36R antibody,
wherein 2 or 3 subcutaneous doses are administered at 4, 6, 8 10 or
12 weeks intervals, and wherein the GPP symptoms comprise postule,
erythema, or scaling and the complete resolution comprises a GPPGA
score of 0.
[0249] In one embodiment related to any of aspects sixth to eight
or the related embodiment(s), at least 10%, 20%, 30%, 40%, 50%,
60%, 70% or 80% of the patients remain in clinical remission as
measured by a GPPGA score of 0 or 1 at Week 12, 24, 36, 48, 60 or
72 of the treatment.
[0250] In one embodiment related to any of aspects sixth to eight
or the related embodiment(s), at least 10%, 20%, 30%, 40%, 50%,
60%, 70% or 80% of the patients remain in clinical remission as
measured by a change in GPPASI from baseline at Week 12, 24, 36,
48, 60 or 72 of the treatment.
[0251] In one embodiment related to any of aspects sixth to eight
or the related embodiment(s), at least 10%, 20%, 30%, 40%, 50%,
60%, 70% or 80% of the patients remain in clinical remission as
measured by a change in GPPASI pustule, erythema or scaling
severity subscore from baseline at Week 12, 24, 36, 48, 60 or 72 of
the treatment. In a related embodiment, proportion of patients with
a response to the administration is statistically significantly
higher as compared to patients on placebo for any of the end points
recited.
[0252] In an embodiment related to any of aspects sixth to eight,
at least 10%, 20%, 30%, 40%, 50%, 60%, 70% or 80% of the patients
remain in clinical remission as measured by a GPPGA score of 0 or 1
at Week 12, 24, 36, 48, 60 or 72 of the treatment. In an embodiment
related to any of aspects sixth to eight, at least 10%, 20%, 30%,
40%, 50%, 60%, 70% or 80% of the patients remain in clinical
remission as measured by a change in GPPASI from baseline at Week
12, 24, 36, 48, 60 or 72 of the treatment. In an embodiment related
to any of aspects sixth to eight, at least 10%, 20%, 30%, 40%, 50%,
60%, 70% or 80% of the patients remain in clinical remission as
measured by a change in GPPASI pustule, erythema or scaling
severity subscore from baseline at Week 12, 24, 36, 48, 60 or 72 of
the treatment. In a related embodiment, proportion of patients with
a response to the administration is statistically significantly
higher as compared to patients on placebo for any of the end points
recited.
[0253] In an embodiment related to any of aspects sixth to eight,
at least 10%, 20%, 30%, 40%, 50%, 60%, 70% or 80% of the patients
remain in clinical remission as measured by a GPPGA score of 0 or 1
at Week 12, 24, 36, 48, 60 or 72 of the treatment. In a related
embodiment, the improved effects are maintained at higher
percentage with an anti-IL-36R antibody of the present invention
than with placebo. In a related embodiment, at least 10%, 11%, 12%,
13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%,
26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%,
39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%,
52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%, 63%, 64%,
65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%,
78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, or 90%
of the mammals or patients maintain improved effects at Week 12,
24, 36, 48, 60 or 72 of the treatment with an anti-IL-36R antibody
of the present invention than with placebo.
[0254] In an embodiment related to any of aspects sixth to eight,
at least 10%, 20%, 30%, 40%, 50%, 60%, 70% or 80% of the patients
remain in clinical remission as measured by a change in GPPASI from
baseline at Week 12, 24, 36, 48, 60 or 72 of the treatment. In a
related embodiment, the improved effects are maintained at higher
percentage with an anti-IL-36R antibody of the present invention
than with placebo. In a related embodiment, at least 10%, 11%, 12%,
13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%,
26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%,
39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 0.48%, 49%, 50%, 51%,
52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%, 63%, 64%,
65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%,
78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, or 90%
of the mammals or patients maintain improved effects at Week 12,
24, 36, 48, 60 or 72 of the treatment with an anti-IL-36R antibody
of the present invention than with placebo.
[0255] In an embodiment related to any of aspects sixth to eight,
at least 10%, 20%, 30%, 40%, 50%, 60%, 70% or 80% of the patients
remain in clinical remission as measured by a change in GPPASI
pustule, erythema or scaling severity subscore from baseline at
Week 12, 24, 36, 48, 60 or 72 of the treatment. In a related
embodiment, the improved effects are maintained at higher
percentage with an anti-IL-36R antibody of the present invention
than with placebo. In a related embodiment, at least 10%, 11%, 12%,
13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%,
26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%,
39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%,
52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%, 63%, 64%,
65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%,
78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, or 90%
of the mammals or patients maintain improved effects at Week 12,
24, 36, 48, 60 or 72 of the treatment with an anti-IL-36R antibody
of the present invention than with placebo.
[0256] In a ninth aspect, the present invention relates to a method
of treating GPP in a patient, including administering to the
patient a therapeutically effective amount of one or more
intravenous dose(s) of the anti-IL-36R antibody, according to
aspects first to fifth and their related embodiments, followed by
one or more subcutaneous dose(s) of the anti-IL-36R antibody.
[0257] In one embodiment relating to aspect ninth, 1 or 2 or 3
intravenous dose(s) of the anti-IL-36R antibody is/are followed by
1 or 2 or 3 subcutaneous doss(s) of the anti-IL-36R antibody.
[0258] In one embodiment relating to aspect ninth, 1 intravenous
dose of the anti-IL-36R antibody is followed by 1 or 2 or 3
subcutaneous doss(s) of the anti-IL-36R antibody.
[0259] In one embodiment relating to aspect ninth, 2 intravenous
doses of the anti-IL-36R antibody are followed by 1 or 2 or 3
subcutaneous doss(s) of the anti-IL-36R antibody.
[0260] In one embodiment relating to aspect ninth, 3 intravenous
doses of the anti-IL-36R antibody are followed by 1 or 2 or 3
subcutaneous doss(s) of the anti-IL-36R antibody.
[0261] In one embodiment relating to aspect ninth and its related
embodiment, each of the one or more intravenous dose(s) includes
210 mg, 300 mg, 350 mg, 450 mg, 600 mg, 700 mg, 750 mg, 800 mg, 850
mg or 900 mg of the anti-IL-36R antibody and each of the one or
more subcutaneous dose(s) includes 150 mg, 225 mg, 300 mg, 450 mg,
or 600 mg of the anti-IL-36R antibody. In a related embodiment, the
intravenous doses are administered at 2, 4, 6, 8, 10 or 12 weeks
intervals, the subcutaneous doses are administered at 4, 6, 8, 10
or 12 weeks intervals, and the first subcutaneous dose is
administered 2 to 8 weeks, 4 to 6 weeks, 2 weeks, 4 weeks, 6 weeks
or 8 weeks after the last intravenous dose is administered.
[0262] In an embodiment relating to any of the above aspects, the
intravenous dose(s) may be followed by one or more subcutaneous
dose(s).
[0263] In an embodiment relating to any of the above aspects, the
anti-IL-36R antibody or an antigen binding fragment thereof
(disclosed herein) is present in a stable pharmaceutical
formulation (as described in co-pending U.S. provisional
application No. 62/815,405, filed Mar. 8, 2019, the entire content
of which is hereby incorporated herein by reference in its
entirety) for administration to a mammal or patient according to
any one of the aspects of the present invention.
[0264] In another embodiment, the formulation comprises a
therapeutic amount of an anti-IL-36R antibody (disclosed herein)
and [0265] i) a pharmaceutically acceptable buffer; or [0266] ii) a
pharmaceutically acceptable tonicifying agent; or [0267] iii) a
pharmaceutically acceptable stabilizing agent; or [0268] iv) a
pharmaceutically acceptable salt; or [0269] v) a pharmaceutically
acceptable surfactant; or [0270] vi) a pharmaceutically acceptable
buffer and a pharmaceutically acceptable tonicifying agent; or
[0271] vii) a pharmaceutically acceptable buffer, a
pharmaceutically acceptable tonicifying agent and a
pharmaceutically acceptable stabilizing agent; or [0272] viii) a
pharmaceutically acceptable buffer, a pharmaceutically acceptable
tonicifying agent, a pharmaceutically acceptable stabilizing agent
and a pharmaceutically acceptable salt; or [0273] ix) a
pharmaceutically acceptable buffer, a pharmaceutically acceptable
tonicifying agent, a pharmaceutically acceptable stabilizing agent,
a pharmaceutically acceptable salt and a pharmaceutically
acceptable surfactant; [0274] each in pharmaceutically acceptable
quantities and at a pharmaceutically acceptable pH.
[0275] In another embodiment, the anti-IL-36R antibody or antigen
binding fragment thereof is present in the formulation at a
concentration of about 15 mg/mL, about 20 mg/mL, about 25 mg/mL,
about 30 mg/mL, about 60 mg/mL, about 75 mg/mL, about 80 mg/mL,
about 100 mg/mL or about 150 mg/mL. In another related embodiment,
the pharmaceutically acceptable buffer is present in the
formulation at a concentration within the range from about 20 mM to
about 80 mM, or at a concentration of about 20 mM, about 25 mM,
about 35 mM, about 40 mM, about 45 mM, about 50 mM, about 60 mM. In
another related embodiment, the pharmaceutically acceptable
tonicifying agent is present in the formulation at a concentration
within the range from about 100 mM to about 250 mM, or at a
concentration of about 100 mM, about 120 mM, about 150 mM, about
180 mM, about 200 mM. In another related embodiment, the
pharmaceutically acceptable stabilizing agent is present in the
formulation at a concentration within the range from about 0 mM to
about 80 mM, or at a concentration of about 25 mM or about 50 mM.
In another related embodiment, the pharmaceutically acceptable salt
is present in the formulation at a concentration of within the
range from about 0 to about 150 mM, or at a concentration of about
3 mM, 5 mM, 10 mM, 25 mM or 50 mM. In another related embodiment,
the pharmaceutically acceptable surfactant is present in the
formulation at a concentration within the range from about 0 g/L to
about 1.5 g/L, or at a concentration of about 0.1 g/L, 0.2 g/L, 0.4
g/L, 0.5 g/L or 1 g/L. In an embodiment related to the first
aspect, the formulation is characterized by a pH within the range
from about 5 to about 8. In another related embodiment, the pH is
about 5, about 5.5, about 6, about 6.5, about 7, about 7.5 or about
8.
[0276] In another embodiment, the buffer comprises histidine,
phosphate, succinate, citrate, acetate or TRIS; the tonicifying
agent is one or more sugar and/or polyol including sucrose,
trehalose, sorbitol, magnesium sulfate (MgSO4), glycerol, mannitol
or dextrose; the stabilizer comprises an amino acid including
arginine, histidine, glycine, cysteine, proline, methionine,
lysine, aspartate, glutamate or pharmaceutically acceptable salts
thereof; the salt comprises sodium chloride (NaCl), magnesium
chloride (MgCl2), potassium chloride (KCl), lithium chloride
(LiCl), calcium chloride (CaCl2)), boric acid salts or zinc
chloride (ZnCl2); and the surfactant comprises poloxamer 188,
polysorbate 20, polysorbate 40, polysorbate 60 or polysorbate
80.
[0277] In one embodiment, the method of treatment according to any
of the aspects described herein, includes administering to the
mammal or patient a therapeutic amount of a stable pharmaceutical
formulation comprising from about 20 mg/mL to about 150 mg/mL of an
anti-IL-36R antibody, about 20 mM to about 80 mM of a
pharmaceutically acceptable buffer (e.g., acetate buffer), about
100 mM to about 250 mM of a pharmaceutically acceptable tonicifying
agent (e.g., sucrose), about 0 mM to about 80 mM of a
pharmaceutically acceptable stabilizing agent (e.g., arginine) or a
pharmaceutically acceptable salt thereof, about 0 to about 150 mM
of a pharmaceutically acceptable salt (e.g., sodium chloride), and
a pharmaceutically acceptable surfactant (e.g., polysorbate 20) in
an amount about 0 g/L to about 1.5 g/L, wherein the generalized
pustular psoriasis (GPP) in the patient is treated, or the moderate
to severe GPP in the patient is treated, or the signs and symptoms
of an acute phase flare-up of GPP in the patient is reduced or
alleviated, or the severity and duration of GPP flares in the
patient is reduced, or the skin disorder associated with acute GPP
in the patient is treated, or the GPP flares in a patient is
prevented or inhibited, or the Generalized Pustular Psoriasis
Global Assessment (GPPGA) score of 0 in the patient is achieved, or
the complete resolution of GPP symptoms in the patient is achieved.
In a related embodiment, the stable pharmaceutical formulation is
an aqueous pharmaceutical formulation. In a related embodiment, the
pH of the aqueous pharmaceutical formulation is about 5 to about 7.
In a related embodiment, the pharmaceutical formulation is for an
intravenous administration to the mammal or patient. In a related
embodiment, the pharmaceutical formulation is for a subcutaneous
administration to the mammal or patient. In a related embodiment,
the pharmaceutical formulation for the intravenous administration
comprises an anti-IL-36R antibody in an amount of about 60 mg/mL.
In a related embodiment, the pharmaceutical formulation for a
subcutaneous administration comprises an anti-IL-36R antibody in an
amount of about 150 mg/mL. In a related embodiment, the anti-IL-36R
antibody comprising: (i) a light chain including an amino acid
sequence set forth as SEQ ID NO:118 and a heavy chain including an
amino acid sequence set forth as SEQ ID NO:125; or (ii) a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as SEQ
ID NO:126; or (iii) a light chain including an amino acid sequence
set forth as SEQ ID NO:118 and a heavy chain including an amino
acid sequence set forth as SEQ ID NO:127. In a related embodiment,
the anti-IL-36R antibody comprising: a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 87; or a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or a light
chain variable region comprising the amino acid sequence of SEQ ID
NO: 77; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 89; or a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 87; or a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or a light
chain variable region comprising the amino acid sequence of SEQ ID
NO: 80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 89.
[0278] In one embodiment, the method of treatment according to any
of the preceding aspects, comprises administering to the mammal or
patient a therapeutic amount of a stable pharmaceutical formulation
selected from the group consisting of consisting of: [0279] I.
formulation including about 20 mg/mL to about 150 mg/mL of the
anti-IL-36R antibody, about 40 mM histidine, about 120 mM sucrose,
about 50 mM L-Arginine, about 5 mM NaCl and about 1.0 g/L
Polysorbate 20, with a pH of about 6.0; [0280] II. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 45 mM acetate, about 150 mM sucrose, about 25 mM
L-Arginine, about 0.4 g/L Polysorbate 20, with a pH of about 5.5;
[0281] III. formulation including about 20 mg/mL to about 150 mg/mL
of the anti-IL-36R antibody, about 45 mM acetate, about 180 mM
sucrose, about 25 mM Glycine, about 0.4 g/L Polysorbate 80, with a
pH of about 5.5; [0282] IV. formulation including about 20 mg/mL to
about 150 mg/mL of the anti-IL-36R antibody, about 25 mM citrate,
about 150 mM trehalose, about 25 mM methionine, about 0.2 g/L
Polysorbate 20, with a pH of about 6.0; [0283] V. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 25 mM histidine, about 180 mM sucrose, about 20 mM
mannitol, about 0.2 g/L Polysorbate 20, with a pH of about 6.5;
[0284] VI. formulation including about 20 mg/mL to about 150 mg/mL
of the anti-IL-36R antibody, about 25 mM citrate, about 200 mM
sucrose, about 0.4 g/L Polysorbate 80, with a pH of about 6.5;
[0285] VII. formulation including about 20 mg/mL to about 150 mg/mL
of the anti-IL-36R antibody, about 45 mM acetate, about 150 mM
sucrose, about 25 mM L-Arginine, about 0.4 g/L Polysorbate 20, with
a pH of about 5.5; [0286] VIII. formulation including about 20
mg/mL to about 150 mg/mL of the anti-IL-36R antibody, about 35 mM
histidine, about 180 mM trehalose, about 25 mM L-Arginine, about 3
mM NaCl, about 0.4 g/L Polysorbate 80, with a pH of about 6.0;
[0287] IX. formulation including about 20 mg/mL to about 150 mg/mL
of the anti-IL-36R antibody, about 25 mM acetate, about 100 mM
mannitol, about 50 mM NaCl, about 0.2 g/L Polysorbate 20, with a pH
of about 5.5; [0288] X. formulation including about 20 mg/mL to
about 150 mg/mL of the anti-IL-36R antibody, about 20 mM succinate,
about 220 mM sucrose, about 0.1 g/L Polysorbate 80, with a pH of
about 6.0; and [0289] XI. formulation including about 20 mg/mL to
about 150 mg/mL of the anti-IL-36R antibody, about 25 mM citrate,
about 0.4 g/L Polysorbate 20, with a pH of about 6.5,
[0290] wherein the generalized pustular psoriasis (GPP) in the
patient is treated, or the moderate to severe GPP in the patient is
treated, or the signs and symptoms of an acute phase flare-up of
GPP in the patient is reduced or alleviated, or the severity and
duration of GPP flares in the patient is reduced, or the skin
disorder associated with acute GPP in the patient is treated, or
the GPP flares in a patient is prevented or inhibited, or the
Generalized Pustular Psoriasis Global Assessment (GPPGA) score of 0
in the patient is achieved, or the complete resolution of GPP
symptoms in the patient is achieved. In a related embodiment, the
stable pharmaceutical formulation is an aqueous pharmaceutical
formulation. In a related embodiment, the pharmaceutical
formulation is for an intravenous administration to the mammal or
patient. In a related embodiment, the pharmaceutical formulation is
for a subcutaneous administration to the mammal or patient. In a
related embodiment, the pharmaceutical formulation for an
intravenous administration comprises an anti-IL-36R antibody in an
amount of about 60 mg/mL. In a related embodiment, the
pharmaceutical formulation for a subcutaneous administration
comprises an anti-IL-36R antibody in an amount of about 150 mg/mL.
In a related embodiment, the anti-IL-36R antibody comprising: (i) a
light chain including an amino acid sequence set forth as SEQ ID
NO:118 and a heavy chain including an amino acid sequence set forth
as SEQ ID NO:125; or (ii) a light chain including an amino acid
sequence set forth as SEQ ID NO:118 and a heavy chain including an
amino acid sequence set forth as SEQ ID NO:126; or (iii) a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as SEQ
ID NO:127. In a related embodiment, the anti-IL-36R antibody
comprising: a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or a light
chain variable region comprising the amino acid sequence of SEQ ID
NO: 77; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 88; or a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 89; or a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or a light
chain variable region comprising the amino acid sequence of SEQ ID
NO: 80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 88; or a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 89.
[0291] In one embodiment, the method of treatment according to any
of the preceding aspects, comprises administering to the mammal or
patient a therapeutic amount of a stable pharmaceutical formulation
selected from the group consisting of consisting of: [0292] I.
formulation including about 20 mg/mL of the anti-IL-36R antibody,
about 40 mM histidine, about 120 mM sucrose, about 50 mM
L-Arginine, about 5 mM NaCl and about 1.0 g/L Polysorbate 20, with
a pH of about 6.0; [0293] II. formulation including about 60 mg/mL
of the anti-IL-36R antibody, about 45 mM acetate, about 150 mM
sucrose, about 25 mM L-Arginine, about 0.4 g/L Polysorbate 20, with
a pH of about 5.5; [0294] III. formulation including about 20 mg/mL
of the anti-IL-36R antibody, about 45 mM acetate, about 180 mM
sucrose, about 25 mM Glycine, about 0.4 g/L Polysorbate 80, with a
pH of about 5.5; [0295] IV. formulation including about 150 mg/mL
of the anti-IL-36R antibody, about 25 mM citrate, about 150 mM
trehalose, about 25 mM methionine, about 0.2 g/L Polysorbate 20,
with a pH of about 6.0; [0296] V. formulation including about 150
mg/mL of the anti-IL-36R antibody, about 25 mM histidine, about 180
mM sucrose, about 20 mM mannitol, about 0.2 g/L Polysorbate 20,
with a pH of about 6.5; [0297] VI. formulation including about 20
mg/mL of the anti-IL-36R antibody, about 25 mM citrate, about 200
mM sucrose, about 0.4 g/L Polysorbate 80, with a pH of about 6.5;
[0298] VII. formulation including about 150 mg/mL of the
anti-IL-36R antibody, about 45 mM acetate, about 150 mM sucrose,
about 25 mM L-Arginine, about 0.4 g/L Polysorbate 20, with a pH of
about 5.5; [0299] VIII. formulation including about 15 mg/mL of the
anti-IL-36R antibody, about 35 mM histidine, about 180 mM
trehalose, about 25 mM L-Arginine, about 3 mM NaCl, about 0.4 g/L
Polysorbate 80, with a pH of about 6.0; [0300] IX. formulation
including about 80 mg/mL of the anti-IL-36R antibody, about 25 mM
acetate, about 100 mM mannitol, about 50 mM NaCl, about 0.2 g/L
Polysorbate 20, with a pH of about 5.5; [0301] X. formulation
including about 100 mg/mL of the anti-IL-36R antibody, about 20 mM
succinate, about 220 mM sucrose, about 0.1 g/L Polysorbate 80, with
a pH of about 6.0; and [0302] XI. formulation including about 60
mg/mL of the anti-IL-36R antibody, about 25 mM citrate, about 0.4
g/L Polysorbate 20, with a pH of about 6.5,
[0303] wherein the generalized pustular psoriasis (GPP) in the
patient is treated, or the moderate to severe GPP in the patient is
treated, or the signs and symptoms of an acute phase flare-up of
GPP in the patient is reduced or alleviated, or the severity and
duration of GPP flares in the patient is reduced, or the skin
disorder associated with acute GPP in the patient is treated, or
the GPP flares in a patient is prevented or inhibited, or a
Generalized Pustular Psoriasis Global Assessment (GPPGA) score of 0
in the patient is achieved, or the complete resolution of GPP
symptoms in the patient is achieved. In a related embodiment, the
stable pharmaceutical formulation is an aqueous pharmaceutical
formulation. In a related embodiment, the pharmaceutical
formulation is for an intravenous administration to the mammal or
patient. In a related embodiment, the pharmaceutical formulation is
for a subcutaneous administration to the mammal or patient. In a
related embodiment, the pharmaceutical formulation for an
intravenous administration comprises an anti-IL-36R antibody in an
amount of about 60 mg/mL. In a related embodiment, the
pharmaceutical formulation for a subcutaneous administration
comprises an anti-IL-36R antibody in an amount of about 150 mg/mL.
In a related embodiment, the anti-IL-36R antibody comprising: (i) a
light chain including an amino acid sequence set forth as SEQ ID
NO:118 and a heavy chain including an amino acid sequence set forth
as SEQ ID NO:125; or (ii) a light chain including an amino acid
sequence set forth as SEQ ID NO:118 and a heavy chain including an
amino acid sequence set forth as SEQ ID NO:126; or (iii) a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as SEQ
ID NO:127. In a related embodiment, the anti-IL-36R antibody
comprising: a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or a light
chain variable region comprising the amino acid sequence of SEQ ID
NO: 77; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 88; or a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 89; or a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or a light
chain variable region comprising the amino acid sequence of SEQ ID
NO: 80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 88; or a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 89. In a tenth aspect, the present invention relates to a
method of treating GPP in a patient, including
[0304] (a) obtaining a biological sample from said patient, wherein
the biological sample is obtained from source including lesional
skin or whole blood;
[0305] (b) determining the gene express profile of one or more of
genes;
[0306] (c) administering to the patient an effective amount of the
anti-IL-36R antibody according to any embodiments relating to
aspects first to fifth.
[0307] In one embodiment relating to aspect tenth, the one or more
of genes are IL12B, IL1B, IL6, CXCL1, IL23A, TNF, IL17C, IL24 or
IL1B in lesional skin, and IL1B, S100A9, S100A12, S100A8, MMP25,
MMP9 or CD177 in whole blood.
[0308] In an embodiment relating to any of the above aspects, the
anti-IL-36R antibody includes: a) a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 26 (L-CDR1); the
amino acid sequence of SEQ ID NO: 35, 102, 103, 104, 105 106 or 140
(L-CDR2); the amino acid sequence of SEQ ID NO: 44 (L-CDR3); and b)
a heavy chain variable region comprising the amino acid sequence of
SEQ ID NO: 53 (H-CDR1); the amino acid sequence of SEQ ID NO: 62,
108, 109, 110 or 111 (H-CDR2); the amino acid sequence of SEQ ID
NO: 72 (H-CDR3).
[0309] In an embodiment relating to any of the above aspects, the
anti-IL36R antibody is an anti-IL-36R antibody of the present
invention. In one embodiment, the anti-IL36R antibody is disclosed
in U.S. Pat. No. 9,023,995 or WO2013/074569. In an embodiment
relating to any of the above aspects, the improved effects
(including the remission or improved symptoms) last for 4, 5, 6, 7,
8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 21, 22, 23, 24, 25,
26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42,
43, 44, 45, 46, 47, 48, 49, 50, 51, or 52 weeks following the
administration of a single dose of an anti-IL-36R antibody of the
present invention.
Pharmaceutical Compositions and Administration Thereof
[0310] The antibodies of the present invention can be administered
either alone or in combination with other agents. Examples of
antibodies for use in such pharmaceutical compositions are those
that comprise an antibody or antibody fragment having the light
chain variable region amino acid sequence of any of SEQ ID NO:
1-10. Examples of antibodies for use in such pharmaceutical
compositions are also those that comprise a humanized antibody or
antibody fragment having the heavy chain variable region amino acid
sequence of any of SEQ ID NO: 11-20.
[0311] Further examples of antibodies for use in such
pharmaceutical compositions are also those that comprise a
humanized antibody or antibody fragment having the light chain
variable region amino acid sequence of any of SEQ ID NO:76-86.
Preferred antibodies for use in such pharmaceutical compositions
are also those that comprise a humanized antibody or antibody
fragment having the heavy chain variable region amino acid sequence
of any of SEQ ID NO:87-101.
[0312] Further examples of antibodies for use in such
pharmaceutical compositions are also those that comprise a
humanized antibody or antibody fragment having the light chain
variable region and heavy chain variable region of any of SEQ ID
NO: 77 and 89, SEQ ID NO: 80 and 88, SEQ ID NO: 80 and 89, SEQ ID
NO: 77 and 87, SEQ ID NO: 77 and 88, SEQ ID NO: 80 and 87, SEQ ID
NO: 86 and 100, SEQ ID NO: 85 and 101, or SEQ ID NO: 85 and 10.
[0313] Further examples of antibodies for use in such
pharmaceutical compositions are also those that comprise a
humanized antibody having the light chain region amino acid
sequence of any of SEQ ID NO:115, 118, 123 or 124. Preferred
antibodies for use in such pharmaceutical compositions are also
those that comprise humanized antibody having the heavy chain
variable region amino acid sequence of any of SEQ ID NO:125, 126,
127, 138 or 139.
[0314] Further examples of antibodies for use in such
pharmaceutical compositions are also those that comprise Antibody
B1, Antibody B2, Antibody B3, Antibody B4, Antibody B5, Antibody
B6, Antibody C1, Antibody C2 or Antibody C3.
[0315] Various delivery systems are known and can be used to
administer the IL-36R binding agent. Methods of introduction
include but are not limited to intradermal, intramuscular,
intraperitoneal, intravenous, subcutaneous, intranasal, epidural,
and oral routes. The IL-36R binding agent can be administered, for
example by infusion, bolus or injection, and can be administered
together with other biologically active agents such as
chemotherapeutic agents. Administration can be systemic or local.
In preferred embodiments, the administration is by subcutaneous
injection. Formulations for such injections may be prepared in for
example prefilled syringes that may be administered once every
other week.
[0316] In one aspect, the invention provides an article of
manufacture comprising a subcutaneous administration device, which
delivers to a patient a fixed dose of an antibody of the present
invention. In some embodiments, the subcutaneous administration
device is a pre-filled syringe, an autoinjector, or a large volume
infusion device. For example, MyDose.TM. product from Roche, a
single use infusion device that enables the subcutaneous
administration of large quantities of liquid medication, may be
used as the administration device. Numerous reusable pen and
autoinjector delivery devices have applications in the subcutaneous
delivery of a pharmaceutical composition of the present invention.
Examples include, but are not limited to AUTOPEN.TM. (Owen Mumford,
Inc., Woodstock, UK), DISETRONIC.TM. pen (Disetronic Medical
Systems, Bergdorf, Switzerland), HUMALOG MIX 75/25.TM. pen,
HUMALOG.TM. pen, HUMALIN 70/30.TM. pen (Eli Lilly and Co.,
Indianapolis, Ind.), NOVOPEN.TM. I, II and III (Novo Nordisk,
Copenhagen, Denmark), NOVOPEN JUNIOR.TM. (Novo Nordisk, Copenhagen,
Denmark), BD.TM. pen (Becton Dickinson, Franklin Lakes, N.J.),
OPTIPEN.TM., OPTIPEN PRO.TM., OPTIPEN STARLET.TM., and OPTICLIK.TM.
(Sanofi-Aventis, Frankfurt, Germany), to name only a few. Examples
of disposable pen delivery devices having applications in
subcutaneous delivery of a pharmaceutical composition of the
present invention include, but are not limited to the SOLOSTAR.TM.
pen (Sanofi-Aventis), the FLEXPEN.TM. (Novo Nordisk), and the
KWIKPEN.TM. (Eli Lilly), the SURECLICK.TM. Autoinjector (Amgen,
Thousand Oaks, Calif.), the PENLET.TM. (Haselmeier, Stuttgart,
Germany), the EPIPEN (Dey, L.P.), and the HUMIRA.TM. Pen (Abbott
Labs, Abbott Park Ill.), YPSOMATE.TM., YPSOMATE 2.25.TM.,
VAIROJECT.TM. (Ypsomed AG, Burgdorf, Switzerland) to name only a
few. Additional information relating to example delivery devices
that could be used with an antibody of the present invention may be
found, for example, in CH705992A2, WO2009/040602, WO2016/169748,
WO2016/179713.
[0317] In specific embodiments, the IL-36R binding agent
composition is administered by injection, by means of a catheter,
by means of a suppository, or by means of an implant, the implant
being of a porous, non-porous, or gelatinous material, including a
membrane, such as a sialastic membrane, or a fiber. Typically, when
administering the composition, materials to which the anti-IL-36R
antibody or agent does not absorb are used.
[0318] In other embodiments, the anti-IL-36R antibody or agent is
delivered in a controlled release system. In one embodiment, a pump
may be used (see, e.g., Langer, 1990, Science 249:1527-1533;
Sefton, 1989, CRC Crit. Ref. Biomed. Eng. 14:201; Buchwald et al.,
1980, Surgery 88:507; Saudek et al., 1989, N. Engl. J. Med.
321:574). In another embodiment, polymeric materials can be used.
(See, e.g., Medical Applications of Controlled Release (Langer and
Wise eds., CRC Press, Boca Raton, Fla., 1974); Controlled Drug
Bioavailability, Drug Product Design and Performance (Smolen and
Ball eds., Wiley, New York, 1984); Ranger and Peppas, 1983,
Macromol. Sci. Rev. Macromol. Chem. 23:61. See also Levy et al.,
1985, Science 228:190; During et al., 1989, Ann. Neurol. 25:351;
Howard et al., 1989, J. Neurosurg. 71:105.) Other controlled
release systems are discussed, for example, in Langer, supra.
[0319] An IL-36R binding agent (e.g., an anti-IL-36R antibody) can
be administered as pharmaceutical compositions comprising a
therapeutically effective amount of the binding agent and one or
more pharmaceutically compatible ingredients.
[0320] In one embodiment, the anti-IL-36R antibody or an antigen
binding fragment thereof (disclosed herein) is present in a
pharmaceutical formulation (as described in co-pending U.S.
provisional application No. 62/815,405, filed Mar. 8, 2019, the
entire content of which is hereby incorporated herein by reference
in its entirety) suitable for administration to a mammal or patient
according to any one of the aspects described herein. Various
examples to this embodiment are described as numbered clauses (1,
2, 3, etc.) below for convenience. These are provided as examples
and do not limit the subject technology. It is noted that any of
the dependent clauses may be combined in any combination, and
placed into a respective independent clause, e.g., clause 1. The
other clauses can be presented in a similar manner. [0321] 1. A
pharmaceutical formulation including: [0322] a. An anti-IL-36R
antibody or an antigen binding fragment thereof, as disclosed
herein, present at a concentration within the range from about 0.5
mg/mL to about 220 mg/mL; and [0323] b. A pharmaceutically
acceptable buffer present at a concentration within the range from
about 20 mM to about 80 mM; [0324] wherein the formulation is
characterized by a pH within the range from about 5 to about 8 when
in aqueous form. [0325] 2. The formulation of clause 1, wherein the
formulation is in liquid or powder form. [0326] 3. The formulation
of clause 1, wherein the anti-IL-36R antibody is present at a
concentration of within the range from about 10 mg/mL to about 200
mg/mL. [0327] 4. The formulation of clause 1, wherein the
anti-IL-36R antibody is present at a concentration of about 20
mg/mL. [0328] 5. The formulation of clause 1, wherein the
anti-IL-36R antibody is present at a concentration of about 60
mg/mL. [0329] 6. The formulation of clause 1, wherein the
anti-IL-36R antibody is present at a concentration of about 150
mg/mL. [0330] 7. The formulation of clause 1, wherein the buffer
comprises histidine, phosphate, succinate, citrate, acetate or
TRIS. [0331] 8. The formulation of clause 1, wherein the buffer
comprises citrate or acetate. [0332] 9. The formulation of clause
1, wherein the buffer comprises histidine. [0333] 10. The
formulation of clause 1, wherein the buffer comprises acetate.
[0334] 11. The formulation of clause 1, wherein the formulation
further comprises a pharmaceutically acceptable tonicifying agent
present at a concentration within the range from about 100 mM to
about 250 mM. [0335] 12. The formulation of clause 11, wherein the
tonicifying agent is one or more sugar and/or polyol. [0336] 13.
The formulation of clause 11, wherein the tonicifying agent is one
or more sugar and/or polyol including sucrose, trehalose, sorbitol,
magnesium sulfate (MgSO.sub.4), glycerol, mannitol or dextrose.
[0337] 14. The formulation of clause 11, wherein the tonicifying
agent comprises sucrose or trehalose. [0338] 15. The formulation of
clause 11, wherein the tonicifying agent comprises sucrose. [0339]
16. The formulation of clause 11, wherein the tonicifying agent
comprises trehalose. [0340] 17. The formulation of clause 1,
wherein the formulation further comprises a pharmaceutically
acceptable stabilizer present at a concentration within the range
from about 0 mM to about 80 mM. [0341] 18. The formulation of
clause 17, wherein the stabilizer comprises an amino acid including
arginine, histidine, glycine, cysteine, proline, methionine,
lysine, aspartate, glutamate or pharmaceutically acceptable salts
thereof. [0342] 19. The formulation of clause 17, wherein the
stabilizer comprises L-arginine or pharmaceutically acceptable
salts thereof. [0343] 20. The formulation of clause 1, wherein the
formulation further comprises a pharmaceutically acceptable salt
present at a concentration of within the range from about 0 to
about 150 mM. [0344] 21. The formulation of clause 20, wherein the
salt comprises sodium chloride (NaCl), magnesium chloride
(MgCl.sub.2), potassium chloride (KCl), lithium chloride (LiCl),
calcium chloride (CaCl.sub.2)), boric acid salts or zinc chloride
(ZnCl.sub.2). [0345] 22. The formulation of clause 20, wherein the
salt comprises sodium chloride (NaCl). [0346] 23. The formulation
of clause 1, wherein the formulation further comprises a
pharmaceutically acceptable surfactant present at a concentration
within the range from about 0 g/L to about 1.5 g/L. [0347] 24. The
formulation of clause 23, wherein the surfactant comprises
poloxamer 188, polysorbate 20, polysorbate 40, polysorbate 60 or
polysorbate 80. [0348] 25. The formulation of clause 23, wherein
the surfactant comprises polysorbate 20, polysorbate 40,
polysorbate 60 or polysorbate 80. [0349] 26. The formulation of
clause 23, wherein the surfactant comprises polysorbate 20. [0350]
27. The formulation of clause 23, wherein the surfactant comprises
polysorbate 80. [0351] 28. A pharmaceutical formulation including:
[0352] a. an anti-IL-36R antibody or an antigen binding fragment
thereof, as disclosed herein, present at a concentration within the
range from about 10 mg/mL to about 200 mg/mL; [0353] b. an acetate
and/or histidine buffer present at a concentration within the range
from about 20 mM to about 80 mM; [0354] c. sucrose and-/-or
trehalose present at a concentration within the range from about
100 mM to about 250 mM; [0355] d. L-arginine and-/-or
pharmaceutically acceptable salts thereof present at a
concentration within the range from about 0 mM to about 80 mM;
[0356] e. sodium chloride (NaCl) present at a concentration of
within the range from about 0 to about 150 mM; and [0357] f.
polysorbate 20 and/or polysorbate 80 present at a concentration
within the range from about 0 g/L to about 1.5 g/L; [0358] wherein
the formulation is characterized by a pH within the range from
about 5 to about 7 when in aqueous form. [0359] 29. A
pharmaceutical formulation including: [0360] a. an anti-IL-36R
antibody or an antigen binding fragment thereof, as disclosed
herein, present at a concentration of about 20 mg/mL; [0361] b. an
citrate buffer present at a concentration at a concentration of
about 25 mM; [0362] c. sucrose and/or trehalose present at a
concentration of about 200 mM; [0363] d. polysorbate 80 present at
a concentration of about 0.4 g/L; [0364] wherein the formulation is
characterized by a pH within the range from about 6 to about 7 when
in aqueous form. [0365] 30. A pharmaceutical formulation including:
[0366] a. an anti-IL-36R antibody or an antigen binding fragment
thereof, as disclosed herein, present at a concentration of about
60 mg/mL; [0367] b. an acetate buffer present at a concentration at
a concentration of about 45 mM; [0368] c. sucrose and/or trehalose
present at a concentration of about 150 mM; [0369] d. L-arginine or
pharmaceutically acceptable salts thereof present at a
concentration of about 25 mM; and [0370] e. polysorbate 20 present
at a concentration of about 0.4 g/L; [0371] wherein the formulation
is characterized by a pH within the range from about 5 to about 6
when in aqueous form. [0372] 31. A pharmaceutical formulation
including: [0373] a. an anti-IL-36R antibody or an antigen binding
fragment thereof, as disclosed herein, present at a concentration
of about 150 mg/mL; [0374] b. an acetate buffer present at a
concentration at a concentration of about 45 mM; [0375] c. sucrose
or trehalose present at a concentration of about 150 mM; [0376] d.
L-arginine or pharmaceutically acceptable salts thereof present at
a concentration of about 25 mM; and [0377] e. polysorbate 20
present at a concentration of about 0.4 g/L; [0378] wherein the
formulation is characterized by a pH within the range from about 5
to about 6 when in aqueous form. [0379] 32. The pharmaceutical
formulation of any one of clauses 1-31, wherein the formulation is
characterized by an osmolality within the range from about 210
mOsmol/kg to about 390 mOsm/kg. [0380] 33. The pharmaceutical
formulation of any one of clauses 1-32, wherein less than about 5%
of the antibody is present in an aggregate form in the formulation.
[0381] 34. The pharmaceutical formulation of any one of clauses
1-33, wherein the formulation is sterile. [0382] 35. The
pharmaceutical formulation of any one of clauses 1-34, wherein the
formulation is stable upon freezing and thawing. [0383] 36. The
pharmaceutical formulation of any of clauses 1-35, wherein the
formulation comprises water or is reconstituted with water. [0384]
37. The pharmaceutical formulation of any of clauses 1-36, wherein
the formulation has a pH of between about 5 to about 6 in liquid
form or when reconstituted with water. [0385] 38. The
pharmaceutical formulation of any of clauses 1-37, wherein the
formulation has a pH of about 6 in liquid or when reconstituted
with water. [0386] 39. The pharmaceutical formulation of any of
clauses 1-37, wherein the formulation has at least one feature
selected from the group consisting of: [0387] (i) Increased shelf
life [0388] (ii) better temperature stability, [0389] (iii)
decreased formation of aggregates, [0390] (iv) better chemical
stability, [0391] (v) decreased viscosity, and [0392] as compared
to a reference formulation. [0393] 40. The pharmaceutical
formulation of any of clauses 1-37, wherein the formulation having
at least one feature selected from the group consisting of: [0394]
(a) decreased percentage of aggregates as measured by High
Performance Size Exclusion Chromatography (HP-SEC), [0395] (b)
higher percentage of monomers as measured by HP-SEC, [0396] (c)
higher percentage of main peak (less degradation of charge
variants) measured by CEX, [0397] (d) lower percentage of subvisual
particles such as .gtoreq.10 .mu.m and .gtoreq.25 .mu.m, and [0398]
(e) lower turbidity value in Formazin Nephelometry Units (FNU),
after storage at about 40.degree. C. as compared to the reference
formulation. [0399] 41. A pharmaceutical formulation including:
[0400] an anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0401] i. a light chain including an amino acid sequence
set forth as SEQ ID NO:118 and a heavy chain including an amino
acid sequence set forth as SEQ ID NO:125; or [0402] ii. a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as SEQ
ID NO:126; or [0403] iii. a light chain including an amino acid
sequence set forth as SEQ ID NO:118 and a heavy chain including an
amino acid sequence set forth as SEQ ID NO:127; [0404] wherein the
formulation is selected from the group consisting of: [0405] I.
formulation including about 20 mg/mL of the anti-IL-36R antibody,
about 40 mM histidine, about 120 mM sucrose, about 50 mM
L-Arginine, about 5 mM NaCl and about 1.0 g/L Polysorbate 20, with
a pH of about 6.0; [0406] II. formulation including about 60 mg/mL
of the anti-IL-36R antibody, about 45 mM acetate, about 150 mM
sucrose, about 25 mM L-Arginine, about 0.4 g/L Polysorbate 20, with
a pH of about 5.5; [0407] III. formulation including about 20 mg/mL
of the anti-IL-36R antibody, about 45 mM acetate, about 180 mM
sucrose, about 25 mM Glycine, about 0.4 g/L Polysorbate 80, with a
pH of about 5.5; [0408] IV. formulation including about 150 mg/mL
of the anti-IL-36R antibody, about 25 mM citrate, about 150 mM
trehalose, about 25 mM methionine, about 0.2 g/L Polysorbate 20,
with a pH of about 6.0; [0409] V. formulation including about 150
mg/mL of the anti-IL-36R antibody, about 25 mM histidine, about 180
mM sucrose, about 20 mM mannitol, about 0.2 g/L Polysorbate 20,
with a pH of about 6.5; [0410] VI. formulation including about 20
mg/mL of the anti-IL-36R antibody, about 25 mM citrate, about 200
mM sucrose, about 0.4 g/L Polysorbate 80, with a pH of about 6.5;
[0411] VII. formulation including about 150 mg/mL of the
anti-IL-36R antibody, about 45 mM acetate, about 150 mM sucrose,
about 25 mM L-Arginine, about 0.4 g/L Polysorbate 20, with a pH of
about 5.5; [0412] VIII. formulation including about 15 mg/mL of the
anti-IL-36R antibody, about 35 mM histidine, about 180 mM
trehalose, about 25 mM L-Arginine, about 3 mM NaCl, about 0.4 g/L
Polysorbate 80, with a pH of about 6.0; [0413] IX. formulation
including about 80 mg/mL of the anti-IL-36R antibody, about 25 mM
acetate, about 100 mM mannitol, about 50 mM NaCl, about 0.2 g/L
Polysorbate 20, with a pH of about 5.5; [0414] X. formulation
including about 100 mg/mL of the anti-IL-36R antibody, about 20 mM
succinate, about 220 mM sucrose, about 0.1 g/L Polysorbate 80, with
a pH of about 6.0; and [0415] XI. formulation including about 60
mg/mL of the anti-IL-36R antibody, about 25 mM citrate, about 0.4
g/L Polysorbate 20, with a pH of about 6.5. [0416] 42. A
pharmaceutical formulation including: [0417] an anti-IL-36R
antibody or antigen-binding fragment thereof, including: [0418] i.
a light chain including an amino acid sequence set forth as SEQ ID
NO:118 and a heavy chain including an amino acid sequence set forth
as SEQ ID NO:125; or [0419] ii. a light chain including an amino
acid sequence set forth as SEQ ID NO:118 and a heavy chain
including an amino acid sequence set forth as SEQ ID NO:126; or
[0420] iii. a light chain including an amino acid sequence set
forth as SEQ ID NO:118 and a heavy chain including an amino acid
sequence set forth as SEQ ID NO:127; [0421] wherein the formulation
includes about 20 mg/mL of the anti-IL-36R antibody, about 40 mM
histidine, about 120 mM sucrose, about 50 mM L-Arginine, about 5 mM
NaCl and about 1.0 g/L Polysorbate 20, with a pH of about 6.0.
[0422] 43. A pharmaceutical formulation including: [0423] an
anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0424] i. a light chain including an amino acid sequence
set forth as SEQ ID NO:118 and a heavy chain including an amino
acid sequence set forth as SEQ ID NO:125; or [0425] ii. a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as SEQ
ID NO:126; or [0426] iii. a light chain including an amino acid
sequence set forth as SEQ ID NO:118 and a heavy chain including an
amino acid sequence set forth as SEQ ID NO:127; [0427] wherein the
formulation includes about 60 mg/mL of the anti-IL-36R antibody,
about 45 mM acetate, about 150 mM sucrose, about 25 mM L-Arginine,
about 0.4 g/L Polysorbate 20, with a pH of about 5.5. [0428] 44. A
pharmaceutical formulation including: [0429] an anti-IL-36R
antibody or antigen-binding fragment thereof, including: [0430] i.
a light chain including an amino acid sequence set forth as SEQ ID
NO:118 and a heavy chain including an amino acid sequence set forth
as SEQ ID NO:125; or [0431] ii. a light chain including an amino
acid sequence set forth as SEQ ID NO:118 and a heavy chain
including an amino acid sequence set forth as SEQ ID NO:126; or
[0432] iii. a light chain including an amino acid sequence set
forth as SEQ ID NO:118 and a heavy chain including an amino acid
sequence set forth as SEQ ID NO:127;
[0433] wherein the formulation includes about 20 mg/mL of the
anti-IL-36R antibody, about 45 mM acetate, about 180 mM sucrose,
about 25 mM Glycine, about 0.4 g/L Polysorbate 80, with a pH of
about 5.5. [0434] 45. A pharmaceutical formulation including:
[0435] an anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0436] i. a light chain including an amino acid sequence
set forth as SEQ ID NO:118 and a heavy chain including an amino
acid sequence set forth as SEQ ID NO:125; or [0437] ii. a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as SEQ
ID NO:126; or [0438] iii. a light chain including an amino acid
sequence set forth as SEQ ID NO:118 and a heavy chain including an
amino acid sequence set forth as SEQ ID NO:127; [0439] wherein the
formulation includes about 150 mg/mL of the anti-IL-36R antibody,
about 25 mM citrate, about 150 mM trehalose, about 25 mM
methionine, about 0.2 g/L Polysorbate 20, with a pH of about 6.0.
[0440] 46. A pharmaceutical formulation including: [0441] an
anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0442] i. a light chain including an amino acid sequence
set forth as SEQ ID NO:118 and a heavy chain including an amino
acid sequence set forth as SEQ ID NO:125; or [0443] ii. a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as SEQ
ID NO:126; or [0444] iii. a light chain including an amino acid
sequence set forth as SEQ ID NO:118 and a heavy chain including an
amino acid sequence set forth as SEQ ID NO:127; [0445] wherein the
formulation includes about 150 mg/mL of the anti-IL-36R antibody,
about 25 mM histidine, about 180 mM sucrose, about 20 mM mannitol,
about 0.2 g/L Polysorbate 20, with a pH of about 6.5. [0446] 47. A
pharmaceutical formulation including: [0447] an anti-IL-36R
antibody or antigen-binding fragment thereof, including: [0448] i.
a light chain including an amino acid sequence set forth as SEQ ID
NO:118 and a heavy chain including an amino acid sequence set forth
as SEQ ID NO:125; or [0449] ii. a light chain including an amino
acid sequence set forth as SEQ ID NO:118 and a heavy chain
including an amino acid sequence set forth as SEQ ID NO:126; or
[0450] iii. a light chain including an amino acid sequence set
forth as SEQ ID NO:118 and a heavy chain including an amino acid
sequence set forth as SEQ ID NO:127; [0451] wherein the formulation
includes about 20 mg/mL of the anti-IL-36R antibody, about 25 mM
citrate, about 200 mM sucrose, about 0.4 g/L Polysorbate 80, with a
pH of about 6.5. [0452] 48. A pharmaceutical formulation including:
[0453] an anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0454] i. a light chain including an amino acid sequence
set forth as SEQ ID NO:118 and a heavy chain including an amino
acid sequence set forth as SEQ ID NO:125; or [0455] ii. a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as SEQ
ID NO:126; or [0456] iii. a light chain including an amino acid
sequence set forth as SEQ ID NO:118 and a heavy chain including an
amino acid sequence set forth as SEQ ID NO:127; [0457] wherein the
formulation includes about 150 mg/mL of the anti-IL-36R antibody,
about 45 mM acetate, about 150 mM sucrose, about 25 mM L-Arginine,
about 0.4 g/L Polysorbate 20, with a pH of about 5.5. [0458] 49. A
pharmaceutical formulation including: [0459] an anti-IL-36R
antibody or antigen-binding fragment thereof, including: [0460] i.
a light chain including an amino acid sequence set forth as SEQ ID
NO:118 and a heavy chain including an amino acid sequence set forth
as SEQ ID NO:125; or [0461] ii. a light chain including an amino
acid sequence set forth as SEQ ID NO:118 and a heavy chain
including an amino acid sequence set forth as SEQ ID NO:126; or
[0462] iii. a light chain including an amino acid sequence set
forth as SEQ ID NO:118 and a heavy chain including an amino acid
sequence set forth as SEQ ID NO:127; [0463] wherein the formulation
includes about 15 mg/mL of the anti-IL-36R antibody, about 35 mM
histidine, about 180 mM trehalose, about 25 mM L-Arginine, about 3
mM NaCl, about 0.4 g/L Polysorbate 80, with a pH of about 6.0.
[0464] 50. A pharmaceutical formulation including: [0465] an
anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0466] i. a light chain including an amino acid sequence
set forth as SEQ ID NO:118 and a heavy chain including an amino
acid sequence set forth as SEQ ID NO:125; or [0467] ii. a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as SEQ
ID NO:126; or [0468] iii. a light chain including an amino acid
sequence set forth as SEQ ID NO:118 and a heavy chain including an
amino acid sequence set forth as SEQ ID NO:127; [0469] wherein the
formulation includes about 80 mg/mL of the anti-IL-36R antibody,
about 25 mM acetate, about 100 mM mannitol, about 50 mM NaCl, about
0.2 g/L Polysorbate 20, with a pH of about 5.5. [0470] 51. A
pharmaceutical formulation including: [0471] an anti-IL-36R
antibody or antigen-binding fragment thereof, including: [0472] i.
a light chain including an amino acid sequence set forth as SEQ ID
NO:118 and a heavy chain including an amino acid sequence set forth
as SEQ ID NO:125; or [0473] ii. a light chain including an amino
acid sequence set forth as SEQ ID NO:118 and a heavy chain
including an amino acid sequence set forth as SEQ ID NO:126; or
[0474] iii. a light chain including an amino acid sequence set
forth as SEQ ID NO:118 and a heavy chain including an amino acid
sequence set forth as SEQ ID NO:127; [0475] wherein the formulation
includes about 100 mg/mL of the anti-IL-36R antibody, about 20 mM
succinate, about 220 mM sucrose, about 0.1 g/L Polysorbate 80, with
a pH of about 6.0. [0476] 52. A pharmaceutical formulation
including: [0477] an anti-IL-36R antibody or antigen-binding
fragment thereof, including: [0478] i. a light chain including an
amino acid sequence set forth as SEQ ID NO:118 and a heavy chain
including an amino acid sequence set forth as SEQ ID NO:125; or
[0479] ii. a light chain including an amino acid sequence set forth
as SEQ ID NO:118 and a heavy chain including an amino acid sequence
set forth as SEQ ID NO:126; or [0480] iii. a light chain including
an amino acid sequence set forth as SEQ ID NO:118 and a heavy chain
including an amino acid sequence set forth as SEQ ID NO:127; [0481]
wherein the formulation includes about 60 mg/mL of the anti-IL-36R
antibody, about 25 mM citrate, about 0.4 g/L Polysorbate 20, with a
pH of about 6.5. [0482] 53. A pharmaceutical formulation including:
[0483] an anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0484] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 77; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 87; or
[0485] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or [0486] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 77; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 89; or [0487] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 87; or [0488] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 88; or [0489] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 80; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 89; [0490]
wherein the formulation includes: about 20 mg/mL of the anti-IL-36R
antibody, about 40 mM histidine, about 120 mM sucrose, about 50 mM
L-Arginine, about 5 mM NaCl and about 1.0 g/L Polysorbate 20, with
a pH of about 6.0. [0491] 54. A pharmaceutical formulation
including: [0492] an anti-IL-36R antibody or antigen-binding
fragment thereof, including: [0493] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 87; or [0494] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 77; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 88; or
[0495] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 89; or [0496] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 80; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 87; or [0497] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 88; or [0498] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 89; [0499] wherein the formulation includes: about 60 mg/mL of
the anti-IL-36R antibody, about 45 mM acetate, about 150 mM
sucrose, about 25 mM L-Arginine, about 0.4 g/L Polysorbate 20, with
a pH of about 5.5. [0500] 55. A pharmaceutical formulation
including: [0501] an anti-IL-36R antibody or antigen-binding
fragment thereof, including: [0502] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 87; or [0503] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 77; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 88; or
[0504] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 89; or [0505] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 80; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 87; or [0506] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 88; or [0507] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 89; [0508] wherein the formulation includes: about 20 mg/mL of
the anti-IL-36R antibody, about 45 mM acetate, about 180 mM
sucrose, about 25 mM Glycine, about 0.4 g/L Polysorbate 80, with a
pH of about 5.5. [0509] 56. A pharmaceutical formulation including:
[0510] an anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0511] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 77; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 87; or
[0512] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or [0513] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 77; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 89; or [0514] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 87; or [0515] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 88; or [0516] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 80; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 89; [0517]
wherein the formulation includes: about 150 mg/mL of the
anti-IL-36R antibody, about 25 mM citrate, about 150 mM trehalose,
about 25 mM methionine, about 0.2 g/L Polysorbate 20, with a pH of
about 6.0. [0518] 57. A pharmaceutical formulation including:
[0519] an anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0520] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 77; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 87; or
[0521] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or [0522] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 77; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 89; or [0523] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 87; or [0524] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 88; or [0525] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 80; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 89; [0526]
wherein the formulation includes: about 150 mg/mL of the
anti-IL-36R antibody, about 25 mM histidine, about 180 mM sucrose,
about 20 mM mannitol, about 0.2 g/L Polysorbate 20, with a pH of
about 6.5. [0527] 58. A pharmaceutical formulation including:
[0528] an anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0529] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 77; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 87; or
[0530] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 77; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or [0531] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 77; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 89; or [0532] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 87; or [0533] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 80; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 88; or
[0534] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 89; [0535] wherein
the formulation includes: about 20 mg/mL of the anti-IL-36R
antibody, about 25 mM citrate, about 200 mM sucrose, about 0.4 g/L
Polysorbate 80, with a pH of about 6.5. [0536] 59. A pharmaceutical
formulation including: [0537] an anti-IL-36R antibody or
antigen-binding fragment thereof, including: [0538] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
77; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 87; or [0539] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 88; or [0540] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 77; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 89; or
[0541] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or [0542] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 80; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 88; or [0543] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 89; [0544] wherein the formulation includes:
about 150 mg/mL of the anti-IL-36R antibody, about 45 mM acetate,
about 150 mM sucrose, about 25 mM L-Arginine, about 0.4 g/L
Polysorbate 20, with a pH of about 5.5. [0545] 60. A pharmaceutical
formulation including: [0546] an anti-IL-36R antibody or
antigen-binding fragment thereof, including: [0547] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
77; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 87; or [0548] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 88; or [0549] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 77; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 89; or
[0550] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or [0551] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 80; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 88; or [0552] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 89; [0553] wherein the formulation includes:
about 15 mg/mL of the anti-IL-36R antibody, about 35 mM histidine,
about 180 mM trehalose, about 25 mM L-Arginine, about 3 mM NaCl,
about 0.4 g/L Polysorbate 80, with a pH of about 6.0. [0554] 61. A
pharmaceutical formulation including: [0555] an anti-IL-36R
antibody or antigen-binding fragment thereof, including: [0556] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 77; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 87; or [0557] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
77; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 88; or [0558] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 89; or [0559] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 80; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 87; or
[0560] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or [0561] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 80; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 89; [0562] wherein the
formulation includes: about 80 mg/mL of the anti-IL-36R antibody,
about 25 mM acetate, about 100 mM mannitol, about 50 mM NaCl, about
0.2 g/L Polysorbate 20, with a pH of about 5.5. [0563] 62. A
pharmaceutical formulation including: [0564] an anti-IL-36R
antibody or antigen-binding fragment thereof, including: [0565] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 77; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 87; or [0566] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
77; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 88; or [0567] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 89; or [0568] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 80; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 87; or
[0569] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 88; or [0570] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 80; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 89; [0571] wherein the
formulation includes: about 100 mg/mL of the anti-IL-36R antibody,
about 20 mM succinate, about 220 mM sucrose, about 0.1 g/L
Polysorbate 80, with a pH of about 6.0. [0572] 63. A pharmaceutical
formulation including: [0573] an anti-IL-36R antibody or
antigen-binding fragment thereof, including: [0574] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
77; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 87; or [0575] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 88; or [0576] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 77; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 89; or
[0577] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or [0578] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 80; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 88; or [0579] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 89; [0580] wherein the formulation includes:
about 60 mg/mL of the anti-IL-36R antibody, about 25 mM citrate,
about 0.4 g/L Polysorbate 20, with a pH of about 6.5. [0581] 64. A
pharmaceutical formulation including: [0582] an anti-IL-36R
antibody or antigen-binding fragment thereof, including: [0583] i.
a light chain including an amino acid sequence set forth as SEQ ID
NO:118 and a heavy chain including an amino acid sequence set forth
as SEQ ID NO:125; or [0584] ii. a light chain including an amino
acid sequence set forth as SEQ ID NO:118 and a heavy chain
including an amino acid sequence set forth as SEQ ID NO:126; or
[0585] iii. a light chain including an amino acid sequence set
forth as SEQ ID NO:118 and a heavy chain including an amino acid
sequence set forth as SEQ ID NO:127; [0586] wherein the formulation
is selected from the group consisting of: [0587] I. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 40 mM histidine, about 120 mM sucrose, about 50 mM
L-Arginine, about 5 mM NaCl and about 1.0 g/L Polysorbate 20, with
a pH of about 6.0; [0588] II. formulation including about 20 mg/mL
to about 150 mg/mL of the anti-IL-36R antibody, about 45 mM
acetate, about 150 mM sucrose, about 25 mM L-Arginine, about 0.4
g/L Polysorbate 20, with a pH of about 5.5; [0589] III. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 45 mM acetate, about 180 mM sucrose, about 25 mM
Glycine, about 0.4 g/L Polysorbate 80, with a pH of about 5.5;
[0590] IV. formulation including about 20 mg/mL to about 150 mg/mL
of the anti-IL-36R antibody, about 25 mM citrate, about 150 mM
trehalose, about 25 mM methionine, about 0.2 g/L Polysorbate 20,
with a pH of about 6.0; [0591] V. formulation including about 20
mg/mL to about 150 mg/mL of the anti-IL-36R antibody, about 25 mM
histidine, about 180 mM sucrose, about 20 mM mannitol, about 0.2
g/L Polysorbate 20, with a pH of about 6.5; [0592] VI. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 25 mM citrate, about 200 mM sucrose, about 0.4 g/L
Polysorbate 80, with a pH of about 6.5; [0593] VII. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 45 mM acetate, about 150 mM sucrose, about 25 mM
L-Arginine, about 0.4 g/L Polysorbate 20, with a pH of about 5.5;
[0594] VIII. formulation including about 20 mg/mL to about 150
mg/mL of the anti-IL-36R antibody, about 35 mM histidine, about 180
mM trehalose, about 25 mM L-Arginine, about 3 mM NaCl, about 0.4
g/L Polysorbate 80, with a pH of about 6.0; [0595] IX. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 25 mM acetate, about 100 mM mannitol, about 50 mM
NaCl, about 0.2 g/L Polysorbate 20, with a pH of about 5.5; [0596]
X. formulation including about 20 mg/mL to about 150 mg/mL of the
anti-IL-36R antibody, about 20 mM succinate, about 220 mM sucrose,
about 0.1 g/L Polysorbate 80, with a pH of about 6.0; and [0597]
XI. formulation including about 20 mg/mL to about 150 mg/mL of the
anti-IL-36R antibody, about 25 mM citrate, about 0.4 g/L
Polysorbate 20, with a pH of about 6.5. [0598] 65. A pharmaceutical
formulation including: [0599] an anti-IL-36R antibody or
antigen-binding fragment thereof, including: [0600] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
77; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 87; or [0601] a light chain variable region
comprising the amino acid sequence of SEQ ID NO: 77; and a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO: 88; or [0602] a light chain variable region comprising the
amino acid sequence of SEQ ID NO: 77; and a heavy chain variable
region comprising the amino acid sequence of SEQ ID NO: 89; or
[0603] a light chain variable region comprising the amino acid
sequence of SEQ ID NO: 80; and a heavy chain variable region
comprising the amino acid sequence of SEQ ID NO: 87; or [0604] a
light chain variable region comprising the amino acid sequence of
SEQ ID NO: 80; and a heavy chain variable region comprising the
amino acid sequence of SEQ ID NO: 88; or [0605] a light chain
variable region comprising the amino acid sequence of SEQ ID NO:
80; and a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO: 89; [0606] wherein the formulation is
selected from the group consisting of: [0607] I. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 40 mM histidine, about 120 mM sucrose, about 50 mM
L-Arginine, about 5 mM NaCl and about 1.0 g/L Polysorbate 20, with
a pH of about 6.0; [0608] II. formulation including about 20 mg/mL
to about 150 mg/mL of the anti-IL-36R antibody, about 45 mM
acetate, about 150 mM sucrose, about 25 mM L-Arginine, about 0.4
g/L Polysorbate 20, with a pH of about 5.5; [0609] III. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 45 mM acetate, about 180 mM sucrose, about 25 mM
Glycine, about 0.4 g/L Polysorbate 80, with a pH of about 5.5;
[0610] IV. formulation including about 20 mg/mL to about 150 mg/mL
of the anti-IL-36R antibody, about 25 mM citrate, about 150 mM
trehalose, about 25 mM methionine, about 0.2 g/L Polysorbate 20,
with a pH of about 6.0; [0611] V. formulation including about 20
mg/mL to about 150 mg/mL of the anti-IL-36R antibody, about 25 mM
histidine, about 180 mM sucrose, about 20 mM mannitol, about 0.2
g/L Polysorbate 20, with a pH of about 6.5; [0612] VI. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 25 mM citrate, about 200 mM sucrose, about 0.4 g/L
Polysorbate 80, with a pH of about 6.5; [0613] VII. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 45 mM acetate, about 150 mM sucrose, about 25 mM
L-Arginine, about 0.4 g/L Polysorbate 20, with a pH of about 5.5;
[0614] VIII. formulation including about 20 mg/mL to about 150
mg/mL of the anti-IL-36R antibody, about 35 mM histidine, about 180
mM trehalose, about 25 mM L-Arginine, about 3 mM NaCl, about 0.4
g/L Polysorbate 80, with a pH of about 6.0; [0615] IX. formulation
including about 20 mg/mL to about 150 mg/mL of the anti-IL-36R
antibody, about 25 mM acetate, about 100 mM mannitol, about 50 mM
NaCl, about 0.2 g/L Polysorbate 20, with a pH of about 5.5; [0616]
X. formulation including about 20 mg/mL to about 150 mg/mL of the
anti-IL-36R antibody, about 20 mM succinate, about 220 mM sucrose,
about 0.1 g/L Polysorbate 80, with a pH of about 6.0; and [0617]
XI. formulation including about 20 mg/mL to about 150 mg/mL of the
anti-IL-36R antibody, about 25 mM citrate, about 0.4 g/L
Polysorbate 20, with a pH of about 6.5. [0618] 66. A pharmaceutical
product including a vial or syringe including the pharmaceutical
formulation according to any of the preceding clauses for use in
any one of the aspects of the present invention. [0619] 67. The
pharmaceutical product according to clause 66 further including a
pre-assembled injection device. [0620] 68. The pharmaceutical
product of clause 67 wherein the pre-assembled injection device is
an autoinjector or a syringe with or without a needle safety
device. [0621] 69. A pre-assembled injection device including a
pharmaceutical formulation according to any of the preceding
clauses for use in any one of the aspects of the present invention.
[0622] 70. The pre-assembled injection device according to clause
69, wherein said device is an autoinjector or a syringe with or
without a needle safety device. [0623] 71. The pre-assembled
injection device according to clause 69, wherein said formulation
is suitable for intravenous, subcutaneous or intramuscular
administration.
[0624] 72. The pre-assembled injection device according to clause
70, wherein the autoinjector or the syringe with or without needle
safety device includes a pharmaceutical formulation including:
[0625] an anti-IL-36R antibody or antigen-binding fragment thereof,
including: [0626] i. a light chain including an amino acid sequence
set forth as SEQ ID NO:118 and a heavy chain including an amino
acid sequence set forth as SEQ ID NO:125; or [0627] ii. a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as SEQ
ID NO:126; or [0628] a light chain including an amino acid sequence
set forth as SEQ ID NO:118 and a heavy chain including an amino
acid sequence set forth as SEQ ID NO:127; wherein the formulation
is selected from the group consisting of: [0629] I. formulation
including about 20 mg/ml of the anti-IL-36R antibody, about 40 mM
histidine, about 120 mM sucrose, about 50 mM L-Arginine, about 5 mM
NaCl and about 1.0 g/L Polysorbate 20, with a pH of about 6.0;
[0630] II. formulation including about 60 mg/mL of the anti-IL-36R
antibody, about 45 mM acetate, about 150 mM sucrose, about 25 mM
L-Arginine, about 0.4 g/L Polysorbate 20, with a pH of about 5.5;
[0631] III. formulation including about 20 mg/mL of the anti-IL-36R
antibody, about 45 mM acetate, about 180 mM sucrose, about 25 mM
Glycine, about 0.4 g/L Polysorbate 80, with a pH of about 5.5;
[0632] IV. formulation including about 150 mg/mL of the anti-IL-36R
antibody, about 25 mM citrate, about 150 mM trehalose, about 25 mM
methionine, about 0.2 g/L Polysorbate 20, with a pH of about 6.0;
[0633] V. formulation including about 150 mg/mL of the anti-IL-36R
antibody, about 25 mM histidine, about 180 mM sucrose, about 20 mM
mannitol, about 0.2 g/L Polysorbate 20, with a pH of about 6.5;
[0634] VI. formulation including about 20 mg/mL of the anti-IL-36R
antibody, about 25 mM citrate, about 200 mM sucrose, about 0.4 g/L
Polysorbate 80, with a pH of about 6.5; [0635] VII. formulation
including about 150 mg/mL of the anti-IL-36R antibody, about 45 mM
acetate, about 150 mM sucrose, about 25 mM L-Arginine, about 0.4
g/L Polysorbate 20, with a pH of about 5.5; [0636] VIII.
formulation including about 15 mg/mL of the anti-IL-36R antibody,
about 35 mM histidine, about 180 mM trehalose, about 25 mM
L-Arginine, about 3 mM NaCl, about 0.4 g/L Polysorbate 80, with a
pH of about 6.0; [0637] IX. formulation including about 80 mg/mL of
the anti-IL-36R antibody, about 25 mM acetate, about 100 mM
mannitol, about 50 mM NaCl, about 0.2 g/L Polysorbate 20, with a pH
of about 5.5; [0638] X. formulation including about 100 mg/mL of
the anti-IL-36R antibody, about 20 mM succinate, about 220 mM
sucrose, about 0.1 g/L Polysorbate 80, with a pH of about 6.0; and
[0639] XI. formulation including about 60 mg/mL of the anti-IL-36R
antibody, about 25 mM citrate, about 0.4 g/L Polysorbate 20, with a
pH of about 6.5. [0640] 73. The pre-assembled injection device
according to clause 70, wherein the autoinjector or the syringe
with a needle safety device includes: [0641] a. about 300 mg of the
antibody in about 2 mL formulation volume; or [0642] b. about 225
mg of the antibody in about 1.5 mL formulation volume; or [0643] c.
about 150 mg of the antibody in about 1 mL formulation volume; or
[0644] d. about 75 mg of the antibody in about 0.5 mL formulation
volume; or [0645] e. about 60 mg of the antibody in about 0.4 mL
formulation volume. [0646] 74. The vial according to clause 66,
wherein the vial includes: [0647] a. about 1200 mg of the antibody
in about 20 mL formulation volume; or [0648] b. about 900 mg of the
antibody in about 15 mL formulation volume; or [0649] c. about 600
mg of the antibody in about 10 mL formulation volume; or [0650] d.
about 300 mg of the antibody in about 150 mL formulation volume; or
[0651] e. about 1500 mg of the antibody in about 2.5 mL formulation
volume. [0652] 75. A pharmaceutical product, including: a vial
including about 100 mg to 1500 mg of an anti-IL-36R antibody in
powder form; instructions for reconstitution of the anti-IL-36R
antibody; and instructions for preparing the reconstituted antibody
for infusion, wherein the anti-IL-36R antibody comprises a light
chain including an amino acid sequence set forth as SEQ ID NO:118
and a heavy chain including an amino acid sequence set forth as any
one of SEQ ID Nos: 125, 126 or 127; and the reconstitution
instructions require reconstitution with water for injection to an
extractable volume from 1 to 50 mL.
[0653] Further, the pharmaceutical composition can be provided as a
pharmaceutical kit comprising (a) a container containing a IL-36R
binding agent (e.g., an anti-IL-36R antibody) in lyophilized form
and (b) a second container containing a pharmaceutically acceptable
diluent (e.g., sterile water) for injection. The pharmaceutically
acceptable diluent can be used for reconstitution or dilution of
the lyophilized anti-IL-36R antibody or agent. Optionally
associated with such container(s) can be a notice in the form
prescribed by a governmental agency regulating the manufacture, use
or sale of pharmaceuticals or biological products, which notice
reflects approval by the agency of manufacture, use or sale for
human administration.
[0654] Such combination therapy administration can have an additive
or synergistic effect on disease parameters (e.g., severity of a
symptom, the number of symptoms, or frequency of relapse).
[0655] With respect to therapeutic regimens for combinatorial
administration, in a specific embodiment, an anti-IL-36R antibody
or IL-36R binding agent is administered concurrently with a
therapeutic agent. In another specific embodiment, the therapeutic
agent is administered prior or subsequent to administration of the
anti-IL-36R antibody or IL-36R binding agent, by at least an hour
and up to several months, for example at least an hour, five hours,
12 hours, a day, a week, a month, or three months, prior or
subsequent to administration of the anti-IL-36R antibody or IL-36R
binding agent.
[0656] The invention is further described in the following
examples, which are not intended to limit the scope of the
invention.
EXAMPLES
Example 1: IL-36 Receptor Inhibition for Treatment of Generalized
Pustular Psoriasis
[0657] An antibody of the present invention, i.e., an anti-IL-36R
antibody of the present invention (disclosed herein and also in
U.S. Pat. No. 9,023,995), is a humanized antagonistic monoclonal
IgG1 antibody that blocks human IL36R signaling. Binding of an
anti-IL-36R antibody of the present invention to IL36R is
anticipated to prevent the subsequent activation of IL36R by
cognate ligands (IL36 .alpha., .beta. and .gamma.) and downstream
activation of proinflammatory and pro-fibrotic pathways with the
aim to reduce epithelial cell/fibroblast/immune cell-mediated
inflammation and interrupt the inflammatory response that drives
pathogenic cytokine production in generalized pustular psoriasis
(GPP).
[0658] Preclinical profiles of an anti-IL-36R antibody of the
present invention and clinical data from healthy volunteer trials
suggest that an anti-IL-36R antibody of the present invention is
safe, tolerable and may address an unmet medical need in GPP
patients.
Background
[0659] Mutations in IL36RN are strongly implicated in the
pathogenesis of generalized pustular psoriasis. The efficacy and
safety of an anti-IL-36R antibody of the present invention, a
humanized monoclonal antibody inhibiting interleukin-36R signaling,
was assessed in this single dose, open-label, proof-of-concept,
phase I study in patients with acute generalized pustular
psoriasis.
Methods
[0660] Seven patients, three of whom were IL36RN mutation-positive,
received a single intravenous dose of 10 mg/kg an anti-IL-36R
antibody of the present invention, and were monitored for 20 weeks.
The primary endpoint was safety; efficacy endpoints included the
proportion of patients with a Generalized Pustular Psoriasis
Physician Global Assessment (GPPGA) score of 0 (clear) or 1 (almost
clear), and percent change from baseline in Generalized Pustular
Psoriasis Area and Severity Index (GPPASI) score at Week 2.
Results
[0661] An anti-IL-36R antibody of the present invention was well
tolerated with no drug-related serious adverse events or safety
signals. At Week 1, GPPGA score of 0 or 1 was achieved in five
patients, and in all patients by Week 4. Within 48 hours, pustules
were cleared in three patients, and in six patients by Week 2. A
major improvement in GPPASI was observed in all patients with a
mean (SD) percent change from baseline of 73.2% (16.2) at Week 2;
by Week 4, this was further reduced to 82.0%. Efficacy was
generally maintained up to 20 weeks.
Conclusions
[0662] Interleukin-36 pathway inhibition with a single dose of an
anti-IL-36R antibody of the present invention resulted in the rapid
and sustained remission of clinical symptoms in patients with acute
generalized pustular psoriasis. Alternatively, a single dose of an
anti-IL-36R antibody of the present invention resulted in the rapid
and sustained remission of clinical symptoms, with no adverse
safety signals in patients with acute generalized pustular
psoriasis, regardless of IL36RN mutation status.
Introduction
[0663] Generalized pustular psoriasis is a rare, severe
multisystemic disease first described by von Zumbusch in 1909,
characterized by intermittent acute flares consisting of a
disseminated erythematous and pustular skin rash associated with
general symptoms including fever, and often extracutaneous organ
involvement; in some cases, life-threatening complications may
occur. Biologically, high C-reactive protein (CRP) serum levels and
leukocytosis with neutrophilia are the most common features,
together with liver test abnormalities. Epidemiological studies
report prevalence as low as 1.76/million, highlighting the rarity
of the disease.
[0664] Therapeutic intervention in generalized pustular psoriasis
is a major challenge with no treatments currently approved in the
US or Europe. A wide range of anti-psoriatic strategies have been
proposed based on the psoriasis vulgaris model, with the efficacy
of apheresis, and inhibitors of tumor necrosis factor,
interleukin-17 and interleukin-23 reported in open-label trials and
case reports forming the basis of approval for generalized pustular
psoriasis in Japan. However, apheresis is restricted to specialized
centers, while the contribution of these key inflammatory cytokines
in psoriasis vulgaris, to the pathogenesis of generalized pustular
psoriasis remains unclear.
[0665] Recently, major advances in our understanding of the
mechanisms underlying pustular psoriasis have been gained from
genetic studies that identified loss-of-function homozygous or
compound heterozygous IL36RN gene mutations in some patients with
generalized pustular psoriasis. These mutations severely alter the
function of the IL36RN product, the interleukin-36 receptor
antagonist (interleukin-36Ra), resulting in the dysregulation of
the proinflammatory interleukin-36 (IL-36.alpha., IL-36.beta. and
IL-36.gamma.) pathway, and lead to generalized pustular psoriasis
according to a monogenic model. While these mutations have been
found in other pustular psoriasis subtypes, they have not been
detected in patients with plaque psoriasis alone, unveiling the
autoinflammatory nature of pustular psoriasis and establishing
generalized pustular psoriasis as a distinct entity from plaque
psoriasis.
[0666] These immunogenetic insights established the rationale to
therapeutically target interleukin-36R in generalized pustular
psoriasis. The results of this first study conducted in a human
disease with an anti-IL-36R antibody of the present invention, a
human monoclonal antibody targeted against the interleukin-36R,
assessing the safety and efficacy in patients with an acute flare
of generalized pustular psoriasis are reported. To our knowledge,
this is the first study to assess treatment in patients with acute
generalized pustular psoriasis.
Methods
[0667] Study Design
[0668] This 20-week, multicenter, single-arm, open-label, phase I,
proof-of-concept trial enrolled patients from five sites (France,
Malaysia, Republic of Korea, Taiwan, and Tunisia). Eligible
patients received a single intravenous (IV) dose of 10 mg/kg an
anti-IL-36R antibody of the present invention and were monitored
for 20 weeks.
[0669] Patients
[0670] Patients aged 18-75 years were eligible if they had a known
and documented history of generalized pustular psoriasis,
regardless of IL36RN mutation status, with previous evidence of
fever, and/or asthenia, and/or myalgia, and/or elevated CRP, and/or
leukocytosis with neutrophilia, presenting with an acute flare
involving 10% or more of their body surface area (BSA) with
erythema and the presence of pustules, and a Generalized Pustular
Psoriasis Physician Global Assessment (GPPGA) score of 3 or higher
(clinician assessment of GPP severity based on a modified PGA [see
Supplementary Appendix]; scores range from 0 [clear skin] to 4
[severe disease]) at the time of treatment. Patients could continue
to receive subcutaneous treatment with retinoids and/or
methotrexate.
[0671] Patients were excluded if they had an immediate
life-threatening generalized pustular psoriasis flare or acute
generalized exanthematous pustulosis (see Table 2 for the full
inclusion/exclusion criteria). Patients providing consent were
enrolled in the trial in the absence of a flare. Screening (visit
1) was initiated several days or weeks before a patient was
admitted for treatment for a flare of generalized pustular
psoriasis (visit 2). For patients satisfying the
inclusion/exclusion criteria, treatment with BI 655130 was
initiated the day after visit 2 (visit 3).
TABLE-US-00010 TABLE 2 Inclusion/Exclusion Criteria Inclusion
Criteria Patients will only be included into the trial if they meet
the following criteria: 1. Male or female patients, aged 18-75
years at screening 2. A known and documented history of generalized
pustular psoriasis (GPP) regardless of the IL36RN mutation status,
with previous evidence of fever, and/or asthenia, and/or myalgia,
and/or elevated C-reactive protein, and/or leukocytosis with
peripheral blood neutrophilia (above ULN) 3. Presenting with a
flare of GPP with at least 10% of body surface area with erythema
and pustules 4. A GPPGA score of at least moderate severity 5. GPP
patients receiving subcutaneous treatment with retinoids and/or
methotrexate for at least 4 weeks or GPP patients not receiving any
subcutaneous therapy, at the screening visit 6. Signed and dated
written informed consent prior to admission to the study in
accordance with good clinical practice and local legislation 7.
Women of childbearing potential* must be ready and able to use
highly effective methods of birth control per ICH M3 that result in
a low failure rate of less than 1% per year when used consistently
and correctly. A list of contraception methods meeting these
criteria is provided in the patient information. Male patients must
be ready and able to use condoms. Birth control method must be
continued up to 20 weeks after an anti-IL-36R antibody of the
present invention administration. * A woman is considered of
childbearing potential, i.e. fertile, following menarche, and until
becoming postmenopausal unless permanently sterile. Permanent
sterilization methods include hysterectomy, bilateral
salpingectomy, and bilateral oophorectomy. Tubal ligation is NOT a
method of permanent sterilization. A postmenopausal state is
defined as no menses for 12 months without an alternative medical
cause. Exclusion Criteria Patients will not be allowed to
participate if any of the following general criteria apply: 1.
Women who are pregnant, nursing, or who plan to become pregnant
while in the trial. Women who stop nursing before the study drug
administration do not need to be prevented from participating. They
should refrain from breastfeeding up to 20 weeks after the study
drug administration 2. Immediate life-threatening flare of GPP or
requiring intensive care treatment, according to the investigator's
judgement. Life-threatening complications mainly include, but are
not limited to, cardiovascular/cytokine driven shock and pulmonary
distress 3. Identified, ongoing serious/severe infection 4. Acute
generalized exanthematous pustulosis 5. Patient's clinical
presentation being considered due to the differential diagnosis of
toxic epidermal necrosis or Stevens-Johnson syndrome 6. Currently
involved in or intending to participate in another investigational
study during the course of this trial 7. Previous enrolment in this
trial 8. Use of any restricted medication as specified in Table 3,
or any drug considered likely to interfere with the safe conduct of
the study 9. Patients with dose escalation of their subcutaneous
therapy with methotrexate and/or retinoids within the 4 weeks
preceding the screening visit 10. Background therapy with
cyclosporine within the last 30 days preceding the screening visit
11. Previous exposure to an interleukin-36R inhibitor 12. Severe,
progressive, or uncontrolled renal, hepatic, hematological,
endocrine, pulmonary, cardiac, neurologic, cerebral, or psychiatric
disease, or signs and symptoms thereof, as judged by the
investigator. Patients with a less than 3-fold ULN increase in
aspartate aminotransferase and/or alanine aminotransferase and/or
alkaline phosphatase and/or with a less than 2-fold ULN increase in
total bilirubin at infusion day may be included, provided that no
cause of liver damage other than GPP has been identified 13. Known
chronic or relevant acute infections including active tuberculosis
(TB), HIV or viral hepatitis; QuantiFERON .RTM. TB test will be
performed at screening. If the result is positive, patients may
participate in the study if further work-up (according to local
practice/guidelines) establishes conclusively that the patient has
no evidence of active TB. If the presence of latent TB is
established, then treatment should have been initiated and
maintained according to local country guidelines 14. Patients with
a transplanted organ (with the exception of a corneal transplant
>12 weeks prior to the screening visit) or those who have ever
received stem cell therapy (e.g. Prochymal .RTM.) 15. Known history
of lymphoproliferative disease, including lymphoma, or signs and
symptoms suggestive of possible lymphoproliferative disease, such
as lymphadenopathy and/or splenomegaly 16. Any documented active or
suspected malignancy or history of malignancy within 5 years prior
to second screening visit, except appropriately treated basal or
squamous cell carcinoma of the skin or in situ carcinoma of uterine
cervix 17. Evidence of a current or previous disease, medical
condition (including chronic alcohol or drug abuse) other than GPP,
surgical procedure (i.e. organ transplant), medical examination
finding (including vital signs and electrocardiogram), or
laboratory value at the second screening visit outside of the
reference range, that in the opinion of the investigator, is
clinically significant and would make the study participant
unreliable to adhere to the protocol or to complete the trial,
compromise the safety of the patient, or compromise the quality of
the data 18. History of allergy/hypersensitivity to a systemically
administered biologic agent or its excipients 19. Patient's refusal
to be hospitalized for 4 days following the infusion
TABLE-US-00011 TABLE 3 Restricted Medications Restriction Duration
Medication or Class of Medications (Through End of Trial Visit*)
Natalizumab, efalizumab, or agents that 6 months prior to screening
(visit 2) deplete B or T cells (e.g. rituximab, alemtuzumab, or
visilizumab), briakinumab, secukinumab, ustekinumab, guselkumab,
tildrakizumab IL-36R inhibitors Not allowed either before nor
during trial participation Brodalumab, ixekizumab 4 months prior to
screening (visit 2) Adalimumab, infliximab, investigational 12
weeks prior to screening (visit 2) products for psoriasis
(non-biologics) Etanercept, live virus vaccinations 6 weeks prior
to screening (visit 2) Any investigational device or product 30
days prior to screening (visit 2) (excludes psoriasis products),
other systemic immunomodulating treatments except background
therapy with methotrexate (e.g. cyclosporine A,
corticosteroids.sup..dagger., cyclophosphamide), tofacitinib,
apremilast, other systemic psoriasis treatments except background
therapy with retinoids (e.g. fumarates, any other drug known to
possibly benefit psoriasis), photochemotherapy (e.g. PUVA).
Phototherapy (e.g. UVA, UVB), topical 14 days prior to screening
(visit 2) treatment for psoriasis or any other skin condition (e.g.
corticosteroids.sup..dagger-dbl., vitamin D analogues, vitamin A
analogues, pimecrolimus, retinoids, salicylvaseline, salicylic
acid, lactic acid, tacrolimus, tar, urea, anthralin,
.alpha.-hydroxy, fruit acids) Anakinra 7 days prior to screening
(visit 2) *In case of worsening of the flare, the use of a rescue
medication is left at the discretion of the investigator; in case
of any other acute setting after Day 28, the use of a restricted
medication is permitted. .sup..dagger.There is no restriction on
corticosteroids with only a topical effect (e.g. inhaled
corticosteroids to treat asthma or corticosteroids drops
administered in the eye or ear). .sup..dagger-dbl.Exception:
Topical steroids of US class 6 (mild, such as desonide) or US class
7 (least potent, such as hydrocortisone) for use on the face,
axilla, and/or genitalia with a restriction of use within 24 hours
prior to trial visit in which GPPASI is assessed. GPPASI =
Generalized Pustular Psoriasis Area and Severity Index.
[0672] All patients underwent genotyping for mutations in IL36RN,
CARD14, and AP1S3.
[0673] Genotyping
[0674] To identify mutations in IL36RN, CARD14 and AP1S3, targeted
re-sequencing was performed using Illumina MiSeq with Nextera Rapid
Capture Custom Enrichment Kit (Illumina Inc., San Diego, Calif.).
The sequences were aligned and mapped against human genome version
19 by MiSeq Reporter (Illumina Inc., San Diego, Calif.). A mutation
was considered potentially pathogenic if there were correlations
with published functional data or risk associations to generalized
pustular psoriasis, or if the mutation was a non-synonymous
substitution, or located in a known gene regulatory element (e.g.
start codon).
[0675] Efficacy and Safety Assessments
[0676] The primary endpoint was the safety and tolerability of an
anti-IL-36R antibody of the present invention. Safety assessments
included adverse events (coded with the use of the Medical
Dictionary for Drug Regulatory Activities, version 20.1), serious
adverse events, laboratory assessments, vital signs, injection site
reactions, and immunogenicity over the duration of the trial.
Immunogenicity assessments are described in the Supplementary
Appendix. Secondary endpoints at Week 2 included percent change
from baseline in Generalized Pustular Psoriasis Area and Severity
Index (GPPASI; a modified composite index based on PASI, (J
Dermatolog Treat 2003; 14:158-65) whereby the induration component
has been substituted with a pustules component; scores range from 0
to 72, higher scores represent greater disease severity),
proportion of patients with GPPGA of 0 (clear) or 1 (almost clear),
change from baseline in Functional Assessment of Chronic Illness
Therapy-Fatigue (FACIT-F; instrument, based on 13 questions, for
monitoring fatigue and its effects on patients; scores range from 0
to 52, lower scores represent greater fatigue) scale, (J Pain
Symptom Manage 1997; 13:63-74) and change from baseline in patients
assessment of pain on a visual analog scale (Pain-VAS). See Table 4
for the demographics and disease characteristics of the patients at
baseline.
TABLE-US-00012 TABLE 4 Demographics and Disease Characteristics at
Baseline Time from Presence of Body initial gene mutations Age Sex
weight BMI diagnosis (+/-) Patient (yrs) (M/F) Race* Country (kg)
(kg/m.sup.2) (years) IL36RN.sup..dagger. CARD14.sup..dagger-dbl.
AP1S3 2100103 47 M White Tunisia 52.0 19.1 46.9 + - - 2100104 31 M
White Tunisia 82.0 25.9 5.0 + - - 3301001 26 F N/A France 70.4 26.5
19.9 - - - 6001003 34 F Asian Malyasia 67.9 29.8 9.7 - - - 6001004
52 F Asian Malyasia 57.6 23.7 4.0 - - - 8201002 22 M Asian Republic
56.9 18.2 0.1 - - - of Korea 8801001 58 F Asian Taiwan 52.8 20.1
29.3 + + - Total 38.6 M = 3 White = 2 NA 62.8 23.3 16.4 3 1 0 (N =
7) (13.8) F = 4 Asian = 4 (11.0) (4.3) (16.8) (42.9%) (14.3%) N/A =
1 Time from current flare to Pustule an anti-IL-36R severity Prior
antibody of GPPGA GPPASI score CRP systemic Patient (0-4)
.sup..sctn. (0-72) .sup. (0-4) ** (mg/l)
FACIT-F.sup..dagger..dagger. Pain-VAS
PSS.sup..dagger-dbl..dagger-dbl. therapies 2100103 1 3 22.2 1.8
237.0 28 95 10 RET 2100104 1 3 52.5 2.3 276.6 12 90 12 RET 3301001
18 3 20.3 1.5 4.0 46 60 8 CYSP 6001003 2 3 26.2 3.0 152.9 18 80 13
CYSP, MTX, RET 6001004 14 3 21.0 2.8 82.8 40 80 12 MTX 8201002 0 3
33.4 1.8 N/A 32 70 9 CYSP 8801001 1 3 16.7 2.8 0.80 46 30 4 RET
Total 5.3 3 27.5 2.3 69.4 31.7 72.1 9.71 CYSP = 3 (42.9) (N = 7)
(7.4) (0) (12.3) (0.6) (57.0) (13.3) (22.0) (3.1) MTX = 2 (28.6)
RET = 4 (57.1) Values are mean (standard deviaton) unless stated
otherwise. *Race was self-reported by the patient. Race was not
reported for patient 3301001. .sup..dagger.Homozygous missense
variant rs387906914 (patients 1 and 2), and intronic mutation
variant rs148755083 (patient 7). .sup..dagger-dbl.Heterozygous
variant rs117360605 (patient 7). .sup..sctn. Generalized Pustular
Psoriasis Physician Global Assessment (GPPGA) is a clinician
assessment of overall GPP severity based on a modified PGA; scores
range from 0 (clear skin) to 4 (severe disease). .sup. Generalized
Pustular Psoriasis Area and Severity Index (GPPASI) is a modified
composite index for patients with GPP, based on the established
PASI, whereby the induration component has been substituted with a
pustules component; scores range from 0 to 72, and higher scores
represent greater disease severity. ** Pustule severity is based on
the GPPASI component subscore and ranges from 0 to 4; higher scores
represent greater severity. .sup..dagger..dagger.Functional
Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scores
range from 0 to 52; lower scores represent greater fatigue.
.sup..dagger-dbl..dagger-dbl.Psoriasis Symptom Scale (PSS) scores
range from 0 to 16, with higher scores representing greater
severity of symptoms (psoriasis pain, redness, itching, and
burning). CI = confidence interval; CRP = C-reactive protein; N/A =
not available; NA = not applicable; SD = standard deviation; VAS =
Visual Analogue Scale. indicates data missing or illegible when
filed
[0677] Other pre-specified efficacy endpoints included change and
percent change from baseline in pustule severity (based on the
GPPASI component), change and percent change from baseline in
GPPASI, proportion of patients with GPPGA score of 0 or 1,
proportion of patients with clearance of edema, change from
baseline in pustular BSA, change and percent change from baseline
in erythema severity (based on GPPASI component); change from
baseline in FACIT-F and Pain-VAS at Weeks 1 and 4; change from
baseline in Psoriasis Symptom Scale (PSS; a four item patient
reported outcome instrument assessing psoriasis pain, redness,
itching, and burning. Symptom severity is assessed using a 5-point
Likert-type scale ranging from 0 (none) to 4 (very severe) and a
total score is calculated by adding all subscore) score, (J
Patient-Rep Outcomes 2017; 1:4) proportion of patients with PSS
total score of 0, and improvement in Clinical Global Impression
(observer-rated scale measuring global illness improvement, based
on a 7-point scale, scores range from 1 [very much improved] to 7
[very much worse]) (Jpn J Dermatol 2010; 120:815-39) (at Weeks 1,
2, and 4. Efficacy endpoints that were not pre-specified included
the proportion of patients achieving 50, 75, and 90 percent
improvement in GPPASI over time and percent change from baseline in
scaling severity (GPPASI component).
[0678] Photographic documentation of skin lesions was performed at
baseline, and post-treatment. Biochemical, cellular, and
pharmacogenomic biomarkers were evaluated in skin and whole blood
(see below for biomarker methodologies). Skin biopsies were
performed at baseline and Week 1 (an additional optional biopsy was
performed at Week 2).
[0679] Generalized Pustular Psoriasis Physician Global Assessment
(GPPGA)
[0680] GPPGA relies on the clinical assessment of the patient's
skin presentation. It is a modified PGA, a physician's assessment
of psoriatic lesions, which has been adapted to the evaluation of
patients with generalized pustular psoriasis. (J Dermatolog Treat
2015; 26(1):23-31) The investigator (or qualified site personnel)
scores the erythema, pustules, and scaling of all psoriatic lesions
from 0-4. Each component is graded separately, the average is
calculated, and the final GPPGA is determined from this composite
score. A lower score then indicates a lesser severity, with 0 being
clear and 1 being almost clear. To receive a score of 0 or 1, the
patient should be afebrile, in addition to the skin presentation
requirements.
[0681] Generalized Pustular Psoriasis Area and Severity Index
(GPPASI)
[0682] The GPPASI is an adaptation of the PASI, an established
measure of severity and area of psoriatic lesions in patients with
psoriasis, for patients with generalized pustular psoriasis.
(Dermatologica 1978; 157(4):238-44) Similar adaptions have been
used for palmoplantar psoriasis. (J Eur Acad Dermatol Venereol
2009; 23(4):415-9) In the GPPASI, the induration component has been
substituted by a pustules component. It is a tool which provides a
numeric scoring for patient's overall generalized pustular
psoriasis disease state, ranging from 0 to 72. It is a linear
combination of percent of surface area of skin (body region area
score) that is affected and the severity (scored on a five-point
scale, ranging from 0 [least severe] to 4 [most severe] (See Table
5)) of erythema, pustules, and scaling (desquamation) over four
body regions (head, upper limb, trunk, and lower limb).
TABLE-US-00013 TABLE 5 Generalized Pustular Psoriasis Area and
Severity Index Score Erythema Pustules Scaling 0 Normal or post- No
visible pustules No scaling or crusting inflammatory
hyperpigmentation 1 Faint, diffuse pink or Low density occasional
Superficial focal scaling slight red small discrete pustules or
crusting restricted to (noncoalescent) periphery of lesions 2 Light
red Moderate density Predominantly fine grouped discrete small
scaling or crusting pustules (noncoalescent) 3 Bright red High
density pustules Moderate scaling or with some coalescence crusting
covering most or all lesions 4 Deep fiery red Very high density
pustules Severe scaling or with pustular crusting covering most
lakes or all lesions Individual score per body region = body region
factor (head = 0.1, upper limb = 0.2, trunk = 0.3, lower limb =
0.4) .times. body region area score .times. sum of component
severity scores in body region Total GPPASI score = sum of
individual score from all body regions
[0683] Immunogenicity Assessments
[0684] Plasma samples from all patients for anti-drug antibody
assessment were taken at pre-dose and on days 7, 14, 21, 28, 84 and
140 post-dose. The samples were analyzed for anti-an anti-IL-36R
antibody of the present invention antibodies using a validated Meso
Scale Discovery.RTM. (MSD) drug bridging electrochemiluminescent
(ECL) method with acid dissociation at QPS, LLC, Newark, Del., USA.
Anti-drug antibody plasma samples and controls were first diluted
in 0.3M acetic acid before neutralization with 1.5M tris base and
master mix, which included biotin-labeled drug and
sulfo-tag-labeled drug, prior to transfer and incubation on a
blocked MSD streptavidin plate. In the presence of
tripropylamine-containing read buffer, sulfo-tag produces an ECL
signal that is triggered when voltage is applied using the MSD
Sector Imager 600s. The resulting chemiluminescence is measured in
relative light units which is proportional to the amount of
anti-drug antibody present in the plasma samples. The
immunogenicity of an anti-IL-36R antibody of the present invention
was assessed using a three-tiered approach.
[0685] All anti-drug antibody samples were first analyzed in the
anti-drug antibody screening assay. A sample was considered
positive for anti-an anti-IL-36R antibody of the present invention
antibodies if its response in the screening assay was greater than
or equal to the screening plate-specific cut point, and if it was
confirmed positive in the confirmatory assay (ECL response
inhibited by addition of excess an anti-IL-36R antibody of the
present invention above the confirmatory cutpoint). Samples that
were confirmed positive for anti-an anti-IL-36R antibody of the
present invention antibodies were further characterized in the
titration assay. Titers were determined by analysis of 2-fold
serial dilutions of a sample. The reported titer was the highest
dilution that produced a mean ECL value greater than or equal to
the plate specific titration cutpoint.
[0686] The anti-drug antibody assay validation demonstrated that
the sensitivity of the screening assay in GPP plasma was 2.5 ng/mL
using an anti-an anti-IL-36R antibody of the present invention
rabbit polyclonal antibody positive control. In addition, 100 and
250 ng/mL levels of the positive control were detected in the
presence of at least 2000 .mu.g/mL an anti-IL-36R antibody of the
present invention. None of the ADA samples had an anti-IL-36R
antibody of the present invention levels greater than 2000
.mu.g/mL. The assay performance data indicated that the method was
reliable for screening, confirmation, and determination of titers
of anti-an anti-IL-36R antibody of the present invention antibodies
in plasma samples from patients in this study.
[0687] Biomarker Assessments
[0688] Assessment of CRP levels (non-high sensitive) and absolute
neutrophil count were conducted using standard methodologies by
local laboratories. Samples for assessments were collected at
baseline before treatment initiation and on days 7, 14, and 28.
[0689] Pharmacogenomics Biomarker Assessments
[0690] Global transcriptome-wide sequencing of RNA from lesion and
non-lesional skin biopsy samples and whole blood from all patients
was achieved using the Illumina Hi-Seq 3000 (IIlumina Inc., San
Diego, Calif.). Data were normalized by TMM using the edgeR
package; log 2 fold changes and corresponding FDR-adjusted p-values
were analyzed using the limma package (Bioconductor, US). (Genome
Biol 2010; 11(3):R25; Nucleic Acids Res 2015; 43(7):e47) Briefly,
data were voom-transformed and correlations between paired
measurements per patient were estimated by the duplicate
Correlation function. A linear model was fitted using the ImFit-f
unction and moderated t-statistics were computed for lesional
versus non-lesional and pre-versus post-treatment with an
anti-IL-36R antibody of the present invention. (Nucleic Acids Res
2015; 43(15):e97; Genome Biol 2014; 15(2):R29) Adjusted P-values of
<0.05 were considered significant.
[0691] Statistical Analyses
[0692] This trial, due to its small sample size and the absence of
a comparator, did not test any statistical hypotheses. Endpoints
are described in their entirety and are evaluated by descriptive
statistical methods. Safety analyses included all treated patients
(full analysis set; FAS); efficacy analyses were conducted with
patients who had a baseline and at least one post-baseline
measurement available for either GPPASI or GPPGA; and biomarker
analyses were conducted with all treated patients who had provided
at least one observation for at least one biomarker matrix.
Non-response imputation was used for binary efficacy endpoints
following use of rescue medication; for continuous endpoints, only
observations collected prior to use of rescue medication were
summarized. One patient received rescue treatment during study
hence data subsequent to this use (post-Week 4) are handled as
described.
Results
[0693] Patients
[0694] Of 16 patients screened, seven patients (three men and four
women, aged between 22 and 58 years) at five study sites, who
experienced a moderate to severe acute flare, received a single IV
dose of 10 mg/kg an anti-IL-36R antibody of the present invention
between February and August. Baseline demographic data and disease
characteristics are reported in Table 3. Two patients carried a
homozygous loss of function IL36RN mutation
(rs387906914/p.Leu27Pro) known to cause generalized pustular
psoriasis and one patient carried potentially generalized pustular
psoriasis-causing mutations, including a homozygous IL36RN mutation
(rs148755083) and a heterozygous CARD14 mutation
(rs117360605/p.Arg275His). The mean (SD) time from initial
diagnosis for all patients was 16.4 (16.8) years. All patients
presented with a flare of moderate severity, characterized by a
GPPGA of 3 and a pustule subscore of 2-4 (moderate to very high
density). The mean (SD) time interval between the onset of the
current flare and an anti-IL-36R antibody of the present invention
infusion was 5.3 (7.4) days (range: 0-18 days). All patients had
previously received prior systemic treatments for generalized
pustular psoriasis and were stopped prior to receiving an
anti-IL-36R antibody of the present invention; cyclosporine was
discontinued 30 days prior to an anti-IL-36R antibody of the
present invention administration. All patients completed the trial
up to Week 20, however, there were two protocol violations: One
patient (patient 8201002) did not satisfy the inclusion criterion
for having a known prior history of generalized pustular psoriasis,
but did satisfy other inclusion criteria, and a second patient
(patient 6001004) received methotrexate at Week 4 for treatment of
"pain". Both patients were included in the FAS, however, only
efficacy data up to Week 4 is included for patient 6001004.
[0695] Safety
[0696] Through 20 weeks, four patients (57.1%) were deemed to have
had a drug-related adverse events (Table 6); all were graded as
mild or moderate. No severe or serious adverse events were
reported. Laboratory parameters were normal in most patients, two
patients (28.6%) had low hemoglobin; two patients (14.3%) had
elevated eosinophils, one patient had elevated creatine kinase, two
patients had elevated triglycerides, and one patient had low
glucose, following treatment with an anti-IL-36R antibody of the
present invention. Three patients (42.9%) had positive anti-drug
antibodies at Week 2, sustained through Week 20 with maximum titer
at Week 12 for two of the patients; no pre-existing anti-drug
antibodies were detected.
TABLE-US-00014 TABLE 6 Adverse Events through Week 20* 10 mg/kg an
anti-IL-36R antibody of Adverse Event, n (%) the present invention
(N = 7) Any adverse event 7 (100) Severe adverse event 0
Drug-related adverse event 4 (57.1) Eosinophilia 2 (28.6) Vomiting
1 (14.3) Chills 1 (14.3) Pain.sup..dagger. 1 (14.3) Upper
respiratory tract infection 2 (28.6) Urinary tract infection 1
(14.3) Infusion related reaction 1 (14.3) Arthralgia 1 (14.3)
Adverse event leading to 0 discontinuation of trial drug Serious
drug-related adverse event 0 *Adverse events were coded with the
use of the Medical Dictionary for Drug Regulatory Activities,
version 20.1. The intensity of adverse events were categorized as
mild, moderate, or severe by investigators. .sup..dagger.Patient
reported pain at sites of previous lesions, located on both
shins.
[0697] Efficacy
[0698] Clinical Endpoints
[0699] A GPPGA score of 0 or 1 was achieved in five patients
(71.4%) as early as Week 1 after a single dose of an anti-IL-36R
antibody of the present invention, and in all patients by Week 4
(FIG. 1A).
[0700] A major improvement in GPPASI was observed in all patients
very early with a mean (SD) percent change from baseline of 73.2%
(16.2) at Week 2 (FIG. 1B); by Week 4, this was further reduced to
79.8%, and was maintained to Week 20 (83.6%). Within 48 hours of
treatment, pustules were completely cleared in three patients
(42.9%); pustules were cleared in five patients (71.4%) by Week 1,
and in six patients (85.7%) by Week 2 (FIG. 1C). By Week 1, 85.7%
of patients had achieved a GPPASI 50, by Week 4, 71.4% of patients
had achieved a GPPASI 75, and by Week 12, 57.1% of patients had
achieved a GPPASI 90 (FIG. 2). The mean GPPASI erythema subscore
was reduced from baseline by 27.8%, 48.3%, and 53.5% at Weeks 1, 2,
and 4, respectively. Similarly, the mean GPPASI scaling subscore
was reduced from baseline by 38.1%, 49.6%, and 57.1% at Weeks 1, 2,
and 4 respectively (FIG. 3).
[0701] Patient-Reported Outcomes
[0702] The mean (SD) improvement in FACIT-F from baseline to Week 2
was 12.3 (10.1) and was maintained to Week 4 (FIG. 4). For
Pain-VAS, the mean (SD) change from baseline to Week 2 was -45.9
(32.3) and was maintained to Week 4 (FIG. 5). Similarly, there was
a mean (SD) change from baseline of -5.14 (3.18) in PSS at Week 2
that was also maintained to Week 4 (FIG. 6).
[0703] Biomarker Analyses
[0704] A rapid reduction in CRP approaching normalization was
observed with a mean (SD) change in CRP from baseline to Week 2 of
-64.2 (55.1) mg/dl that was maintained to Week 4 (FIG. 7). Absolute
neutrophil count was reduced rapidly by Week 2 and was maintained
to Week 4 (FIG. 8).
[0705] Global transcriptome analysis of lesional and non-lesional
skin biopsies samples found 3276 genes to be differentially
expressed (1885 elevated; 1391 decreased) at baseline between
lesional and non-lesional skin biopsies (adjusted P.ltoreq.0.05,
fold-change .gtoreq.2). After seven days of treatment with an
anti-IL-36R antibody of the present invention, expression of 1444
genes in lesional skin was strongly up or downregulated, reaching
near non-lesional skin levels; genes differentially expressed were
associated with innate (e.g. IL6, TNF, and CXCL1) and Th1/Th17
mediated inflammation (e.g. IL1B, IL12B, and IL23A) and with
proinflammatory processes of keratinocyte activation (e.g. IL17C
and IL24) (Table 7).
TABLE-US-00015 TABLE 7 Gene Expression Profile in Lesional versus
Non-Lesional Skin and Pre and Post-Treatment with an anti-IL-36R
antibody of the present invention Lesional skin Pre Versus post an
anti-IL-36R Lesional Versus antibody of the Non-Lesional present
invention Skin at Baseline treatment at Week 1 Gene Description
(Log2FC) (Log2FC) IL36A Interleukin 36 alpha 6.5042** -1.98 IL36B
Interleukin 36 beta 1.3974 0.0258 IL36G Interleukin 36 gamma
3.7135** -0.9053 IL12B Interleukin 12B 5.5762** -3.4247* IL1B
Interleukin 1 beta 4.4361** -2.2585* IL6 Interleukin 6 3.9185*
-3.6732* CXCL1 Chemokine 5.4683*** -2.6705* (C--X--C motif) ligand
1 CXCL8 Interleukin 8 4.8027** -1.1786 IL23A Interleukin 23A
4.5025** -2.8952* TNF Tumor necrosis factor 1.7834*** -1.5952*
IL17C Interleukin 17C 5.6359** -3.6090* IL24 Interleukin 24 8.0150*
-4.3571* Adjusted P-values: *P < 0.05, **P < 0.01, ***P <
0.001. Data was normalized by TMM using the edgeR package. The
limma package was utilized to derive log 2 fold changes and
corresponding false discovery rate adjusted P-values. TMM = Trimmed
mean of M-values.
[0706] In all patients, IL-36.alpha., IL-36.gamma. and IL-8 were
strongly increased in lesional skin biopsies; after seven days of
treatment with an anti-IL-36R antibody of the present invention,
the expression of IL-36.alpha. and IL-36.gamma. was strongly
reduced in four patients, while IL-8 was strongly reduced in three
patients (fold change .gtoreq.2). RNA expression from whole blood
detected differentially expressed genes (adjusted P.ltoreq.0.05,
fold-change .gtoreq.2) after 7, 14 and 28 days (364, 476 and 568
genes, respectively). Genes of proinflammatory mediators involved
in neutrophil activation, such as IL1B, CD177, S100A8/9, S100A12,
MMP9, and MMP25 were among those most strongly downregulated (Table
8).
TABLE-US-00016 TABLE 8 Gene Expression Profile in Whole Blood Pre-
and Post-Treatment with an anti- IL-36R antibody of the present
invention Whole blood Differential expression from baseline
following an anti-IL-36R antibody of the present invention
treatment (Log2FC) Gene Description Day 1 Week 1 Week 2 Week 4 IL1B
Interleukin 1 beta -0.0569 -0.8180* -0.9891** -1.1283** S100A9 S100
calcium binding protein A9 -0.3686 -0.9398 -1.2238* -1.5496**
S100A12 S100 calcium binding protein A12 -0.5480 -1.3200* -1.8570**
-2.1336*** S100A8 S100 calcium binding protein A8 -0.5096 -1.0197
-1.3282* -1.6132** MMP25 Matrix metallopeptidase 25 -0.2015 -0.5665
-1.0276** -0.8226* MMP9 Matrix metallopeptidase 9 -0.2247 -0.5728
-1.5403* -1.6919** CD177 CD177 molecule -0.4945 -2.6019 -4.6062*
-4.7470** Adjusted P-values: *P < 0.05, **P < 0.01, ***P <
0.001. Data was normalized by TMM using the edgeR package. The
limma package was utilized to derive log 2 fold changes and
corresponding false discovery rate adjusted P-values. TMM = Trimmed
mean of M-values.
[0707] Discussion
[0708] This first-in-human disease study investigating the safety
and efficacy of an anti-IL-36R antibody of the present invention,
an anti-interleukin-36R human monoclonal antibody, studied patients
with generalized pustular psoriasis due to the significant disease
burden, high unmet need, and the robust evidence for the
contribution of interleukin-36 dysregulation to skin and systemic
inflammation in this syndrome. Indeed, the absence or impairment of
interleukin-36Ra due to IL36RN mutations causes generalized
pustular psoriasis, although the prevalence of such mutations
varies across different cohorts, ranging from 5% to 70%, leading to
the identification of a new autoinflammatory syndrome called DITRA
(Deficiency of Interleukin-36 Receptor Antagonist). The relevance
of the interleukin-36R inhibiting strategy in generalized pustular
psoriasis has been reinforced by a genetically-engineered mouse
model of DITRA, and by advanced knowledge of the structure and
function of the human interleukin-36R that has enabled the
production of an anti-IL-36R antibody of the present invention,
which inhibits the inflammatory effects of interleukin-36. Results
from this proof-of-concept study demonstrate rapid resolution of
systemic inflammation and efficacy, with five of seven patients
clear or almost clear one week after an anti-IL-36R antibody of the
present invention infusion, and all patients achieving this status
by Week 4. The assessment of efficacy at these early time points
was designed specifically to avoid wrongly attributing the drug
intervention (in this single-arm study) with the spontaneously
self-remitting course of generalized pustular psoriasis flares
which usually occurs over a few weeks to months--a disease
characteristic which limits the impact of many therapeutic studies
in generalized pustular psoriasis with later timed efficacy end
points. (Br J Dermatol 1968; 80:771-93) Likewise, advocated
successful treatments with a wide range of targeted biologics such
as inhibitors of tumor necrosis factor, interleukin-17 and
interleukin-23, should be considered with caution. (J Dermatol
2016; 43:1011-7; Arch Dermatol 2012; 148:1423-5; Ann Intern Med
2010; 153:66-7) This early, striking response pattern of both skin
and systemic components suggest that interleukin-36R inhibition
with a single dose of an anti-IL-36R antibody of the present
invention leads to a rapid and sustained shutdown of the
inflammatory cascade in generalized pustular psoriasis. These early
responses were also reflected in rapid improvements in
patient-reported outcomes (FACIT-F, Pain-VAS, and PSS). Another key
observation is the similar efficacy observed in patients with and
without IL36RN mutations, supporting the recent hypothesis that
interleukin-36 cytokines are engaged in skin inflammation not only
across pustular psoriasis subtypes with different genetic
backgrounds, but also potentially in psoriasis vulgaris lesions.
The rapid improvement in clinical endpoints were reflected by a
rapid improvement in the gene expression profile of lesional skin
to near normal skin levels within seven days, underlining the
central role of the interleukin-36 pathway in this disease. The
differentially expressed genes in whole blood up to 28 days support
the durable and long lasting clinical effect of a single dose of an
anti-IL-36R antibody of the present invention.
[0709] Regarding tolerance, no clear treatment-emergent safety
signal was identified, adding to previous safety data in 124
healthy volunteers (unpublished data) and are consistent with the
recent characterization of individuals with IL36R knockout
mutations, resulting in the complete absence of the interleukin-36R
but without any evidence of an increased risk of superinfection,
nor of a significant impact on the innate and adaptive immune
responses. (Sci Transl Med 2017; 9)
[0710] Given the low number of patients in the trial, no clear
association between immunogenicity with a change in either safety
or efficacy was detected.
[0711] Taking into consideration the limitations associated with a
proof-of-concept study in a rare disease (a small open-label study
of short duration), these results of interleukin-36R inhibition
with a single dose of an anti-IL-36R antibody of the present
invention provide promising perspectives for the treatment of
generalized pustular psoriasis. Larger randomized controlled trials
to confirm these findings are ongoing. The results of the current
study also provide additional support to the hypothesis that
inhibiting the interleukin-36 pathway may be beneficial in pustular
psoriasis beyond patients with IL36RN mutations.
[0712] In conclusion, inhibition of the interleukin-36 pathway
following a single dose of an anti-IL-36R antibody of the present
invention, resulted in the rapid and sustained remission of
clinical symptoms, with no adverse safety signals in patients with
acute generalized pustular psoriasis.
Example 2: Multi-Center, Double-Blind, Randomized,
Placebo-Controlled, Phase II Study to Evaluate Efficacy, Safety and
Tolerability of an Anti-IL-36R Antibody of the Present Invention in
Patients with Generalized Pustular Psoriasis (GPP) Presenting with
an Acute Flare of Moderate to Severe Intensity
[0713] Current treatment options for controlling acute GPP,
complete resolution of symptoms and prevention of reoccurrence of
flares are limited and do not provide sustained efficacy. No
treatments are currently approved for GPP in the US and EU, though
a combination of retinoids, cyclosporine or methotrexate has been
recommended as primary options for controlling worsening of chronic
GPP. However, long-term use of these treatments is limited due to
side effects and contraindications (retinoids: teratogenicity, hair
loss; cyclosporine: excessive hair growth, renal toxicity; MTX:
liver toxicity). Side effects, such as hair loss, excessive hair
growth and teratogenicity particularly limit the use of these
treatments in women. Biologics (mostly TNF inhibitors, occasionally
IL-1 or IL-17 inhibitors) are increasingly used to treat more
severe, extensive or treatment resistant patients with GPP, based
on small published case series. However, these drugs are also
associated with limitations in efficacy (incomplete and delayed
responses are frequent) and safety (risk of infections and infusion
reactions).
[0714] Based on the limitations described above, current
therapeutic options are not suitable for life-long treatment and do
not provide sustained responses in most patients. Therefore, to
address the high unmet needs in GPP there is a critical need to
develop (i) a highly effective treatment with rapid onset of action
for patients presenting with an acute GPP flare; and (ii) to
develop an effective treatment that also reliably reduces the
occurrence of flares and leads to complete resolution of
manifestations such as widespread erythema and scaling, and is safe
and tolerable for lifelong treatment. In addition, a search of the
current literature did not yield any published studies focusing on
moderate to severe GPP flares. Thus, our PoC approach and
subsequent development plan further addresses the need for GPP
treatment options.
[0715] The strong genetic link between the IL36 signaling pathway
and GPP and experimental data identifying IL-36 as the dominant
cytokine driving GPP suggest that inhibition of IL36R signaling
with the humanized anti-IL36R antibody an anti-IL-36R antibody of
the present invention might be beneficial in treatment of
GPP--similar to the strong responses seen in IL1R antagonist
deficient patients with sterile multifocal osteomyelitis after
treatment with Anakinra. In addition, a recent characterization of
individuals with homozygous IL36R KO mutations revealed that normal
immune function was broadly preserved suggesting that IL36
signaling pathway inhibition does not compromise host defenses.
[0716] Based on this rationale, an open-label, single arm study
trial has been conducted to investigate proof-of-concept of a
single dose of an anti-IL-36R antibody of the present invention in
patients with GPP. In total, seven patients have been treated with
a single IV administration of 10 mg/kg of an anti-IL-36R antibody
of the present invention.
[0717] As described above, inhibiting IL36R activity results in a
rapid and sustained improvement in GPP clinical skin and systemic
symptoms. In the patients studied, an anti-IL-36R antibody of the
present invention was well tolerated. Through 20 weeks of the trial
duration, only adverse events of mild or moderate intensity were
reported. In addition, no severe or serious adverse events were
reported.
[0718] Based on these results, the objective of this subsequent GPP
trial is to evaluate efficacy, safety, and tolerability of an
anti-IL-36R antibody of the present invention compared to placebo
in patients with GPP presenting with an acute flare of moderate to
severe intensity.
[0719] In order to be able to address future scientific questions,
patients will be asked to voluntarily donate biospecimens for
banking. If the patient agrees, banked samples may be used for
future biomarker research and drug development projects, e.g. to
identify patients that are more likely to benefit from a treatment
or experience an adverse event (AE), or to gain a mechanistic or
genetic understanding of drug effects and thereby better match
patients with therapies.
[0720] Trial Objectives and Endpoints
[0721] Main Objectives
[0722] To evaluate efficacy, safety, and tolerability of an
anti-IL-36R antibody of the present invention in patients with
Generalized Pustular Psoriasis (GPP) presenting with an acute flare
of moderate to severe intensity.
[0723] Clinical Trial Protocol Synopsis
TABLE-US-00017 Number of patients At least 27 entered: Number of
patients on 18 patients on an anti-IL-36R antibody of the present
invention and each treatment: 9 patients on placebo Diagnosis:
Patients with Generalized Pustular Psoriasis (GPP) presenting with
an acute flare of moderate to severe intensity. Main in- and
exclusion Main inclusion criteria: criteria Patients will be
enrolled (screened) into the trial, if they meet the following
criteria: 1a) Patients with GPPGA of 0 or 1 and a known and
documented history of GPP per European Rare And Severe Psoriasis
Expert Network (ERASPEN) criteria regardless of IL36RN mutation
status, with previous evidence of fever, and/or asthenia,
and/ormyalgia, and/or elevated C-reactive protein, and/or
leukocytosis with peripheral blood neutrophilia. OR 1b) Patients
with an acute flare of moderate to severe intensity meeting the
(ERASPEN) criteria of GPP with a known and documented history of
GPP (per ERASPEN criteria) regardless of IL36RN mutation status,
with previous evidence of fever, and/orasthenia, and/or myalgia,
and/or elevated C-reactive protein, and/or leucocytosis with
peripheral blood neutrophilia. OR 1c) Patients with first episode
of an acute GPP flare of moderate to severe intensity with evidence
of fever, and/or asthenia, and/ormyalgia, and/or elevated
C-reactive protein, and/or leukocytosis with peripheral blood
neutrophilia (above ULN). For these patients the diagnosis will be
confirmed retrospectively by a central external expert/committee.
Patients may or may not be receiving background treatment with
retinoids and/or methotrexate and/or cyclosporine. Patients must
discontinue retinoids/methotrexate/cyclosporine prior to receiving
the first dose of an anti-IL-36R antibody of the present invention/
placebo. Male or female patients, aged 18 to 75 years at screening.
Signed and dated written informed consent prior to admission to the
study in accordance with ICH-GCP and local legislation prior to
start of any screening procedures. Women of childbearing potential
and men able to father a child must be ready and able to use highly
effective methods of birth control per ICH M3 (R2) that result in a
low failure rate of less than 1% per year when used consistently
and correctly. Note: A woman is considered of childbearing
potential, i.e. fertile, following menarche and until becoming
postmenopausal unless permanently sterile. Permanent sterilisation
methods include hysterectomy, bilateral salpingectomy and bilateral
oophorectomy. Tubal ligation is not a method of permanent
sterilization. A postmenopausal state is defined as no menses for
12 months without an alternative medical cause. Main Exclusion
Criteria: Patients with SAPHO
(Synovitis-acne-pustulosis-hyperostosis- osteitis) syndrome.
Patients with primary erythrodermic psoriasis vulgaris. Patients
with primary plaque psoriasis vulgaris without presence of pustules
or with pustules that are restricted to psoriatic plaques.
Drug-triggered Acute Generalized Exanthematous Pustulosis (AGEP).
Immediate life-threatening flare of GPP or requiring intensive care
treatment, according to the investigator's judgement. Life-
threatening complications mainly include, but are not limited to,
cardiovascular/cytokine driven shock, pulmonary distress syndrome,
or renal failure. [TMM to send TCM threshold] Severe, progressive,
or uncontrolled hepatic disease, defined as >3-fold Upper Limit
of Normal (ULN) elevation in AST or ALT or alkaline phosphatase, or
>2-fold ULN elevation in total bilirubin. Patients with dose
escalation of their subcutaneous therapy with cyclosporine and/or
methotrexate and/or retinoids within the 2 weeks prior to receiving
the first dose of an anti-IL-36R antibody of the present
invention/placebo. The initiation of systemic agents such as
cyclosporine and/orretinoids and/or methotrexate 2 weeks prior to
receiving the first dose of an anti-IL-36R antibody of the present
invention/ placebo. Treatment (Visit 2) will be initiated
immediately in patients: Who meet the inclusion criteria above Who
are presenting with an acute GPP flare of moderate to severe
intensity, defined by emergence of: a) Generalized Pustular
Psoriasis Physician Global Assessment(GPPGA) score of at least 3
(moderate), and b) presence of fresh pustules (new appearance or
worsening of pustules), and c) GPPGA pustulation sub score of at
least 2 (mild), and d) at least 5% of Body Surface Area (BSA)
covered with erythema and the presence of pustules And who do not
meet any of the exclusion criteria above. dose: 900 mg, single dose
mode of administration: i.v. Comparator products: Placebo
comparator dose: Not applicable mode of administration: i.v.
Duration of treatment: Single dose Endpoints Primary Endpoints: The
co-Primary Endpoints of the study are: A Generalized Pustular
Psoriasis Physician Global Assessment(GPPGA) score of 0 or 1 at
Week 1. A GPPGA pustulation subscore of 0 indicating no visible
pustules at Week 1. Secondary Endpoints: Secondary Endpoints of the
study at week 4 which are included in the statistical testing
strategy in a hierarchical manner subsequent to performance of the
tests on the co-primary endpoints are: A Psoriasis Area and
Severity Index for Generalized Pustular Psoriasis (GPPASI) 75 at
Week 4. Change from baseline in Pain Visual Analog Scale (VAS)
score at Week 4. Change from baseline in Psoriasis Symptom Scale
(PSS) score at Week 4. Change from baseline in Functional
Assessment of Chronic Illness Therapy (FACIT) Fatigue score at Week
4. Secondary endpoints of the study which are not included in the
statistical testing hierarchy are: A GPPGA 0 or 1 at Week 4. A
GPPGA pustulation subscore of 0 indicating no visible pustules at
Week 4. A GPPASI 50 at Week 1, and 4. The percent reduction in
GPPASI from baseline at Week 1, and 4. The following safety
endpoint is also defined: The occurrence of Treatment Emergent
Adverse Events (TEAEs).
[0724] This study will be a single-dose, placebo-controlled study
of patients with acute GPP flares of moderate to severe intensity
receiving 900 mg an anti-IL-36R antibody of the present invention
and then followed for an additional 12 weeks. Patients who satisfy
the inc/exc criteria of subsequent open-label extension trial will
receive an option to continue receiving treatment for GPP with s.c.
dosing. See FIG. 9 for additional details on the trial design.
Example 3: Treating Patients with Acute GPP Flares
[0725] In this example, an anti-IL36R antibody (e.g., an
anti-IL-36R antibody of the present invention) is used to treat
patients with acute GPP flares. Initially, each patient has one or
more inclusion criteria listed in Example 2. A single 900 mg dose
i.v. of an anti-IL36R antibody of the present invention (in
solution for infusion at 60 mg/mL) is administered to each
patient.
[0726] Following the administration of the anti-IL-36R antibody
(e.g., an anti-IL-36R antibody of the present invention), safety
and efficacy assessments reveal the followings: At least 10%, 11%,
12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%,
25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%,
38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%,
51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%, 63%,
64%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%,
77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, or
90% of the patients achieve clinical remission as defined by (a)
Generalized Pustular Psoriasis Global Assessment (GPPGA) score of 0
or 1 at Week 1; (b) GPPGA pustulation subscore of 0 indicating no
visible pustules at Week 1; (c) Psoriasis Area and Severity Index
for Generalized Pustular Psoriasis (GPPASI) 75 at Week 4; (d)
Change from baseline in Pain Visual Analog Scale (VAS) score at
Week 4; (e) Change from baseline in Psoriasis Symptom Scale (PSS)
score at Week 4; (f) Change from baseline in Functional Assessment
of Chronic Illness Therapy (FACIT) Fatigue score at Week 4; (g)
GPPGA 0 or 1 at Week 4; (h) GPPGA pustulation subscore of 0
indicating no visible pustules at Week 4; (i) GPPASI 50 at Week 1
and 4; or (j) Change in GPPASI pustule, erythema or scaling
severity subscore from baseline at Week 1 and 4 of the treatment.
The proportion of patients with a response to the administration is
statistically significantly higher as compared to patients on
placebo for one or more of end points (a)-(j).
Example 4: Preventing Flares from Recurring in GPP Patients
[0727] In this example, a single 900 mg dose i.v. of an anti-IL36R
antibody of the present invention (in solution for infusion at 60
mg/mL) is used to treat patients with acute GPP flares. Subsequent
to the i.v. dose, as shown in Table 1, additional subcutaneous
doses of the anti-IL36R antibody are administered to prevent the
GPP flares from recurring.
[0728] Following the administration of the last dose of the
anti-IL-36R antibody (e.g., an anti-IL-36R antibody of the present
invention), at least 10%, 20%, 30%, 40%, 50%, 60%, 70% or 80% of
the patients remain in clinical remission as measured by a GPPGA
score of 0 or 1 at Week 12, 24, 36, 48, 60 or 72. The improved
effects are maintained at higher percentage with an anti-IL-36R
antibody of the present invention than with placebo. At least 10%,
11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%,
24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%,
37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%,
50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%,
63%, 64%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%,
76%, 77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%,
89%, or 90% of the mammals or patients maintain improved effects at
Week 12, 24, 36, 48, 60 or 72 after the last dose of the
anti-IL-36R is administered, as compared to placebo.
[0729] Following the administration of the last dose of the
anti-IL-36R antibody (e.g., an anti-IL-36R antibody of the present
invention), at least 10%, 20%, 30%, 40%, 50%, 60%, 70% or 80% of
the patients remain in clinical remission as measured by a change
in GPPASI from baseline at Week 12, 24, 36, 48, 60 or 72. The
improved effects are maintained at higher percentage with an
anti-IL-36R antibody of the present invention than with placebo. At
least 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%,
22%, 23%, 24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%,
35%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%,
48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%,
61%, 62%, 63%, 6.4%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%,
74%, 75%, 76%, 77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%,
87%, 88%, 89%, or 90% of the mammals or patients maintain improved
effects at Week 12, 24, 36, 48, 60 or 72 after the last dose of the
anti-IL-36R is administered, as compared to placebo.
[0730] Following the administration of the last dose of the
anti-IL-36R antibody (e.g., an anti-IL-36R antibody of the present
invention), at least 10%, 20%, 30%, 40%, 50%, 60%, 70% or 80% of
the patients remain in clinical remission as measured by a change
in GPPASI pustule, erythema or scaling severity subscore from
baseline at Week 12, 24, 36, 48, 60 or 72. The improved effects are
maintained at higher percentage with an anti-IL-36R antibody of the
present invention than with placebo. At least 10%, 11%, 12%, 13%,
1.4%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%, 26%,
27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%, 39%,
40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 0.48%, 49%, 50%, 51%, 52%,
53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%, 63%, 64%, 65%,
66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%,
79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, or 90% of
the mammals or patients maintain improved effects at Week 12, 24,
36, 48, 60 or 72 after the last dose of the anti-IL-36R is
administered, as compared to placebo.
Example 5: Achieving Complete Resolution of GPP Symptoms in GPP
Patients
[0731] In this example, a single 900 mg dose i.v. of an anti-IL36R
antibody of the present invention (in solution for infusion at 60
mg/mL) is used to treat patients with acute GPP flares. Subsequent
to the i.v. dose, as shown in Table 1, additional subcutaneous
doses of the anti-IL36R antibody are administered to achieve
complete resolution of GPP symptoms in the patients.
[0732] Following the administration of the last dose of the
anti-IL-36R antibody (e.g., an anti-IL-36R antibody of the present
invention), at least 10%, 20%, 30%, 40%, 50%, 60%, 70% or 80% of
the patients complete resolution of GPP symptoms as measured by a
GPPGA score of 0 at Week 12, 24, 36, 48, 60 or 72. The improved
effects are maintained at higher percentage with an anti-IL-36R
antibody of the present invention than with placebo. At least 10%,
11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%,
24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%,
37%, 38%, 39%, 40%, 0.41%, 42%, 43%, 0.44%, 45%, 0.4.6%, 47%, 48%,
49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%,
62%, 63%, 6.4%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%,
75%, 76%, 77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%,
88%, 89%, or 90% of the mammals or patients maintain improved
effects at Week 12, 24, 36, 48, 60 or 72 after the last dose of the
anti-IL-36R is administered, as compared to placebo.
[0733] While certain aspects and embodiments of the invention have
been described, these have been presented by way of example only,
and are not intended to limit the scope of the invention. Indeed,
the novel methods and systems described herein may be embodied in a
variety of other forms without departing from the spirit thereof.
The accompanying claims and their equivalents are intended to cover
such forms or modifications as would fall within the scope and
spirit of the invention.
[0734] All patents and/or publications including journal articles
cited in this disclosure are expressly incorporated herein by
reference.
Sequence CWU 1
1
1401108PRTMus sp. 1Gln Ile Val Leu Thr Gln Ser Pro Ala Ile Met Ser
Ala Ser Leu Gly1 5 10 15Glu Arg Val Thr Met Thr Cys Thr Ala Ser Ser
Ser Val Ser Ser Ser 20 25 30Tyr Leu His Trp Tyr Gln Lys Lys Pro Gly
Ser Ser Pro Lys Leu Trp 35 40 45Val Tyr Ser Thr Ser Asn Leu Ala Ser
Gly Val Pro Val Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr Ser Tyr
Ser Leu Thr Ile Ser Ser Met Glu65 70 75 80Ala Glu Asp Ala Ala Thr
Tyr Tyr Cys His Gln His His Arg Ser Pro 85 90 95Val Thr Phe Gly Ser
Gly Thr Lys Leu Glu Met Lys 100 1052107PRTMus sp. 2Asp Ile Gln Met
Thr Gln Ser Pro Ala Ser Gln Ser Ala Ser Leu Gly1 5 10 15Glu Ser Val
Thr Phe Thr Cys Leu Ala Ser Gln Thr Ile Gly Thr Trp 20 25 30Leu Ala
Trp Tyr Gln Gln Arg Pro Gly Lys Ser Pro Gln Leu Leu Ile 35 40 45Tyr
Ala Ala Thr Ser Leu Ala Asp Gly Val Pro Ser Arg Phe Ser Gly 50 55
60Ser Gly Ser Gly Thr Gln Phe Ser Phe Asn Ile Arg Ser Leu Gln Ala65
70 75 80Glu Asp Phe Ala Ser Tyr Tyr Cys Gln Gln Val Tyr Thr Thr Pro
Leu 85 90 95Thr Phe Gly Gly Gly Thr Lys Leu Glu Ile Lys 100
1053107PRTMus sp. 3Asp Ile Gln Met Thr Gln Ser Pro Ala Ser Gln Ser
Ala Ser Leu Gly1 5 10 15Glu Ser Val Thr Phe Thr Cys Leu Ala Ser Gln
Thr Ile Gly Thr Trp 20 25 30Leu Gly Trp Tyr Gln Gln Lys Pro Gly Lys
Ser Pro Gln Leu Leu Ile 35 40 45Tyr Arg Ser Thr Thr Leu Ala Asp Gly
Val Pro Ser Arg Phe Ser Gly 50 55 60Ser Gly Ser Gly Thr Lys Phe Ser
Phe Lys Ile Ser Ser Leu Gln Ala65 70 75 80Ala Asp Phe Ala Ser Tyr
Tyr Cys Gln Gln Leu Tyr Ser Ala Pro Tyr 85 90 95Thr Phe Gly Gly Gly
Thr Lys Leu Glu Ile Arg 100 1054112PRTMus sp. 4Asp Val Leu Leu Thr
Gln Thr Pro Leu Ser Leu Pro Val Ser Leu Gly1 5 10 15Asp Gln Ala Ser
Ile Ser Cys Arg Ser Ser Gln Asn Ile Val His Ser 20 25 30Asn Gly Asn
Thr Tyr Leu Gln Trp Tyr Leu Gln Lys Pro Gly Gln Ser 35 40 45Pro Lys
Leu Leu Ile Tyr Lys Val Ser Asn Arg Phe Ser Gly Val Pro 50 55 60Asp
Arg Phe Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Lys Ile65 70 75
80Ser Arg Val Glu Ala Glu Asp Leu Gly Val Tyr Tyr Cys Phe Gln Gly
85 90 95Ser His Val Pro Phe Thr Phe Gly Ala Gly Thr Lys Leu Glu Leu
Lys 100 105 1105107PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 5Asp Ile Gln Met Thr Gln Thr Thr Ser
Ser Leu Ser Ala Ser Leu Gly1 5 10 15Asp Arg Val Thr Ile Ser Cys Arg
Ala Ser Gln Asp Ile Tyr Lys Tyr 20 25 30Leu Asn Trp Tyr Gln Gln Lys
Pro Asp Gly Thr Leu Lys Leu Leu Ile 35 40 45Tyr Tyr Thr Ser Gly Leu
His Ser Gly Val Pro Ser Arg Phe Ser Gly 50 55 60Ser Gly Ser Gly Thr
Asp Phe Ser Leu Thr Ile Ser Asn Leu Glu Pro65 70 75 80Glu Asp Ile
Ala Thr Tyr Phe Cys Gln Gln Asp Ser Lys Phe Pro Trp 85 90 95Thr Phe
Gly Gly Asp Thr Lys Leu Glu Ile Lys 100 1056108PRTMus sp. 6Gln Ile
Val Leu Thr Gln Ser Pro Ala Ile Met Ser Ala Ser Leu Gly1 5 10 15Glu
Arg Val Thr Met Thr Cys Thr Ala Ser Ser Ser Val Ser Ser Ser 20 25
30Tyr Phe His Trp Tyr Gln Gln Lys Pro Gly Ser Ser Pro Lys Leu Trp
35 40 45Ile Tyr Arg Thr Ser Asn Leu Ala Ser Gly Val Pro Gly Arg Phe
Ser 50 55 60Gly Ser Gly Ser Gly Thr Ser Tyr Ser Leu Thr Ile Ser Ser
Met Glu65 70 75 80Ala Glu Asp Ala Ala Thr Tyr Tyr Cys His Gln Phe
His Arg Ser Pro 85 90 95Leu Thr Phe Gly Ala Gly Thr Lys Leu Glu Leu
Lys 100 1057107PRTMus sp. 7Asp Ile Val Met Thr Gln Ser Gln Lys Phe
Leu Ser Thr Ser Val Gly1 5 10 15Val Arg Val Ser Val Thr Cys Lys Ala
Ser Gln Asp Val Gly Thr Asn 20 25 30Val Leu Trp Tyr Gln Gln Lys Ile
Gly Gln Ser Pro Lys Pro Leu Ile 35 40 45Tyr Ser Ala Ser Tyr Arg His
Ser Gly Val Pro Asp Arg Phe Thr Gly 50 55 60Ser Gly Ser Gly Thr Asp
Phe Thr Leu Ile Ile Ser Asn Val Gln Ser65 70 75 80Glu Asp Leu Ala
Glu Tyr Phe Cys Gln Gln Tyr Ser Arg Tyr Pro Leu 85 90 95Thr Phe Gly
Pro Gly Thr Lys Leu Glu Leu Lys 100 1058107PRTMus sp. 8Asp Ile Val
Met Thr Gln Ser Gln Lys Phe Leu Ser Thr Ser Val Gly1 5 10 15Val Arg
Val Ser Val Thr Cys Lys Ala Ser Gln Asp Val Gly Thr Asn 20 25 30Val
Leu Trp Tyr Gln Gln Lys Ile Gly Gln Ser Pro Lys Ala Leu Ile 35 40
45Tyr Ser Ala Ser Tyr Arg His Ser Gly Val Pro Asp Arg Phe Thr Gly
50 55 60Ser Gly Ser Gly Thr Asp Phe Thr Leu Ile Ile Thr Asn Val Gln
Ser65 70 75 80Glu Asp Leu Ala Glu Tyr Phe Cys Gln Gln Tyr Ser Arg
Tyr Pro Leu 85 90 95Thr Phe Gly Pro Gly Thr Lys Leu Glu Leu Lys 100
1059107PRTMus sp. 9Asp Ile Val Met Thr Gln Ser Gln Lys Phe Met Ser
Ala Thr Val Gly1 5 10 15Gly Arg Val Asn Ile Thr Cys Lys Ala Ser Gln
Asn Val Gly Arg Ala 20 25 30Val Ala Trp Tyr Gln Gln Lys Pro Gly Gln
Ser Pro Lys Leu Leu Thr 35 40 45His Ser Ala Ser Asn Arg Tyr Thr Gly
Val Pro Asp Arg Phe Thr Gly 50 55 60Ser Gly Ser Gly Thr Asp Phe Thr
Leu Thr Ile Thr Asn Met Gln Ser65 70 75 80Glu Asp Leu Ala Asp Tyr
Phe Cys Gln Gln Tyr Ser Ser Tyr Pro Leu 85 90 95Thr Phe Gly Ala Gly
Thr Lys Leu Asp Leu Lys 100 10510107PRTMus sp. 10Asp Ile Gln Met
Thr Gln Ser Pro Ala Ser Gln Ser Ala Ser Leu Gly1 5 10 15Glu Ser Val
Thr Phe Ser Cys Leu Ala Ser Gln Thr Ile Gly Thr Trp 20 25 30Leu Gly
Trp Tyr Gln Gln Lys Pro Gly Lys Ser Pro Gln Leu Leu Ile 35 40 45Tyr
Arg Ala Thr Ser Leu Ala Asp Gly Val Pro Ser Arg Phe Ser Gly 50 55
60Ser Gly Ser Gly Thr Asn Phe Ser Phe Lys Ile Ser Ser Leu Gln Ala65
70 75 80Glu Asp Leu Ala Ser Tyr Tyr Cys Gln Gln Leu Tyr Ser Gly Pro
Tyr 85 90 95Thr Phe Gly Gly Gly Thr Lys Leu Glu Ile Arg 100
10511119PRTMus sp. 11Gln Val Gln Leu Gln Gln Ser Gly Thr Glu Leu
Leu Lys Pro Gly Ala1 5 10 15Ser Val Lys Leu Ser Cys Lys Ala Ser Gly
Asn Thr Val Thr Ser Tyr 20 25 30Trp Met His Trp Val Lys Gln Arg Pro
Gly Gln Gly Leu Glu Trp Ile 35 40 45Gly Glu Ile Leu Pro Ser Thr Gly
Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Lys Gly Lys Ala Met Leu Thr
Val Asp Lys Ser Ser Ser Thr Ala Tyr65 70 75 80Met Gln Leu Ser Ser
Leu Ala Ser Glu Asp Ser Ala Val Tyr Tyr Cys 85 90 95Thr Ile Val Tyr
Phe Gly Asn Pro Trp Phe Ala Tyr Trp Gly Gln Gly 100 105 110Thr Leu
Val Thr Val Ser Ala 11512125PRTMus sp. 12Glu Val Gln Leu Gln Gln
Ser Gly Pro Glu Leu Val Lys Pro Gly Ala1 5 10 15Ser Val Lys Leu Ser
Cys Lys Ala Ser Gly Tyr Thr Phe Thr Asp Asn 20 25 30Tyr Met Asn Trp
Val Arg Gln Ser His Gly Lys Ser Leu Glu Trp Ile 35 40 45Gly Arg Val
Asn Pro Ser Asn Gly Asp Thr Lys Tyr Asn Gln Asn Phe 50 55 60Lys Gly
Lys Ala Thr Leu Thr Val Asp Lys Ser Leu Ser Thr Ala Tyr65 70 75
80Met Gln Leu Asn Gly Leu Thr Ser Glu Asp Ser Ala Val Tyr Tyr Cys
85 90 95Gly Arg Thr Lys Asn Phe Tyr Ser Ser Tyr Ser Tyr Asp Asp Ala
Met 100 105 110Asp Tyr Trp Gly Gln Gly Thr Ser Val Thr Val Ser Ser
115 120 12513124PRTMus sp. 13Glu Val Gln Leu Gln Gln Ser Gly Ala
Glu Phe Val Arg Pro Gly Ala1 5 10 15Ser Val Lys Phe Ser Cys Thr Ala
Ser Gly Phe Asn Ile Lys Asp Asp 20 25 30Tyr Ile His Trp Val Arg Gln
Arg Pro Glu Gln Gly Leu Glu Trp Val 35 40 45Gly Arg Ile Asp Pro Ala
Asn Gly Asn Thr Lys Tyr Ala Pro Lys Phe 50 55 60Gln Asp Lys Ala Thr
Ile Thr Ala Asp Thr Ser Ser Asn Thr Ala Tyr65 70 75 80Leu Gln Leu
Ser Ser Leu Thr Ser Glu Asp Thr Ala Val Tyr Tyr Cys 85 90 95Ala Lys
Ser Phe Pro Asn Asn Tyr Tyr Ser Tyr Asp Asp Ala Phe Ala 100 105
110Tyr Trp Gly Gln Gly Thr Leu Val Thr Val Ser Ala 115
12014118PRTMus sp. 14Gln Val Gln Leu Lys Glu Ser Gly Pro Val Leu
Val Ala Pro Ser Gln1 5 10 15Ser Leu Ser Ile Thr Cys Thr Val Ser Gly
Phe Ser Leu Thr Lys Phe 20 25 30Gly Val His Trp Ile Arg Gln Thr Pro
Gly Lys Gly Leu Glu Trp Leu 35 40 45Gly Val Ile Trp Ala Gly Gly Pro
Thr Asn Tyr Asn Ser Ala Leu Met 50 55 60Ser Arg Leu Thr Ile Ser Lys
Asp Ile Ser Gln Ser Gln Val Phe Leu65 70 75 80Arg Ile Asp Ser Leu
Gln Thr Asp Asp Thr Ala Met Tyr Tyr Cys Ala 85 90 95Lys Gln Ile Tyr
Tyr Ser Thr Leu Val Asp Tyr Trp Gly Gln Gly Thr 100 105 110Ser Val
Thr Val Ser Ser 11515120PRTMus sp. 15Gln Val Gln Leu Lys Glu Ser
Gly Pro Gly Leu Val Ala Pro Ser Gln1 5 10 15Ser Leu Phe Ile Thr Cys
Thr Val Ser Gly Phe Ser Leu Ser Ser Tyr 20 25 30Glu Ile Asn Trp Val
Arg Gln Val Pro Gly Lys Gly Leu Glu Trp Leu 35 40 45Gly Val Ile Trp
Thr Gly Ile Thr Thr Asn Tyr Asn Ser Ala Leu Ile 50 55 60Ser Arg Leu
Ser Ile Ser Lys Asp Asn Ser Lys Ser Leu Val Phe Leu65 70 75 80Lys
Met Asn Ser Leu Gln Thr Asp Asp Thr Ala Ile Tyr Tyr Cys Ala 85 90
95Arg Gly Thr Gly Thr Gly Phe Tyr Tyr Ala Met Asp Tyr Trp Gly Gln
100 105 110Gly Thr Ser Val Thr Val Ser Ser 115 12016119PRTMus sp.
16Gln Val Gln Leu Gln Gln Pro Gly Ala Asp Phe Val Arg Pro Gly Ala1
5 10 15Ser Met Arg Leu Ser Cys Lys Ala Ser Gly Tyr Ser Phe Thr Ser
Ser 20 25 30Trp Ile His Trp Val Lys Gln Arg Pro Gly Gln Gly Leu Glu
Trp Ile 35 40 45Gly Glu Ile Asn Pro Gly Asn Val Arg Thr Asn Tyr Asn
Glu Asn Phe 50 55 60Arg Asn Lys Ala Thr Leu Thr Val Asp Lys Ser Ser
Thr Thr Ala Tyr65 70 75 80Met Gln Leu Arg Ser Leu Thr Ser Ala Asp
Ser Ala Val Tyr Tyr Cys 85 90 95Thr Val Val Phe Tyr Gly Glu Pro Tyr
Phe Pro Tyr Trp Gly Gln Gly 100 105 110Thr Leu Val Thr Val Ser Ala
11517119PRTMus sp. 17Gln 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 Asn Tyr 20 25 30Ala Val His Trp Val Arg Gln Phe Pro
Gly Lys Gly Leu Glu Trp Leu 35 40 45Gly Val Ile Trp Ser Asp Gly Ser
Thr Asp Phe Asn Ala Pro Phe Lys 50 55 60Ser Arg Leu Ser Ile Asn Lys
Asp Asn Ser Lys Ser Gln Val Phe Phe65 70 75 80Lys Met Asn Ser Leu
Gln Ile Asp Asp Thr Ala Ile Tyr Tyr Cys Ala 85 90 95Arg Lys Gly Gly
Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln Gly 100 105 110Thr Leu
Val Thr Val Ser Ala 11518119PRTMus sp. 18Gln 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 Asn Tyr 20 25 30Ala Val His Trp
Val Arg Gln Phe Pro Gly Lys Gly Leu Glu Trp Leu 35 40 45Gly Val Ile
Trp Ser Asp Gly Ser Thr Asp Tyr Asn Ala Pro Phe Lys 50 55 60Ser Arg
Leu Ser Ile Asn Lys Asp Asn Ser Lys Ser Gln Val Phe Phe65 70 75
80Lys Met Asn Ser Leu Gln Thr Asp Asp Thr Ala Ile Tyr Tyr Cys Ala
85 90 95Arg Lys Gly Gly Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln
Gly 100 105 110Thr Leu Val Thr Val Ser Ala 11519117PRTMus sp. 19Gln
Val Gln Leu Lys Glu Ser Gly Pro Val Leu Val Ala Pro Ser Gln1 5 10
15Ser Leu Ser Ile Thr Cys Thr Val Ser Gly Phe Ser Leu Thr Asn Tyr
20 25 30Gly Val His Trp Val Arg Gln Pro Pro Gly Lys Gly Leu Glu Trp
Leu 35 40 45Gly Val Ile Trp Pro Val Gly Ser Thr Asn Tyr Asn Ser Ala
Leu Met 50 55 60Ser Arg Leu Ser Ile His Lys Asp Asn Ser Lys Ser Gln
Val Phe Leu65 70 75 80Arg Met Asn Ser Leu Gln Thr Asp Asp Thr Ala
Ile Tyr Tyr Cys Ala 85 90 95Lys Met Asp Trp Asp Asp Phe Phe Asp Tyr
Trp Gly Gln Gly Thr Thr 100 105 110Leu Thr Val Ser Ser
11520124PRTMus sp. 20Glu Val Gln Leu Gln Gln Ser Gly Ala Glu Leu
Val Arg Pro Gly Ala1 5 10 15Ser Val Arg Leu Ser Cys Thr Ala Ser Gly
Phe Asn Ile Lys Asp Asp 20 25 30Tyr Ile His Trp Val Arg Gln Arg Pro
Lys Gln Gly Leu Glu Trp Leu 35 40 45Gly Arg Ile Asp Pro Ala Asn Gly
Asn Thr Lys Tyr Asp Pro Arg Phe 50 55 60Gln Asp Lys Ala Thr Ile Thr
Ala Asp Thr Ser Ser Asn Thr Ala Tyr65 70 75 80Leu His Leu Ser Ser
Leu Thr Ser Glu Asp Thr Ala Val Tyr Tyr Cys 85 90 95Ala Lys Ser Phe
Pro Asp Asn Tyr Tyr Ser Tyr Asp Asp Ala Phe Ala 100 105 110Tyr Trp
Gly Gln Gly Thr Leu Val Thr Val Ser Ala 115 1202112PRTMus sp. 21Thr
Ala Ser Ser Ser Val Ser Ser Ser Tyr Leu His1 5 102211PRTMus sp.
22Leu Ala Ser Gln Thr Ile Gly Thr Trp Leu Ala1 5 102311PRTMus sp.
23Leu Ala Ser Gln Thr Ile Gly Thr Trp Leu Gly1 5 102416PRTMus sp.
24Arg Ser Ser Gln Asn Ile Val His Ser Asn Gly Asn Thr Tyr Leu Gln1
5 10 152511PRTMus sp. 25Arg Ala Ser Gln Asp Ile Tyr Lys Tyr Leu
Asn1 5 102612PRTMus sp. 26Thr Ala Ser Ser Ser Val Ser Ser Ser Tyr
Phe His1 5 102711PRTMus sp. 27Lys Ala Ser Gln Asp Val Gly Thr Asn
Val Leu1 5 102811PRTMus sp. 28Lys Ala Ser Gln Asn Val Gly Arg Ala
Val Ala1 5 102911PRTMus sp. 29Leu Ala Ser Gln Thr Ile Gly Thr Trp
Leu Gly1 5 10307PRTMus sp. 30Ser Thr Ser Asn Leu Ala Ser1
5317PRTMus sp. 31Ala Ala Thr Ser Leu Ala Asp1 5327PRTMus sp. 32Arg
Ser Thr Thr Leu Ala Asp1 5337PRTMus sp. 33Lys Val Ser Asn Arg Phe
Ser1
5347PRTMus sp. 34Tyr Thr Ser Gly Leu His Ser1 5357PRTMus sp. 35Arg
Thr Ser Asn Leu Ala Ser1 5367PRTMus sp. 36Ser Ala Ser Tyr Arg His
Ser1 5377PRTMus sp. 37Ser Ala Ser Asn Arg Tyr Thr1 5387PRTMus sp.
38Arg Ala Thr Ser Leu Ala Asp1 5399PRTMus sp. 39His Gln His His Arg
Ser Pro Val Thr1 5409PRTArtificial SequenceDescription of
Artificial Sequence Synthetic peptide 40Gln Gln Val Tyr Thr Thr Pro
Leu Thr1 5419PRTMus sp. 41Gln Gln Leu Tyr Ser Ala Pro Tyr Thr1
5429PRTMus sp. 42Phe Gln Gly Ser His Val Pro Phe Thr1 5439PRTMus
sp. 43Gln Gln Asp Ser Lys Phe Pro Trp Thr1 5449PRTMus sp. 44His Gln
Phe His Arg Ser Pro Leu Thr1 5459PRTMus sp. 45Gln Gln Tyr Ser Arg
Tyr Pro Leu Thr1 5469PRTMus sp. 46Gln Gln Tyr Ser Ser Tyr Pro Leu
Thr1 5479PRTMus sp. 47Gln Gln Leu Tyr Ser Gly Pro Tyr Thr1
54810PRTMus sp. 48Gly Asn Thr Val Thr Ser Tyr Trp Met His1 5
104910PRTMus sp. 49Gly Tyr Thr Phe Thr Asp Asn Tyr Met Asn1 5
105010PRTMus sp. 50Gly Phe Asn Ile Lys Asp Asp Tyr Ile His1 5
105110PRTMus sp. 51Gly Phe Ser Leu Thr Lys Phe Gly Val His1 5
105210PRTMus sp. 52Gly Phe Ser Leu Ser Ser Tyr Glu Ile Asn1 5
105310PRTMus sp. 53Gly Tyr Ser Phe Thr Ser Ser Trp Ile His1 5
105410PRTMus sp. 54Gly Phe Ser Leu Thr Asn Tyr Ala Val His1 5
105510PRTMus sp. 55Gly Phe Ser Leu Thr Asn Tyr Gly Val His1 5
105610PRTMus sp. 56Gly Phe Asn Ile Lys Asp Asp Tyr Ile His1 5
105717PRTMus sp. 57Glu Ile Leu Pro Ser Thr Gly Arg Thr Asn Tyr Asn
Glu Asn Phe Lys1 5 10 15Gly5817PRTMus sp. 58Arg Val Asn Pro Ser Asn
Gly Asp Thr Lys Tyr Asn Gln Asn Phe Lys1 5 10 15Gly5917PRTMus sp.
59Arg Ile Asp Pro Ala Asn Gly Asn Thr Lys Tyr Ala Pro Lys Phe Gln1
5 10 15Asp6016PRTMus sp. 60Val Ile Trp Ala Gly Gly Pro Thr Asn Tyr
Asn Ser Ala Leu Met Ser1 5 10 156116PRTMus sp. 61Val Ile Trp Thr
Gly Ile Thr Thr Asn Tyr Asn Ser Ala Leu Ile Ser1 5 10 156215PRTMus
sp. 62Glu Ile Asn Pro Gly Asn Val Arg Thr Asn Tyr Asn Glu Asn Phe1
5 10 156316PRTMus sp. 63Val Ile Trp Ser Asp Gly Ser Thr Asp Phe Asn
Ala Pro Phe Lys Ser1 5 10 156416PRTMus sp. 64Val Ile Trp Ser Asp
Gly Ser Thr Asp Tyr Asn Ala Pro Phe Lys Ser1 5 10 156516PRTMus sp.
65Val Ile Trp Pro Val Gly Ser Thr Asn Tyr Asn Ser Ala Leu Met Ser1
5 10 156617PRTMus sp. 66Arg Ile Asp Pro Ala Asn Gly Asn Thr Lys Tyr
Asp Pro Arg Phe Gln1 5 10 15Asp6710PRTMus sp. 67Val Tyr Phe Gly Asn
Pro Trp Phe Ala Tyr1 5 106816PRTMus sp. 68Thr Lys Asn Phe Tyr Ser
Ser Tyr Ser Tyr Asp Asp Ala Met Asp Tyr1 5 10 156915PRTMus sp.
69Ser Phe Pro Asn Asn Tyr Tyr Ser Tyr Asp Asp Ala Phe Ala Tyr1 5 10
157010PRTMus sp. 70Gln Ile Tyr Tyr Ser Thr Leu Val Asp Tyr1 5
107112PRTMus sp. 71Gly Thr Gly Thr Gly Phe Tyr Tyr Ala Met Asp Tyr1
5 107210PRTMus sp. 72Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr1 5
107311PRTMus sp. 73Lys Gly Gly Tyr Ser Gly Ser Trp Phe Ala Tyr1 5
10749PRTMus sp. 74Met Asp Trp Asp Asp Phe Phe Asp Tyr1 57515PRTMus
sp. 75Ser Phe Pro Asp Asn Tyr Tyr Ser Tyr Asp Asp Ala Phe Ala Tyr1
5 10 1576108PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 76Glu Ile Val Leu Thr Gln Ser Pro
Gly Thr Leu Ser Leu Ser Pro Gly1 5 10 15Glu Arg Ala Thr Met Ser Cys
Thr Ala Ser Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His Trp Tyr Gln
Gln Lys Pro Gly Gln Ala Pro Arg Leu Leu 35 40 45Ile Tyr Arg Thr Ser
Thr Leu Ala Ser Gly Ile Pro Asp Arg Phe Ser 50 55 60Gly Ser Gly Ser
Gly Thr Asp Phe Thr Leu Thr Ile Ser Arg Leu Glu65 70 75 80Pro Glu
Asp Ala Ala Thr Tyr Tyr Cys His Gln Phe His Arg Ser Pro 85 90 95Leu
Thr Phe Gly Gln Gly Thr Lys Leu Glu Ile Lys 100
10577108PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 77Glu Ile Val Leu Thr Gln Ser Pro Gly Thr Leu
Ser Leu Ser Pro Gly1 5 10 15Glu Arg Ala Thr Met Ser Cys Thr Ala Ser
Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys Pro
Gly Gln Ala Pro Arg Leu Leu 35 40 45Ile Tyr Arg Thr Ser Ile Leu Ala
Ser Gly Val Pro Asp Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr Asp
Phe Thr Leu Thr Ile Ser Arg Leu Glu65 70 75 80Pro Glu Asp Phe Ala
Thr Tyr Tyr Cys His Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe Gly
Gln Gly Thr Lys Leu Glu Ile Lys 100 10578108PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
78Glu Ile Val Leu Thr Gln Ser Pro Gly Thr Leu Ser Leu Ser Pro Gly1
5 10 15Glu Arg Ala Thr Met Ser Cys Thr Ala Ser Ser Ser Val Ser Ser
Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg
Leu Trp 35 40 45Ile Tyr Arg Thr Ser Arg Leu Ala Ser Gly Val Pro Asp
Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile
Ser Arg Leu Glu65 70 75 80Pro Glu Asp Ala Ala Thr Tyr Tyr Cys His
Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe Gly Gln Gly Thr Lys Leu
Glu Ile Lys 100 10579108PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 79Glu Ile Val Leu Thr Gln
Ser Pro Gly Thr Leu Ser Leu Ser Pro Gly1 5 10 15Glu Arg Ala Thr Met
Thr Cys Thr Ala Ser Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His Trp
Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg Leu Leu 35 40 45Ile Tyr Arg
Thr Ser Arg Leu Ala Ser Gly Val Pro Asp Arg Phe Ser 50 55 60Gly Ser
Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile Ser Arg Leu Glu65 70 75
80Pro Glu Asp Phe Ala Val Tyr Tyr Cys His Gln Phe His Arg Ser Pro
85 90 95Leu Thr Phe Gly Gln Gly Thr Lys Leu Glu Ile Lys 100
10580108PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 80Gln Ile Val Leu Thr Gln Ser Pro Gly Thr Leu
Ser Leu Ser Pro Gly1 5 10 15Glu Arg Ala Thr Met Thr Cys Thr Ala Ser
Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys Pro
Gly Gln Ala Pro Arg Leu Trp 35 40 45Ile Tyr Arg Thr Ser Arg Leu Ala
Ser Gly Val Pro Asp Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr Asp
Phe Thr Leu Thr Ile Ser Arg Leu Glu65 70 75 80Pro Glu Asp Ala Ala
Thr Tyr Tyr Cys His Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe Gly
Ala Gly Thr Lys Leu Glu Ile Lys 100 10581108PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
81Gln Ile Val Leu Thr Gln Ser Pro Gly Thr Leu Ser Leu Ser Pro Gly1
5 10 15Glu Arg Val Thr Met Ser Cys Thr Ala Ser Ser Ser Val Ser Ser
Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg
Leu Leu 35 40 45Ile Tyr Arg Thr Ser Gln Leu Ala Ser Gly Ile Pro Asp
Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile
Ser Arg Leu Glu65 70 75 80Pro Glu Asp Ala Ala Thr Tyr Tyr Cys His
Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe Gly Gln Gly Thr Lys Leu
Glu Ile Lys 100 10582108PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 82Gln Ile Val Leu Thr Gln
Ser Pro Gly Thr Leu Ser Leu Ser Pro Gly1 5 10 15Glu Arg Ala Thr Met
Thr Cys Thr Ala Ser Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His Trp
Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg Leu Leu 35 40 45Ile Tyr Arg
Thr Ser Lys Leu Ala Ser Gly Val Pro Asp Arg Phe Ser 50 55 60Gly Ser
Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile Ser Arg Leu Glu65 70 75
80Pro Glu Asp Phe Ala Thr Tyr Tyr Cys His Gln Phe His Arg Ser Pro
85 90 95Leu Thr Phe Gly Gln Gly Thr Lys Leu Glu Ile Lys 100
10583108PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 83Glu Ile Val Leu Thr Gln Ser Pro Gly Thr Leu
Ser Leu Ser Pro Gly1 5 10 15Glu Arg Ala Thr Met Ser Cys Thr Ala Ser
Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys Pro
Gly Gln Ala Pro Arg Leu Leu 35 40 45Ile Tyr Arg Thr Ser His Leu Ala
Ser Gly Ile Pro Gly Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr Asp
Phe Thr Leu Thr Ile Ser Arg Leu Glu65 70 75 80Pro Glu Asp Ala Ala
Val Tyr Tyr Cys His Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe Gly
Gln Gly Thr Lys Leu Glu Ile Lys 100 10584107PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
84Glu Ile Val Met Thr Gln Ser Pro Ala Thr Leu Ser Val Ser Pro Gly1
5 10 15Val Arg Ala Thr Leu Ser Cys Lys Ala Ser Gln Asp Val Gly Thr
Asn 20 25 30Val Leu Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg Pro
Leu Ile 35 40 45Tyr Ser Ala Ser Tyr Arg His Ser Gly Ile Pro Asp Arg
Phe Ser Gly 50 55 60Ser Gly Ser Gly Thr Glu Phe Thr Leu Thr Ile Ser
Ser Leu Gln Ser65 70 75 80Glu Asp Phe Ala Glu Tyr Phe Cys Gln Gln
Tyr Ser Arg Tyr Pro Leu 85 90 95Thr Phe Gly Gln Gly Thr Lys Leu Glu
Ile Lys 100 10585107PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 85Glu Ile Val Met Thr Gln Ser Pro
Ala Thr Leu Ser Val Ser Pro Gly1 5 10 15Val Arg Ala Thr Leu Ser Cys
Lys Ala Ser Gln Asp Val Gly Thr Asn 20 25 30Val Leu Trp Tyr Gln Gln
Lys Pro Gly Gln Ala Pro Arg Pro Leu Ile 35 40 45Tyr Ser Ala Ser Tyr
Arg His Ser Gly Ile Pro Asp Arg Phe Ser Gly 50 55 60Ser Gly Ser Gly
Thr Glu Phe Thr Leu Thr Ile Ser Ser Leu Gln Ser65 70 75 80Glu Asp
Phe Ala Val Tyr Tyr Cys Gln Gln Tyr Ser Arg Tyr Pro Leu 85 90 95Thr
Phe Gly Gln Gly Thr Lys Leu Glu Ile Lys 100 10586107PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
86Glu Ile Val Met Thr Gln Ser Pro Ala Thr Leu Ser Val Ser Pro Gly1
5 10 15Val Arg Ala Thr Leu Ser Cys Lys Ala Ser Gln Asp Val Gly Thr
Asn 20 25 30Val Leu Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg Pro
Leu Ile 35 40 45Tyr Ser Ala Ser Tyr Arg His Ser Gly Ile Pro Ala Arg
Phe Ser Gly 50 55 60Ser Gly Ser Gly Thr Glu Phe Thr Leu Thr Ile Ser
Ser Leu Gln Ser65 70 75 80Glu Asp Phe Ala Glu Tyr Tyr Cys Gln Gln
Tyr Ser Arg Tyr Pro Leu 85 90 95Thr Phe Gly Gln Gly Thr Lys Leu Glu
Ile Lys 100 10587119PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 87Gln Val Gln Leu Val Gln Ser Gly
Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys
Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp Val Arg
Gln Ala Pro Gly Gln Gly Leu Glu Trp Ile 35 40 45Gly Glu Ile Asn Pro
Gly Asn Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn Lys Ala
Thr Met Thr Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75 80Met Glu
Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys 85 90 95Ala
Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser 11588119PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
88Gln Val Gln Leu Val Gln Ser Gly Ala Glu Val Lys Lys Pro Gly Ala1
5 10 15Ser Val Lys Val Ser Cys Lys Ala Ser Gly Tyr Ser Phe Thr Ser
Ser 20 25 30Trp Ile His Trp Val Arg Gln Arg Pro Gly Gln Gly Leu Glu
Trp Ile 35 40 45Gly Glu Ile Asn Pro Gly Asn Val Arg Thr Asn Tyr Asn
Glu Asn Phe 50 55 60Arg Asn Arg Val Thr Met Thr Val Asp Thr Ser Ile
Ser Thr Ala Tyr65 70 75 80Met Glu Leu Ser Arg Leu Arg Ser Asp Asp
Thr Ala Val Tyr Tyr Cys 85 90 95Thr Val Val Phe Tyr Gly Glu Pro Tyr
Phe Pro Tyr Trp Gly Gln Gly 100 105 110Thr Leu Val Thr Val Ser Ser
11589119PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 89Gln Val Gln Leu Val Gln Ser Gly Ala Glu Val
Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys Ala Ser Gly
Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp Val Lys Gln Ala Pro
Gly Gln Gly Leu Glu Trp Met 35 40 45Gly Glu Ile Asn Pro Gly Asn Val
Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn Lys Val Thr Met Thr
Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75 80Met Glu Leu Ser Arg
Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys 85 90 95Thr Val Val Phe
Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln Gly 100 105 110Thr Leu
Val Thr Val Ser Ser 11590119PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 90Gln Val Gln Leu Val Gln
Ser Gly Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser
Cys Lys Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp
Val Arg Gln Arg Pro Gly Gln Gly Leu Glu Trp Met 35 40 45Gly Glu Ile
Asn Pro Gly Asn Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn
Arg Ala Thr Leu Thr Arg Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75
80Met Glu Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys
85 90 95Ala Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln
Gly 100 105 110Thr Leu Val Thr Val Ser Ser 11591119PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
91Gln Val Gln Leu Val Gln Ser Gly Ala Glu Val Lys Lys Pro Gly Ala1
5 10 15Ser Val Lys Val Ser Cys Lys Ala Ser Gly Tyr Ser Phe Thr Ser
Ser 20 25 30Trp Ile His Trp Val Arg Gln Arg Pro Gly Gln Gly Leu Glu
Trp Met 35 40 45Gly Glu Ile Leu Pro Gly Val Val Arg Thr Asn Tyr Asn
Glu Asn
Phe 50 55 60Arg Asn Lys Val Thr Met Thr Val Asp Thr Ser Ile Ser Thr
Ala Tyr65 70 75 80Met Glu Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala
Val Tyr Tyr Cys 85 90 95Thr Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro
Tyr Trp Gly Gln Gly 100 105 110Thr Leu Val Thr Val Ser Ser
11592119PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 92Gln Val Gln Leu Val Gln Ser Gly Ala Glu Val
Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys Ala Ser Gly
Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp Val Arg Gln Arg Pro
Gly Gln Gly Leu Glu Trp Ile 35 40 45Gly Glu Ile Asn Pro Gly Ala Val
Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn Arg Val Thr Met Thr
Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75 80Met Glu Leu Ser Arg
Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys 85 90 95Thr Val Val Phe
Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln Gly 100 105 110Thr Leu
Val Thr Val Ser Ser 11593119PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 93Gln Val Gln Leu Val Gln
Ser Gly Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser
Cys Lys Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp
Val Arg Gln Ala Pro Gly Gln Gly Leu Glu Trp Ile 35 40 45Gly Glu Ile
Asn Pro Gly Leu Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn
Lys Val Thr Met Thr Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75
80Met Glu Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys
85 90 95Ala Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln
Gly 100 105 110Thr Leu Val Thr Val Ser Ser 11594119PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
94Gln Val Gln Leu Val Gln Ser Gly Ala Glu Val Lys Lys Pro Gly Ala1
5 10 15Ser Val Lys Val Ser Cys Lys Ala Ser Gly Tyr Ser Phe Thr Ser
Ser 20 25 30Trp Ile His Trp Val Arg Gln Ala Pro Gly Gln Gly Leu Glu
Trp Ile 35 40 45Gly Glu Ile Asn Pro Gly Ala Val Arg Thr Asn Tyr Asn
Glu Asn Phe 50 55 60Arg Asn Lys Val Thr Met Thr Val Asp Thr Ser Ile
Ser Thr Ala Tyr65 70 75 80Met Glu Leu Ser Arg Leu Arg Ser Asp Asp
Thr Ala Val Tyr Tyr Cys 85 90 95Ala Val Val Phe Tyr Gly Glu Pro Tyr
Phe Pro Tyr Trp Gly Gln Gly 100 105 110Thr Leu Val Thr Val Ser Ser
11595119PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 95Gln Val Gln Leu Val Gln Ser Gly Ala Glu Val
Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys Ala Ser Gly
Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp Val Arg Gln Ala Pro
Gly Gln Gly Leu Glu Trp Ile 35 40 45Gly Glu Ile Asn Pro Gly Ser Val
Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn Lys Ala Thr Met Thr
Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75 80Met Glu Leu Ser Arg
Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys 85 90 95Ala Val Val Phe
Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln Gly 100 105 110Thr Leu
Val Thr Val Ser Ser 11596119PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 96Gln Val Gln Leu Gln Glu
Ser Gly Pro Gly Leu Val Lys Pro Ser Glu1 5 10 15Thr Leu Ser Ile Thr
Cys Thr Val Ser Gly Phe Ser Leu Thr Asp Tyr 20 25 30Ala Val His Trp
Ile Arg Gln Pro Pro Gly Lys Gly Leu Glu Trp Ile 35 40 45Gly Val Ile
Trp Ser Asp Gly Ser Thr Asp Tyr Asn Ala Pro Phe Lys 50 55 60Ser Arg
Val Thr Ile Asn Lys Asp Thr Ser Lys Ser Gln Val Ser Phe65 70 75
80Lys Met Ser Ser Val Gln Ala Ala Asp Thr Ala Val Tyr Tyr Cys Ala
85 90 95Arg Lys Gly Gly Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln
Gly 100 105 110Thr Leu Val Thr Val Ser Ser 11597119PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
97Gln Val Gln Leu Gln Glu Ser Gly Pro Gly Leu Val Lys Pro Ser Glu1
5 10 15Thr Leu Ser Ile Thr Cys Thr Val Ser Gly Phe Ser Leu Thr Asp
Tyr 20 25 30Ala Val His Trp Ile Arg Gln Pro Pro Gly Lys Gly Leu Glu
Trp Ile 35 40 45Gly Val Ile Trp Ser Asp Gly Ser Thr Asp Tyr Asn Ala
Pro Phe Lys 50 55 60Ser Arg Val Thr Ile Ser Lys Asp Thr Ser Lys Asn
Gln Val Ser Leu65 70 75 80Lys Met Asn Ser Leu Thr Thr Asp Asp Thr
Ala Val Tyr Tyr Cys Ala 85 90 95Arg Lys Gly Gly Tyr Ser Gly Ser Trp
Phe Ala Tyr Trp Gly Gln Gly 100 105 110Thr Leu Val Thr Val Ser Ser
11598119PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 98Gln Val Gln Leu Gln Glu Ser Gly Pro Gly Leu
Val Lys Pro Ser Glu1 5 10 15Thr Leu Ser Ile Thr Cys Thr Val Ser Gly
Phe Ser Leu Thr Asp Tyr 20 25 30Ala Val His Trp Ile Arg Gln Pro Pro
Gly Lys Gly Leu Glu Trp Ile 35 40 45Gly Val Ile Trp Ser Asp Gly Ser
Thr Asp Tyr Asn Ala Pro Phe Lys 50 55 60Ser Arg Val Thr Ile Ser Lys
Asp Asn Ser Lys Ser Gln Val Ser Leu65 70 75 80Lys Met Asn Ser Val
Thr Val Ala Asp Thr Ala Val Tyr Tyr Cys Ala 85 90 95Arg Lys Gly Gly
Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln Gly 100 105 110Thr Leu
Val Thr Val Ser Ser 11599119PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 99Gln Val Gln Leu Gln Glu
Ser Gly Pro Gly Leu Val Lys Pro Ser Glu1 5 10 15Thr Leu Ser Ile Thr
Cys Thr Val Ser Gly Phe Ser Leu Thr Asp Tyr 20 25 30Ala Val His Trp
Val Arg Gln Pro Pro Gly Lys Gly Leu Glu Trp Ile 35 40 45Gly Val Ile
Trp Ser Asp Gly Ser Thr Asp Tyr Asn Ala Pro Phe Lys 50 55 60Ser Arg
Val Thr Ile Ser Lys Asp Thr Ser Lys Asn Gln Val Ser Phe65 70 75
80Lys Leu Ser Ser Val Thr Val Asp Asp Thr Ala Val Tyr Tyr Cys Ala
85 90 95Arg Lys Gly Gly Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln
Gly 100 105 110Thr Leu Val Thr Val Ser Ser 115100119PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
100Gln Val Gln Leu Gln Glu Ser Gly Pro Gly Leu Val Ala Pro Ser Glu1
5 10 15Thr Leu Ser Leu Thr Cys Thr Val Ser Gly Phe Ser Leu Thr Asp
Tyr 20 25 30Ala Val His Trp Ile Arg Gln Phe Pro Gly Lys Gly Leu Glu
Trp Ile 35 40 45Gly Val Ile Trp Ser Asp Gly Ser Thr Asp Phe Asn Ala
Pro Phe Lys 50 55 60Ser Arg Val Thr Ile Ser Lys Asp Thr Ser Lys Asn
Gln Val Ser Phe65 70 75 80Lys Leu Ser Ser Val Thr Thr Asp Asp Thr
Ala Val Tyr Tyr Cys Ala 85 90 95Arg Lys Gly Gly Tyr Ser Gly Ser Trp
Phe Ala Tyr Trp Gly Gln Gly 100 105 110Thr Leu Val Thr Val Ser Ser
115101119PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 101Gln Val Gln Leu Gln Glu Ser Gly Pro Gly
Leu Val Lys Pro Ser Glu1 5 10 15Thr Leu Ser Ile Thr Cys Thr Val Ser
Gly Phe Ser Leu Thr Asp Tyr 20 25 30Ala Val His Trp Ile Arg Gln Pro
Pro Gly Lys Gly Leu Glu Trp Ile 35 40 45Gly Val Ile Trp Ser Asp Gly
Ser Thr Asp Tyr Asn Ala Pro Phe Lys 50 55 60Ser Arg Val Thr Ile Ser
Lys Asp Asn Ser Lys Ser Gln Val Ser Phe65 70 75 80Lys Met Ser Ser
Val Thr Ala Asp Asp Thr Ala Val Tyr Tyr Cys Ala 85 90 95Arg Lys Gly
Gly Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln Gly 100 105 110Thr
Leu Val Thr Val Ser Ser 1151027PRTMus sp. 102Arg Thr Ser Thr Leu
Ala Ser1 51037PRTMus sp. 103Arg Thr Ser Ile Leu Ala Ser1
51047PRTMus sp. 104Arg Thr Ser Arg Leu Ala Ser1 51057PRTMus sp.
105Arg Thr Ser Gln Leu Ala Ser1 51067PRTMus sp. 106Arg Thr Ser Lys
Leu Ala Ser1 510710PRTMus sp. 107Gly Phe Ser Leu Thr Asp Tyr Ala
Val His1 5 1010815PRTMus sp. 108Glu Ile Leu Pro Gly Val Val Arg Thr
Asn Tyr Asn Glu Asn Phe1 5 10 1510915PRTMus sp. 109Glu Ile Asn Pro
Gly Ala Val Arg Thr Asn Tyr Asn Glu Asn Phe1 5 10 1511015PRTMus sp.
110Glu Ile Asn Pro Gly Leu Val Arg Thr Asn Tyr Asn Glu Asn Phe1 5
10 1511115PRTMus sp. 111Glu Ile Asn Pro Gly Ser Val Arg Thr Asn Tyr
Asn Glu Asn Phe1 5 10 15112330PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 112Ala Ser Thr Lys Gly
Pro Ser Val Phe Pro Leu Ala Pro Ser Ser Lys1 5 10 15Ser Thr Ser Gly
Gly Thr Ala Ala Leu Gly Cys Leu Val Lys Asp Tyr 20 25 30Phe Pro Glu
Pro Val Thr Val Ser Trp Asn Ser Gly Ala Leu Thr Ser 35 40 45Gly Val
His Thr Phe Pro Ala Val Leu Gln Ser Ser Gly Leu Tyr Ser 50 55 60Leu
Ser Ser Val Val Thr Val Pro Ser Ser Ser Leu Gly Thr Gln Thr65 70 75
80Tyr Ile Cys Asn Val Asn His Lys Pro Ser Asn Thr Lys Val Asp Lys
85 90 95Arg Val Glu Pro Lys Ser Cys Asp Lys Thr His Thr Cys Pro Pro
Cys 100 105 110Pro Ala Pro Glu Ala Ala Gly Gly Pro Ser Val Phe Leu
Phe Pro Pro 115 120 125Lys Pro Lys Asp Thr Leu Met Ile Ser Arg Thr
Pro Glu Val Thr Cys 130 135 140Val Val Val Asp Val Ser His Glu Asp
Pro Glu Val Lys Phe Asn Trp145 150 155 160Tyr Val Asp Gly Val Glu
Val His Asn Ala Lys Thr Lys Pro Arg Glu 165 170 175Glu Gln Tyr Asn
Ser Thr Tyr Arg Val Val Ser Val Leu Thr Val Leu 180 185 190His Gln
Asp Trp Leu Asn Gly Lys Glu Tyr Lys Cys Lys Val Ser Asn 195 200
205Lys Ala Leu Pro Ala Pro Ile Glu Lys Thr Ile Ser Lys Ala Lys Gly
210 215 220Gln Pro Arg Glu Pro Gln Val Tyr Thr Leu Pro Pro Ser Arg
Glu Glu225 230 235 240Met Thr Lys Asn Gln Val Ser Leu Thr Cys Leu
Val Lys Gly Phe Tyr 245 250 255Pro Ser Asp Ile Ala Val Glu Trp Glu
Ser Asn Gly Gln Pro Glu Asn 260 265 270Asn Tyr Lys Thr Thr Pro Pro
Val Leu Asp Ser Asp Gly Ser Phe Phe 275 280 285Leu Tyr Ser Lys Leu
Thr Val Asp Lys Ser Arg Trp Gln Gln Gly Asn 290 295 300Val Phe Ser
Cys Ser Val Met His Glu Ala Leu His Asn His Tyr Thr305 310 315
320Gln Lys Ser Leu Ser Leu Ser Pro Gly Lys 325
330113107PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 113Arg Thr Val Ala Ala Pro Ser Val Phe Ile
Phe Pro Pro Ser Asp Glu1 5 10 15Gln Leu Lys Ser Gly Thr Ala Ser Val
Val Cys Leu Leu Asn Asn Phe 20 25 30Tyr Pro Arg Glu Ala Lys Val Gln
Trp Lys Val Asp Asn Ala Leu Gln 35 40 45Ser Gly Asn Ser Gln Glu Ser
Val Thr Glu Gln Asp Ser Lys Asp Ser 50 55 60Thr Tyr Ser Leu Ser Ser
Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu65 70 75 80Lys His Lys Val
Tyr Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser 85 90 95Pro Val Thr
Lys Ser Phe Asn Arg Gly Glu Cys 100 105114215PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
114Glu Ile Val Leu Thr Gln Ser Pro Gly Thr Leu Ser Leu Ser Pro Gly1
5 10 15Glu Arg Ala Thr Met Ser Cys Thr Ala Ser Ser Ser Val Ser Ser
Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg
Leu Leu 35 40 45Ile Tyr Arg Thr Ser Thr Leu Ala Ser Gly Ile Pro Asp
Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile
Ser Arg Leu Glu65 70 75 80Pro Glu Asp Ala Ala Thr Tyr Tyr Cys His
Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe Gly Gln Gly Thr Lys Leu
Glu Ile Lys Arg Thr Val Ala 100 105 110Ala Pro Ser Val Phe Ile Phe
Pro Pro Ser Asp Glu Gln Leu Lys Ser 115 120 125Gly Thr Ala Ser Val
Val Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu 130 135 140Ala Lys Val
Gln Trp Lys Val Asp Asn Ala Leu Gln Ser Gly Asn Ser145 150 155
160Gln Glu Ser Val Thr Glu Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu
165 170 175Ser Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His
Lys Val 180 185 190Tyr Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser
Pro Val Thr Lys 195 200 205Ser Phe Asn Arg Gly Glu Cys 210
215115215PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 115Glu Ile Val Leu Thr Gln Ser Pro Gly Thr
Leu Ser Leu Ser Pro Gly1 5 10 15Glu Arg Ala Thr Met Ser Cys Thr Ala
Ser Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys
Pro Gly Gln Ala Pro Arg Leu Leu 35 40 45Ile Tyr Arg Thr Ser Ile Leu
Ala Ser Gly Val Pro Asp Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr
Asp Phe Thr Leu Thr Ile Ser Arg Leu Glu65 70 75 80Pro Glu Asp Phe
Ala Thr Tyr Tyr Cys His Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe
Gly Gln Gly Thr Lys Leu Glu Ile Lys Arg Thr Val Ala 100 105 110Ala
Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln Leu Lys Ser 115 120
125Gly Thr Ala Ser Val Val Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu
130 135 140Ala Lys Val Gln Trp Lys Val Asp Asn Ala Leu Gln Ser Gly
Asn Ser145 150 155 160Gln Glu Ser Val Thr Glu Gln Asp Ser Lys Asp
Ser Thr Tyr Ser Leu 165 170 175Ser Ser Thr Leu Thr Leu Ser Lys Ala
Asp Tyr Glu Lys His Lys Val 180 185 190Tyr Ala Cys Glu Val Thr His
Gln Gly Leu Ser Ser Pro Val Thr Lys 195 200 205Ser Phe Asn Arg Gly
Glu Cys 210 215116215PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 116Glu Ile Val Leu Thr
Gln Ser Pro Gly Thr Leu Ser Leu Ser Pro Gly1 5 10 15Glu Arg Ala Thr
Met Ser Cys Thr Ala Ser Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His
Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg Leu Trp 35 40
45Ile Tyr Arg Thr Ser Arg Leu Ala Ser Gly Val Pro Asp Arg Phe Ser
50 55 60Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile Ser Arg Leu
Glu65 70 75 80Pro Glu Asp Ala Ala Thr Tyr Tyr Cys His Gln Phe His
Arg Ser Pro 85 90 95Leu Thr Phe Gly Gln Gly Thr Lys Leu Glu Ile Lys
Arg Thr Val Ala 100 105 110Ala Pro Ser Val Phe Ile Phe Pro Pro Ser
Asp Glu Gln Leu Lys Ser 115 120 125Gly Thr Ala Ser Val Val Cys Leu
Leu Asn Asn Phe Tyr Pro Arg Glu 130 135 140Ala Lys Val Gln Trp Lys
Val Asp Asn Ala Leu Gln Ser Gly Asn Ser145 150 155 160Gln Glu Ser
Val Thr Glu Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu 165 170 175Ser
Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His Lys Val 180 185
190Tyr Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser Pro Val Thr Lys
195 200 205Ser Phe Asn Arg Gly Glu Cys 210 215117215PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
117Glu Ile Val Leu Thr Gln Ser Pro Gly Thr Leu Ser Leu Ser Pro Gly1
5 10 15Glu Arg Ala Thr Met Thr Cys Thr Ala Ser Ser Ser Val Ser Ser
Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg
Leu Leu 35 40 45Ile Tyr Arg Thr Ser Arg Leu Ala Ser Gly Val Pro Asp
Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile
Ser Arg Leu Glu65 70 75 80Pro Glu Asp Phe Ala Val Tyr Tyr Cys His
Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe Gly Gln Gly Thr Lys Leu
Glu Ile Lys Arg Thr Val Ala 100 105 110Ala Pro Ser Val Phe Ile Phe
Pro Pro Ser Asp Glu Gln Leu Lys Ser 115 120 125Gly Thr Ala Ser Val
Val Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu 130 135 140Ala Lys Val
Gln Trp Lys Val Asp Asn Ala Leu Gln Ser Gly Asn Ser145 150 155
160Gln Glu Ser Val Thr Glu Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu
165 170 175Ser Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His
Lys Val 180 185 190Tyr Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser
Pro Val Thr Lys 195 200 205Ser Phe Asn Arg Gly Glu Cys 210
215118215PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 118Gln Ile Val Leu Thr Gln Ser Pro Gly Thr
Leu Ser Leu Ser Pro Gly1 5 10 15Glu Arg Ala Thr Met Thr Cys Thr Ala
Ser Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys
Pro Gly Gln Ala Pro Arg Leu Trp 35 40 45Ile Tyr Arg Thr Ser Arg Leu
Ala Ser Gly Val Pro Asp Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr
Asp Phe Thr Leu Thr Ile Ser Arg Leu Glu65 70 75 80Pro Glu Asp Ala
Ala Thr Tyr Tyr Cys His Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe
Gly Ala Gly Thr Lys Leu Glu Ile Lys Arg Thr Val Ala 100 105 110Ala
Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln Leu Lys Ser 115 120
125Gly Thr Ala Ser Val Val Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu
130 135 140Ala Lys Val Gln Trp Lys Val Asp Asn Ala Leu Gln Ser Gly
Asn Ser145 150 155 160Gln Glu Ser Val Thr Glu Gln Asp Ser Lys Asp
Ser Thr Tyr Ser Leu 165 170 175Ser Ser Thr Leu Thr Leu Ser Lys Ala
Asp Tyr Glu Lys His Lys Val 180 185 190Tyr Ala Cys Glu Val Thr His
Gln Gly Leu Ser Ser Pro Val Thr Lys 195 200 205Ser Phe Asn Arg Gly
Glu Cys 210 215119215PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 119Gln Ile Val Leu Thr
Gln Ser Pro Gly Thr Leu Ser Leu Ser Pro Gly1 5 10 15Glu Arg Val Thr
Met Ser Cys Thr Ala Ser Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His
Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg Leu Leu 35 40 45Ile Tyr
Arg Thr Ser Gln Leu Ala Ser Gly Ile Pro Asp Arg Phe Ser 50 55 60Gly
Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile Ser Arg Leu Glu65 70 75
80Pro Glu Asp Ala Ala Thr Tyr Tyr Cys His Gln Phe His Arg Ser Pro
85 90 95Leu Thr Phe Gly Gln Gly Thr Lys Leu Glu Ile Lys Arg Thr Val
Ala 100 105 110Ala Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln
Leu Lys Ser 115 120 125Gly Thr Ala Ser Val Val Cys Leu Leu Asn Asn
Phe Tyr Pro Arg Glu 130 135 140Ala Lys Val Gln Trp Lys Val Asp Asn
Ala Leu Gln Ser Gly Asn Ser145 150 155 160Gln Glu Ser Val Thr Glu
Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu 165 170 175Ser Ser Thr Leu
Thr Leu Ser Lys Ala Asp Tyr Glu Lys His Lys Val 180 185 190Tyr Ala
Cys Glu Val Thr His Gln Gly Leu Ser Ser Pro Val Thr Lys 195 200
205Ser Phe Asn Arg Gly Glu Cys 210 215120215PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
120Gln Ile Val Leu Thr Gln Ser Pro Gly Thr Leu Ser Leu Ser Pro Gly1
5 10 15Glu Arg Ala Thr Met Thr Cys Thr Ala Ser Ser Ser Val Ser Ser
Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg
Leu Leu 35 40 45Ile Tyr Arg Thr Ser Lys Leu Ala Ser Gly Val Pro Asp
Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile
Ser Arg Leu Glu65 70 75 80Pro Glu Asp Phe Ala Thr Tyr Tyr Cys His
Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe Gly Gln Gly Thr Lys Leu
Glu Ile Lys Arg Thr Val Ala 100 105 110Ala Pro Ser Val Phe Ile Phe
Pro Pro Ser Asp Glu Gln Leu Lys Ser 115 120 125Gly Thr Ala Ser Val
Val Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu 130 135 140Ala Lys Val
Gln Trp Lys Val Asp Asn Ala Leu Gln Ser Gly Asn Ser145 150 155
160Gln Glu Ser Val Thr Glu Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu
165 170 175Ser Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His
Lys Val 180 185 190Tyr Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser
Pro Val Thr Lys 195 200 205Ser Phe Asn Arg Gly Glu Cys 210
215121215PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 121Glu Ile Val Leu Thr Gln Ser Pro Gly Thr
Leu Ser Leu Ser Pro Gly1 5 10 15Glu Arg Ala Thr Met Ser Cys Thr Ala
Ser Ser Ser Val Ser Ser Ser 20 25 30Tyr Phe His Trp Tyr Gln Gln Lys
Pro Gly Gln Ala Pro Arg Leu Leu 35 40 45Ile Tyr Arg Thr Ser His Leu
Ala Ser Gly Ile Pro Gly Arg Phe Ser 50 55 60Gly Ser Gly Ser Gly Thr
Asp Phe Thr Leu Thr Ile Ser Arg Leu Glu65 70 75 80Pro Glu Asp Ala
Ala Val Tyr Tyr Cys His Gln Phe His Arg Ser Pro 85 90 95Leu Thr Phe
Gly Gln Gly Thr Lys Leu Glu Ile Lys Arg Thr Val Ala 100 105 110Ala
Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln Leu Lys Ser 115 120
125Gly Thr Ala Ser Val Val Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu
130 135 140Ala Lys Val Gln Trp Lys Val Asp Asn Ala Leu Gln Ser Gly
Asn Ser145 150 155 160Gln Glu Ser Val Thr Glu Gln Asp Ser Lys Asp
Ser Thr Tyr Ser Leu 165 170 175Ser Ser Thr Leu Thr Leu Ser Lys Ala
Asp Tyr Glu Lys His Lys Val 180 185 190Tyr Ala Cys Glu Val Thr His
Gln Gly Leu Ser Ser Pro Val Thr Lys 195 200 205Ser Phe Asn Arg Gly
Glu Cys 210 215122214PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 122Glu Ile Val Met Thr
Gln Ser Pro Ala Thr Leu Ser Val Ser Pro Gly1 5 10 15Val Arg Ala Thr
Leu Ser Cys Lys Ala Ser Gln Asp Val Gly Thr Asn 20 25 30Val Leu Trp
Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg Pro Leu Ile 35 40 45Tyr Ser
Ala Ser Tyr Arg His Ser Gly Ile Pro Asp Arg Phe Ser Gly 50 55 60Ser
Gly Ser Gly Thr Glu Phe Thr Leu Thr Ile Ser Ser Leu Gln Ser65 70 75
80Glu Asp Phe Ala Glu Tyr Phe Cys Gln Gln Tyr Ser Arg Tyr Pro Leu
85 90 95Thr Phe Gly Gln Gly Thr Lys Leu Glu Ile Lys Arg Thr Val Ala
Ala 100 105 110Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln Leu
Lys Ser Gly 115 120 125Thr Ala Ser Val Val Cys Leu Leu Asn Asn Phe
Tyr Pro Arg Glu Ala 130 135 140Lys Val Gln Trp Lys Val Asp Asn Ala
Leu Gln Ser Gly Asn Ser Gln145 150 155 160Glu Ser Val Thr Glu Gln
Asp Ser Lys Asp Ser Thr Tyr Ser Leu Ser 165 170 175Ser Thr Leu Thr
Leu Ser Lys Ala Asp Tyr Glu Lys His Lys Val Tyr 180 185 190Ala Cys
Glu Val Thr His Gln Gly Leu Ser Ser Pro Val Thr Lys Ser 195 200
205Phe Asn Arg Gly Glu Cys 210123214PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
123Glu Ile Val Met Thr Gln Ser Pro Ala Thr Leu Ser Val Ser Pro Gly1
5 10 15Val Arg Ala Thr Leu Ser Cys Lys Ala Ser Gln Asp Val Gly Thr
Asn 20 25 30Val Leu Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg Pro
Leu Ile 35 40 45Tyr Ser Ala Ser Tyr Arg His Ser Gly Ile Pro Asp Arg
Phe Ser Gly 50 55 60Ser Gly Ser Gly Thr Glu Phe Thr Leu Thr Ile Ser
Ser Leu Gln Ser65 70 75 80Glu Asp Phe Ala Val Tyr Tyr Cys Gln Gln
Tyr Ser Arg Tyr Pro Leu 85 90 95Thr Phe Gly Gln Gly Thr Lys Leu Glu
Ile Lys Arg Thr Val Ala Ala 100 105 110Pro Ser Val Phe Ile Phe Pro
Pro Ser Asp Glu Gln Leu Lys Ser Gly 115 120 125Thr Ala Ser Val Val
Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu Ala 130 135 140Lys Val Gln
Trp Lys Val Asp Asn Ala Leu Gln Ser Gly Asn Ser Gln145 150 155
160Glu Ser Val Thr Glu Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu Ser
165 170 175Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His Lys
Val Tyr 180 185 190Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser Pro
Val Thr Lys Ser 195 200 205Phe Asn Arg Gly Glu Cys
210124214PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 124Glu Ile Val Met Thr Gln Ser Pro Ala Thr
Leu Ser Val Ser Pro Gly1 5 10 15Val Arg Ala Thr Leu Ser Cys Lys Ala
Ser Gln Asp Val Gly Thr Asn 20 25 30Val Leu Trp Tyr Gln Gln Lys Pro
Gly Gln Ala Pro Arg Pro Leu Ile 35 40 45Tyr Ser Ala Ser Tyr Arg His
Ser Gly Ile Pro Ala Arg Phe Ser Gly 50 55 60Ser Gly Ser Gly Thr Glu
Phe Thr Leu Thr Ile Ser Ser Leu Gln Ser65 70 75 80Glu Asp Phe Ala
Glu Tyr Tyr Cys Gln Gln Tyr Ser Arg Tyr Pro Leu 85 90 95Thr Phe Gly
Gln Gly Thr Lys Leu Glu Ile Lys Arg Thr Val Ala Ala 100 105 110Pro
Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln Leu Lys Ser Gly 115 120
125Thr Ala Ser Val Val Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu Ala
130 135 140Lys Val Gln Trp Lys Val Asp Asn Ala Leu Gln Ser Gly Asn
Ser Gln145 150 155 160Glu Ser Val Thr Glu Gln Asp Ser Lys Asp Ser
Thr Tyr Ser Leu Ser 165 170 175Ser Thr Leu Thr Leu Ser Lys Ala Asp
Tyr Glu Lys His Lys Val Tyr 180 185 190Ala Cys Glu Val Thr His Gln
Gly Leu Ser Ser Pro Val Thr Lys Ser 195 200 205Phe Asn Arg Gly Glu
Cys 210125449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 125Gln Val Gln Leu Val Gln Ser Gly
Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys
Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp Val Arg
Gln Ala Pro Gly Gln Gly Leu Glu Trp Ile 35 40 45Gly Glu Ile Asn Pro
Gly Asn Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn Lys Ala
Thr Met Thr Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75 80Met Glu
Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys 85 90 95Ala
Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200 205Ser Asn Thr
Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys 210 215 220Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly Gly Pro225 230
235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315 320Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys 325 330 335Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr 340 345
350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr
355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu
Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr
Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser Phe Phe Leu Tyr
Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp Gln Gln Gly Asn
Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala Leu His Asn His
Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys126449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 126Gln Val Gln Leu Val Gln Ser Gly
Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys
Ala Ser Gly Tyr Ser Phe Thr Ser Ser
20 25 30Trp Ile His Trp Val Arg Gln Arg Pro Gly Gln Gly Leu Glu Trp
Ile 35 40 45Gly Glu Ile Asn Pro Gly Asn Val Arg Thr Asn Tyr Asn Glu
Asn Phe 50 55 60Arg Asn Arg Val Thr Met Thr Val Asp Thr Ser Ile Ser
Thr Ala Tyr65 70 75 80Met Glu Leu Ser Arg Leu Arg Ser Asp Asp Thr
Ala Val Tyr Tyr Cys 85 90 95Thr Val Val Phe Tyr Gly Glu Pro Tyr Phe
Pro Tyr Trp Gly Gln Gly 100 105 110Thr Leu Val Thr Val Ser Ser Ala
Ser Thr Lys Gly Pro Ser Val Phe 115 120 125Pro Leu Ala Pro Ser Ser
Lys Ser Thr Ser Gly Gly Thr Ala Ala Leu 130 135 140Gly Cys Leu Val
Lys Asp Tyr Phe Pro Glu Pro Val Thr Val Ser Trp145 150 155 160Asn
Ser Gly Ala Leu Thr Ser Gly Val His Thr Phe Pro Ala Val Leu 165 170
175Gln Ser Ser Gly Leu Tyr Ser Leu Ser Ser Val Val Thr Val Pro Ser
180 185 190Ser Ser Leu Gly Thr Gln Thr Tyr Ile Cys Asn Val Asn His
Lys Pro 195 200 205Ser Asn Thr Lys Val Asp Lys Arg Val Glu Pro Lys
Ser Cys Asp Lys 210 215 220Thr His Thr Cys Pro Pro Cys Pro Ala Pro
Glu Ala Ala Gly Gly Pro225 230 235 240Ser Val Phe Leu Phe Pro Pro
Lys Pro Lys Asp Thr Leu Met Ile Ser 245 250 255Arg Thr Pro Glu Val
Thr Cys Val Val Val Asp Val Ser His Glu Asp 260 265 270Pro Glu Val
Lys Phe Asn Trp Tyr Val Asp Gly Val Glu Val His Asn 275 280 285Ala
Lys Thr Lys Pro Arg Glu Glu Gln Tyr Asn Ser Thr Tyr Arg Val 290 295
300Val Ser Val Leu Thr Val Leu His Gln Asp Trp Leu Asn Gly Lys
Glu305 310 315 320Tyr Lys Cys Lys Val Ser Asn Lys Ala Leu Pro Ala
Pro Ile Glu Lys 325 330 335Thr Ile Ser Lys Ala Lys Gly Gln Pro Arg
Glu Pro Gln Val Tyr Thr 340 345 350Leu Pro Pro Ser Arg Glu Glu Met
Thr Lys Asn Gln Val Ser Leu Thr 355 360 365Cys Leu Val Lys Gly Phe
Tyr Pro Ser Asp Ile Ala Val Glu Trp Glu 370 375 380Ser Asn Gly Gln
Pro Glu Asn Asn Tyr Lys Thr Thr Pro Pro Val Leu385 390 395 400Asp
Ser Asp Gly Ser Phe Phe Leu Tyr Ser Lys Leu Thr Val Asp Lys 405 410
415Ser Arg Trp Gln Gln Gly Asn Val Phe Ser Cys Ser Val Met His Glu
420 425 430Ala Leu His Asn His Tyr Thr Gln Lys Ser Leu Ser Leu Ser
Pro Gly 435 440 445Lys127449PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 127Gln Val Gln Leu Val
Gln Ser Gly Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val
Ser Cys Lys Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His
Trp Val Lys Gln Ala Pro Gly Gln Gly Leu Glu Trp Met 35 40 45Gly Glu
Ile Asn Pro Gly Asn Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg
Asn Lys Val Thr Met Thr Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75
80Met Glu Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys
85 90 95Thr Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln
Gly 100 105 110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro
Ser Val Phe 115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly
Gly Thr Ala Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro
Glu Pro Val Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr
Ser Gly Val His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly
Leu Tyr Ser Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser
Leu Gly Thr Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200
205Ser Asn Thr Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys
210 215 220Thr His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly
Gly Pro225 230 235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp
Thr Leu Met Ile Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val
Val Asp Val Ser His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp
Tyr Val Asp Gly Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro
Arg Glu Glu Gln Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val
Leu Thr Val Leu His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315
320Tyr Lys Cys Lys Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys
325 330 335Thr Ile Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val
Tyr Thr 340 345 350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln
Val Ser Leu Thr 355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp
Ile Ala Val Glu Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn
Tyr Lys Thr Thr Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser
Phe Phe Leu Tyr Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp
Gln Gln Gly Asn Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala
Leu His Asn His Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys128449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 128Gln Val Gln Leu Val Gln Ser Gly
Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys
Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp Val Arg
Gln Arg Pro Gly Gln Gly Leu Glu Trp Met 35 40 45Gly Glu Ile Asn Pro
Gly Asn Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn Arg Ala
Thr Leu Thr Arg Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75 80Met Glu
Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys 85 90 95Ala
Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200 205Ser Asn Thr
Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys 210 215 220Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly Gly Pro225 230
235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315 320Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys 325 330 335Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr 340 345
350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr
355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu
Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr
Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser Phe Phe Leu Tyr
Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp Gln Gln Gly Asn
Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala Leu His Asn His
Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys129449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 129Gln Val Gln Leu Val Gln Ser Gly
Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys
Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp Val Arg
Gln Arg Pro Gly Gln Gly Leu Glu Trp Met 35 40 45Gly Glu Ile Leu Pro
Gly Val Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn Lys Val
Thr Met Thr Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75 80Met Glu
Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys 85 90 95Thr
Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200 205Ser Asn Thr
Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys 210 215 220Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly Gly Pro225 230
235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315 320Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys 325 330 335Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr 340 345
350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr
355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu
Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr
Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser Phe Phe Leu Tyr
Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp Gln Gln Gly Asn
Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala Leu His Asn His
Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys130449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 130Gln Val Gln Leu Val Gln Ser Gly
Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys
Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp Val Arg
Gln Arg Pro Gly Gln Gly Leu Glu Trp Ile 35 40 45Gly Glu Ile Asn Pro
Gly Ala Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn Arg Val
Thr Met Thr Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75 80Met Glu
Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys 85 90 95Thr
Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200 205Ser Asn Thr
Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys 210 215 220Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly Gly Pro225 230
235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315 320Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys 325 330 335Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr 340 345
350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr
355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu
Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr
Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser Phe Phe Leu Tyr
Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp Gln Gln Gly Asn
Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala Leu His Asn His
Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys131449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 131Gln Val Gln Leu Val Gln Ser Gly
Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys
Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp Val Arg
Gln Ala Pro Gly Gln Gly Leu Glu Trp Ile 35 40 45Gly Glu Ile Asn Pro
Gly Leu Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn Lys Val
Thr Met Thr Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75 80Met Glu
Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys 85 90 95Ala
Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser
180 185 190Ser Ser Leu Gly Thr Gln Thr Tyr Ile Cys Asn Val Asn His
Lys Pro 195 200 205Ser Asn Thr Lys Val Asp Lys Arg Val Glu Pro Lys
Ser Cys Asp Lys 210 215 220Thr His Thr Cys Pro Pro Cys Pro Ala Pro
Glu Ala Ala Gly Gly Pro225 230 235 240Ser Val Phe Leu Phe Pro Pro
Lys Pro Lys Asp Thr Leu Met Ile Ser 245 250 255Arg Thr Pro Glu Val
Thr Cys Val Val Val Asp Val Ser His Glu Asp 260 265 270Pro Glu Val
Lys Phe Asn Trp Tyr Val Asp Gly Val Glu Val His Asn 275 280 285Ala
Lys Thr Lys Pro Arg Glu Glu Gln Tyr Asn Ser Thr Tyr Arg Val 290 295
300Val Ser Val Leu Thr Val Leu His Gln Asp Trp Leu Asn Gly Lys
Glu305 310 315 320Tyr Lys Cys Lys Val Ser Asn Lys Ala Leu Pro Ala
Pro Ile Glu Lys 325 330 335Thr Ile Ser Lys Ala Lys Gly Gln Pro Arg
Glu Pro Gln Val Tyr Thr 340 345 350Leu Pro Pro Ser Arg Glu Glu Met
Thr Lys Asn Gln Val Ser Leu Thr 355 360 365Cys Leu Val Lys Gly Phe
Tyr Pro Ser Asp Ile Ala Val Glu Trp Glu 370 375 380Ser Asn Gly Gln
Pro Glu Asn Asn Tyr Lys Thr Thr Pro Pro Val Leu385 390 395 400Asp
Ser Asp Gly Ser Phe Phe Leu Tyr Ser Lys Leu Thr Val Asp Lys 405 410
415Ser Arg Trp Gln Gln Gly Asn Val Phe Ser Cys Ser Val Met His Glu
420 425 430Ala Leu His Asn His Tyr Thr Gln Lys Ser Leu Ser Leu Ser
Pro Gly 435 440 445Lys132449PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 132Gln Val Gln Leu Val
Gln Ser Gly Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val
Ser Cys Lys Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His
Trp Val Arg Gln Ala Pro Gly Gln Gly Leu Glu Trp Ile 35 40 45Gly Glu
Ile Asn Pro Gly Ala Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg
Asn Lys Val Thr Met Thr Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75
80Met Glu Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys
85 90 95Ala Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln
Gly 100 105 110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro
Ser Val Phe 115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly
Gly Thr Ala Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro
Glu Pro Val Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr
Ser Gly Val His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly
Leu Tyr Ser Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser
Leu Gly Thr Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200
205Ser Asn Thr Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys
210 215 220Thr His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly
Gly Pro225 230 235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp
Thr Leu Met Ile Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val
Val Asp Val Ser His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp
Tyr Val Asp Gly Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro
Arg Glu Glu Gln Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val
Leu Thr Val Leu His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315
320Tyr Lys Cys Lys Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys
325 330 335Thr Ile Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val
Tyr Thr 340 345 350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln
Val Ser Leu Thr 355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp
Ile Ala Val Glu Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn
Tyr Lys Thr Thr Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser
Phe Phe Leu Tyr Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp
Gln Gln Gly Asn Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala
Leu His Asn His Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys133449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 133Gln Val Gln Leu Val Gln Ser Gly
Ala Glu Val Lys Lys Pro Gly Ala1 5 10 15Ser Val Lys Val Ser Cys Lys
Ala Ser Gly Tyr Ser Phe Thr Ser Ser 20 25 30Trp Ile His Trp Val Arg
Gln Ala Pro Gly Gln Gly Leu Glu Trp Ile 35 40 45Gly Glu Ile Asn Pro
Gly Ser Val Arg Thr Asn Tyr Asn Glu Asn Phe 50 55 60Arg Asn Lys Ala
Thr Met Thr Val Asp Thr Ser Ile Ser Thr Ala Tyr65 70 75 80Met Glu
Leu Ser Arg Leu Arg Ser Asp Asp Thr Ala Val Tyr Tyr Cys 85 90 95Ala
Val Val Phe Tyr Gly Glu Pro Tyr Phe Pro Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200 205Ser Asn Thr
Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys 210 215 220Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly Gly Pro225 230
235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315 320Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys 325 330 335Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr 340 345
350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr
355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu
Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr
Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser Phe Phe Leu Tyr
Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp Gln Gln Gly Asn
Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala Leu His Asn His
Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys134449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 134Gln Val Gln Leu Gln Glu Ser Gly
Pro Gly Leu Val Lys Pro Ser Glu1 5 10 15Thr Leu Ser Ile Thr Cys Thr
Val Ser Gly Phe Ser Leu Thr Asp Tyr 20 25 30Ala Val His Trp Ile Arg
Gln Pro Pro Gly Lys Gly Leu Glu Trp Ile 35 40 45Gly Val Ile Trp Ser
Asp Gly Ser Thr Asp Tyr Asn Ala Pro Phe Lys 50 55 60Ser Arg Val Thr
Ile Asn Lys Asp Thr Ser Lys Ser Gln Val Ser Phe65 70 75 80Lys Met
Ser Ser Val Gln Ala Ala Asp Thr Ala Val Tyr Tyr Cys Ala 85 90 95Arg
Lys Gly Gly Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200 205Ser Asn Thr
Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys 210 215 220Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly Gly Pro225 230
235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315 320Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys 325 330 335Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr 340 345
350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr
355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu
Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr
Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser Phe Phe Leu Tyr
Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp Gln Gln Gly Asn
Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala Leu His Asn His
Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys135449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 135Gln Val Gln Leu Gln Glu Ser Gly
Pro Gly Leu Val Lys Pro Ser Glu1 5 10 15Thr Leu Ser Ile Thr Cys Thr
Val Ser Gly Phe Ser Leu Thr Asp Tyr 20 25 30Ala Val His Trp Ile Arg
Gln Pro Pro Gly Lys Gly Leu Glu Trp Ile 35 40 45Gly Val Ile Trp Ser
Asp Gly Ser Thr Asp Tyr Asn Ala Pro Phe Lys 50 55 60Ser Arg Val Thr
Ile Ser Lys Asp Thr Ser Lys Asn Gln Val Ser Leu65 70 75 80Lys Met
Asn Ser Leu Thr Thr Asp Asp Thr Ala Val Tyr Tyr Cys Ala 85 90 95Arg
Lys Gly Gly Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200 205Ser Asn Thr
Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys 210 215 220Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly Gly Pro225 230
235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315 320Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys 325 330 335Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr 340 345
350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr
355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu
Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr
Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser Phe Phe Leu Tyr
Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp Gln Gln Gly Asn
Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala Leu His Asn His
Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys136449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 136Gln Val Gln Leu Gln Glu Ser Gly
Pro Gly Leu Val Lys Pro Ser Glu1 5 10 15Thr Leu Ser Ile Thr Cys Thr
Val Ser Gly Phe Ser Leu Thr Asp Tyr 20 25 30Ala Val His Trp Ile Arg
Gln Pro Pro Gly Lys Gly Leu Glu Trp Ile 35 40 45Gly Val Ile Trp Ser
Asp Gly Ser Thr Asp Tyr Asn Ala Pro Phe Lys 50 55 60Ser Arg Val Thr
Ile Ser Lys Asp Asn Ser Lys Ser Gln Val Ser Leu65 70 75 80Lys Met
Asn Ser Val Thr Val Ala Asp Thr Ala Val Tyr Tyr Cys Ala 85 90 95Arg
Lys Gly Gly Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200 205Ser Asn Thr
Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys 210 215 220Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly Gly Pro225 230
235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315 320Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys 325 330 335Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg
Glu Pro Gln Val Tyr Thr 340 345 350Leu Pro Pro Ser Arg Glu Glu Met
Thr Lys Asn Gln Val Ser Leu Thr 355 360 365Cys Leu Val Lys Gly Phe
Tyr Pro Ser Asp Ile Ala Val Glu Trp Glu 370 375 380Ser Asn Gly Gln
Pro Glu Asn Asn Tyr Lys Thr Thr Pro Pro Val Leu385 390 395 400Asp
Ser Asp Gly Ser Phe Phe Leu Tyr Ser Lys Leu Thr Val Asp Lys 405 410
415Ser Arg Trp Gln Gln Gly Asn Val Phe Ser Cys Ser Val Met His Glu
420 425 430Ala Leu His Asn His Tyr Thr Gln Lys Ser Leu Ser Leu Ser
Pro Gly 435 440 445Lys137449PRTArtificial SequenceDescription of
Artificial Sequence Synthetic polypeptide 137Gln Val Gln Leu Gln
Glu Ser Gly Pro Gly Leu Val Lys Pro Ser Glu1 5 10 15Thr Leu Ser Ile
Thr Cys Thr Val Ser Gly Phe Ser Leu Thr Asp Tyr 20 25 30Ala Val His
Trp Val Arg Gln Pro Pro Gly Lys Gly Leu Glu Trp Ile 35 40 45Gly Val
Ile Trp Ser Asp Gly Ser Thr Asp Tyr Asn Ala Pro Phe Lys 50 55 60Ser
Arg Val Thr Ile Ser Lys Asp Thr Ser Lys Asn Gln Val Ser Phe65 70 75
80Lys Leu Ser Ser Val Thr Val Asp Asp Thr Ala Val Tyr Tyr Cys Ala
85 90 95Arg Lys Gly Gly Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln
Gly 100 105 110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro
Ser Val Phe 115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly
Gly Thr Ala Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro
Glu Pro Val Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr
Ser Gly Val His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly
Leu Tyr Ser Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser
Leu Gly Thr Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200
205Ser Asn Thr Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys
210 215 220Thr His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly
Gly Pro225 230 235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp
Thr Leu Met Ile Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val
Val Asp Val Ser His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp
Tyr Val Asp Gly Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro
Arg Glu Glu Gln Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val
Leu Thr Val Leu His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315
320Tyr Lys Cys Lys Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys
325 330 335Thr Ile Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val
Tyr Thr 340 345 350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln
Val Ser Leu Thr 355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp
Ile Ala Val Glu Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn
Tyr Lys Thr Thr Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser
Phe Phe Leu Tyr Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp
Gln Gln Gly Asn Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala
Leu His Asn His Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys138449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 138Gln Val Gln Leu Gln Glu Ser Gly
Pro Gly Leu Val Ala Pro Ser Glu1 5 10 15Thr Leu Ser Leu Thr Cys Thr
Val Ser Gly Phe Ser Leu Thr Asp Tyr 20 25 30Ala Val His Trp Ile Arg
Gln Phe Pro Gly Lys Gly Leu Glu Trp Ile 35 40 45Gly Val Ile Trp Ser
Asp Gly Ser Thr Asp Phe Asn Ala Pro Phe Lys 50 55 60Ser Arg Val Thr
Ile Ser Lys Asp Thr Ser Lys Asn Gln Val Ser Phe65 70 75 80Lys Leu
Ser Ser Val Thr Thr Asp Asp Thr Ala Val Tyr Tyr Cys Ala 85 90 95Arg
Lys Gly Gly Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200 205Ser Asn Thr
Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys 210 215 220Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly Gly Pro225 230
235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315 320Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys 325 330 335Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr 340 345
350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr
355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu
Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr
Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser Phe Phe Leu Tyr
Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp Gln Gln Gly Asn
Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala Leu His Asn His
Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys139449PRTArtificial SequenceDescription of Artificial
Sequence Synthetic polypeptide 139Gln Val Gln Leu Gln Glu Ser Gly
Pro Gly Leu Val Lys Pro Ser Glu1 5 10 15Thr Leu Ser Ile Thr Cys Thr
Val Ser Gly Phe Ser Leu Thr Asp Tyr 20 25 30Ala Val His Trp Ile Arg
Gln Pro Pro Gly Lys Gly Leu Glu Trp Ile 35 40 45Gly Val Ile Trp Ser
Asp Gly Ser Thr Asp Tyr Asn Ala Pro Phe Lys 50 55 60Ser Arg Val Thr
Ile Ser Lys Asp Asn Ser Lys Ser Gln Val Ser Phe65 70 75 80Lys Met
Ser Ser Val Thr Ala Asp Asp Thr Ala Val Tyr Tyr Cys Ala 85 90 95Arg
Lys Gly Gly Tyr Ser Gly Ser Trp Phe Ala Tyr Trp Gly Gln Gly 100 105
110Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe
115 120 125Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala Leu 130 135 140Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser Trp145 150 155 160Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val Leu 165 170 175Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro Ser 180 185 190Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro 195 200 205Ser Asn Thr
Lys Val Asp Lys Arg Val Glu Pro Lys Ser Cys Asp Lys 210 215 220Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Ala Ala Gly Gly Pro225 230
235 240Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
Ser 245 250 255Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu Asp 260 265 270Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His Asn 275 280 285Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg Val 290 295 300Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys Glu305 310 315 320Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys 325 330 335Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr 340 345
350Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr
355 360 365Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu
Trp Glu 370 375 380Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr
Pro Pro Val Leu385 390 395 400Asp Ser Asp Gly Ser Phe Phe Leu Tyr
Ser Lys Leu Thr Val Asp Lys 405 410 415Ser Arg Trp Gln Gln Gly Asn
Val Phe Ser Cys Ser Val Met His Glu 420 425 430Ala Leu His Asn His
Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly 435 440
445Lys1407PRTMus sp. 140Arg Thr Ser His Leu Ala Ser1 5
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