JP6017422B2 - 赤血球結合療法 - Google Patents
赤血球結合療法 Download PDFInfo
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- JP6017422B2 JP6017422B2 JP2013524170A JP2013524170A JP6017422B2 JP 6017422 B2 JP6017422 B2 JP 6017422B2 JP 2013524170 A JP2013524170 A JP 2013524170A JP 2013524170 A JP2013524170 A JP 2013524170A JP 6017422 B2 JP6017422 B2 JP 6017422B2
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Description
本出願は、出典明示により本明細書に組み込まれる、2010年8月10日に出願された米国仮特許出願第61/372,181号の優先権を主張する。
本明細書は、赤血球に特異的に結合するペプチドについて記載する。これらは、赤血球に特異的に結合する配列を有するペプチド性リガンドとして、または赤血球に特異的に結合する抗体もしくはそのフラグメントとして提供される。ペプチドは、治療薬、寛容抗原または標的化ペプチドとの分子融合体として調製してもよい。治療薬は、融合体の一部分である場合、インビボの長い循環半減期を有利に有し得る。免疫寛容は、融合体の使用およびトレランスが望まれる物質上の抗原の選択により引き起こすことができる。標的化ペプチドを有する融合体は、融合体を標的、たとえば腫瘍に誘導し、そこで赤血球結合リガンドが、赤血球を標的にリクルートすることにより腫瘍への血液の流れを減少させる、または完全に阻止する。
赤血球に特異的に結合するペプチドが発見された。実施例1は、赤血球に特異的に結合するペプチド(ERY1)の発見について記載する。実施例8は、ヒト赤血球に特異的に結合する6種のペプチド(ERY19、ERY59、ERY64、ERY123、ERY141およびERY162)の発見について記載する。本発明の一実施形態は、ERY1のアミノ酸配列、もしくはヒト赤血球結合ペプチドのアミノ酸配列、またはそれらの保存的置換、あるいはそれらをコードする核酸を含む、実質的に純粋なポリペプチドである。こうしたポリペプチドは赤血球に特異的に結合するもので、赤血球に対するリガンドである。リガンドとは、標的分子に特異的に結合する化学部分をいう用語である。標的とは、使用者がリガンドと結合させようとする所定の分子、組織または部位をいう。したがって組織への標的送達とは、分子または細胞などの他の材料を目的の標的組織に送達することをいう。このため、実施形態は、赤血球への結合に使用される本明細書に開示されたリガンドの少なくとも1つを含む、分子または組成物を含む。ポリペプチドの赤血球への結合活性は、本明細書に記載するような以下の実験プロトコルだけで決定することができる。こうした方法を用いれば、一定の生理的条件下で、ERY1またはヒト赤血球結合ペプチドと比較して、ポリペプチドバリアントの結合力を決定することができ、たとえば、保存的置換、隣接する基の付加または除去、または水溶液に対する配列の溶解性を調節するための変化または付加により配列を作製することができる。
本明細書には、赤血球に結合するペプチドだけでなく、タンパク質、特に抗体、とりわけ一本鎖抗体も提示する。抗原に対する抗体の産生技術はよく知られている。この文脈で抗原という用語は、抗原に反応する宿主免疫系により認識される部位をいう。抗原の選択は、数ある技術分野の中でも抗体を産生する技術分野において公知である。実施形態は、分子融合体および本明細書に示した他の方法を用いた、これらのペプチドの使用を含む。本開示を読んだ当業者であれば、赤血球に特異的に結合する抗体を作製することができよう。実施例15〜17は、抗体もしくはそのフラグメントの作製に関する。
赤血球に結合するペプチドリガンドだけでなく、赤血球表面成分に対するヌクレオチドアプタマーリガンドも教示する。したがって、アプタマーは、本明細書に記載するように他の赤血球結合部分に対して作製および使用してもよい。DNAアプタマーおよびRNAアプタマーを使用して、非共有結合性の赤血球結合を提供してもよい。それらはヌクレオチドのみからなるため、スクリーニング手法が十分に確立しており、化学合成しやすいうえ、インビボでのクリアランスが速いことから副作用の毒性および/または免疫原性が限られているという点で、アプタマーは有望な生体分子の標的化部分となる(Keefe,Paiら,2010年)。さらに、ヌクレオチド−標的タンパク質相互作用の非標準的(non−canonical)性質により、インビボでの標的結合時に任意の増殖性(productive)アゴニストシグナル伝達が起こるが可能性が少なく、したがって免疫原性および毒性への寄与が低い。このため、多くのアプタマーに基づく分子が現在、白血病、黄斑変性症、血栓症および2型糖尿病などいくつかの臨床適応症に関するヒト臨床試験に入っている(Keefe,Paiら,2010年)。アプタマーはまた、癌化学療法および蛍光または放射性物質による腫瘍検出技術などの分野で、薬剤の正味重量をインビボで特定の組織に送達するための標的化剤としても使用されてきた(Rockey,Huangら,2011年;Savla,Taratulaら,2011年)。
分子融合体は、第1のペプチド性赤血球結合リガンドと第2のペプチドとの間で形成してもよい。融合体は、相互に、直接的または間接的にコンジュゲートされたペプチドを含む。ペプチドは、相互に、直接的にコンジュゲートしても、またはリンカーを介して間接的にコンジュゲートしてもよい。リンカーはペプチドでも、ポリマーでも、アプタマーでも、核酸でも、または粒子でもよい。粒子は、たとえばマイクロ粒子でも、ナノ粒子でも、ポリマーソーム(polymersome)でも、リポソームでも、またはミセルでもよい。ポリマーは、たとえば天然でも、合成でも、線状でも、または分岐でもよい。第1のペプチドおよび第2のペプチドを含む融合タンパク質は、ペプチドの分子融合体の一例であり、この融合タンパク質は、相互に直接結合したペプチドを含むか、あるいは、介在するリンカー配列および/またはさらなる配列を一端または両端に含む。リンカーとのコンジュゲーションは、共有結合を介したものでもよい。他の結合としてはイオン結合がある。方法は、分子融合体、または分子融合体を含む組成物を調製することを含み、該分子融合体は、赤血球に特異的に結合するペプチドおよび、治療薬、寛容抗原または他の物質を含むものである。
多くの薬剤は血液循環系に全身的に送達されるため、効果的な薬物送達という問題に対する解決策は、多くの場合、血液中の薬剤を長時間にわたり維持することに焦点を当てる。このため、長時間にわたり血液中で生物学的に利用可能な状態にある、長時間循環型(長い半減期の)療法剤の開発は、有効性、安全性および経済的実現可能性の観点から操作された新世代の薬剤を代表する。
本発明の実施形態は、scFvと赤血球に特異的に結合するペプチドとの分子融合体である。scFvは治療薬として使用することができ、赤血球結合ペプチドとの組み合わせを使用してその循環半減期を延長し、体内コンパートメントにアクセスさせてもよい。組換え抗体および組換え抗体フラグメントは、生物製剤産業において療法剤として有望である(Sheridan,2010)。
操作された療法剤が赤血球に結合する能力は、薬剤の半減期を長くするだけでなく、赤血球に選択的に結合して体内の特定の部位に局在化させるためにも有用である。固形癌(solid tumor)の処置では、肝動脈化学塞栓療法(TACE)を用いて腫瘍への血液供給を限定し、それにより腫瘍の増殖に必要な栄養素との接触を妨げる。TACEの処置は、腫瘍の血液供給の上流へのポリマー固体マイクロ粒子の外科的挿入を含む。マイクロ粒子が腫瘍血管床に到達すると、血管網に物理的に捕捉されることで、腫瘍への血液供給の遮断が引き起こされる(Vogl,Naguibら,2009年)。
治療薬の薬物動態学的挙動を改善するだけでなく、赤血球親和性が、抗原特異的トレランスを引き起こす方法に使用され得ることが発見されている。ある種の実施形態を、実施例に記載する。
本明細書に記載した本発明の多くの実施形態は、ヒトまたは他の動物患者に投与してもよい組成物について記載する。本発明の実施形態は、たとえば、赤血球または腫瘍または腫瘍血管系のほか、これらの組み合わせの抗原を認識する分子融合体、融合タンパク質、ペプチドリガンド、抗体、scFvを含む。これらの組成物は、好適な薬学的に許容されるキャリアまたは賦形剤と共に薬学的に許容される組成物として調製してもよい。
選択には、New England Biolabs(NEB)から市販されているPhDナイーブ12アミノ酸ペプチドファージライブラリーを使用した。スクリーニングの各ラウンドに、50mg/mLのBSA(PBSA−50)を含むPBS中、1011のインプットファージをマウス赤血球とインキュベートした。37Cで1時間後、非結合ファージを、パーコール(GE Life Sciences)を用いて1500gで15分間遠心分離により除去した。引き続き、低親和結合ファージを除去するためPBSA−50中で解離ステップを行った。選択プロセスの厳密性を高めるため、後のラウンドのスクリーニングでは解離の持続時間を長くし、温度を上昇させた。ラウンド1では、ファージの結合後に、洗浄および溶出の前に2分の解離ステップを室温で行った。ラウンド2では、ファージの結合後に、10分の解離を37℃で行った。ラウンド3および4では、2種の連続した解離ステップを37℃で行った。すなわち、ラウンド3では10分に続き15分、ラウンド4では10分に続き30分行った。赤血球結合ファージを0.2Mのグリシン、pH2.2で10分間溶出し、この溶液を0.15量の1Mのトリス、pH9.1で中和させた。全赤血球に対して4ラウンドの選択を行い、フローサイトメトリーで示されるように、ライブラリーを高親和性ファージクローンに実質的に濃縮した。感染またはプラーク形成単位を標準的な力価測定法により算出した。ファージサンプルを新鮮なLB培地に段階希釈し、10μLのファージ希釈液を200μLの対数期初期ER2738大腸菌(E.coli)(NEB)に加えた。室温で3分のインキュベーション後、この溶液を3mLの上層寒天に加え、混合し、IPTGおよびXGalを含むLBプレートに注いだ。37℃で一晩インキュベーション後、青色のコロニーをプラーク形成単位(pfu)と見なした。
結果:顕微鏡観察から、ERY1ファージが細胞形態を変化させず、かつ細胞質移行をせずに、赤血球細胞表面に結合することが確認された。蛍光および位相差画像により、非選択ライブラリーと比較してERY1ファージの赤血球結合能が再確認された。高解像度共焦点イメージングからは、ERY1ファージが細胞表面全体に分布し(単一部位でクラスター化するのではなく)、細胞表面の赤道周辺に優先的に結合すること、および結合が赤血球間で均一であることが明らかになった(図1)。
結果:ERY1ペプチドの分子標的の探索には、ビオチン化した可溶性ペプチドを用いた親和性プルダウン法を利用した。この方法により、赤血球膜上のERY1リガンドとしてグリコホリンA(GYPA)が明らかになった。ビオチン官能基を有するERY1ペプチドおよび光活性化型クロスリンカーと全赤血球をインキュベートして、ストレプトアビジンウエスタンブロットで検出したところ、単一の28kDaのタンパク質がペプチド−ビオチン複合体とコンジュゲートした(図2A)。この反応ライセートを十分に洗浄し、赤血球ライセートに非標識タンパク質が確実に残存しないようにストレプトアビジン磁性ビーズを用いて精製した。予想通り、ミスマッチペプチドは、どの赤血球タンパク質ともコンジュゲートしなかった。ミスマッチペプチドPLLTVGMDLWPW(配列番号2)は、ERY1と同じアミノ酸残基を含み、その疎水性分布(hydropathy topography)と一致するように設計した。この相互作用タンパク質の見かけの大きさの証明から、考えられるリガンドとしていくつかのより小さい1回膜貫通タンパク質、すなわち、グリコホリンが示唆された。架橋反応から精製された同じサンプルの抗GYPAウエスタンブロッティングにより、この候補ビオチン化タンパク質が実際にGYPAであることが確認された(図2B)。
結果:一連の種間細胞株のフローサイトメトリーによるスクリーニングにより、ERY1ファージがマウスおよびラット赤血球に対して特異的であり、マウス白血球またはヒト細胞に測定できるほど結合しないことが証明された(図3)。これらのデータから、ERY1リガンドとして働く特異的膜タンパク質は、赤血球細胞にのみ認められ、骨髄またはリンパ系細胞系譜には認められないことが示唆された。さらに、このことにより、標的の遠心分離以外に事前の精製をほとんど行わずに新たに単離された血液を使用するスクリーニング方法の妥当性も立証された。
結果:我々は、タンパク質の薬物動態に対するERY1ペプチドの作用の特徴付けを行うため、モデルタンパク質マルトース結合タンパク質(MBP)をERY1ペプチドとのN末端融合体として発現させた(ERY1−MBP)。血管内投与すると、このERY1−MBPバリアントは、野生型タンパク質と比較して循環の延長を示した(図4)。注射直後に取得した時点での血液サンプルから、どちらの製剤も初濃度、したがってその用量が同一であることが確認された。静脈内注射の4時間後から、ERY1−MBPは、非結合の生型MBPより統計学的に有意にゆっくりとした速度で循環から除去された。
式1:標準的な1−コンパートメントモデル
式2:標準的な2−コンパートメントモデル
結果:ERY1−MBPバリアントは血管外投与すると、野生型タンパク質と比較して、循環の延長を示した(図5)。注射直後に取得した時点での血液サンプルから、どちらの製剤も初濃度、したがってその用量が同一であることが確認された。皮下注射後も、ERY1−MBPの血中濃度の上昇という同様の傾向が見られ、実験期間を通して維持された。血中濃度の解析から、ERY1−MBPバリアントは野生型MBPと比較して、バイオアベイラビリティーが1.67の上昇を示すことが明らかになった。したがって、本明細書に教示されたヒト赤血球結合ペプチドおよび他の赤血球結合リガンドにより半減期が延長される可能性がある。
式3:バイオアベイラビリティー
方法:フィブロネクチンのエキストラドメインAに対するscFvフラグメントをコードする遺伝子を注文し、DNA2.0(Menlo Park,CA,USA)で合成した:
5’ATGGCAAGCATGACCGGTGGCCAACAAATGGGTACGGAAGTGCAACTGCTGGAGTCTGGCGGTGGCCTGGTTCAGCCGGGTGGCAGCTTGCGCCTGAGCTGTGCGGCGTCTGGCTTCACCTTTAGCGTCATGAAAATGAGCTGGGTTCGCCAGGCACCAGGTAAAGGCCTGGAGTGGGTGTCGGCAATCAGCGGTTCCGGTGGTAGCACCTATTACGCTGACAGCGTGAAAGGCCGTTTTACGATTTCGCGTGATAACAGCAAGAACACGCTGTACTTGCAAATGAATAGCCTGCGTGCAGAGGACACGGCAGTGTACTATTGTGCGAAGAGCACTCACCTGTACTTGTTTGATTACTGGGGTCAAGGCACCCTGGTTACCGTTAGCAGCGGCGGTGGTGGCTCCGGTGGTGGTGGTAGCGGTGGCGGTGGTTCTGGTGGTGGCGGCTCTGAAATTGTCCTGACTCAGAGCCCTGGCACGCTGAGCCTGAGCCCGGGTGAGCGCGCGACGCTGAGCTGCCGTGCGAGCCAGTCCGTTAGCAACGCGTTCCTGGCTTGGTATCAACAGAAACCGGGTCAGGCCCCTCGCCTGCTGATTTACGGTGCCAGCTCCCGTGCGACGGGCATCCCGGACCGTTTTTCCGGCTCCGGTAGCGGCACCGACTTCACCCTGACCATCAGCCGCCTGGAGCCGGAGGATTTCGCGGTGTATTACTGCCAGCAAATGCGTGGCCGTCCGCCGACCTTCGGTCAGGGTACCAAGGTCGAGATTAAGGCTGCGGCCGAACAGAAACTGATCAGCGAAGAAGATTTGAATGGTGCCGCG−3’(配列番号21)。野生型scFvを含む発現プラスミドを構築する場合には、プライマーSK01およびSK02を使用して遺伝子をPCR増幅し、HindIII(5’末端)およびXhoI(3’末端)制限部位のほか、3’末端に2つの終止コドンを付加した。scFvのリンカー領域にERY1ペプチドを含むREP変異体scFvを構築する場合には、オーバーラップエクステンションPCRを使用した。プライマーSK01およびSK03を用い、scFvの5’半分に続きERY1遺伝子フラグメントを含む遺伝子フラグメントをPCRにより作製した。プライマーSK02およびSK04を用い、ERY1遺伝子フラグメント(前述のフラグメントに相補的(complimentary))に続きscFvの3’半分を含む遺伝子フラグメントをPCRにより作製した。標準的なキット(Zymo Research,Orange,CA,USA)を用いて、この遺伝子フラグメントをアガロース電気泳動後に精製し、PCRを用いて2つのフラグメントを融合した。SK01およびSK02プライマーを用いた最終の増幅PCRを行い、正しい制限部位および終止コドンを作製した。INS変異体scFvの構築については、プライマーSK03の代わりにSK05を使用し、SK04の代わりにSK06を使用したこと以外はREP変異体とちょうど同じようにした。最終的に完成したscFv遺伝子産物をそれぞれHindIIIおよびXhoI(NEB、Ipswich、MA、USA)で消化し、pSecTagA哺乳動物発現プラスミド(Invitrogen,Carlsbad,CA,USA)の同じ部位にライゲートした。
結果:ヒト赤血球に結合する7種の新規なペプチドを選択するため、大腸菌(E.coli)表面提示ライブラリーを利用した。白血球への非特異的結合を減らすため、高濃度の血清アルブミン(50mg/mL)を用いて4Cで洗浄した全血を用いてスクリーニングプロセスを行った。3つのラウンドで最初に、ペプチドライブラリーを血液とインキュベートしてから、細菌の結合した赤血球を十分な洗浄および密度勾配遠心分離により他の細胞から慎重に分離して濃縮した。その後、選択したペプチドをコードする細菌プラスミドを、緑色蛍光タンパク質バリアントを発現する細菌に形質転換した。これにより、赤血球に結合した緑色細菌をハイスループットFACSでソートできるようになり、回収された個々の細菌クローンについて、赤血球への結合をサイトメトリーによりアッセイした。表1に示すように7種の赤血球結合ペプチドを同定した。これらのペプチドは、UniProtのBLASTアルゴリズムを用いて既知のタンパク質に対して解析したところ、コンセンサスモチーフを含まず、関連するタンパク質配列の相同性も認められなかった。
結果:ヒト赤血球に結合した選択されたペプチドの特徴付けを行うため、個々のペプチドを提示している細菌を、複数の細胞型による結合アッセイに供した。7種のうち6種(ERY19、ERY59、ERY64、ERY123、ERY141およびERY162)のペプチドが、ヒト上皮293T細胞およびヒト内皮HUVEC(図7A)に対する結合と比較してヒト赤血球に特異的に結合した。加えて、ヒト血液型AおよびBに結合したが、マウス血液に結合しなかったペプチドがあることから(図7B)、これらのペプチドは、ヒト血液に特異的であるが、共通の血液型抗原に依存しないことが示唆された。ペプチドは、標準的な固相f−moc化学を用いて合成し、ナノ粒子にコンジュゲートし、上述の個々の細胞型に対する結合について解析する。赤血球表面への結合は、顕微鏡観察およびフローサイトメトリーの両方を用いて調べた。
腫瘍血管マーカーフィブロネクチンEDA(EDA)に対して操作したscFvを、ヒト赤血球に特異的に結合するペプチドとの融合体として作製することができる。実施例8の複数のペプチドまたは各々のペプチドを、2つのERY1を含むように設計した変異体と同様に(GGGGS)4(配列番号18)リンカー領域または同等の領域に挿入する。したがって、REPおよびINS変異体(図6A)の配列中のERY1の代わりにペプチドERY19、ERY50、ERY59、ERY64、ERY123、ERY141、ERY162を加えることになる。ヒトERYペプチドは、骨格タンパク質eCPXのN末端につながっていることが分かったため、リンカー領域に挿入されたこれらのコンストラクトは、赤血球結合に影響を与える可能性がある。このことを検討するため、ERY1(図6C)と同様に合成ヒトERYペプチドとの化学的コンジュゲーションによりscFvバリアントを作製する。これにより、単独あるいは組み合わせて最適な数のERYペプチドをscFvに加えて赤血球結合を刺激することができる。
本発明の研究室は以前に、薬物送達および免疫調節に使用されるポリマーを用いたナノ粒子およびミセルを多く開発したことがある。この技術は、チオールを含む分子のナノ粒子への定量的な部位特異的コンジュゲーションを容易に行うことができるため強力である(van der Vlies,O’Neilら,2010年)。本研究室はまた、単一のミセル上に複数の化学基を提示するミセル製剤、および疎水性薬剤の制御送達を可能にする製剤も開発した(O’Neil,van der Vliesら,2009年;Velluto,Demurtasら,2008年)。本研究室はさらに、それらの製剤がリンパ節の抗原提示細胞を標的とするため、研究室のナノ粒子技術を免疫応答のモジュレーターとして使用することも検討してきた(Reddy,Rehorら,2006年;Reddy,van der Vliesら,2007年)。本明細書の材料および方法を組み合わせるミセル技術および粒子技術は、米国特許出願公開第2008/0031899号明細書、米国特許出願公開第2010/0055189号明細書、および米国特許出願公開第2010/0003338号明細書に記載されており、これらを本明細書に援用する。
赤血球および腫瘍血管マーカーの両方に対する二重特異性を持つように設計された操作されたポリマーナノ粒子およびミセルを調製して、腫瘍血管床に赤血球の凝集現象を引き起こし、その血液供給を特異的に閉塞することができる。リンカー領域にシステインを含むフィブロネクチンEDAの修飾scFv、GPRPペプチドモチーフを含むフィブリノーゲン結合ペプチドの修飾scFv、および切断型組織因子融合タンパク質の修飾scFv(各々粒子に結合できるように操作されたシステインまたはビオチンを含む)など、いくつかの腫瘍標的化マーカーを評価して利用してもよい。これらの腫瘍標的化リガンドは、赤血球結合ペプチドまたはグリコホリンA scFvと組み合わせてナノ粒子およびミセルに二重標的化を達成するのに最適な比率でつなげてもよい。ジスルフィド結合またはアビジン−ビオチン相互作用により、複数のリガンドを粒子に結合することができる。検証のため、標準的なマウス固形癌モデルを利用することにより、マウスの背部皮膚にマウス腫瘍細胞を注射し、所定の期間増殖させ、この時点でマウスにナノ粒子またはミセルを投与してもよい。投与量および処置レジメンは、療法剤の薬物動態の特徴付け後に決定してもよい。さらに検証するには、処置後の様々な時点で処置群間の腫瘍容積を比較して、腫瘍塊のさらなる増殖を阻止する療法剤の能力を評価してもよい。赤血球による腫瘍血管系の遮断の詳細な確認は、腫瘍を有する生きたマウスを用いた灌流実験により評価してもよい。赤血球に対する療法剤の親和性と腫瘍血管閉塞との間で正の相関関係が観察されよう。
腫瘍血管マーカーEDAおよび赤血球に対して特異的である操作されたscFvは、腫瘍血管床に赤血球の凝集現象を引き起こし、その血液供給を特異的に閉塞することができる。EDAに対して修飾されたscFvは、融合体としてリンカー領域に、またはscFvとのコンジュゲートとして、ヒトERY結合ペプチドを含む。標準的なマウス固形癌モデルを利用することにより、マウスの背部皮膚にマウス腫瘍細胞を注射し、所定の期間増殖させ、この時点でマウスにナノ粒子またはミセルを投与してもよい。投与量および処置レジメンは、療法剤の薬物動態の特徴付け後に決定する。処置後の様々な時点で、処置群間の腫瘍容積を比較して、腫瘍塊のさらなる増殖を阻止する療法剤の能力を評価してもよい。赤血球による腫瘍血管系の遮断の確認は、腫瘍を有する生きたマウスを用いた灌流実験により評価してもよい。赤血球に対する療法剤の親和性は、腫瘍血管閉塞に相関する。
我々は、赤血球に対する抗原の強力で特異的な生物物理学的結合を得るため、我々がファージディスプレイによりマウスグリコホリンAに特異的に結合することを発見した合成12アミノ酸ペプチド(ERY1)を使用した(Kontos and Hubbell,2010)。この研究では、モデル抗原OVAを、CD8+T細胞集団がMHC I免疫優性OVAペプチドSIINFEKL(配列番号3)に特異的なT細胞受容体を発現するトランスジェニックマウス株(OT−I)と共に使用した。ERY1ペプチドをOVAに化学的にコンジュゲートして、高い親和性および特異性でマウス赤血球に結合するOVAバリアント(ERY1−OVA)を作製した(図8a)。高解像度供焦点顕微鏡観察から、ERY1結合に関して従来の観察結果が確認された(Kontos and Hubbell,2010)、すなわち細胞膜赤道周辺に局在するが、ERY1−コンジュゲートタンパク質の細胞内トランスロケーションがないことが確認された。ERY1と同一のアミノ酸を含むが、一次配列の順序を入れ換えたミスマッチペプチド(MIS−OVA)とコンジュゲートしたOVAバリアントは、無視できる程度の結合を示したため(図8b)、ERY1によるグリコホリンAへの結合は配列特異的であった。OVAペプチドをコンジュゲートするのに使用した架橋分子のみとコンジュゲートしたOVAは、赤血球に対して測定可能な親和性を何ら示さなかったことから、ERY1−OVA結合は、赤血球表面でのERY1ペプチドとグリコホリンAとの非共有結合性相互作用によるものであることが示唆された。さらに、ERY1−OVAは、高親和性で赤血球に結合し、平衡状態における結合の測定により判定すると、6.2±1.3nMという抗体と同様の解離定数(Kd)を示した(図8c)。
スイス獣医当局は既にすべての動物処置を承認した。インビボ結合研究には8〜12週齢の雌C57BL/6マウス(Charles River)をE.G7−OVA腫瘍の宿主として使用した。C57BL/6−Tg(TcraTcrb)1100Mjb(OT−I)マウス(Jackson Labs)をEPFL動物施設で飼育し、脾細胞単離には6〜12週齢の雌を使用した。OT−I CD8+T細胞の養子移入およびトレランス誘導研究には、8〜12週齢の雌B6.SJL−PtprcaPepcb/Boy(CD45.1)マウス(Charles River)を対象宿主として使用した。
ERY1
ジメチルホルムアミドに溶解させた10モル当量のスクシンイミジル−4−(N−マレイミドメチル)シクロヘキサン−1−カルボキシレート(SMCC、CAS番号64987−85−5、Thermo Scientific)を5mg/mLのエンドトキシンフリー(<1EU/mg)OVA(Hyglos GmbH)とPBS中、1時間室温で反応させた。2mLのZeba脱塩スピンカラム(Thermo Scientific)で脱塩後、3Mのグアニジン−HClに溶解させた10当量のERY1またはMISペプチドを加え、2時間室温で反応させた。このコンジュゲートを2mLのZeb脱塩スピンカラムを用いて脱塩し、0.2μmのフィルターで濾過滅菌し、作業アリコート(working aliquot)に分け、−20Cで保存した。タンパク質濃度は、BCAアッセイ(Thermo Scientific)により決定した。このスキームにより、ペプチドのシステイン側鎖と抗原のリジン側鎖とのコンジュゲーションが得られる。グルタチオン−S−トランスフェラーゼ(GST)をBL21エシェリキア・コリ(Escherichia coli)に発現させ、標準的なグルタチオンアフィニティークロマトグラフィーを用いて精製した。十分なトリトン−X114(Sigma Aldrich)洗浄によりオンカラムエンドトキシン除去を行い、エンドトキシンの除去は、THP−1X Blue細胞(InvivoGen)で確認した。同じ反応手順を使用してERY1をGSTにコンジュゲートした。マレイミド活性化アロフィコシアニン(Innova Biosciences)をPBSに溶解させ、上記のようにERY1またはMISとコンジュゲートした。
単離されたばかりのマウス赤血球5×105を、10mg/mLのBSAを含むPBS中の100nMのERY1−OVAまたはOVAに37Cで1時間さらした。遠心分離および洗浄の後、1:200希釈ヤギ抗マウスグリコホリンA(Santa Cruz)およびウサギ抗OVA(AbD SEROTEC)で細胞を氷上にて20分間標識した。遠心分離および洗浄の後、1:200 ALEXAFLUOR488抗ヤギIgG(Invitrogen)およびAlexaFluor546抗ウサギIgG(Invitrogen)で細胞を氷上にて20分間標識した。最終の回転/洗浄サイクル後、細胞を固化固定し、63×油浸対物レンズを備えたZeiss LSM700共焦点倒立顕微鏡で画像を取得した。画像解析は、IMAGEJ(NIH)で行い、どちらの画像も同一の処理を行った。
150μgのERY1−OVAまたはOVAを含む0.9%食塩水(B.Braun)を100μLの量で8〜12週齢の雌C57BL/6マウスの尾に、イソフルランによる麻酔下で静脈内注射した。実験中は、加温パッドを用いてマウスを37Cに確実に維持するように注意した。所定の時点で、尾に小さな切れ目を入れて5μLの血液を採取し、10mMのEDTAを含むPBSに100倍希釈し、10mg/mLのBSAを含むPBSで3回洗浄し、フローサイトメトリーおよびELISAによりOVA含有量について解析した。OVAは、サンドイッチELISAにより定量し、捕獲用にマウスモノクローナル抗OVA抗体(Sigma)、検出用にポリクローナルウサギ抗OVA抗体(AbD SEROTEC)、最終検出用にヤギ抗ウサギ−IgG−HRP抗体(BioRad)を、続いてTMB基質(GE Life Sciences)を使用した。ADVIVA 2120 Hematology System(Siemens)で血液学的特徴付けを行った。赤血球結合ERY1−GSTは、標識細胞をヤギ抗GST(GE Healthcare Life Sciences)とインキュベートし、続いてAlexaFluor488ロバ抗ヤギ(Invitrogen)とインキュベーションすることにより検出し、フローサイトメトリーにより解析した。体内分布の研究では、上記のような8〜12週齢の雌C57BL/6マウスの尾静脈に20μgのERY1−APCまたはMIS−APCを静脈内注射した。マウスを所定の時点で屠殺し、脾臓、血液および肝臓を除去した。各器官をコラゲナーゼD(Roche)で消化し、ホモジナイズしてフローサイトメトリー染色のための単一細胞浮遊液を得た。
CD8磁性ビーズネガティブ選択キット(Miltenyi Biotec)を製造者の指示通り用いて、OT−I(CD45.2+)マウス脾臓由来のCD8+T細胞を単離した。単離されたばかりのCD8+OT−I細胞をPBSに再懸濁し、1μMのカルボキシフルオレセインスクシンイミジルエステル(CFSE、Invitrogen)で6分間室温にて標識し、10%FBS(Gibco)を含む等量のIMDMで反応を1分間クエンチした。細胞を洗浄し、カウントし、注射前に純粋なIMDMに再懸濁した。CFSE標識CD8+OT−I細胞3×106を被注射CD45.1+マウス尾静脈に静脈内注射した。短期増殖研究では、養子移入から24時間後に10μgのERY1−OVAまたはOVAを100μL量で注射した。抗原投与から5日後に脾細胞を採取し、フローサイトメトリーによる解析のため染色した。
CFSE標識OT−I CD8+T細胞3×105を上記のようにCD45.1+被注射マウスに注射した。養子移入から1日後および6日後に、マウスの尾静脈に10μgのERY1−OVAまたはOVAを含む100μLの食塩水を静脈内投与した。養子移入から15日後、5μgのOVAおよび25ngの超高純度のエシェリキア・コリ(Escherichia coli)LPS(InvivoGen)を25μLでマウスの後肢の肉趾それぞれに皮内チャレンジした(Hock法、10μgのOVAおよび50ngのLPSの総投与量)。マウスをチャレンジから4日後に屠殺し、再刺激のため脾臓および流入領域リンパ節細胞を単離した。細胞内サイトカインのフローサイトメトリー解析では、細胞を1mg/mLのOVAまたは1μg/mLのSIINFEKL(配列番号3)ペプチド(Genscript)の存在下で3時間再刺激した。ブレフェルジンA(Sigma、5μg/mL)を加え、染色およびフローサイトメトリー解析の前に再刺激をさらに3時間続けた。分泌因子のELISA測定では、100μg/mLのOVAまたは1μg/mLのSIINFEKL(配列番号3)ペプチドの存在下で4日間細胞を再刺激した。細胞を回転させ、IFNγおよびIL−10のReady−Set−Goキット(eBiosciences)を製造者の指示通り使用してELISA解析のため培地を集めた。OVA特異的血清IgGを、OVAコートプレートでマウス血清を様々に希釈してインキュベートしてから、最後にヤギ抗マウスIgG−HRP(Southern Biotech)とインキュベートして検出した。
CFSE標識OT−I CD8+T細胞1×106を、上記のように8〜12週齢の雌C57BL/6マウスに注射した。養子移入から1日後および6日後、10μgのERY1−OVAまたは10μgのOVAを含む100μLの食塩水をマウスの尾静脈に静脈内投与した。養子移入から5日後、フローサイトメトリーによるOT−I CD8+T細胞増殖の特徴付けのため血液を採取した。OVA発現EL−4胸腺腫細胞(E.G7−OVA、ATCC CRL−2113)をATCCガイドライン通りに培養した。簡単に言えば、10%ウシ胎仔血清、10mMのHEPES、1mMのピルビン酸ナトリウム、0.05mMのβ−メルカプトエタノール、1%ピューロマイシン/ストレプトマイシン(Invitrogen Gibco)および0.4mg/mLのG418(PAA Laboratories)を補充したRPMI1640で細胞を培養した。注射の直前に、G418を含まない培地で細胞を増幅させ、回収時にHBSS(Gibco)に再懸濁した。養子移入から9日後、マウスをイソフルランで麻酔し、背部を剪毛し、両肩甲骨の間にE.G7−OVA細胞を皮内注射した。E.G7−OVA移植から4日後、腫瘍寸法を24時間毎にデジタルカリパスで測定し、腫瘍容積を楕円体(V=(π/6)l・w・h)として計算した。式中、Vは腫瘍の容積、lは長さ、wは幅、hは高さである)。養子移入から15日後、5μgのOVAおよび25ngの超高純度のエシェリキア・コリ(Escherichia coli)LPS(InvivoGen)を25μLでマウスの前肢の肉趾それぞれに皮内チャレンジした(10μgのOVAおよび50ngのLPSの総投与量)。
フローサイトメトリーには以下の抗マウス抗体:CD1d Pacific Blue、CD3ε PerCP−Cy5.5、CD8α PE−Cy7、CD11b PE−Cy7、CD11c Pacific Blue、ビオチン化CD45、CD45.2 Pacific Blue、CD45 Pacific Blue、IFNγ−APC、CD8α APC−eF780、CD44 PE−Cy5.5、CD62L PE、CD205 PE−Cy7、F4/80 PE、I−A/I−E MHCII FITC(すべてeBioscience)のほか、fixable live/dead色素(Invitrogen)、アネキシン−V−Cy5標識キット(BioVision)、ストレプトアビジン Pacific Orange(Invitrogen)および抗OVA−FITC(Abcam)を使用した。サンプルは、CyAn ADPフローサイトメーター(Beckman Coulter)で解析した。最初にPBSで細胞を洗浄し、live/dead色素にて20分間氷上で染色し、24G2ハイブリドーマ培地にて20分間氷上でブロッキングし、20分間氷上で表面染色し、2%パラホルムアルデヒドで20分間氷上にて固定し、0.5%サポニンの存在下で45分間氷上にて細胞内染色してから、解析の前に最後の洗浄を行った。アポトーシス染色の場合、解析の前にアネキシン−V−Cy5を5分加えた。CD45染色では、細胞をストレプトアビジンPacific Orangeで20分間氷上にて染色し、洗浄して解析した。
免疫寛容誘導のため、ERY1ペプチドを、ERY1ペプチドおよび寛容誘導抗原の両方をコンジュゲートしたナノ粒子の形態でも実施した。
抗原特異的免疫学的トレランスを誘導するため、赤血球に非共有結合的に結合する別の方法として、赤血球結合抗体を使用してもよい。最新のディスプレイプラットフォーム、以下に限定されるものではないが、バクテリオファージディスプレイ、酵母および大腸菌(E.coli)表面提示を使用した抗体ライブラリーのスクリーニングにより、赤血球表面タンパク質に対して高親和性を示す抗体を単離することができる。新規な赤血球結合抗体を発見したら、ERY1で行ったのと同様に結合に関する生化学的特徴付けを評価することができる。結合特性の向上した、より高い親和性の変異体を作製するには、最初のライブラリーのスクリーニングから赤血球に結合することが分かった抗体フラグメントに対し親和性成熟を行う。エラープローンPCRおよび部位特異的変異誘発などの標準的な組換えDNA技術を用いて、親結合配列から新しいライブラリーを作製する。次いで上記のような最新のディスプレイプラットフォームを用いて、親結合配列と比較して赤血球に対する親和性が増強された他の抗体フラグメントの親和性成熟ライブラリーを提示させる。
5’−GAGGTGAAGCTGCAGGAGTCTGGAGGAGGCTTGGTGCAACCTGGGGGGTCTCTGAAACTCTCCTGTGTAGCCTCAGGATTCACTTTCAGGGACCACTGGATGAATTGGGTCCGGCAGGCTCCCGGAAAGACCATGGAGTGGATTGGAGATATTAGACCTGATGGCAGTGACACAAACTATGCACCATCTGTGAGGAATAGATTCACAATCTCCAGAGACAATGCCAGGAGCATCCTGTACCTGCAGATGAGCAATATGAGATCTGATTACACAGCCACTTATTACTGTGTTAGAGACTCACCTACCCGGGCTGGGCTTATGGATGCCTGGGGTCAAGGAACCTCAGTCACTGTCTCCTCAGCCGGTGGTGGTGGTTCTGGTGGTGGTGGTTCTGGCGGCGGCGGCTCCGGTGGTGGTGGATCCGACATTCAGATGACGCAGTCTCCTTCAGTCCTGTCTGCATCTGTGGGAGACAGAGTCACTCTCAACTGCAAAGCAAGTCAGAATATTAACAAGTACTTAAACTGGTATCAGCAAAAGCTTGGAGAAGCTCCCAAAGTCCTGATATATAATACAAACAATTTGCAAACGGGCATCCCATCAAGGTTCAGTGGCAGTGGATCTGGTACAGATTTCACACTCACCATCAGTAGCCTGCAGCCTGAAGATTTTGCCACATATTTCTGCTTTCAGCATTATACTTGGCCCACGTTTGGAGGTGGGACCAAGCTGGAAATCAAACGTACT−3’(配列番号76)。この配列は、翻訳されたタンパク質のN末端にTER−119クローンのVH領域、続いて(Gly−Gly−Gly−Gly−Ser)4(配列番号18)リンカードメイン、続いて翻訳されたタンパク質のC末端にTER−119クローンのVL領域をコードする。TER−119 scFv遺伝子は、下記のVH領域に特異的なプライマーSK07およびSK08、ならびにVL領域に特異的なSK09およびSK10を用いてTER−119 cDNAを増幅することにより構築した。
5’−GTTATTACTCGCGGCCCAGCCGGCCATGGCGGCGCAGGTGAAACTGCAGCAGAGCGGCGCGGAACTGGTGAAACCGGGCGCGAGCGTGAAACTGAGCTGCAAAGCGAGCGGCTATACCTTTAACAGCTATTTTATGCATTGGATGAAACAGCGCCCGGTGCAGGGCCTGGAATGGATTGGCATGATTCGCCCGAACGGCGGCACCACCGATTATAACGAAAAATTTAAAAACAAAGCGACCCTGACCGTGGATAAAAGCAGCAACACCGCGTATATGCAGCTGAACAGCCTGACCAGCGGCGATAGCGCGGTGTATTATTGCGCGCGCTGGGAAGGCAGCTATTATGCGCTGGATTATTGGGGCCAGGGCACCACCGTGACCGTGAGCAGCGGCGGCGGCGGCAGCGGCGGCGGCGGCAGCGGCGGCGGCGGCAGCGATATTGAACTGACCCAGAGCCCGGCGATTATGAGCGCGACCCTGGGCGAAAAAGTGACCATGACCTGCCGCGCGAGCAGCAACGTGAAATATATGTATTGGTATCAGCAGAAAAGCGGCGCGAGCCCGAAACTGTGGATTTATTATACCAGCAACCTGGCGAGCGGCGTGCCGGGCCGCTTTAGCGGCAGCGGCAGCGGCACCAGCTATAGCCTGACCATTAGCAGCGTGGAAGCGGAAGATGCGGCGACCTATTATTGCCAGCAGTTTACCAGCAGCCCGTATACCTTTGGCGGCGGCACCAAACTGGAAATTAAACGCGCGGCGGCGGCCTCGGGGGCCGAGGGCGGCGGTTCT−3’(配列番号81)。
抗体は、実施例14および本明細書の他の箇所で言及された標準的な架橋反応を用いて抗原とコンジュゲートしてもよい。精製された抗体−抗原コンジュゲートは、1型糖尿病、多発性硬化症、膵島移植の標準的なマウスモデルにおける抗原、およびOVAモデル抗原に対するトレランスの誘導を示す。
一本鎖抗体フラグメント(scFv)は、赤血球に対する非共有結合バインダーとして使用してもよい。赤血球表面タンパク質に対して高親和性を示すScFvは、実施例13で考察したように最新のディスプレイプラットフォームを用いてscFvライブラリーをスクリーニングすることにより単離することができる。新規な赤血球結合抗体フラグメントを発見したら、ERY1ペプチドで行ったのと同様に結合の生化学的特徴付けを評価する。scFvは1本のポリペプチド鎖を有するため、標準的な組換えDNA技術を用いた部位特異的組換え法で抗原に融合される。抗原融合パートナーの性質に応じて、scFvを抗原のNまたはC末端に融合して二機能タンパク質種を作製する。抗原の主要組織適合性複合体(MHC)ペプチド認識配列が分かっている場合には、ペプチドをさらにscFvのリンカードメインに挿入して、ネイティブなscFvの末端を含む新しい二機能性抗体/抗原コンストラクトを作製する。
8アームPEG−チオアセテートを合成するため、8アームPEG−OH(Nektar)をトルエンに溶解させ、10当量のトリエチルアミン(Sigma Aldrich、CAS番号121−44−8)および10当量のメタンスルホニルクロリド(Sigma Aldrich、CAS番号124−63−0)とアルゴン下、室温で18時間反応させた。残渣を濾過し、濾液を減圧下で濃縮し、ジメチルホルムアミド(DMF)に溶解させ、10当量のチオ酢酸カリウム(Sigma Aldrich、CAS番号10387−40−3)を加えた。室温で18時間後、残渣を濾過し、濾液を減圧下で濃縮し、ジエチルエーテルで沈殿させた。沈殿物を濾過し、減圧下で乾燥させて最終生成物を得た。
非共有結合的赤血球結合による免疫学的トレランスの誘導能力を測定するため、他の非抗体生体親和性試薬を用いた方法を行ってもよい。他のタンパク質ベースの親和性部分、たとえば、設計されたアンキリンリピートタンパク質(DARPin)(Steiner,Forrerら,2008年)、設計されたアルマジロリピートタンパク質(Parmeggiani,Pellarinら,2008年)、フィブロネクチンドメイン(Hackel,Kapilaら,2008年)およびシステイン−ノット(knottin)親和性骨格(Silverman,Levinら,2009年)などを、赤血球に対する結合親和性を示す部分についてスクリーニングする。
本発明の種々の実施形態について記載する。実施形態は、配列番号11、配列番号13、配列番号14、配列番号15、配列番号16、配列番号17、配列番号1およびそれらの保存的置換体からなる群から選択される配列の少なくとも5個の連続したアミノ酸残基を含む単離されたペプチドであり、前記配列は赤血球に特異的に結合する。実施形態は、配列番号11、配列番号13、配列番号14、配列番号15、配列番号16、配列番号17、および配列番号1からなる群から選択される配列の少なくとも1個および2個以下のアミノ酸のDからLへの置換を有する1つ以上の残基を含むペプチドであるか、または配列番号11、配列番号13、配列番号14、配列番号15、配列番号16、配列番号17、および配列番号1からなる群から選択される配列の少なくとも1個および2個以下のアミノ酸の保存的置換を有する。実施形態は、配列番号11、配列番号13、配列番号14、配列番号15、配列番号16、配列番号17、配列番号1およびそれらの保存的置換体からなる群から選択される配列の少なくとも5個の連続したアミノ酸残基を含むペプチドであり、前記配列は赤血球に特異的に結合する。ペプチドは、たとえば、約10〜約80個の多くの残基を有してもよい。ペプチドは、たとえば、インスリン、酢酸プラムリンチド、成長ホルモン、インスリン様成長因子−1、エリスロポエチン、1型インターフェロンα、インターフェロンα2a、インターフェロンα2b、インターフェロンβ1a、インターフェロンβ1b、インターフェロンγ1b、β−グルコセレブロシダーゼ、アデノシンデアミナーゼ、顆粒球コロニー刺激因子、顆粒球マクロファージコロニー刺激因子、インターロイキン1、インターロイキン2、インターロイキン11、第VIIa因子、第VIII因子、第IX因子、エクセナチド、L−アスパラギナーゼ、ラスブリカーゼ、腫瘍壊死因子受容体およびエンフビルチドからなる群から選択される治療薬をさらに含んでもよい。ペプチドは、抗体、抗体フラグメントおよび一本鎖抗原結合ドメイン(ScFv)からなる群のメンバーをさらに含んでいてもよい。ペプチドは、たとえば、遺伝性疾患により欠損しているタンパク質、非ヒト型グリコシル化タンパク質、非ヒトタンパク質、ヒトに天然には見出されない合成タンパク質、ヒト食物抗原、ヒト移植抗原およびヒト自己免疫抗原からなる群から選択される寛容誘導抗原をさらに含んでいてもよい。ペプチドは、赤血球に特異的に結合する1つ以上の配列を有してもよく、配列は、同じ配列の反復でも、または前記結合を行う様々な配列を混合したものでもよい。
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Claims (8)
- 抗原特異的免疫トレランスを誘導するための薬学的に許容される組成物であって、該組成物は、赤血球結合部分と組換え的に融合された、または化学的にコンジュゲートされた、寛容誘導抗原を含み、
ここで、該赤血球結合部分は、血液においてin situでヒト赤血球に非共有結合的に特異的に結合する能力を有し、さらに他の血液成分と比べ赤血球に対して高い親和性を有する、ペプチドリガンド、抗体、抗体フラグメント、一本鎖可変フラグメント(scFv)、またはアプタマーを含み、かつ
該寛容誘導抗原が、外来抗原を含み、ここで該外来抗原は、食物抗原である、
組成物。 - セリアック病を治療するための、請求項1に記載の組成物。
- 食物抗原が、ピーナッツ、リンゴ、乳、キウイ、カラシナ、セロリ、エビ、コムギおよび/もしくは他の穀類、イチゴ、ならびに/またはバナナ由来である、請求項1に記載の組成物。
- 食物抗原が、コンアラキン(Ara h 1)、アレルゲンII(Ara h 2)、ピーナッツアグルチニン、コングルチン(Ara h 6)、31kdaの主要アレルゲン/耐病性タンパク質ホモログ(Mal d 2)、脂質転移タンパク質前駆物質(Mal d 3)、主要アレルゲンMal d 1.03D(Mal d 1)、α−ラクトアルブミン(ALA)、ラクトトランスフェリン、アクチニジン(Act c 1、Act d 1)、フィトシスタチン、タウマチン様タンパク質(Act d 2)、キウェリン(Act d 5)、2Sアルブミン(Sin a 1)、11Sグロブリン(Sin a 2)、脂質転移タンパク質(Sin a 3)、プロフィリン(Sin a 4)、プロフィリン(Api g 4)、高分子量糖タンパク質(Api g 5)、Pen a 1アレルゲン(Pen a 1)、アレルゲンPen m 2(Pen m 2)、速筋トロポミオシンアイソフォーム、高分子量グルテニン、低分子量グルテニン、α−およびγ−グリアジン、ホルデイン、セカリン、アベニン、主要イチゴアレルギーFra a 1−E(Fra a 1)、プロフィリン(Mus xp 1)から選択される、請求項3に記載の組成物。
- 赤血球結合部分と組換え的に融合された、または化学的にコンジュゲートされた寛容誘導抗原を含む、セリアック病を予防または治療するための医薬組成物であって、
ここで、該赤血球結合部分は、血液においてin situでヒトグリコホリンAに結合する、抗体、抗体フラグメント、または一本鎖可変フラグメント(scFv)を含み、かつ
該寛容誘導抗原が、セリアック病患者が望ましくない免疫応答を示す食物抗原を含む、
組成物。 - セリアック病を予防または治療するための請求項5に記載の医薬組成物であって、該寛容誘導抗原が、組織トランスグルタミナーゼ、グリアジン、高分子量グルテニン、低分子量グルテニン、α−グリアジン、γ−グリアジン、ホルデイン、セカリン、もしくはアベニン、またはそれらの一部分を含む、組成物。
- 非経口投与用に製剤化される、請求項1から6のいずれかに記載の組成物。
- 該寛容誘導抗原が、共刺激分子の影響を受けることなくそれが特異的に結合する赤血球のアポトーシスの際に免疫系に提示される、請求項1から6のいずれかに記載の組成物。
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Publication number | Priority date | Publication date | Assignee | Title |
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JP2018135348A (ja) * | 2010-08-10 | 2018-08-30 | エコール・ポリテクニーク・フェデラル・ドゥ・ローザンヌ(ウペエフエル)Ecole Polytechnique Federale de Lausanne (EPFL) | 赤血球結合療法 |
JP2018127458A (ja) * | 2012-02-15 | 2018-08-16 | エコール・ポリテクニーク・フェデラル・ドゥ・ローザンヌ(ウペエフエル)Ecole Polytechnique Federale de Lausanne (EPFL) | 赤血球結合治療剤 |
JP2020147591A (ja) * | 2012-02-15 | 2020-09-17 | エコール・ポリテクニーク・フェデラル・ドゥ・ローザンヌ(ウペエフエル)Ecole Polytechnique Federale de Lausanne (EPFL) | 赤血球結合治療剤 |
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EP2603520A2 (en) | 2013-06-19 |
US20210238277A1 (en) | 2021-08-05 |
JP2017008046A (ja) | 2017-01-12 |
CN108117586A (zh) | 2018-06-05 |
CN103282380B (zh) | 2018-02-16 |
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AU2019257362A1 (en) | 2019-11-14 |
CA2807942C (en) | 2021-07-27 |
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