AU2005270660A1 - Bacterial delivery system - Google Patents

Bacterial delivery system Download PDF

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AU2005270660A1
AU2005270660A1 AU2005270660A AU2005270660A AU2005270660A1 AU 2005270660 A1 AU2005270660 A1 AU 2005270660A1 AU 2005270660 A AU2005270660 A AU 2005270660A AU 2005270660 A AU2005270660 A AU 2005270660A AU 2005270660 A1 AU2005270660 A1 AU 2005270660A1
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helicobacter
pylori
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Barry J. Marshall
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  • Medicines Containing Antibodies Or Antigens For Use As Internal Diagnostic Agents (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
  • Medicines Containing Material From Animals Or Micro-Organisms (AREA)
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Description

WO 2006/015445 PCT/AU2005/001211 BACTERIAL DELIVERY SYSTEM FIELD OF THE INVENTION 5 The present invention relates to the delivery of biologically active agents in vivo. In particular, the present invention relates to treating, palliating or preventing diseases using a bacterial delivery system for delivering biologically active agents directly to an 10 anatomical site in vivo. In one embodiment, the bacterial delivery system comprises Helicobacter or bacterium exhibiting Helicobacter features for delivering heterologous nucleic acid into an animal or animal cell, wherein the heterologous nucleic acid is expressed. In a 15 further embodiment the Helicobacter has been engineered to contain a DNA vector that encodes heterologous nucleic acid, wherein upon infection the nucleic acid vector is expressed such that the biologically active agent is delivered to the animal body, especially at the mucosa. 20 BACKGROUND TO THE INVENTION There is a continuing need for long-term delivery of pharmacologic and immunologic agents to individuals with 25 both congenital and acquired diseases. In most cases, this involves repeated administration of therapeutic compounds several times per day, daily or at intervals. However, it is appreciated that any long-term therapeutic or preventive regime has problems such as compliance, side effects and 30 drug resistance. Consequently, there is a constant need to identify treatments, which will be usually 100% effective, free from side effects and cheap. One form of delivery that has'been investigated in recent 35 times for various therapeutic and prophylactic agents has been the use of microorganisms. Genes of interest from various organisms including bacteria, viruses, parasites as WO 2006/015445 PCT/AU2005/001211 -2 well as mammals have, for example, been cloned into a variety of bacteria, viruses and mycobacteria for the purpose of directing these micro-organisms to express foreign protein or impart certain desired properties. These 5 microorganisms have been used in vaccination programs, gene-replacement therapies and therapeutic composition delivery. Microorganisms have also been used to transform animal 10 (host) cells in vivo. Host cell transformation can be accomplished using gene-delivery vectors comprising replication incompetent viruses (see for example U.S. Pat. No. 5,824,544), naked DNA, (see for example U.S. Pat. No. 6,261,834), liposomes containing recombinant expression 15 cassettes (see for example U.S. Pat. No. 6,271,207). Other molecular-based therapeutic composition delivery approaches include using replication incompetent recombinant viruses designed to express heterologous surface proteins (see, for example, U.S. Pat. No. 6,376,236). 20 In recent times, pharmaceutical researchers have also attempted to develop methods for in vivo therapeutic composition expression using recombinant organism-based vectors, inanimate vectors and naked DNA. Examples of 25 recombinant organism-based vectors include recombinant bacteria (see for example U.S. Pat. No. 5,547,664) and viruses such as alphaviruses (see for example U.S. Pat. No. 6,391,632), vaccinia viruses (see for example U.S. Pat. No. 6,267,965), adenoviruses (see for example U.S. Pat. No. 30 5,698,202) and adenovirus associated virus (AAV) (see for example U.S. Pat. No. 6,171,597). Inanimate vectors include lipidic gene delivery vector constructs such as DNA/cationic liposome complexes, DNA encapsulated in neutral or anionic liposomes, and liposome-entrapped, 35 polycation-condensed DNA (LPDI and LPDII). (see Ropert, 1999, Braz J Med Biol Res, 32(2):163-9).
WO 2006/015445 PCT/AU2005/001211 -3 Examples of other genes that have been delivered by various bacteria include cloning the invasion genes of Shigella into the normally non-invasive E. coli rendering the E. coli invasive and therefore more suitable for use as a 5 vaccine strain, or cloning of Plasmodium falciparum malaria genes into Salmonella typhimurium which subsequently express these malaria proteins and, following oral administration of the bacteria, induce specific cytotoxic T cell immunity and protection in mice against malaria 10 challenge (see, for example, Hone et al., 1991, Vaccine, 9:810-816; Tacket et al., 1992, Infect. Immun., 60:536-541; Hone et al., 1992, J. Clin. Invest., 90:412-420; Chatfield et al., 1992, Vaccine, 10:8-11; Tacket et al., 1992, Vaccine, 10:443-446; and Mims et al., 1993, In: Medical 15 Microbiology, Eds., Mosby-Year Book Europe Ltd., London; Sadoff et al., 1988, Science, 240:336-338; Aggrawal et al., 1990, J. Exp. Med., 172:1083-1090). Attenuated or less virulent Shigella (see, for example, 20 Noriega et al., 1994, Infect. Immun., 62:5168-5172; US Pat. Appl. No. 20020176848), Salmonella (see, for example, US Pat. No. 6,531,313; US Pat. Appl. No. 20030170211), Listeria (see, for example, Schafer et al., 1992, J. Immunol., 149:53-59; US Pat. Appl. No. 20030008839), and 25 other bacteria have been given orally to immunise against subsequent infection with more virulent forms of these bacteria. Likewise, attenuated bacterial and mycobacterial organisms such as Bacille Calmette-Guerin (BCG) (Lagranderie et al., 1993, Vaccine, 11:1283-1290; Flynn, 30 1994, Cell. Molec. Biol., 40(Suppl. 1):31-36) have been administered parenterally to protect against related organisms such as M. tuberculosis. Some of the other bacterial species that have been used as 35 vectors include Yersinia enterocolitica (van Damme et al., 1992, Gastroenterol., 103:520-531) and Vibrio cholerae (Levine et al., 1994, In: Vibrio cholerae, Molecular to WO 2006/015445 PCT/AU2005/001211 -4 Global Perspective's, Wachsmuth et al., Eds, ASM Press, Washington, D.C., pages 395-414). Despite all of the research all of the above bacterial 5 delivery systems have technical difficulties, which need to be overcome before these can be used in vivo. Indeed, most of the bacterial systems require the bacteria themselves to produce functional molecules and are dependent on a bacterium which is sufficiently attenuated to be safe for 10 use in humans, but still able to produce biologically active agents. However, all of the attenuated strains of bacteria used previously are not capable of surviving lengthy periods in vivo, without causing side effects. More importantly, many of these bacterial species are not 15 capable of delivering therapeutic or prophylactic agents to the mucosal epithelial cells of an animal. However, many of the most important therapeutic agents are taken up via the mucosa; therefore there is a need for a bacterial delivery system capable of delivering biologically active 20 agents directly to the mucosa. U.S. Pat. No. 5,877,159 to Powell et al., describes live bacteria that can invade mucosal cells without establishing a productive infection or causing disease to thereby 25 introduce a eukaryotic expression cassette encoding an antigen capable of being expressed by the animal cells. While this method allows delivery of the DNA vaccine to mucosal surfaces, including easy administration, a concern for vaccine delivery in developing countries, it does not 30 have the advantage of providing amplifiable mRNA encoding the gene of interest. Moreover, the bacterium disclosed in Powell et al. is not capable of sustained delivery. Non-pathogenic, non-colonising, non-invasive food-grade 35 bacterium Lactococcus lactis has been used previously in the past to deliver agents to the mucosa (see, for example, UK patent GB-2278358B). However, while Lactococcus lactis WO 2006/015445 PCT/AU2005/001211 -5 is non-invasive it is not capable of establishing a chronic infection, which is capable of delivering continuous therapeutic agents directly into mucosal epithelial cells. 5 Consequently, there is a continuing need for a delivery system, which is capable of establishing a non-invasive, chronic infection in close proximity to the mucosal epithelial cells of an animal such that biologically active agents can be delivered thereto. Moreover, there is a 10 continuing need for improved delivery mechanisms for pharmacologically active molecules at the mucosal surface sufficient to elicit a useful and beneficial immunogenic response. Such would provide an effective in vivo delivery system for pharmacological active agents, as well as an 15 effective method for immunization, i.e., antigen exposure at mucosal surface sufficient to elicit a general humoral and mucosal immune response. SUMMARY OF THE INVENTION 20 The present invention is directed to overcoming the above mentioned challenges and is exemplified in a number of implementations and applications, some of which are summarized below. 25 The inventors have now surprisingly found that Helicobacter and in particular Helicobacter pylori, which is capable of forming a chronic infection, can be used to produce continuous drug delivery. Moreover, Helicobacter of the 30 present invention can be activated and inactivated at various times and because of its chronicity, the Helicobacter can be used to deliver drugs through the gastric mucosa. 35 Helicobacter pylori is a gram-negative spiral shaped bacterium found almost exclusively in the human gastric mucosa. The acidity of the human stomach is an effective WO 2006/015445 PCT/AU2005/001211 -6 barrier to colonization by essentially all bacteria, with the exception of Helicobacter species. H. pylori has the unique ability to colonize and persist 5 for decades within the human gastric mucosa, despite development of a mucosal inflammatory and immune response. This characteristic renders H. pylori an interesting candidate for the delivery of selected agents though the mucosa. 10 In accordance with some aspects, compositions, methods and systems are provided for preparing and using a Helicobacter-based construct comprising a Helicobacter sequence having a promoter region and a non-Helicobacter 15 sequence encoding a non-Helicobacter pharmacologically active molecule. This construct in some embodiments is described as a vector or a plasmid vector, wherein the promoter sequence is capable of controlling the expression of the non-Helicobacter pharmacologically active molecule 20 of interest. Accordingly, in a first aspect the present invention provides a method of delivering one or more biologically active agents to a subject comprising the step of 25 administering to a subject an effective amount, preferably a therapeutically or prophylactically effective amount of, Helicobacter cells or bacterial cells having the features of Helicobacter, which cells express said one or more biologically active agents. 30 In a second aspect, the present invention provides a non invasive or non-pathogenic Helicobacter cell expressing one or more heterologous biologically active agents. 35 Preferably, the Helicobacter is of the species H. pylori. The biologically active agent can be either homologous to WO 2006/015445 PCT/AU2005/001211 -7 the Helicobacter genus or heterologous to cells of the genus or species of the Helicobacter cells used for delivery. Heterologous agents may be derived from either eukaryotic or prokaryotic sources. 5 In some aspects, the Helicobacter-based vector and vector plasmid constructs comprise biologically active agents such as an antigen, organic or inorganic molecule or substance, a pharmacological agent eg a therapeutic agent or 10 prophylactic agent, such as a gene product or gene sequence (isolated nucleic acid). By way of example, such agents may include an immunoregulatory agent, hormone, ligand, an enzyme or an anti-sense RNA, a catalytic RNA, a protein, a peptide or any other molecule which can be present on or 15 released from the bacterial cells so that it may be delivered to an animal or to an animal cell. In some embodiments, the biologically active agent is encoded by a nucleic acid molecule, which is preferably 20 obtained in isolated form, and subsequently inserted into the bacterial delivery vehicle of this invention. It will be appreciated by those skilled in the art that the isolated nucleic acid molecule of the present invention may be cDNA, genomic DNA, RNA, or a hybrid molecule thereof. 25 Preferably, the nucleic acid is cDNA. By way of example, a protein and/or peptide of interest may comprise ghrelin, amylin, insulin, motilin, P-glucosidase, a chemical chaperone, or other molecule useful in the 30 treatment of Gauchers disease, cell wasting, human immunodeficiency disease (AIDS), appetite suppression, preparations useful in the treatment of diabetes, etc. The isolated nucleic acid is preferably incorporated into 35 an expression vector, which can be transformed into and maintained in the Helicobacter cells.
WO 2006/015445 PCT/AU2005/001211 -8 Accordingly, in a third aspect, the present invention provides a recombinant vector for delivering biologically active agents directly to an anatomical site in need thereof. The Helicobacter cell of the present invention has 5 preferably been adapted to secrete and/or express on its surface the biologically active agents. In a fourth aspect, the present invention provides a vector or construct for delivering in vivo an effective amount of 10 a biologically active agent, comprising: a) a nucleotide sequence encoding a biologically active agent; b) operatively linked thereto, a control or regulatory sequence capable of controlling the expression 15 of the nucleotide sequence of (a) such that the biologically active agent is produced in vivo when the delivery vehicle comprising the vector is delivered to a subject. 20 The vector maybe modified chemically by means of chemical or enzymatic treatment, or in vivo by means of recombinant DNA technology to produce a modified or variant vector. Such a construct may differ from those disclosed, for 25 example, by virtue of one or more nucleotide substitutions, deletions or insertions, but substantially retain a desired biological activity of the construct or nucleic acid molecule, or its encoded product, in accordance with this invention. 30 In another embodiment of the present invention, the Helicobacter vector or construct is provided with a reporter gene(s) expressed from a constitutive promoter cloned into the expression vector and used as a screening 35 tool. Non-limiting examples of reporter genes suitable for use herein include green fluorescent protein (GFP), $ galactosidase, amylase, and chloramphenicol acetyl WO 2006/015445 PCT/AU2005/001211 -9 transferase (CAT). In another embodiment of the present invention the Helicobacter cell is used to deliver a heterologous gene of 5 interest to a subject in need thereof. The gene of interest may encode a therapeutic product (a transgene product), including, but not limited to a peptide hormone (such as, but not limited to a-melanocyte-stimulating hormone (a-MSH), insulin, growth hormone, and parathyroid hormone), 10 a cytokine including, but not limited to an interferon, interleukin (IL)-2, IL-4, IL-10, IL-12, granulocyte colony stimulating factor (G-CSF), granulocyte-macrophage colony stimulating factor (GM-CSF) and erythropoietin (EPO). 15 In still another embodiment, the present invention provides methods for treating, palliating or preventing a disease in a subject. These methods are facilitated with the use of a therapeutic or prophylactic composition. Accordingly, in a fifth aspect, the present invention provides a 20 pharmaceutical composition comprising (a) live non pathogenic Helicobacter cells expressing and/or secreting a biologically active agent, together with (b) a therapeutically effective carrier. 25 In a sixth aspect the present invention provides a method of treating, preventing or palliating a disease comprising administering to a subject in need thereof an effective amount of a Helicobacter cells of the present invention that express the biologically active agent. 30 Non-limiting examples of subjects in which the present invention may be used, include mammals such as primates, equines, bovines, porcines, ovines and rodents. Also intended are fish and birds. 35 In one embodiment of the present invention the disease being treated, prevented or palliated is cancer, a disease WO 2006/015445 PCT/AU2005/001211 - 10 or condition of the immune/hemnatopoietic system, a disease or condition of the reproductive system, a disease or condition of the musculoskeletal system, a disease or condition of the cardiovascular system, a disease or a 5 condition described as mixed fetal, a disease or a condition of the excretory system, a disease or a condition of the neural/sensory system, a disease or a condition of the endocrine system, a disease or condition of the respiratory system, a disease or condition of the digestive 10 system and a disease or condition associated with connective/epithelial tissue or disease or conditions caused by bacterial, viral or parasitic infection. The present invention provides a variety of 15 pharmaceutically acceptable preparations formulated for delivery to a patient, such as, gastrically, orally, or intranasaly. In particular embodiments, the composition are suitable for delivery at a mucosal surface. In particular embodiments, the composition is suitable for 20 delivery to the mucosal surface of the gut. By way of example, the mucosa may be that of the gastric, vaginal, nasal, oral, or ocular surface, or any other of the body characterized by the presence of a penetrable 25 mucosal surface or lining. In some embodiments, the mucosal surface is the gastric mucosal surface. The various delivery forms of the compositions are readily prepared for use in the practice of the present invention 30 given the specific types and ratios of specific Helicobacter, Helicobacter constructs and other delivery vehicles described herein, and those formulation techniques known to those in the formulary arts, such as are described in Remington's Pharmaceutical Sciences, 20th edition, Mack 35 Publishing Company, which text is specifically incorporated herein by reference.
WO 2006/015445 PCT/AU2005/001211 - 11 It is envisioned that the delivery System may be employed in animals, particularly primates, including humans, equines, bovines, ovines, and rodents, fish and birds. It is also anticipated that the preparations may be used on 5 both infants and adults, as well as parentally or for administration to pregnant or lactating animals. The preparations and methods may be further described as suitable for both male and female animals. 10 In yet another aspect, a method is provided for vaccinating an animal. In some embodiments, the method comprises administering a composition comprising a vaccine comprising cells transformed with the Helicobacter- based plasmid vector and/or plasmid vectors as described herein. In 15 other embodiments, the method provides for the delivery of an effective amount of the pharmacologically active molecule of interest sufficient to eliminate or inhibit a disease or physiological condition in the animal, or sufficient to elicit an immune response specific for the 20 pharmacologically active molecule of interest. By way of example, the non-Helicobacter pharmacologically active molecule of interest useful in the vaccine may comprise a mammalian protein, peptide, enzyme, hormone, or 25 any combination of these. In particular embodiments, the pharmacologically active molecule of interest is further defined as a human pharmacologically active molecule of interest. In some embodiments the pharmacologically active molecule of interest is a human pathogen molecule/antigen, 30 human protein antigen, such as amylin or an analog or derivative thereof, or ghrelin, or an analog or derivative thereof. In particular embodiments, the vaccine conveys immunity 35 against the human pathogen, Ebola virus, HIV virus, Marburg virus, influenza virus, and the like. Replication competent vaccines based on attenuated recombinant vesicular WO 2006/015445 PCT/AU2005/001211 - 12 stomatitis virus vectors have been described by Jones et al. (2005, Nat. Med. 11: 786-90) that include Ebola glycoprotein and Marburg glycoprotein. Hence, it is envisioned that constructs using the Helicobacter-based 5 vector systems and plasmid vector systems with these and other glycoprotein's associated with human pathogens may also be provided according to the present invention together with the disclosure provided herein. 10 BRIEF DESCRIPTION OF THE FIGURES Figure 1 is a schematic diagram of the plasmid construct pHPAl (2.8kb). 15 Figure 2 is a schematic diagram of the plasmid construct pHP3 (3.4kb). Figure 3 is a schematic diagram of the plasmid vector pTMI03-8. 20 Figure 4 shows the structure of sulfasalazine (SSN). Figure 5 is a schematic diagram showing the use of ion exchange resin (Amberlite XE-96) conjugated with a dye 25 (Azure-A). BRIEF DESCRIPTION OF THE SEQUENCES The following nucleic acid and amino acid sequences are 30 referenced throughout the description of the present invention: SEQ ID NO: 1 - Nucleotide sequence of plasmid pHP1 (2796 nucleotides); 35 SEQ ID NO: 2 - Nucleotide sequence of pHP1 (2796 nucleotides); WO 2006/015445 PCT/AU2005/001211 - 13 SEQ ID NO: 3 - Nucleotide sequence of plasmid pHP3 (3444 nucleotides); 5 SEQ ID NO: 4 - Hepatitis C virus are antigen (HCV) nucleotide Sequence; SEQ ID NO: 5 - Nucleotide sequence 135 bp (45 amino acids) immunogenic coding sequence from the Hepatitis C virus 10 (HCV) core antigen; SEQ ID NO: 6 - Nucleotide sequence of the surface exposed loop of the HopE gene (at nt504, aa position 168) of H. pylori; 15 SEQ ID NO: 7 - Upstream primer (29 nucleotides); SEQ ID NO: 8 - Downstream Primer (28 nucleotides); 20 SEQ ID NO: 9 - Oligonucleotide Primer (15 nucleotides). DEFINITION OF TERMS Prior to setting forth the invention, it may be helpful to 25 an understanding thereof to set forth definitions of certain terms that will be used hereinafter. An "antibiotic resistance gene" as defined herein includes heterologous nucleic acid sequences purposely provided to a 30 vector and used as a selection system. The term "antibiotic resistance gene" does not include other mechanisms or genes that impart antibiotic resistance to naturally occurring micro-flora organisms. 35 The term "attenuated" as used herein for example to describe a bacterial strain, particularly an E. coli or a Helicobacter strain such as Helicobacter pylori, is defined WO 2006/015445 PCT/AU2005/001211 - 14 as a strain that is less virulent and/or toxic (invasive) that a native, wild type bacterial strain. The term "biologically active" as used herein refers to 5 ability to perform a biological function and with reference to a polypeptide implies that the polypeptide adopts a stable conformation ("folded form") which is the same or closely analogous to its native conformation. When folded correctly or substantially correctly, for example with 10 formation of proper folded units a-helices, 0-sheets, domains, disulphide bridges etc., a polypeptide should have the ability to perform its natural function. Generally, the unit of function in a polypeptide is a domain. 15 Mere ability to be bound by an antibody or other receptor, either with or without elicitation of an immune response, is passive or does not constitute "biological activity". Any antigen has the ability to be bound by an antibody but is not necessarily biologically active. 20 "Clinical grade vector" as used herein means a plasmid or other expression vector that is capable of being expressed in Helicobacter or a non-pathogenic bacterium engineered to have features of Helicobacter. The clinical grade vectors 25 of the present invention do not use antibiotic resistance markers for selection and/or have been modified to prevent replication outside the host e.g. such as a suicide vector. An example of suicide system in H. pylori has been 30 described by Panthel et al. 2003 (Infection & Immunity, 71: 109-116). This system introduces a plasmid into H. pylori which contains the PhiX174 lysis gene E. To eradicate the strain, incubation at 42'C for 5 hours was used. In vivo this would mean that the animal would consume a drink at 35 45-50 0 C to raise the temperature of the gastric environment above 42'C.
WO 2006/015445 PCT/AU2005/001211 - 15 A second example is the L-Dap selection system, commonly used to allow survival of bacterial mutants on supplemented plates (see, for example, Kirata et al. 1997 (Infection & Immunity, 65: 4158-4164). In this system the animal subject 5 must supplement their diet with a missing substrate i.e. diamino-pimelic-acid (DAP), in order for the DapE deficient H. pylori mutant to survive. In order to eradicate the then DAP consumption is ceased. 10 A third possible system relates to metronidazole sensitivity of H. pylori because of its rdxA gene. Excessive replication of the rdxA gene is harmful to mammalian cells and E. coli. However, duplication may be tolerated by the bacterium. Therefore a Helicobacter 15 species of the present invention can be engineered to contain two copies of rdxA which prevent the normal mutation-dependant rdxA loss. The introduction of at least two functional rdxA genes into the Helicobacter genome should result in a Helicobacter strain, which is 20 permanently sensitive to metronidazole. Jeong et al. 2000 (J. Bacteriol., 182: 5082-5090) showed that the nitroreductase produced by a functional rdxA gene converts metronidazole from a prodrug to a bactericidal compound. The mode of action of the active compound is to cause DNA 25 breaks of the Helicobacter genome. "Detectable immune response" as used herein is either an antibody (humoral) or cytotoxic (cellular) response formed in an animal in response to an antigen that can be measured 30 using routine laboratory methods including, but not limited to enzyme-linked immunosorbant assays (ELISA), radio-immune assays (RIA), Enzyme-linked ImmunoSPOT- (ELISPOT), immunofluorescent assays (IFA), complement fixation assays (CF), Western Blot (WB) or an equivalent thereto. 35 "Gene of interest" as used herein refers to any nucleic acid sequence encoding for a polypeptide or protein whose WO 2006/015445 PCT/AU2005/001211 - 16 expression is desired. The gene of interest may or may not include the promoter or other regulatory components. The gene of interest also includes constructs capable of producing anti-sense RNA. 5 "Gene therapy" as used herein is defined as the delivery of a gene of interest to an animal in need thereof using a recombinant vector. The gene of interest can be a transgene encoding for a therapeutic or prophylactic protein or 10 polypeptide including, but not limited to cytokines, anti inflammatories, anti-proliferatives, antibiotics, metabolic inhibitors/activators and immunologically active antigens and fragments thereof. Furthermore, "gene therapy" as used herein also includes gene replacement technologies directed 15 at both inherited and non-inherited disorders. The term Helicobacter includes all bacteria of the genus Helicobacter including H. pylori and H. mustelae. The term also includes bacteria that have similar biology to H. 20 pylori in that they are capable of residing on the gastric mucosa of primates and/or capable of establishing a chronic, but isolated infection of the mucosa. The term also encompasses bacteria that have been modified so that the bacterium has H. pylori features such as the ability to 25 reside on the gastric mucosa. A "heterologous" polypeptide is one not native to Helicobacter, i.e., not expressed by Helicobacter in nature or prior to introduction into Helicobacter, or an ancestor 30 thereof, of encoding nucleic acid for the biologically active agent. "Host" as used herein defines the intended recipient of a therapeutic composition of the present invention. Host 35 includes all animals. Specifically, hosts include, but are not limited to, primates (including man), bovine, equine, canine, feline, porcine, ovine, rabbits, rodents, birds and WO 2006/015445 PCT/AU2005/001211 - 17 fish. "Immunologically inert" as used herein shall mean any substance, including microorganisms such as microflora that 5 does not provoke a significant immune response in its host. Examples of immunologically inert materials as used herein include stainless steel, biocompatible polymers such as poly-L-lactide, medical grade plastics and the microflora organisms of the present invention. A "significant immune" 10 response is any immune response that would limit or restrict the in vivo utility of a material or organism used in accordance with the teachings of the present invention. A detectable immune response is not necessarily a "significant immune response." 15 An "isolated nucleic acid" is a nucleic acid the structure of which is not identical to that of any naturally occurring nucleic acid or to that of any fragment of a naturally occurring genomic nucleic acid spanning more than 20 three separate genes. The term therefore covers, for example, (a) a DNA molecule which has the sequence of part of a naturally occurring genomic DNA molecule but is not flanked by both of the coding sequences that flank that part of the molecule in the genome of the organism in which 25 it naturally occurs; (b) a nucleic acid incorporated into a vector or into the genomic DNA of a prokaryote or eukaryote in a manner such that the resulting molecule is not identical to any naturally occurring vector or genomic DNA; (c) a separate molecule such as a cDNA, a genomic fragment, 30 a fragment produced by polymerase chain reaction (PCR), or a restriction fragment; and (d) a recombinant nucleotide sequence that is part of a hybrid gene, i.e., a gene encoding a fusion protein. Specifically excluded from this definition are nucleic acids present in mixtures of (i) DNA 35 molecules, (ii) transfected cells, and (iii) cell clones, e.g., as these occur in a DNA library such as a cDNA or genomic DNA library.
WO 2006/015445 PCT/AU2005/001211 - 18 "Percent identity (homology)" of two amino acid sequences or of two nucleic acids is determined using the algorithm of Karlin and Altschul, 1990, Proc. Natl. Acad. Sci. USA, 5 87:2264-2268, 1990, modified as in Karlin and Altschul (Proc. Natl. Acad. Sci. USA 90:5873-5877, 1993). Such an algorithm is incorporated into the NBLAST and XBLAST programs of Altschul et al. (J. Mol. Biol. 215:403-410, 1990). BLAST nucleotide searches are performed with the 10 NBLAST program, score=100, wordlength=12, to obtain nucleotide sequences homologous to a nucleic acid molecule of the invention. BLAST protein searches are performed with the XBLAST program, score=50, wordlength=3, to obtain amino acid sequences homologous to a reference polypeptide (eg., 15 SEQ ID NO: 2). To obtain gapped alignments for comparison purposes, Gapped BLAST is utilised as described in Altschul et al. (Nucleic Acids Res. 25:3389-3402, 1997). When utilising BLAST and Gapped BLAST programs, the default parameters of the respective programs (eg., XBLAST and 20 NBLAST) are used. These maybe found on the World Wide Web at the URL "ncbi.nim.nih.gov." The term "reporter gene" as used herein is a nucleic acid sequence incorporated into (or adjacent to) the 25 heterologous nucleic acid encoding for the gene of interest that provides the transformed vector expressing the gene of interest an identifiable phenotype. Non-limiting examples of reporter genes include GFP, 0-galactosidase, amylase, and CAT. 30 "Screening marker" as used herein refers to an identifying characteristic (phenotype) provided to a transformed vector made in accordance with the teachings of the present invention. In one embodiment of the present invention the 35 screening marker is a reporter gene. "Selectable marker," "selectable gene," "reporter gene" and WO 2006/015445 PCT/AU2005/001211 - 19 "reporter marker" (referred to hereinafter as a "selectable marker") as used herein refer to nucleic acid sequences encoding for phenotypic traits that permit the rapid identification and isolation of a transformed bacterial 5 vector. Generally, bacterial vectors deemed "clinical grade" and made in accordance with the teachings of the present invention are those vectors having selectable markers that do not encode for antibiotic resistance. 10 "Transgene" as used herein refers to a gene that is inserted, using cDNA technology, into a cell in a manner that ensures its function, replication and transmission as a normal gene. 15 "Transforming nucleic acid sequence" as used herein means a plasmid, or other expression cassette containing a nucleic acid sequence encoding a gene of interest. In some embodiments of the present invention the nucleic acid sequence can encode for one or more therapeutic agents. 20 "Transforming nucleic acid sequence" can also be used to mean a "transgene" in accordance with certain embodiments of the present invention. In another embodiment of the present invention the transforming nucleic acid sequence includes nucleic acid sequence encoding for a promoter 25 and/or other regulatory elements. The term "cancer" as used herein refers to neoplastic diseases (e.g., leukemia, cancers and "hyperproliferative disorders"). The neoplasm may be located in a tissue 30 selected from the group consisting of: colon, abdomen, bone, breast, digestive system, liver, pancreas, prostate, peritoneum, lung, blood (e.g., leukemia), endocrine glands (adrenal, parathyroid, pituitary, testicles, ovary, thymus, thyroid), uterus, eye, head and neck, nervous (central and 35 peripheral), lymphatic system, pelvic, skin, soft tissue, spleen, thoracic, and urogenital.
WO 2006/015445 PCT/AU2005/001211 - 20 In one embodiment the term "cancer" also encompasses pre neoplastic conditions selected from the group consisting of hyperplasia (e.g., endometrial hyperplasia), metaplasia (e.g., connective tissue metaplasia and/or dysplasia (e.g., 5 cervical dysplasia, and bronchopulmonary dysplasia). In another embodiment, the term "cancer" also encompasses benign dysproliferative disorder selected from the group consisting of: benign tumors, fibrocystic conditions, and 10 tissue hypertrophy. The term "a disease or condition of the immune/haematopoietic system" as used herein refers to a disease or condition selected from the group consisting of: 15 anaemia, pancytopenia, leukopenia, thrombocytopenia, leukemia, Hodgkin's disease, non-Hodgkin's lymphoma, acute lymphocytic anaemia (ALL), plasmacytomas, multiple myeloma, Burkitt's lymphoma, arthritis, asthma, AIDS, autoimmune disease, rheumatoid arthritis, granulomatous disease, 20 immune deficiency, inflammatory bowel disease, sepsis, neutropenia, neutrophilia, psoriasis, immune reactions to transplanted organs and tissues, systemic lupus erythematosis, haemophilia, hypercoagulation, diabetes mellitus, endocarditis, meningitis, Lyme Disease, Celiac 25 disease and allergies. The term "a disease or condition of the reproductive system" as used herein refers to a disease or condition selected from the group consisting of: cryptorchism, 30 prostatitis, inguinal hernia, varicocele, leydig cell tumours, verrucous carcinoma, prostatitis, malacoplakia, Peyronie's disease, penile carcinoma, squamous cell hyperplasia, dysmenorrhea, ovarian adenocarcinoma, Turner's syndrome, mucopurulent cervicitis, Sertoli-leydig tumours, 35 ovarian cancer, uterine cancer, pelvic inflammatory disease, testicular cancer, prostate cancer, Klinefelter's syndrome, Young's syndrome, premature ejaculation, diabetes WO 2006/015445 PCT/AU2005/001211 - 21 mellitus, cystic fibrosis, Kartagener's syndrome, testicular atrophy, testicular feminization, anorchia, ectopic testis, epididymitis, orchitis, gonorrhoea, syphilis, testicular torsion, vasitis nodosa, germ cell 5 tumours, stromal tumours, dysmenorrhea, retroverted uterus, endometriosis, fibroids, adenomyosis, anovulatory bleeding, amenorrhoea, Cushing's syndrome, hydatidiform moles, Asherman's syndrome, premature menopause, precocious puberty, uterine polyps, dysfunctional uterine bleeding, 10 cervicitis, chronic cervicitis, mucopurulent cervicitis, cervical dysplasia, cervical polyps, Nabothian cysts, cervical erosion, cervical incompetence, cervical neoplasms, pseudohermaphroditism, and premenstrual syndrome. 15 The term "a disease or condition of the musculoskeletal system" as used herein refers to a disease or condition selected from the group consisting of: bone cancers (e.g., osteochond'romas, benign chondromas, chondroblastoma, 20 chondromyxoid fibromas, osteoid osteomas, giant cell tumours, multiple myeloma, osteosarcomas), Paget's Disease, rheumatoid arthritis, systemic lupus erythematosus, osteomyelitis, Lyme Disease, gout, bursitis, tendonitis, osteoporosis, osteoarthritis, muscular dystrophy, 25 mitochondrial myopathy, cachexia, and multiple sclerosis. The term "a disease or condition of the cardiovascular system" as used herein refers to a disease or condition selected from the group consisting of: myxomas, fibromas, 30 rhabdomyomas, cardiovascular abnormalities (e.g., congenital heart defects, cerebral arteriovenous malformations, septal defects), heart disease (e.g., heart failure, congestive heart disease, arrhythmia, tachycardia, fibrillation, pericardial Disease, endocarditis), cardiac 35 arrest, heart valve disease (e.g., stenosis, regurgitation, prolapse), vascular disease (e.g., hypertension, coronary artery disease, angina, aneurism, arteriosclerosis, WO 2006/015445 PCT/AU2005/001211 - 22 peripheral vascular disease), hyponatremia, hypematremia, hypokalemia, and hyperkalemia. The term "a disease or condition described as mixed fetal" 5 as used herein refers to a disease or condition selected from the group consisting of: spina bifida, hydranencephaly, neurofibromatosis, fetal alcohol syndrome, diabetes mellitus, PKU, Down's syndrome, Patau syndrome, Edwards syndrome, Turner syndrome, Apert syndrome, 10 Carpenter syndrome, Conradi syndrome, Crouzon syndrome, cutis laxa, Cornelia de Lange syndrome, Ellis-van Creveld syndrome, Holt-Oram syndrome, Kartagener syndrome, Meckel Gruber syndrome, Noonan syndrome, Pallister-Hall syndrome, Rubinstein-Taybi syndrome, Scimitar syndrome, Smith-Lemli 15 Opitz syndrome, thromocytopenia-absent radius (TAR) syndrome, Treacher Collins syndrome, Williams syndrome, Hirschsprung's disease, Meckel's diverticulum, polycystic kidney disease, Turner's syndrome, and gonadal dysgenesis, Klippel-Feil syndrome, Ostogenesis imperfecta, muscular 20 dystrophy, Tay-Sachs disease, Wilm's tumour, neuroblastoma, and retinoblastoma. The term "a disease or condition of the excretory system" as used herein refers to a disease or condition selected 25 from the group consisting of: bladder cancer, prostate cancer, benign prostatic hyperplasia, bladder disorders (e.g., urinary incontinence, urinary retention, urinary obstruction, urinary tract Infections, interstitial cystitis, prostatitis, neurogenic bladder, hematuria), 30 renal disorders (e.g., hydronephrosis, proteinuria, renal failure, pyelonephritis, urolithiasis, reflux nephropathy, and unilateral obstructive uropathy). The term "a disease or condition of the neural/sensory 35 system" as used herein refers to a disease or condition selected from the group consisting of: brain cancer (e.g., brain stem glioma, brain tumours, central nervous system WO 2006/015445 PCT/AU2005/001211 - 23 (Primary) lymphoma, central nervous system lymphoma, cerebellar astrocytoma, and cerebral astrocytoma, neurodegenerative disorders (e.g., Alzheimer's Disease, Creutzfeldt-Jakob Disease, Parkinson's Disease, and 5 Idiopathic Presenile Dementia), encephalomyelitis, cerebral malaria, meningitis, metabolic brain diseases (e.g., phenylketonuria and pyruvate carboxylase deficiency), cerebellar ataxia, ataxia telangiectasia, and AIDS Dementia Complex, schizophrenia, attention deficit disorder, 10 hyperactive attention deficit disorder, autism, and obsessive compulsive disorders. The term "a disease or condition of the respiratory system" as used herein refers to a disease or disorder selected 15 from the group consisting of: cancers of the respiratory system such as larynx cancer, pharynx cancer, trachea cancer, epiglottis cancer, lung cancer, squamous cell carcinomas, small cell (oat cell) carcinomas, large cell carcinomas, and adenocarcinomas. Allergic reactions, cystic 20 fibrosis, sarcoidosis, histiocytosis X, infiltrative lung diseases (e.g., pulmonary fibrosis and lymphoid interstitial pneumonia), obstructive airway diseases (e.g., asthma, emphysema, chronic or acute bronchitis), occupational lung diseases (e.g., silicosis and 25 asbestosis), pneumonia, and pleurisy. The term "a disease or condition of the endocrine system" as used herein refers to a disease or condition selected from the group consisting of: cancers of endocrine tissues 30 and organs (e.g., cancers of the hypothalamus, pituitary gland, thyroid gland, parathyroid glands, pancreas, adrenal glands, ovaries, and testes), diabetes (e.g., diabetes insipidus, type I and type II diabetes mellitus), obesity, disorders related to pituitary glands (e.g., 35 hyperpituitarism, hypopituitarism, and pituitary dwarfism), hypothyroidism, hyperthyroidism, goiter, reproductive disorders (e.g., male and female infertility), disorders WO 2006/015445 PCT/AU2005/001211 - 24 related to adrenal glands (e.g., Addison's Disease, corticosteroid deficiency, and Cushing's Syndrome), kidney cancer (e.g., hypemephroma, transitional cell cancer, and Wilm's tumour), diabetic nephropathy, interstitial 5 nephritis, polycystic kidney disease, glomerulonephritis (e.g., IgM mesangial proliferative glomerulonephritis and glomerulonephritis caused by autoimmune disorders; such as Goodpasture's syndrome), and nephrocalcinosis. 10 The term "a disease or condition of the digestive system" as used herein refers to a disease or condition selected from the group consisting of: ulcerative colitis, appendicitis, Crohn's disease, hepatitis, hepatic encephalopathy, portal hypertension, cholelithiasis, cancer 15 of the digestive system (e.g., biliary tract cancer, stomach cancer, colon cancer, gastric cancer, pancreatic cancer, cancer of the bile duct, tumours of the colon (e.g., polyps or cancers), and cirrhosis), pancreatitis, ulcerative disease, pyloric stenosis, gastroenteritis, 20 gastritis, gastric atropy, benign tumours of the duodenum, distension, irritable bowel syndrome, malabsorption, congenital disorders of the small intestine, bacterial and parasitic infection, megacolon, Hirschsprung's disease, aganglionic megacolon, acquired megacolon, colitis, 25 anorectal disorders (e.g., anal fistulas, haemorrhoids), congenital disorders of the liver (e.g., Wilson's disease, hemochromatosis, cystic fibrosis, biliary atresia, and alpha 1-antitrypsin deficiency), portal hypertension, cholelithiasis, and jaundice. 30 The term "a disease or condition of the connective / epithelial" as used herein refers to a disease or condition selected from the group consisting of: connective tissue metaplasia, mixed connective tissue disease, focal 35 epithelial hyperplasia, epithelial metaplasia, mucoepithelial dysplasia, graft v. host disease, polymyositis, cystic hyperplasia, cerebral dysplasia, WO 2006/015445 PCT/AU2005/001211 - 25 tissue hypertrophy, Alzheimer's disease, lymphoproliferative disorder, Waldenstron's macroglobulinemia, Crohn's disease, pernicious anaemia, idiopathic Addison's disease, glomerulonephritis, bullous 5 pemphigoid, Sjogren's syndrome, diabetes mellitus, cystic fibrosis, osteoblastoma, osteoclastoma, osteosarcoma, chondrosarcoma, osteoporosis, osteocarthritis, periodontal disease, wound healing, relapsing polychondritis, vasculitis, polyarteritis nodosa, Wegener's granulomatosis, 10 cellulitis, rheumatoid arthritis, psoriatic arthritis, discoid lupus erythematosus, systemic lupus erythematosus, scleroderma, CREST syndrome, Sjogren's syndrome, polymyositis, dermatomyositis, mixed connective tissue disease, relapsing polychondritis, vasculitis, Henoch 15 Schonlein syndrome, erythema nodosum, polyarteritis nodosa, temporal (giant cell) arteritis, Takayasu's arteritis, Wegener's granulomatosis, Reiter's syndrome, Behcet's syndrome, ankylosing spondylitis, cellulitis, keloids, Ehler Danlos syndrome, Marfan syndrome, pseudoxantoma 20 elasticum, osteogenese imperfecta, chondrodysplasias, epidermolysis bullosa, Alport syndrome, and cutis laxa. The term "a" and "the" as used in the present descriptive is intended to include both one (the singular) and more 25 than one (plural). A "therapeutically effective amount" of an active agent or combination of agents as described herein is understood to comprise an amount effective to elicit the desired response 30 but insufficient to cause a toxic reaction. A desired response, for example, may constitute the formation of a sufficient and/or acceptable detectable antibody titer level in a blood sample. The dosage and duration of treatment of the preparation to be administered to a 35 subject will be determined by the health professional attending the subject in need of treatment, and will consider the age, sex, weight, extent of existing diseased WO 2006/015445 PCT/AU2005/001211 - 26 state and/or tissue damage of the subject, and specific formulation of Helicobacter and the gene of interest product being used as the treatment for the subject. 5 The phrase, "effective level" refers to the level of the desired activity of the molecules and not necessarily limited to the number of molecules. For example, the effective level of amylin may be decreased to stimulate ghrelin secretion by using amylin antagonists, without a 10 necessary concomitant decrease in the amount of free amylin present in a subject. The phrase "ghrelin-associated diseases and disorders" refers to any condition that can be treated prevented or 15 ameliorated through the modulation of ghrelin activity. These include conditions that are enhanced, exacerbated or stimulated by ghrelin, for example, growth hormone release or drive to eat. The physiological actions of ghrelin are considered to include, by way of example, the stimulation 20 of growth hormone release, the stimulation of hormone secretion from lactotrophs and corticotropes, orexigenic and cardiovascular actions, anti-proliferative effects on thyroid and breast tumors and regulation of gastric motility and acid secretion through vagal mediation. (See 25 WO 2005021026). Throughout the specification, unless the context requires otherwise, the word "comprise" or variations such as "comprises" or "comprising", will be understood to imply 30 the inclusion of a stated integer or group of integers but not the exclusion of any other integer or group of integers. Where the definition of terms departs from the commonly 35 used meaning of the term, applicant intends to utilize the definitions provided herein, unless specifically indicated.
WO 2006/015445 PCT/AU2005/001211 - 27 DETAILED DESCRIPTION OF THE INVENTION Before describing the present invention in detail, it is to 5 be understood that this invention is not limited to particularly exemplified methods and may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments of the invention only, and is not intended to 10 be limiting which will be limited only by the appended claims. All publications, patents and patent applications cited herein, whether supra or infra, are hereby incorporated by 15 reference in their entirety. However, publications mentioned herein are cited for the purpose of describing and disclosing the protocols, reagents and vectors which are reported in the publications and which might be used in connection with the invention. Nothing herein is to be 20 construed as an admission that the invention is not entitled to antedate such disclosure by virtue of prior invention. Furthermore, the practice of the present invention employs, 25 unless otherwise indicated, conventional immunological and molecular biological techniques and pharmacology within the skill of the art. Such techniques are well known to the skilled worker, and are explained fully in the literature. See, eg., Coligan et al. "Current protocols in Protein 30 Science" (1999) Volume I and II (John Wiley & Sons Inc.); Sambrook et al., (Molecular Cloning: A Laboratory Manual, 2 & 3 rd Editions, Cold Spring Harbor Laboratory press (1989) (2001); and Bailey, J.E. and Ollis, D.F., Biochemical Engineering Fundamentals, McGraw-Hill Book 35 Company, NY, 1986. It must be noted that as used herein and in the appended WO 2006/015445 PCT/AU2005/001211 - 28 claims, the singular forms "a," "an," and "the" include plural reference unless the context clearly dictates otherwise. Thus, for example, a reference to "a nucleic acid" includes a plurality of such nucleic acids, and a 5 reference to "an isolated peptide" is a reference to one or more peptides, and so forth. Unless defined otherwise, all technical and scientific terms used herein have the same meanings as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any 10 materials and methods similar o'r equivalent to those described herein can be used to practice or test the present invention, the preferred materials and methods are now described. 15 Delivery of therapeutic compositions and nucleic acids to specific target sites within the animal body is an ongoing challenge faced by the drug development industry. The present inventor has developed a Helicobacter-based bacterial delivery system capable of carrying vectors 20 encoding biologically active agents, wherein these agents are expressed on the surface of the bacterium, or secreted therefrom. In one embodiment, the bacterium is a species of Helicobacter. More preferably, H. pylori. In some embodiments the strain of H. pylori can be any strain known 25 in the field. In some embodiments, the H. pylori strain is a non-pathogenic strain such as genomic strain 26695. In another embodiment, a bacterium, other than Helicobacter, is utilised wherein the bacterium has been 30 genetically altered such that it has Helicobacter or H. pylori features including the ability to chronically colonise the gastric mucosa or other areas of gastrointestinal tract, urinary tract, bronchial epithelium or other mucosal organ, without significant toxicity to the 35 host. In one embodiment, the H. pylori has been manipulated so WO 2006/015445 PCT/AU2005/001211 - 29 that some of the pathogenic features have been removed and/or attenuated. For example, the vacuolating cytotoxin and the cag pathogenicity island genes can be removed so that the H. pylori is less pathogenic. In one embodiment, 5 the H. pylori has been manipulated so that some of the pathogenic features have been removed and/or attenuated. For example, the vacuolating cytotoxin and the cag pathogenicity island genes can be removed so that the H. pylori are less pathogenic. Attenuating mutations can be 10 introduced into Helicobacter using non-specific mutagenesis either chemically, using N-methyl-N-nitro-N nitrosoquanidine, or using recombinant DNA technologies. The skilled person will appreciate that the methods of the 15 present invention could be used to deliver a range of biologically active agents. Examples of suitable agents include ones which are capable of functioning locally or systemically, eg an agent capable of exerting endocrine activities affecting local or whole-body metabolism and/or 20 an agent which is capable of regulating the activities of cells belonging to the immuno/haemopoeitic system and/or an agent which is capable of affecting the viability, growth and differentiation of a variety of normal or neoplastic cells in the body or affecting the immune regulation or 25 induction of acute phase inflammatory responses to injury and infection and/or an agent which is capable of enhancing or inducing resistance to infection of cells and tissues mediated by chemokines acting on their target cell receptors, or the proliferation of epithelial cells or the 30 promotion of wound healing and/or an agent which modulates the expression or production of substances by cells in the body. Specific examples of such biologically active agents 35 include insulin, growth hormone, prolactin, calcitonin, luteinising hormone, parathyroid hormone, somatostatin, thyroid stimulating hormone, vasoactive intestinal WO 2006/015445 PCT/AU2005/001211 - 30 polypeptide, a structural group 1 cytokine adopting an antiparallel 4 a helical bundle structure such as IL-2, IL 3, IL-4, IL-5, IL-6, IL-7, IL-9, IL-10, IL-11, IL-12, IL 13, GM-CSF, M-CSF, SCF, IFN-y, EPO, G-CSF, LIF, OSM, CNTF, 5 GH, PRL or IFN a/p, a structural group 2 cytokine which are often cell-surface associated, form symmetric homotrimers and the subunits take up the conformation of p-jelly roll described for certain viral coat proteins such as the tumor necrosis factor (TNF) family of cytokines, eg TNF a, TNF P, 10 CD40, CD27 or FAS ligands, the IL-1 family of cytokines, the fibroblast growth factor family, the platelet derived growth factors, transforming growth factor P and nerve growth factors, a structural group 3 cytokine comprising short chain a/P molecules, which are produced as large 15 transmembrane pre-cursor molecules which each contain at least one epidermal growth factor (EGF) domain in the extracellular region, e.g., the EGF family of cytokines, the chemokines characterised by their possession of amino acid sequences grouped around conserved cysteine residues 20 (the C--C or C--X--C chemokine subgroups) or the insulin related cytokines, a structural group 4 cytokine which exhibit mosaic structures such as the heregulins or neuregulins composed of different domains, e.g., EGF, immunoglobulin-like and kringle domains. 25 Alternatively, the biologically active agent can be a receptor or antagonist for biologically active agent as defined above. 30 In some embodiments, the H. pylori-based vector and/or vector plasmid construct is employed to create transformed cells (such as an E. coli or Helicobacter cell) that permits the expression and/or secretion of a biologically active agent from an isolated nucleic acid molecule 35 contained within it at the mucosa surface of a host to which the transformed cell preparation is administered. The isolated nucleic acid contained within the transformed cell WO 2006/015445 PCT/AU2005/001211 - 31 (or vector) may comprise one or more nucleic acid constructs in which nucleic acid encoding the biologically active agent is under control of appropriate regulatory sequences for expression in the H. pylori. 5 Suitable vectors and shuttle vector sequences comprising nucleic acid for introduction into H. pylori can be chosen or constructed, to contain appropriate regulatory sequences, including promoter sequences, terminator 10 fragments, enhancer sequences, marker genes and other sequences as appropriate. Vectors may be plasmids, viral eg. phage or phagemid, as appropriate. For further details see, for example, Sambrook et al., supra. Many known techniques and protocols for manipulation of nucleic acid, 15 for example in preparation of nucleic acid constructs, mutagenesis, sequencing, introduction of DNA into cells and gene expression, and analysis of proteins, are described in detail in Short Protocols in Molecular Biology, Second Edition, Ausubel et al. eds., John Wiley & Sons, 1992. The 20 disclosures of Sambrook et al. supra and Ausubel et al. are incorporated herein by reference. In some embodiments, the coding sequence for the biologically active agent is contained in an operon, i.e., 25 a nucleic acid construct for multi-cistronic expression. In an operon, transcription from the promoter results in a mRNA which comprises more than one coding sequence, each with its own suitably positioned ribosome binding site upstream. Thus, more than one agent can be translated from 30 a single mRNA. Use of an operon enables expression of the biologically active agent to be coordinated. A nucleic acid construct or vector comprising a coding sequence for a biologically active agent of the present 35 invention is preferably under the control of a promoter for expression in H. pylori.
WO 2006/015445 PCT/AU2005/001211 - 32 In one embodiment, the promoter employed in accordance with the present invention is expressed constitutively in the H. pylori. Use of a constitutive promoter avoids the need to supply an inducer or other regulatory signal for expression 5 to take place. Preferably, the promoter directs expression at a level at which the H. pylori host cell remains viable, i.e., retains some metabolic activity, even if growth is not reduced. Advantageously then, such expression may be at a low level. For example, where the expression product 10 accumulates intracellularly, the level of expression may lead to accumulation of the expression product at less than about 10% of cellular protein, preferably about or less than about 5%, for example about 1-3%. 15 The promoter may be homologous to the H. pylori strain employed, i.e., one found in that strain of H. pylori in nature. In some embodiments the promoter is arabinose inducible promoter. Other promoters include FlaB sigma 54 promoter (Josenhans et al., 1998, FEMS Microbiol Lett, 20 161(2): 263-73), T7 promoter, and nir B promoter of salmonella (Chatfield et al., 1992, Biotechnology, 10(8): 888-92). In another embodiment the promoter is inducible. Inducible 25 promoters that may be used with the clinical grade vectors include, but are not limited to, a pH inducible promoter as described in U.S. Pat. No. 6,242,194 issued to Kullen et al., a lactose inducible promoter such as that used in E. coli plasmids (e.g., pBluescript"m from Stratagene) or the 30 endogenous lactose promoter in Lactobacillus; promoters induced during anaerobic growth such as the promoter for alcohol dehydrogenase (adhE), as described in Aristarkhov et al., 1999, J. Bacteriology, Vol. 178(14), 4327-4332. 35 In one embodiment, the constructs of the present invention also include a toxic gene. These toxic genes are preferably under the control of inducible promoters so WO 2006/015445 PCT/AU2005/001211 - 33 that, on completion of treatment, the Helicobacter of the present invention can be readily eliminated by inducing the expression of the toxic gene. Non-limiting examples of toxic genes include bacterial autolysins under the control 5 of an inducible promoter. The autolysing gene may then be triggered at the appropriate time and place in the gastrointestinal tract through the use of one or more of the inducible promoters described immediately above. 10 In some embodiment, the engineered Helicobacter vector and plasmid vector constructs are sensitive to oxygen. This oxygen sensitivity is another method for limiting dissemination of the clinical grade vectors of the present invention. The environment of the human gut is very low in 15 oxygen, suitable for growth of anaerobic and microaerophilic microorganisms, including Helicobacter. Thus, an efficient means of eliminating Helicobacter delivery vehicles once they have exited the human body upon discharge of intestinal waste into the oxygen-rich outside 20 environment, is to engineer genes into the transformed micro-organisms that confer oxygen sensitivity. The nucleic acid construct or constructs of the present invention may comprise a secretory signal sequence. Thus, 25 in some embodiments the nucleic acid encoding the biologically active agent eg non-Helicobacter polypeptide, may provide for secretion of the agent at a cell membrane by appropriately coupling a nucleic acid sequence encoding a secretory signal sequence to the nucleic acid sequence 30 encoding the molecule (polypeptide). The ability of Helicobacter harbouring the nucleic acid to secrete the polypeptide may be tested in vitro in culture conditions, which maintain viability of the Helicobacter. 35 Suitable secretory signal sequences include any of those with activity in Gram negative organisms such as Escherichia, Klebsiella and Salmonella. Secretory signal WO 2006/015445 PCT/AU2005/001211 - 34 sequences may include the secretion leader of the Staphylokinase enzyme secreted by some strains of Staphylococcus, which is known to function in both Gram positive and Gram-negative hosts (see "Gene Expression 5 Using Bacillus", Rapoport (1990) Curr Opin Biotech 1:21 27). Other secretory signal sequences that can be used include, for example, the P-lactamase gene (Talmadge et al., 1980, 10 Proc. Natl. Acad. Sci. USA 77:3369-3373) or the enteroinvasive E. coli hemolysin A (hlyA) (Su et al., 1992, Microbial Pathogen, 13:465-476). An illustrative list of secretory signal sequences is presented in Pugsley, 1988, Protein secretion across the outer membrane of gram 15 negative bacteria. In: Protein Transfer and organelle Biogenesis, R. C. Dand and P. W. Robbins (eds), Academic Press, Inc., San Diego, pp 607-652. Selectable markers provide researchers and technicians a 20 convenient means for distinguishing transformed microorganisms from non-transformed ones in a mixed population. One means of identifying transformed organism is to incorporate a selectable marker nucleic acid sequence into the plasmid containing the gene of interest. The 25 selectable marker sequence is generally inserted downstream of the gene of interest and is driven off the same promoter. As a result, cells successfully transformed with the gene of interest will also be transformed with selectable marker nucleic acid sequence. When antibiotic 30 resistance is used as the selectable marker, only transformed cells will survive and/or grow in media containing the antibiotic. Thus, antibiotic resistance is a convenient and much used 35 phenotype when developing transformants. However, vectors having antibiotic resistant genes as selective markers are capable of horizontal gene transfer that can endow other WO 2006/015445 PCT/AU2005/001211 - 35 organisms with antibiotic-resistant phenotypes. This risk is especially acute when Helicobacter is used as part of a therapeutic vector. 5 In order to use Helicobacter as a gene delivery system to animals, the present disclosure presents, in some embodiments, a clinical grade vector system that does not use an antibiotic selection marker. One of the alternatives to using antibiotic resistance genes provided by the 10 present delivery systems includes clinical grade vectors having chromosomal deletions or lethal mutations in an essential "house-keeping" gene. Next, a functional analogous house-keeping gene is inserted into a plasmid encoding for a gene of interest. Consequently, the "house 15 keeping" gene becomes the selectable marker allowing for the rapid isolation and identification of transformants. Examples of essential "house-keeping" genes include genes that encode for any number of metabolic regulators and/or 20 enzymes including, but not limited to kinases, proteases, synthetases, dehydrogenases and others. Another alternative to antibiotic resistance genes provided by the present invention includes clinical grade vectors having reporter genes incorporated into the plasmid containing the gene of 25 interest. Other non-limiting examples of reporter genes used in accordance with the teachings of the present invention include green fluorescent Protein (GFP), galactosidase and amylase. 30 In one embodiment, the biologically active polypeptide preferably has cytokine activity. Cytokines are discussed in "The Cytokine Facts Book", Callard and Gearing (1994), Academic Press. Preferred polypeptides with cytokine activity are interleukins, including Interleukin-2 (IL-2) 35 and Interleukin 6 (IL-6). In some embodiments, the Helicobacter delivery system, WO 20061015445 PCT/AU2005/001211 - 36 vector or vector plasmid system comprises a nucleic acid construct as described above is introduced into a Helicobacter or other suitable host cell, to provide transformed cells. Thus, a further aspect of the present 5 invention provides a method comprising introducing nucleic acid as disclosed into a non-pathogenic Helicobacter. The transformation of a culture of host cells, such as Helicobacter, may employ any available technique. For H. pylori cells, suitable techniques may include calcium 10 chloride transformation, electroporation and transfection using bacteriophage. The introduction of the vector plasmid into a Helicobacter cell may be followed by causing or allowing expression from 15 the nucleic acid, e.g., by culturing H. pylori under conditions for expression of the gene. Growing the Helicobacter in culture under conditions for expression of the biologically active polypeptide may be employed to verify that the Helicobacter contain the encoding nucleic 20 acid and is able to produce the encoded material. In a further aspect, the present invention provides a method of delivering a therapeutic or prophylactic dose of a biologically active agent in vivo, the method comprising 25 administering to a subject an effective amount of the non pathogenic preparation of the H. pylori compositions and vaccines of the present invention. It will be appreciated that the methods of the present 30 invention and the use of a non-invasive or non-pathogenic Helicobacter as described herein provide a wide range of therapeutic methods which would enable the skilled person to manipulate, for instance, the immume response of a subject. Thus, in one aspect the present invention provides 35 a method of regulating the survival, growth, differentiation, effector functions or susceptibility to infection of cells or tissues which comprises administering WO 2006/015445 PCT/AU2005/001211 - 37 to a subject a non-invasive or non-pathogenic Helicobacter as defined herein. In another aspect, a method of boosting an immune response 5 against tumour cells or an infection colonising a mucosal surface or adjacent or distant tissue is provided which comprises administering to a subject a non-invasive or non pathogenic Helicobacter as defined herein. 10 In yet another aspect, a method of modulating the type of immune response (antibody versus cell-mediated) against a pathogenic infectious agent is provided which comprises administering to a subject a non-invasive or non-pathogenic Helicobacter as defined herein. 15 In another aspect, a' method of modulating the infiltration of normal tissues with inflammatory or tumour cells is provided which comprises administering to a subject a non invasive or non-pathogenic Helicobacter as defined herein. 20 In some aspects a method of controlling the rate of growth, rate of invasion or survival of tumour cells is provided which comprises administering to a subject a non-invasive or non-pathogenic Helicobacter as defined herein. 25 In yet another aspect a method of inducing apoptosis in tumour cells is provided which comprises administering to a subject a non-invasive or non-pathogenic Helicobacter as defined herein. 30 Other aspects provided for a method of down-regulating an immune response is provided which comprises administering to a subject a non-invasive or non-pathogenic bacterium which expresses a biologically active agent. 35 In another aspect a method of treating an allergic autoimmune or other immune dysregulative disease state is WO 2006/015445 PCT/AU2005/001211 - 38 provided, which comprises administering to a subject a non invasive or non-pathogenic Helicobacter which expresses a biologically active agent. 5 The subject can be any primate, equine, bovine, porcine, ovine, rodent, fish, or bird. In one embodiment, the subject is human. Administration may conveniently be nasal or oral. 10 In a therapeutic context, i.e., where the biological effect of delivery of the biologically active agent to a subject is beneficial to that subject, administration is preferably in a "therapeutically effective amount", this being sufficient to show benefit to a subject. Such benefit may 15 be at least amelioration or reduce the severity or occurrence of at least one symptom. In a prophylactic context, the amount may be sufficient to reduce the deleterious effect on the subject of a subsequent pathogenic challenge, for instance by enhancing the immune 20 response. The actual amount administered, and rate and time-course of administration will depend on the aim of the administration, e.g. the biological effect sought in view of the nature and severity of the challenge, and is the subject of routine optimisation. Prescription of treatment, 25 including prophylactic vaccination, for example decisions on dosage etc, is within the responsibility of general practitioners and other medical doctors. A composition comprising Helicobacter may be administered 30 in accordance with the present invention alone or in combination with other treatments, either simultaneously or sequentially. The present invention also provides a pharmaceutical 35 composition comprising a Helicobacter as disclosed. Such a pharmaceutical composition is in one embodiment preferably suitable for application to a mucosal membrane.
WO 2006/015445 PCT/AU2005/001211 - 39 Pharmaceutical compositions according to the present invention, and for use in accordance with the present invention, may comprise, in addition to the Helicobacter, a 5 pharmaceutically acceptable excipient, carrier, buffer, stabiliser or other materials well known to those skilled in the art. Such materials should be non-toxic and should not interfere with the efficacy of the active ingredient. The precise nature of the carrier or other material may 10 depend on the route of administration. For oral administration a parenterally acceptable aqueous solution may be employed which is pyrogen-free and has suitable pH, isotonicity and stability. Those of relevant skill in the art are well able to prepare suitable solutions. 15 Preservatives, stabilisers, buffers, antioxidants and/or other additives may be included, as required. As discussed, a pharmaceutical comprising a Helicobacter for administration in accordance with the present invention may comprise one or more nutrient substances, e.g., an energy 20 source such as glucose, amino acids and so on. In another aspect, the present invention provides a method of manufacture of pharmaceutical formulations comprising formulating Helicobacter as disclosed with a suitable 25 carrier medium suitable for administration to an individual. In one embodiment, the pharmaceutical is suitable for application to a mucosal membrane of an individual. 30 In another aspect, the present invention provides a non pathogenic Helicobacter expressing a heterologous biologically active polypeptide for pharmaceutical use, e.g., for use in a method of treatment of the human or animal body by surgery or therapy, including prophylaxis 35 ("vaccination"). In one embodiment the methods of the present invention can WO 2006/015445 PCT/AU2005/001211 - 40 be used to treat, prevent or palliate a disease such as cancer. The methods and deliver system can also be used to treat or prevent a disease or condition of the immune/haematopoietic system, a disease or condition of the 5 reproductive system, a disease or condition of the musculoskeletal system, a disease or condition of the cardiovascular system, a disease or condition described as mixed fetal, a disease or condition of the excretory system, a disease or condition of the neural/sensory 10 system, a disease or condition of the endocrine system, a disease or condition of the respiratory system, a disease or condition of the digestive system and a disease or condition associated with connective/epithelial tissue or a disease or condition caused by bacterial, viral or 15 parasitic infection. In another embodiment, the Helicobacter delivery system described herein is capable of concomitant or sequential delivery of a number of different nucleic acid molecules, 20 which encode products capable of treating a number of conditions or diseases as described herein. Moreover, preferred delivery systems would also deliver compositions capable of producing additional desirable physiological effects such as appetite suppression or enhancement. 25 An example of suicide system in H. pylori has been described by Panthel et al. 2003 (Infection & Immunity, 71: 109-116). This system introduces a plasmid into H. pylori which contains the PhiX174 lysis gene E. To eradicate the 30 strain, incubation at 420C for 5 hours was used. In vivo this would mean that the animal would consume a drink at 45-50*C to raise the temperature of the gastric environment above 420C. 35 A second example is the L-Dap selection system, commonly used to allow survival of bacterial mutants on supplemented plates (see, for example, Kirata et al. 1997 (Infection & WO 2006/015445 PCT/AU2005/001211 - 41 Immunity, 65: 4158-4164). In this system the animal subject must supplement their diet with a missing substrate i.e., diamino-pimelic-acid (DAP), in order for the DapE deficient H. pylori mutant to survive. In order to eradicate the 5 mutants, DAP consumption is ceased. A third possible system relates to metronidazole sensitivity of H. pylori because of its rdxA gene. Excessive replication of the rdxA gene is harmful to 10 mammalian cells and E. coli. However, duplication may be tolerated by the bacterium. Therefore a Helicobacter species of the present invention can be engineered to contain two copies of rdxA which prevent the normal mutation-dependant rdxA loss. The introduction of at least 15 two functional rdxA genes into the Helicobacter genome will result in a Helicobacter strain that is permanently sensitive to metronidazole. Jeong et al. 2000 (J. Bacteriol., 182: 5082-5090) showed that the nitroreductase produced by a functional rdxA gene converts metronidazole 20 from a prodrug to a bactericidal compound. The mode of action of the active compound is to cause DNA breaks of the Helicobacter genome. The invention will now be further described by reference 25 only to the following non-limiting examples. It should be understood, however, that the examples following are illustrative, and should not be taken in any way as a restriction on the generality of the invention described herein. In particular, while the invention is described in 30 detail in relation to the use of a specific H. pylori strain, it will be clearly understood that the findings herein are not limited to this strain. 35 WO 2006/015445 PCT/AU2005/001211 - 42 EXAMPLE 1 VECTORS AND TRANSGENIC H. pylori ORGANISMS FOR STABLE EXPRESSION OF FOREIGN PROTEINS The genetic manipulation of H. pylori is uncommon. The 5 present example demonstrates the utility of the invention for providing a genetically transformed Helicobacter, particularly transformed H. pylori. The transformed bacterium are prepared using plasmids and plasmid vectors derived from Helicobacter, which have had been subject to 10 prior manipulation in a non-Helicobacter organism, such as E. coli. Several H. pylori plasmids described in the literature can be successfully converted to H. pylori/E. coli shuttle 15 vectors. Many strains of E. coli have been reported to be naturally competent for DNA uptake. Resistance markers for streptomycin, rifampin and metronidazole have also been successfully transformed into most strains of H. pylori. However, while plasmid DNA from E. coli and other organisms 20 can be introduced into H. pylori these plasmids cannot be stably maintained. Moreover, H. pylori plasmids cannot be transformed into E. coli or Helicobacter species. Accordingly, H. pylori shuttle vectors must be constructed. 25 Two plasmids from H. pylori are illustrated in the schematics shown in Figures 1 and 2. Vectors pHPAl (2.8kb) (Fig. 1) and pHP3 (3.4kb) (Fig. 2) have been sequenced and it has been revealed that pHPAl replicated via the theta mode of plasmid replication. In contrast to rolling-circle 30 replicating plasmids, theta plasmids do not generate single-stranded DNA intermediates during replication and are thus more stable vector candidates because they are less prone to undergo illegitimate recombination. Furthermore, the pHPAl origin of replication (ori) contains 35 a series of direct repeat sequences (termed "iterons") that are involved in replication control and maintaining stable copy number. Vector pHP623 shares many of these features.
WO 2006/015445 PCT/AU2005/0012 11 - 43 The nucleotide sequences for these two vectors are shown below. (1) Plasmid pHP1 shown in double stranded form (top 5 strand is SEQ ID NO:l; bottom strand is SEQ ID NO:2) GTCATGCGCGTTGTTTTTAATTACATTTTAAACAACTTGTTGTTGTTTTTACATGTTTTACTCGC 65 ATGCGCGCGCGTGAGGGATTGGGGGTTGCAACCCCCTAATACGAACCTGTAGGGTTTCTCATT 130 10 TACGCGCGCGCACTCCCTAACCCCCAACGTTGGGGGATTTATTGCTTCGACATcCCWGAGTAA TTGGTAATATAAAACTTGCAATAAACTTGCAAT 195 AAACACCACTTTTACTTATTTTGTCTTGAAGAACGGTTGTGATTGTCTTGAGA\CGGTTGTGAT 15 ACGATCTCACCACGATCTCACCACGATCTATTA 260 TGTCTTGAAGAACGGTTGTGATTGTCTTGAGACGGTTGTGATTGTCTTGAGAAATAAAATTT GTTATGATTATTAACAATTTTTAGACATAATAACAGCGTGTGAAGATACTTTTCTAGCGGTATTT 325 20 CAATACTAATAATTGTTAAAAATCTGTATTATTGTCGCACACTTCTATCGAACATCGCCATAJA CCTATGTGCGGCAAAATTTGGAGCAJXTTAGCTTGACTTGGTTGAGTTAGTGGCTTGGAGGATAGA 390 GCATACACOCCGTTTTAAACCTCGTTAATCGAACTGAACCAACTCAATCACCC4JACCTCCTATCT GAGGGCGACACCTCGTTAGGAGGTATCAATGTGAAAGTATTTCTCCTATTAGTTCTAGTATTAGT 455 25 CTCCCGCTGTGGACCAATCCTCCATAGTTACACTTTCATAACAGCATATCJAGATCATAATCA AATTCTCGCACAATTGCTATATTAGGCTTATTCGTGGTCTACCCCTTGTTTATGGGGGTTGCT 520 TTAAGAGGGTGTTAACGATATAATCCGAATAGCACCAGATTCCGGACAAACTACCCCCAACCGA 3 0 CGTTATAAGCATACTGATACGATCACACTTATTATACACCAGATAAGGAGTATAGAGTGGAA 585 GCAATATTCGTATGACTATGCTAGTGTGAATP2ATATGTGGTTTTCTATTCCTCATATCTCACCTT TTTGATCAATCAGATTTACAAAGCGTTGAAATATTAATACACTCCCAAcACCCCACAAT 650 3571 ACTCGATGTTTTTGTTCTTTATGTTTTGGCGTAGTTGTTTTATTGTCTCTGTTAGTAATTTCTTA TACTATCAAAGCATGAAATCAAGAAAGAAGAACTAG?24CCCACTCTAACCCCAAJACCCACACCA 780 4 0 ATCATAGTTTCGTACTTTAGTTCTTTCTTCTTGATCTTGGGTGAGATTGGGGTTTTGCGTGTGGT CTCAAAGACCCACAAACCACCCCAACACCATGCAAJAGATTTAGTGGTTAGCACCCCTWGATAA84 GAGTTTCTCCGTCTTTGGTGGGGTTCTGGTACGTTTCTI±JATCACCATCGTGGGGATTTCTATT84 4 5 AACATTACACCAACCATAGCACAGAATACAAGA 910 TTGGATTATAGTGGATGGTGTTATTGCGATTATTCCAGTTAGATCCCTTTAACTCGCTTTCCCTT GCCAATCTTTTATTCGCTArTTTTCAAAAACTCAAAGCCCAAPGGGDJXTACCCTCATTCGTTTTGA 975 CGGTTAGAAAATAAGCGATAAAAAGTTTTTGAGTTTCGGGTTCCCTTATGGGAGTAAGCAAACT 50 ACCCCAAGATTTGAAACGCATGCTAAACATAGATATTTCTAATGAGCGCTTATCAAAGTCcTTA 1040 TCCCGTTCTAACTTTGCGTACGATTTGTATCTATAAGATTACTCGCGATAGTCTTCAGCAT TTACGGGTGATAACCGTTTGAATGGACGACTAT 1105 5 5 AATTCGACACCCTATCCTAATTTTGGCGACTAAACCTTTTAAJTCGCTTTGGCTTTGAAGTTAG ATTCAAGAAATTACATGCTTTTTAGTCGGTGTATTGATTGACAAACCGAGTAAGATTT 1170 TAAGTTCTTTTAATCTACCAAAAATCAGCCACATTTTACTTAACTTGTTTGGCTCATTTCTAAA 60 GAAGTATTTAGAAATCAACTCAACGATAACTATCAGACTTACTCACATCTGGGCATCCGTC 1235 CTTCATAAATCTTTAGGTTGAGTTGCTATTGATAGTTCTGAAJTCAGTTGTTAGACCCGTACCCAG AATACACTTCTTTCAATCTGTTAGAATTTCAAGAGTGAGGGGTAATACGCTAAACGCTCTAT 1300 65 TTATGTGAAGAAAGTTACACAATCTTAAAGTTTCTCACTCCCCATTTATGCGATTTTGCGAGATA CGCTTCCTCAAGCAATACAAAAGCACAGGGATTTTGAGCGTGGAATGGACTCATTCAGGGAGCT 1365 GCGAACGAGTTCGTTATGTTTTCGTGTCCCTAAAACTCGCACCTTACCTGAGTTAAGTCCCTCGA TTTAGACATTCCAAAAGACTACAAAATGGAAAACATCCATCAAAAAGTCTTAACCCCCTCTCTCA 1430 WO 2006/015445 PCT/AU2005/001211 - 44 AAATCTGTAAGGTTTTCTGATGTTTTACCTTTTGTAGCTAGTTTTTCAGAATTGGGGGAGAGAGT AAGAACTCAGAAAAATCTACCCTTTTGAACACTTGAGCTATAAAAAAGAACGCAAAAGCCATTAC 1495 5 TTCTTGAGTCTTTTTAGATGGGAAAACTTGTGAACTCGATATTTTTTCTTGCGTTTTCGGTAATG AAGCGCAAAGTAACCCACATTGATTTTTATTTTGAGCAATTTCCTTAAGGCGAAAATAAGAAACA 1560 TTCGCGTTTCATTGGGTGTAACTAAAAATAAAACTCGTTAAAGGAATTCCGCTTTTATTCTTTGT AAACAAAGCCGACAAGCAACGCGCTCAAAGGGACATCAAGCTTGTAGCATGGGATATTCACAACC 1625 10 TTTGTTTCGGCTGTTCGTTGCGCGAGTTTCCCTGTAGTTCGAACATCGTACCCTATAAGTGTTGG AAATCGCTAAAAGAAACGCAAAAGCCACTATGGAAGCTAGGTTTCTTGAATTGAAAACTTTGATC 1690 TTTAGCGATTTTCTTTGCGTTTTCGGTGATACCTTCGATCCAAAGAACTTAACTTTTGAAACTAG 15 GGCTATCAGTTCAGGAACAATGACAGTAGGAACAAATTAAAGATTGACAACACCACTTTTGAAAG 1755 CCGATAGTCAAGTCCTTGTTACTGTCATCCTTGTTTAATTTCTAACTGTTGTGGTGAAAACTTTC AATCAAATGTATTTACATGTATCTTAACCCTAAAAATAAGCATAACCCCCAA-AAATTCCTTGTAT 1820 20 TTAGTTTACATAAATGTACATAGAATTGGGATTTTTATTCGTATTGGGGGTTTTTAAGGAACATA CCAACAAGACATTCGCATTGGAACTACTATATATCAATAGATACAGCCTAAAAAAAAGACAACTT 1885 GGTTGTTCTGTAAGCGTAACCTTGATGATATATAGTTATCTATGTCGGATTTTTTTTCTGTTGAA GCTAGAAGAATTTAACCCCCCAAAATCCACCCTATCACCAACGAACCTATCAAGGAATTTGCAGA 1950 25 CGATCTTCTTAAATTGGGGGGTTTTAGGTGGGATAGTGGTTGCTTGGATAGTTCCTTAAACGTCT ATACATCGGCAAAACGATTAACATCACCAACTTCAATGTGGATCAATGCCATGAGGGAATCAGCA 2015 TATGTAGCCGTTTTGCTAATTGTAGTGGTTGAAGTTACACCTAGTTACGGTACTCCCTTAGTCGT 30 ACTACCTGACAATCACTAGGATCGTGAACTGGACGTAATCGGATCTGTATTTGGTCCAGATGTGG 2080 TGATGGACTGTTAGTGATCCTAGCACTTGACCTGCATTAGCCTAGACATAAACCAGGTCTACACC ATAAGCCTGGGACTTCTCAAGCCTTTCATTGCTAAAGTGAGAAAATTTGGGGATTGGTTCAAGAA 2145 TATTCGGACCCTGAAGAGTTCGGAAAGTAACGATTTCACTCTTTTAAACCCCTAACCAAGTTCTT CACTACAGGTGAAAAGACAGATGCATGCTGACTAAACTCATAGAAAAACTGAATCACGAAAGAAA 2210 GTGATGTCCACTTTTCTGTCTACGTACGACTGATTTGAGTATCTTTTTGACTTAGTGCTTTCTTT GAATGCAAGCAGAAAACAAACACCTAAAAGAACAAGGACTAGAAAAAATCTACACTCAAAAAGAC 2275 4 0 CTTACGTTCGTCTTTTGTTTGTGGATTTTCTTGTTCCTGATCTTTTTTAGATGTGAGTTTTTCTG TACGAGCAGTTAAAAGAACAGCATTTGAAAGAAATTGAAGCACTCAAAAAAGAAATCCAAAAAAC 2340 ATGCTCGTCAATTTTCTTGTCGTAAACTTTCTTTAACTTCGTGAGTTTTTTCTTTAGGTTTTTTG 45 CAAGCAAGAAACATACACGCAACCAAAAGAATGTAGCCATTTAGCGCATTCTTTTAGCCCTAATT 2405 GTTCGTTCTTTGTATGTGCGTTGGTTTTCTTACATCGGTAAATCGCGTAAGAAAATCGGGATTAA CATTCTTTCAATCAAAATCCGACTAATTCATCGGCTAAACGCTAAAAATCGCTTAAAACGAAAAA 2470 GTAAGAAAGTTAGTTTTAGGCTGATTAAGTAGCCGATTTGCGATTTTTAGCGAATTTTGCTTTTT TACAAAGCAAAAAACTTCATTCCCCTTTTAGTCGTTAACCATTTAGCCAATCTAACTAGTTTAGC 2535 ATGTTTCGTTTTTTGAAGTAAGGGGAAAATCAGCAATTGGTAAATCGGTTAGATTGATCAAATCG ATCTAAAGGCGAATCTATCTTGTGTTAGACATCCAACCTTACCAAAACCGCAGAGCGAGCTTAAG 2600 55 TAGATTTCCGCTTAGATAGAACACAATCTGTAGGTTGGAATGGTTTTGGCGTCTCGCTCGAATTC AGAGATTCAAGCGGTTTTGCACGATTGTTTGCTGCCAAGAAAACCAACAAGCGAAGTAAGGCGCA 2665 TCTCTAAGTTCGCCAAAACGTGCTAACAAACGACGGTTCTTTTGGTTGTTCGCTTCATTCCGCGT 60 TAGACAAAAGCGCATCGCAGTTTGAAAGCGTAGGCGTCAGAAGTGGTTTGCGTTAGAATCAAACA 2730 ATCTGTTTTCGCGTAGCGTCAAACTTTCGCATCCGCAGTCTTCACCAAACGCAATCTTAGTTTGT AGATAGCGCAAACCTGGCGTTAGGCTAAAAAACCCCTAAAAACTAAAACCCCAAAATATGTAGTGC 2796 TCTATCGCGTTTGGACCGCAATCCGATTTTTTGGGGATTTTTGATTTTGGGGTTTTATACATCACG 65 2) Plasmid pHP3 shown in single stranded form (SEQ ID NO:3): TCTACACAATTAACAATCTTTAGCTACAATAACAGCGTGTGAAGATGCTTTCACAGCGGT 60 70 ATTTCCTATGTGCGGCAAAATTTGGAGCAATTAACTTGACTTGGTTGGGTTAGTGGGTTG 120 WO 2006/015445 PCT/AU2005/00121 1 - 45 GAGGATAGRGAGGGCGACACCTCGTTAGGAGGTATCAATGTGAAAGTATTTGTCGTATTA 180 GTTCTAGTATTAGTAATTCTCGCACAZXTTGCTATATTAGGCTTATTTGTGGTCTAACCCC 240 TTGTTTATGGGGGTTAGATCCTTATAAGCATACTGATACGATCACACTTATTATACACCA 300 AAAGATAAGGAGTATAGAGTGGAATTTGATCAATTAGAATCACAAAGATCAGACTTACAA 360 5 AAAGTGTTAAAAGAATTAGATACACTCCCAAAAACCCCACAAATTGAGCTACAAAAACAA 420 GAAATACAAAACCGCATCAACAAAATAACAGACACAATCATTAAAGAATTACTATCAAAA 480 CATGAAATCAAAAAAGAAGAACTAGAACCCACTCTAACCCCAAAACCCACACCAACAAAA 540 GAGCCACAAACCACCCCCACACCATGCAAAAATTTAGTGGTTAGCACCCCTAAAGATAAA 600. ACCTATATCACCTACCACAATAACGCTAATAAGGTCAATCTAGGGAAATTGAGCGAAAGG 660 10 GAAGCCAATCTTTTATTCGCTATTTTTCAAAGGCTTAAAGATCAAGGGAATACCCTCATT 720 CGTTTTGAACCGCAAGATTTAAAACGCATGATCATGGTCAAATCCAACTTAACCAACAGG 780 CAATTATTGCAAGTCTTAAAAAATTTGCTTGACAACATTAGCGGTGCTAATTTTTGGATC 840 AATTAGAGAGCATGTTGAAAATGGCGAAATCTATGAAGATCACACTAGCTACATGCTTTT 900 CAAACAATTTGAAATCCGCATCCATAAGCCAACACAAACTATAGAATACTTAGATGTCCA 960 15 ACTCAATGATAGCTATCAATACTTGCTCAACAATCTAGGAATGGGCGGTCAATACACTTC 1020 TTTCAATCTCTTAGAATTTCAAAGGGTGAGGGGCAAATAGTGAGAGCGTTAAATTTCCCC 1080 CCCCTATTCCCCTTAAAAAGGACCCTTATCCCAGGGAATTTTTGGCCCCAATACAATTAG 1140 GGCCAA2AAACCCGGTCCCTTCCATGGCTTAACCAACCCAATTGGGGGATTCCAATTTCCC 1200 CTGGATGGGAATAACCCAAGGCTTTTTTTGAAAATTCCACCTACCATTTGGTCCAAAATT 1260 20 GGATGGACAATTCCAAATTCCAAATCTTCTTTTCCAAGAATGGGGGCCAACCCTTGACAA 1320 ACTCCTTAAACCTTTTCATTCGGCTAAAAGTTGAA.AAACATTTGGAAGATTTGGTTTAA 1380 GGAAATATTTATCGGGTGAAAAGACCAGATGCATGGCTAACTTAAACTCCATAGAAAAAC 1440 TGAATCACGAAAGAAAGAATGCTATCAAAAATGGCATTTACCACTTGATCCAAATCAAAT 1500 TTTCTTACAACTCCAATCGCATTGAAGGAAGCGGTTTGACTTATGAACAAACCGCTCATA 1560 2 5 TTTTTGACAAATCCGTTCTCATAACTGAAAAAAACACCAATATCAAACTTGATGATATTT 1620 TTGAAACTATCAATCATTTTGAATGCGTGAATTACTTGCTTCIAAAGCTATAAAGAACCTT 1680 TGAGTTTAGAATACTTTAAGAATTTACACAAAATCTTGAAAAAGAATTGTTCTGATGAAG 1740 TTATTGGTGATTTTAAAAAACGCCCTAATTTTGTAGGCAATAGCGCCACAACAAGACCCA 1800 AATTAGTTGAAAGCGAATTGACAA.ATCTTGTGAAAAATTATCAACGCA\CCTTGAAGTGA 1860 30 GTTTGAAAAACAATATCATGCCTTTCATCATAGAAAACGAACACAAAGCCTTTTACTACA 1920 GGGGCATCAAAGAATATGACAACACAAAAGGCTACTTGAAAGACACCATTTTGCAAAGTC 1980 AAGACAATTTCAATGAAATGGTTAGCTATTTCTTTTCTTGAGTGAAACCGCTTATTTTTG 2040 CTTGTGTGCTTTTGTTTTTTGCGTTTTTAGTTGTAGGTGGTAAGAAATATCGGTTTTTTG 2100 CTTTTCGTTGGTTGTAGGCGATTTTAGATAGCAAAAAACAGCTAAAAAATCCAAGCAACC 2160 3 5 TAATTGATTTCAAACCAACTTCATTTCCCTTTTAGTCGTTAGCCATTTAGCCAATCTAAC 2220 TAGTTTAGCATCTAAAAGCGCATATAACTTGAGTTAGCAATCCAACCAATACTAAAACCG 2280 CCTAGCGAAGCGTTAGCGAGCAAAATAAGCGGTTTTAGACCGATTGTTTGCTGACAAGCA 2340 AACACCAATAAGCGAGCGTTAGCGAGCATGGACAAAAGCGCATCGCAGTTTGAAAGCGTA 2400 GGCGTTAGCCGAAGCTGTTTTGCGTAAGCAAATCAAACAAGATAGCGCAAGCCGAGGTGC 2460 40 AGCCCAAGAATTTGAATTAATCCATGCGGTGTTTAGGGCGTTTTAGCGTGATCCCTTTAT 2520 TACATGTTTTAAACAGCATGCTGTTTTTTACATGTTTTACTCGCATGCGCGCGCGCTAGG 2580 TATTGGTGGTTGGAATAGCCTAAATAACGCAGCTGTATGGTTTCTCATTTTTCGGTGACA 2640 ATGAATAAGGGGTAGTTCTTGCGAGTCATAAGTGTAGTTCTTGCGAGTCATAAGTGTAGT 2700 TCTTGCGAGTCATAAGTGTAGTTCTTGCGAGTCA'rAAGTGTAGTTCTCTTCACAATATCT 2760 45 ACACAATTCACAATCTCTAGCTACAATAACAGCGTGTGAAGATGCTTTCACAGCGGTATT 2820 TCCTATGTGCGGCAAAATTTGGAGCAATTAGCTTTAAAAGCTAGTGGGTTGGGAGTTTGT 2880 AGCGGGTATGCACTCCGTTAGGAGGCACACCATGAAAGCATTTTTGATAGTAGTGATTTT 2940 AGTGGTAATCTTGACACAGCCACTATATTAAAACCTTAGCGTTTTAATAACCCTTATAAG 3000 TCCGCCAAGACTTCTTAAGGGTTTCACTCCTGTTATTATATCGTCTTTTGAAAAATAAGC 3060 5 0 ATTAAAAGGCGCTTAAATGCCCATGAATACGAATTTTGAACAGCTTAGAAAACAAGAATT 3120 GGAATTACGAAAATTATTAGAAGAATTAGAAACGCTCCCACAAACCCCACAAATTAAACT 3180 GCAAAAACAAAAAATACAAACTTACATAGACAAGATAACACCAAGTATTTTGAGCGGTTT 3240 TGATCAAAAATTCAAAGAAATTATAGAAAATCTATCAAATGAATTTGAAAAAGAAAAATC 3300 CACACCACTCAAAGAGCCACAAACCACCCCCACACCATGCAAAGATTTAGTGGTTAGCAC 3360 5 5 CCCTAAGATAACACCTATACCACCTACCACAATAACGCTAATAAGGTCAATCTAGGGAA 3420 ATTGAGCGAAAGGGAAGCCAATCT 3444 An additional nucleotide sequence that was cloned is provided at SEQ TD NO: 4, which includes a 135 bp segment WO 2006/015445 PCT/AU2005/001211 - 46 that encodes a peptide of 45 amino acids (SEQ ID NO: 5). This smaller 45 amino acid peptide is an immunogenic polypeptide of the Hepatitis C virus (HCV) core antigen. The nucleic acid sequence encoding the 45 amino acid 5 peptide is shown below with the indicated 135 nucleotides underscored. (SEQ ID NO: 5) CATGAGCACG AATCCTAAAC CTCAAAGAAA AACCAAACGT AACACCAACC GTCGCCCACA GGACGTCAAG TTCCCGGGTG GCGGTCAGAT CGTTGGTGGA GTTTACTTGT TGCCGCGCAG 10 GGGCCCTAGA TTGGGTGTGC GCGCGACGAG GAAGACTTCC GAGCGGTCGC AACCTCGAGG TAGACGTCAG CCTATCCCCA AGGCACGTCG GCCCGAGGGC AGGACCTGGG CTCAGCCCGG GTACCCTTGG CCCCTCTATG GCAATGAGGG TTGCGGGTGG GCGGGATGGC TCCTGTCTCC CCGTGGCTCT CGGCCTAGCT GGGGCCCCAC AGACCCCCGG CGTAGGTCGC GCAATTTGGG TAAGGTCATC GATACCCTTA CGTGCGGCTT CGCCGACCTC ATGGGGTACA TACCGCTCGT 15 CGGCGCCCCT CTTGGAGGCG CTGCCAGGGC CCTGGCGCAT GGCGTCCGGG TTCTGGAAGA CGGCGTGAAC TATGCAACAG GGAACCTTCC TGGTTGCTCT TTCTCTATCT TCCTTCTGGC CCTGCTCTCT TGCCTGACTG TGCCCGCTTC AGCCTACCAA SEQ ID NO:4 20 AATCCTAAAC CTCAAAGAAA AACCAAACGT AACACCAACC GTCGCCCACA GGACGTCAAG TTCCCGGGTG GCGGTCAGAT CGTTGGTGGA GTTTACTTGT TGCCGCGCAG GGGCCCTAGA TTGGGTGTGC GCGCG SEQ ID NO:5 25 The nucleic acid of SEQ ID NO: 4 was cloned into the hopE gene (SEQ ID NO: 6, shown below), of H. pylori 26695 at nt504 of SEQ ID NO: 4 (noted in bold/underscore; corresponding to amino acid residue 168 of the protein 30 product) so that the expressed product would be located as part of the surface exposed loop of the HopE gene product. This construct, designated as vector pTMI03-8 (Figure 6) was expressed on the surface of E. coli. 35 ATGCCATAGC ATTTTTATCC ATAAGATTAG CGGATCCTAC CTGACGCTTT TTATCGCAAC TCTCTACTGT TTCTCCATAC CCGTTTTTTG GGCTAACAGG AGGAATTAAC C 1 ATGGAATTTA TGAAAAAGTT TGTAGCTTTA GGGCTTCTAT CCGCAGTTTT 40 51 AAGCTCTTCG TTGTTAGCCG AAGGTGATGG TGTTTATATA GGGACTAATT 101 ATCAGCTTGG ACAAGCCCGT TTGAATAGTA ATATTTATAA TACAGGGGAT 151 TGCACAGGGA GTGTTGTAGG TTGCCCCCCA GGTCTTACCG CTAATAAGCA 201 TAATCCAGGA GGCACCAATA TCAATTGGCA TGCTAAATAC GCTAATGGGG 251 CTTTGAATGG TCTTGGGTTG AATGTGGGTT ATAAGAAGTT CTTCCAGTTC 45 301 AAGTCTTTTG ATATGACAAG CAAGTGGTTT GGTTTTAGAG TGTATGGGCT 351 TTTTGATTAT GGGCATGCCA CTTTAGGCAA GCAAGTTTAT GCACCTAATA 401 AAATCCAGTT GGATATGGTC TCTTGGGGTG TGGGGAGCGA TTTGTTAGCT 451 GATATTATTG ATAACGATAA CGCTTCTTTT GGTATTTTTG GTGGGGTCGC 501 TATCGGCGGT AACACTTGGA AAAGCTCAGC GGCAAACTAT TGGAAAGAGC 50 551 AAATCATTGA AGCTAAGGGT CCTGATGTTT GTACCCCTAC TTATTGTAAC 601 CCTAACGCTC CTTATAGCAC CAAAACTTCA ACCGTCGCTT TTCAGGTATG 651 GTTGAATTTT GGGGTGAGAG CCAATATTTA CAAGCATAAT GGCGTAGAGT 701 TTGGCGTGAG AGTGCCGCTA CTCATCAACA AGTTTTTGAG TGCGGGTCCT 751 AACGCTACTA ATCTTTATTA CCATTTGAAA CGGGATTATT CGCTTTATTT 55 801 AGGGTATAAC TACACTTTTT WO 2006/015445 PCT/AU2005/001211 - 47 CTCGAGATCT GCAGCTGGTA CGATATGGGA ATTCGAAGCT TTCTAGAACA AAAACTCATC TCAGAAGAGG ATCTGAATAG CGCCGTCGAC CATCATCATC 5 ATCATTGAGT TTAACGGTCT CCAGCTTGGC TGTTTTGGCG GATGAGAGAA GATTTTCAGC CTGATACAGA TTAAATC (SEQ ID NO:6) Briefly, one method of accomplishing the isolation of hopE gene is amplification from H. pylori 22695 by using Taq DNA 10 polymerase. The upstream primer 5'AAGGATCCGATAGGAATGTAAAGGAATGG-3' (SEQ ID NO:7) containing a BamHI site and the downstream primer 5'CCGAATTCTAAAGGCATGAACGCTTGCA-3' (SEQ ID NO:8) containing a EcoRI site can be constructed by using a DNA synthesizer, 15 such as the Perkin-Elmer Applied Biosystems, Inc. model 332 (ABI; Mississauga, Ontario, Canada). The resulting PCR fragment can be blunt-end cloned into the EcoRV site in pBluescript II KS(+) in the same orientation as the lac promoter. 20 PCR primers can then be designed to insert two unique restriction enzyme sites into the hopE gene for insertion of the 135bp immunogenic coding sequence from the Hepatitis C virus (HCV) core antigen. The PCR amplification using Taq 25 DNA polymerase can be performed using a touchdown amplification procedure as follows. The PCR thermocycler is programmed for an initial denaturation step of 96 0 C for 4 min, followed by 18 cycles at an initial annealing temperature of 65'C (for 90 s), which is decreased by 0.5 0 C 30 for each successive cycle, an extension step at 72*C for 6 min, and denaturation at 96 0 C for 1 min. Subsequent to completion of the first 18 cycles, an additional 14 amplification cycles can be performed by using 72'C extension and 96*C denaturation steps with a constant 55 0 C 35 annealing temperature. The resulting amplicon is then purified by column, precipitated with ethanol, and made blunt by digestion with the Klenow fragment of DNA polymerase. The PCR products can be digested with restriction enzyme to remove the template DNA, and WO 2006/015445 PCT/AU2005/001211 - 48 religated into an appropriate vector such as pTM103.8 under the control of the arabinose inducible promoter, and transformed into E. coli JM105. 5 Recombinant clones can be identified by using oligonucleotide primer 5'-AGATCTAAGGACGTC-3' (SEQ ID NO:9) plus the reverse sequencing primer in PCR amplification reactions. Identified clones can be sequenced to verify that the inserted restriction endonuclease sites are in 10 frame and that no errors had been introduced into the hopE gene. The 135bp immunogenic coding sequence from the Hepatitis C virus (HCV) core antigen can then be inserted using standard techniques. 15 Once vector pTMI03-8 had been created it was transformed into E. coli, which was grown at 37 0 C. Cells were then harvested and the expression of the HCV insert was confirmed by Western Blot. 20 Briefly, a procedure for this is as follows. Cells are harvested from about 20 plates and resuspended in 20% sucrose with 50mg of DNase I (Boehringer Mannheim) in 10mM Tris-HCl (pH8.0). The cells are then disrupted with a French pressure cell at 15,000 lb/in 2 . Broken cells are 25 overlaid on a sucrose step gradient of lml of 70% and 6ml of 70% sucrose in 10mM Tris-HCl (pH8.0). The outer membrane fraction is collected and pelleted at 150,000 x g, and the pellet is resuspended in 100pl of distilled water. 30 Alternatively, outer membranes from 500 ml of log-phase culture can be solubilized in 10mM Tris-HCl (pH 8.0)-3% n octyl-polyoxyethylene incubated at 23 0 C for lh and centrifuged for 30min at 173,000 x g. The pellet is resuspended in 10mM Tris-HCl-3% n-octyl-polyoxyethylene-5mM 35 EDTA (pH8.0), incubated at 23 0 C for lh, and centrifuged for 30min at 173,000 x g, and the supernatant collected. A Western immunoblot indicated the presence of HCV/hopE in WO 2006/015445 PCT/AU2005/001211 - 49 the supernatant of the second solubilization step. The supernatant containing HCV/hopE is mixed with an equal volume of 0.125 M Tris-HCl (pH 6.8), 4% (wt/vol) sodium dodecyl sulfate (SDS), and 20% (vol/vol) glycerol and 5 subjected to SDS-12% polyacrylamide gel electrophoresis (PAGE) . If required the HCV/hopE band can be excised from an unstained portion of the gel and eluted overnight at 40C into 10mM Tris-HCl (pH 8 .0), 1mM EDTA (pH8.0), and 100mM NaCl. The elution supernatant can then be run on an SDS 10 PAGE gel to check for purity, and a Western immunoblot using standard techniques undertaken. For example, isolated outer membranes can be loaded at a concentration of 15pg/lane. Electrophoresis is then carried out by SDS-PAGE on a discontinuous 12% polyacrylamide gel. Proteins are 15 then stained with Coomassie brilliant blue. For Western immunoblotting, unstained gels can be electroblotted onto Immobilon-P membranes (Millipore, Bedford, Mass.). After blocking for 2h at 23'C with 3% bovine serum albumin (BSA; Boehringer Mannheim)-0.1% Tween 20 (Sigma) in phosphate 20 buffered saline (PBS), the membranes are then incubated with a 1/10,000 dilution of anti-HCV rabbit antiserum in 1% BSA-0.05% Tween 20 in PBS for 1 h at 37 0 C. The membranes are then washed with PBS and incubated with a 1/5,000 dilution of an alkaline phosphatase-conjugated secondary 25 antibody (Bio-Rad, Richmond, Calif.) for lh at 370C. The bound antibodies are detected with 5-bromo-4-chloro-3 indolylphosphate (BCIP, Calbiochem, La Jolla, Calif.) and nitroblue tetrazolium (NBT, Sigma). 30 EXAMPLE 2 EXPRESSION VECTORS AND SELECTION OF ANTIGENS FOR STABLE EXPRESSION Because HopE is a native protein of H. pylori and is tolerated by this organism and can thus form a construct 35 useful for expressing foreign antigens or other heterologous gene products in H. pylori. Other H. pylorilE. coli shuttle vectors that can be readily WO 2006/015445 PCT/AU2005/001211 - 50 developed as described above include, for example, vectors comprising two plasmid ori sites and markers which are suitable for each host. Markers might include genes for chloramphenicol/kanamycin resistance as well as promoters 5 that can be recognised by both the E. coli and H. pylori. transcriptional systems. The requirements for replication in E. coli can be achieved by using any number of known E. coli plasmids (e.g. 10 pBR322). Constructed shuttle vectors can be tested for replication in both E. coli and H. pylori in vitro and compared to existing shuttle plasmids described in the literature. 15 The choice of antigen or other heterologous gene product to be expressed would ideally be one that is not toxic to H. pylori and E. coli and that is highly immunogenic (or possesses another desirable property) when delivered to a 20 selected site in a mammal. In the case of an expressed antigen for immunization of the mammal, such a site might be a mucosal site. As described in Example 1, hopE/HCV core antigen fusion 25 protein can be expressed at the E. coli surface. The product of pTMI03-8 (Figure 3) is preferably targeted to the H. pylori outer membrane, so that it would display the HCV core antigen in a mucosal environment. 30 Tetanus toxoid (TT) has been studied extensively as an antigen in humans, and immune responses to it are well characterized. TT elicits good mucosal immune responses when administered orally or intranasally when displayed on the surface of bacterial spores (Duc & Cutting, 2003, 35 Expert Opinion Biol Ther, 3(8), 1263-70). The tetanus toxin C fragment can be fused to the hopE gene product as described above or engineered to contain a membrane anchor WO 2006/015445 PCT/AU2005/001211 - 51 and cell surface target sequence. The advantage of this system is the existence of well-characterized murine models for assessment of the effectiveness of the vaccination procedure, whereas; in the case of HCV where the known 5 murine models typically rely on immune-deficient mice. The gB protein of cytomegalovirus (CMV) has been shown to immunize mice against a lethal dose of an engineered Vaccinia virus expressing the gB antigen. Accordingly, shuttle vectors such as those described herein, comprising 10 gB antigen in place of an HCV antigen can be constructed using the protocol described in Example 1. A number of promoters can be used in the shuttle vectors. Ideally the promoter used is inducible either by a natural 15 in vivo colonization mechanism of Helicobacter or by induction with an innocuous foodstuff or chemical that can be consumed. For example, the promoter from the H. pylori histidine kinase HP165 that is reported to be induced by acidic pH and may be a virulence factor related to gastric 20 mucosa colonization is one such promoter. The benefit of this promoter is that a construct can be made in vitro with the foreign antigen only becoming expressed when exposed to the acidic environment of the gastric mucosa. 25 Other promoters include the arabinose inducible promoter used in pTMI03.8 and FlaB sigma 54 promoter (Josenhans et al., 1998, FEMS Microbial Lett., 161(2), 263-73), the extensively studied T7 promoter used in many constitutive and inducible E. coli systems and the nir B promoter of 30 Salmonella which is induced in anaerobic environments (Chatfield et al., 1992, Biotechnology, 10(8): 888-92). The ability of any of these promoters to function in H. pylori can be tested using the system developed by Angelini et al. (2004) (Plasmid, 51:101-107) that uses CAT and GFP 35 reporters as a readout of promoter activity in a H. pylori plasmid vector.
WO 2006/015445 PCT/AU2005/001211 - 52 The target sites of expression will depend on the antigen or other gene product used. Initial studies focused on the HopE proteins and fusion polypeptides which target the expressed polypeptide (e.g., antigen) to the cell surface 5 of H. pylori. Plasmid stability is also very important and, while the use of antibiotic resistance genes as a selective determinant for plasmid maintenance is useful in vitro, is less 10 practical in vivo. An alternative is a balanced-lethal system, for example, the asd gene that is used inactivated in Salmonella. The asd gene, which exists natively in H. pylori, encodes aspartate-p-semialdehyde dehydrogenase (an enzyme in biosynthetic pathway for diaminopimelic acid 15 (DAP), an essential component of the cell wall peptidoglycan of gram-negative bacteria). In the absence of DAP, asd mutants undergo lysis. Since DAP is not present in mammalian tissues, this balanced-lethal system imposes a requirement for all living H. pylori to carry the 20 recombinant asd gene-containing plasmid. In order to use the asd gene system the genomic copy of the asd gene is inactivated using standard gene knockout protocols. This strain of H. pylori will then only grow 25 with the supply of DAP or with a plasmid that contains the asd gene. Other systems that can be used for similar purposes include E. coli enterotoxin or Cholera toxin (CT) as mucosal 30 adjuvants. Adjuvants can also be used to boost the mucosal immune response. Two such adjuvants are CT and E. coli enterotoxin (LT) wherein expressed antigens are fused to the LTB and CTB mutants that maintain their strong mucosal adjuvant properties but have dramatically reduced toxicity. 35 WO 2006/015445 PCT/AU2005/001211 - 53 EXAMPLE 3 VIRULENCE, LD 5 0 As described in Examples 1 and 2, Helicobacter-based vectors such as pHP3 and pHP1 are capable of providing 5 protection against infection in a mammal, such as a mouse or human. In the present example, a murine model is used to demonstrate the utility of using the Helicobacter-based systems to provide delivery of a pharmacologically active molecule of interest to a mammal, including a human. The 10 murine model is employed to demonstrate the activity of a transgenic strain of H. pylori to elicit a serological response to an expressed surface antigen in vivo. Mice are infected with wild-type H. pylori, while other 15 mice are inoculated by gavage with temperature-sensitive H. pylori as described in Example 2. Sera from both control and test animals are assayed for antibody and gastric histology are performed on sacrificed animals in accordance with the schedule shown in Table 1. A mouse urea breath 20 test can also be used. As shown in Table 2, a 50% decrease in virulence (from 75% to 40%) was observed. Specific antibody titre increased 4 fold above baseline, indicating a serological response. 25 Serum samples were taken at baseline, 12, 24, 48 weeks. At these times 10, 10 and 20 animals were sacrificed and gastric histology performed.
WO 2006/015445 PCT/AU2005/001211 - 54 TABLE 1 IN VIVO STUDY Week Mice* Mice Used Serology Histology Adjistment Remaining 0 50 0 40 0 0 12 50 10 40 10 109.2 24 40 10 30 10 218.4 48 30 30 20 20 1310.4 49 0 Totals 50 130 40 5 *C57BL/6J females, 40 test and 10 control WO 2006/015445 PCT/AU2005/001211 - 55 TABLE 2 POWER CALCULATION VIRULENCE STUDY At a=0.05 and Power=80% and various Infection Rates of H. pylori Normal=75% vs TSHP=50% n=58 mice in each group Normal=75% vs TSHP=40% n=30 mice in each group Sample size of 20 will only give you 37% Power: to detect a difference (75% vs 50%) and 62% Power: to detect a difference (75% vs 40%). In order to use a sample size of 20 you would need the infection rate in TSHP to be at least 32% or less (with 80% Power and ax=0.05) 5 WO 2006/015445 PCT/AU2005/001211 - 56 EXAMPLE 4 COMPARISON OF VIRULENCE AND ANTIGENICITY OF SEVERAL TEMPERATURE SENSITIVE H. pylori STRAINS 5 In order detect a major change in virulence related to expression/modification of an outer membrane protein, mice are inoculated with temperature-sensitive H. pylori as described in Example 3. An equal sized control group of mice were infected with a wild type H. pylori strain. Non 10 invasive means were used to determine presence or absence of H. pylori. Mice were bled at 3 and 6 months for antibody estimation. At sacrifice, histology was performed to assay gastritis and confirm colonization. Table 3 shows the serology and histology of the mice used.
WO 2006/015445 PCT/AU2005/001211 - 57 TABLE 3 VIRULENCE AND SEROLOGY COMPARISON STUDY Week Mice Mice Used Serology Histology Adjistment Remaining 0 180 280 24 180 180 48 180 180 180 180 7862.4 49 0 Totals 180 540 180 5 WO 2006/015445 PCT/AU2005/001211 - 58 EXAMPLE 5 LD 50 STUDY TO EVALUATE TEMPERATURE SENSITIVE H. pylori VACCINE EFFICACY FOR A PNEUMOCOCCAL ANT IGEN 5 In order to demonstrate the Helicobacter-based vaccine protection effect from a standard pathogen (pneumococcus), mice were inoculated with temperature sensitive H. pylori by gavage. An equal sized control group was infected with the wild type H. pylori strain. Non-invasive means are 10 used to determine presence or absence of H. pylori as described in Example 4. At 6 months post infection, all mice were given intraperitoneal challenge with 10 times the
LD
5 o of live virulent pneumococci type 4 (-20 CFU/mouse), as per the method of Aaberge et al. (1995, Microb. Pathog. 15 18:141-152). As shown in Table 4, allowing for 75% lethality in the controls, the study has a power of 0.8 to detect a 50% decrease in mortality (75% vs 50%).
WO 2006/015445 PCT/AU2005/001211 - 59 TABLE 4
LD
50 TO PNEUMOCOCCUS FOR IMMUNIZED MICE Week Mice Mice Used Serology Histology Adjistment Remaining 0 60 0 0 24 60 0 25 60 60 0 0 1365 26 0 Totals 60 0 0 5 WO 2006/015445 PCT/AU2005/001211 - 60 EXAMPLE 6 DETERMINATION OF H. pylori STATUS OF MICE: BREATH TEST METHOD In the present Example, the urea breath test used in humans 5 was adapted use in mice. Ten mice were fed a diet devoid of urease (uncooked soy). Mice were then administered 3.7 kBq 14 C urea in 200pl flavoured citrate by gavage and placed in air-filled 2L 10 plastic ziplock bags for 20 minutes. Mice were then removed without exchanging the air within the bag. Hyamine, 0.1 mmol in ethanol, was then introduced and scintillant was added to the hyamine solution and counted for 10 min or up to a count of 1,000 dpm. 15 EXAMPLE 7 HUMAN STUDIES To confirm virulence and antibody response in humans, a strain of H. pylori like the "Baylor Strain" will be 20 employed and the following criteria will be adopted: 1. The infected individuals have no symptoms, no more than mild histologic damage, and no evidence of infection with hepatitis viruses or HIV. 25 2. The isolate is a single strain, cagA negative, and sensitive to metronidazole, clarithromycin, tetracycline, and amoxicillin. 30 3. Volunteers to receive a challenge are healthy with normal gastric histology, no history of peptic ulcer, no young children at home, no regular contact with young children, and no allergies to the antibiotics that might be required to treat the infection. 35 Challenge will consist of 40mg famotidine at bedtime followed by administration of H. pylori in beef broth WO 2006/015445 PCT/AU2005/001211 - 61 orally in the morning. Subjects are contacted daily for 14 days. A 13c-UBT is performed after 7 and 14 days and endoscopy with quantitative culture and histology after 2 weeks and 3 months. Antibiotics are used to eradicate the 5 infection. EXAMPLE 8 DEVELOPMENT OF EXTERNAL CHEMICAL MARKER FOR THE DETECTION OF WILD TYPE AND/OR TSHP IN VIVO 10 An example of a chemical marker that may be used for the detection of wild type or TSHP in vivo is sulfasalazine (SSN), the structure of which is shown in Figure 4. Studies in germ free mice and conventional rats have shown that 15 intestinal bacteria are solely responsible for the diazo bond reduction, resulting in the reductive catabolism of SSN and the release of sulfapyridine and 5-aminosalicylate. The enzyme(s) which catalyses this reaction is referred to as diazoreductase(s) (synonym azoreductase(s)). 20 Conventional rats given SSN excrete 5-aminosalicylate and sulfapyridine (and their respective conjugates) in urine and faeces, whereas germ-free rats show no evidence of SSN degradation. 25 Several bacterial species have been shown to have diazoreductases (AZR's). Preliminary bioinformatic studies have indicated that H. pylori may not contain the AZR gene. The presence of similar analogous sequences has also produced a negative result. Under these circumstances a 30 transgenic strain of H. pylori (TSHP) which has a viable and functional azoreductase (azr + TSHP) can be used to assess the use of these markers. Plasmid pTMI03-02 is digested by EcoR I and HindIII, and 35 ligated with the Azoreductase (AZR) gene from Bacillus subtilis treated with EcoR I and HindIII, to generate a vector containing both HopE 168aa and AZR named pTMI03-azr.
WO 2006/015445 PCT/AU2005/001211 - 62 This plasmid is transformed into E. coli to assess whether expression of HopE and the B. subtilis AZR occurs. pTMI02 when similarly treated with full-length hepatitis C core antigen (HCCA) demonstrated transport of HopE::HCCA to E. 5 coli outer membrane employing western blots and anti-HopE Abs. Mice (n =30) are infected with the azr + TSHP by gavage and once AZR expression in vivo to produce 5-aminosalicylate 10 and sulfapyridine (and their respective conjugates) in urine and faeces is established human trials can begin. EXAMPLE 9 USE OF DIAGNEX BLUE AS A MARKER 15 The diagnostic agent "Diagnex Blue" consists of an ion exchange resin (Amberlite XE-96) conjugated with a dye (Azure-A). This test relies on the fact that the resin-dye combination disassociates at pH less than 2.5 after which the dye is absorbed and appears in the urine. Persons 20 without dye in the urine are achlorhydric. This principle is shown in Figure 5. The same principle can be used to test for H. pylori. For example, a dye-resin combination which disassociates at pH 25 > 7.0 could detect urease if the resin was given with urea. This would produce a pH > 7.0 in the mucus layer where H. pylori resides thus releasing the dye. Mice (n =30) are inoculated with a wild type H. pylori 30 strain while germ-free mice (n =30) are used as controls (Pilot study). After an optimal period allowing for the H. pylori to establish an active infection, the test group and the controls are introduced with a predetermined quantity of the resin-dye complex by gavage. This will be followed 35 by a urea solution. (Range 0.01M to 0.5M). The mice are kept in metabolic cages and the excretion of the azure dye are monitored and quantified. Different ratios of the WO 2006/015445 PCT/AU2005/001211 - 63 resin and urea concentrations are tested to verify the optimal combinations to be used. EXAMPLE 10 DELIVERY FORMULATIONS 5 For administration by aerosol, the present invention can be delivered in the form of aerosol spray presentation from pressurized packs or a nebulizer, with the use of a suitable propellant. In the case of a pressurized aerosol, 10 the dosage unit can be determined by providing a valve to deliver a metered amount. The formulation would be prepared as a powder for administration by.inhalation. Administration by inhalation can also be carried out by atomizing solutions or suspensions which contain the 15 compositions according to the invention. The compositions according to the invention may also be formulated in a liquid for oral digestion for administration to a subject as an intravenous preparation. 20 All of the various preparations of the invention may be prepared by procedures familiar to those skilled in the art, if appropriate using further suitable pharmaceutical auxiliaries. Compositions according to the invention 25 advantageously contain the species of Helicobacter, alone or in combination with other desired ingredients. Any of the above individual or combination of Helicobacter formulations may be included in a pharmaceutical 30 composition comprising the pharmaceutically acceptable composition according to the present invention. The pharmaceutical compositions as described herein may be in solid (e.g. powder, particles, granules, sachets, tablets, capsules etc.), semi-solid (gels, pastes etc.) or liquid 35 (solutions, dispersions, suspensions, emulsions, mixtures etc) form and adapted for administration via e.g. the gastrointestinal tract and gastric mucosa. The WO 2006/015445 PCT/AU2005/001211 - 64 pharmaceutical compositions may thus be in powder or particulate form adapted to be dispersed in an aqueous medium before use. 5 A pharmaceutical composition in liquid form may be in the form of a dispersion comprising the Helicobacter composition and an electrolyte solution such as, e.g. a composition that is adapted to physiological conditions e.g. a physiologically acceptable solution. 10 A pharmaceutical composition according to the invention may further comprise another therapeutically, prophylactically and/or diagnostically active substance. 15 In another aspect, the invention relates to a pharmaceutical kit comprising a first and a second container, the first container comprising a recombinant Helicobacter composition comprising the plasmid and/or plasmid vector according to the invention and the second 20 container comprising a dispersion medium for the Helicobacter composition, accompanied by instructions for administering and/or dosing the Helicobacter composition in the dispersion medium before use. 25 The Helicobacter composition according to the present invention contained in the kit may be in powder or particulate form. A pharmaceutical kit according to the present invention may 30 include instructions with recommendations for the time period during which the Helicobacter composition should be administered after dispersion in the dispersion medium. 35 WO 2006/015445 PCT/AU2005/001211 - 65 EXAMPLE 11 IMMUNE MODULATION WITH Helicobacter VACCINE PREPARATION The TH1 response (T-helper cell type 1) is a cell mediated 5 response. Over activity of this is a presumed cause of diseases such as rheumatoid arthritis (RA) and lupus. In contrast, TH-2 is an antibody type serological response characteristic of vaccines. The present example provides a technique to obtain a TH-2 type response in an animal when 10 treated with a Helicobacte-r-based vaccine treatment preparation according to the present invention. Use of the Helicobacter vectors and vector plasmid systems as described herein may be used to invoke antibody response 15 in an animal. By way of example, a system employing a gene expression cassette in a construct that provided for the transformation of the bacterium, Clostridium, and the subsequent secretion of a protein (S-layer protein) from the surface of the transformed Clostridium, this resulting 20 in initiation of mucosal vaccination, is described in W00194599, which disclosure is hereby incorporated herein in its entirety. These constructs may also include a secretory leader sequence selected from ORF1, ORF3, ORF5 7., ORF7 or ORFll. 25 In accordance with some embodiments of the vaccine, the Helicobacter-based vectors and vector plasmids may comprise a sequence encoding a bacterial surface layer protein. A surface layer protein is defined herein as any molecule of 30 proteinaceous nature, including e.g., protein, glycol protein or lipoprotein occurring in the outer membrane of a bacterium and capable of being exposed on the surface of the bacterium. S-layer proteins may be continuously and spontaneously produced in larger amounts than any other 35 class of protein in the cell.
WO 2006/015445 PCT/AU2005/001211 - 66 A process for preparation of a recombinant cell preparation comprising a gram negative host cell, Clostridium, having the S-layer protein, is also provided in WO-97/28263. The process may be modified and followed in accord with the 5 procedures described herein to incorporate an S-protein as part of the Helicobacter constructs of the present invention. Accordingly, in some of the vector and vector plasmid 10 constructs, a fusion protein is provided that comprises a Helicobacter sequence and a non-Helicobacter pharmacologically active molecule of interest. In order to enhance the immunogenicity of a vaccine employing the Helicobacter constructs of the present invention, the 15 Helicobacter sequence of the fusion protein may comprise a sequence encoding an S-layer protein. Bacillus constructs that include the S-layer protein as part of a fusion protein have been reported to express the S-layer protein at the Bacillus surface. (See WO-95/19371, describing 20 Bacillus sphaericus), thus enhancing the immunogenicity of the preparation. Mucosal immunization is already provided against some diseases, including an oral polio vaccine and an oral 25 (drinkable) vaccine against cholera and diarrhea due to E. coli (an inactivated vaccine). In some embodiments, it is contemplated that the vaccines of the invention may thus comprise an inactivated vaccine. 30 The present invention contemplates a live vaccine, as such will provide a single-dose, long lasting vaccination, because the carrier organism, Helicobacter, will continue to produce the antigen, i.e., non-Helicobacter pharmacologically active molecule of interest, and boost 35 immunity in vivo. In addition, the vaccines will be administered in combination with an adjuvant. These adjuvants' comprise molecules such as aluminium hydroxide WO 2006/015445 PCT/AU2005/001211 - 67 or lipid vesicles that increase the exposure time for the vaccine by slowing its removal forte site of administration. Adjuvants' also act by evoking production of immunomodulatory peptides called cytokines and 5 chemokines (Brewer et al. 1997, J. Cytokines Cell Mol. Ther., 4:223-246). Thus, the present vaccines may comprise cytokine adjuvant to enhance immune response. The transformed Helicobacter or E. coli bacterium, when administered orally to a mammal such as a human or animal, 10 will provide for the gastro intestinal colonization, production and presentation of the desired polypeptide through the gastric wall, which is the natural site of colonization. The gastro intestinal tract is surrounded by an immense immune apparatus specialized in mounting immune 15 response of various types. Gastro intestinal colonization by recombinant Helicobacter vaccine or peptide producer strain thus enables a much longer immune stimulus than traditional vaccination. Additionally, antigen can be presented preferentially to the gut wall or the lumen. 20 EXAMPLE 12 Helicobacter AND USES THEREOF AS AN APPETITE SUPPRESSANT The present example is provided to demonstrate the utility 25 of the present invention as a method for employing Helicobacter in preparations and treatment regimens that provide for appetite suppression. In particular, delivery to the gut mucosa of a construct that comprises attenuated Helicobacter together with a non-Helicobacter 30 pharmacologically active molecule of interest that regulates the level of ghrelin (a hormone) or an agonist of ghrelin, is expected to provide an effective means for providing suppression of the gut-brain axis that regulates appetite and sanity. 35 Studies have suggested that ghrelin is an appetite stimulant, i.e., ghrelin increases food intake in mice WO 2006/015445 PCT/AU2005/001211 - 68 (Asakawa et al. 2003, Gut, 52(7):947-52). Ghrelin has also been reported to reduce fat utilization in adipose tissue in rodents (Tschop et al., 2000, Nature, 407: 908-13), as well as to be involved in rat adipogenesis (Choi et al. 5 (2003), Endocrinology, 144 (3) :751-9) . Ghrelin has also been reported to be a hunger signal, prompting the subject to eat when nutrition availability is low. Ghrelin, an endogenous ligand for the growth hormone 10 secretagogue receptor (GHS-R), stimulates growth hormone (GH) release from cultured pituitary cells in a dose dependent manner, and is produced and secreted from the A like cells found mainly in the oxyntic glands of the gastric fundus. Ghrelin is now known to play a role in not 15 only GH release, but also in controlling the appetite and body weight. Both parenterally and intracerebro-ventricularly administered ghrelin have been shown to stimulate food 20 intake and increase the body weight of mice and rats with free access to food, even those animals with GH deficiency. The control of appetite and body weight may be independent of GH release. 25 Ghrelin, a 28-amino-acid peptide, is activated when its third serine residue is acylated by n-octanoic acid, and GHS-R is responsive to the first four or five residues including the octanylated serine residue of the whole ghrelin peptide. GHS-R has been shown to be present in the 30 pituitary, hypothalamus, adrenal glands, thyroid, pancreas, myocardium, spleen and testes. Ghrelin stimulates the expression of both NPY and AGRP mRNA in the hypothalamus. The central orexigenic effect of ghrelin is mediated by the NPY/AGRP-expressing neurons in the hypothalamus. Ghrelin 35 has also been reported to suppress vagal afferent activity. The peripheral orexigenic effect of ghrelin may be mediated, at least in part, by its suppressive effect on WO 2006/015445 PCT/AU2005/001211 - 69 the vagal afferent activity. IL-1 -is a pro-inflammatory cytokine that mediates the cachectic process by stimulating the expression and release of leptin, and/or by mimicking the effect on the hypothalamus of excessive negative 5 feedback signalling from leptin. It is proposed that antagonists to ghrelin if provided to the animal at the gut mucosa will reduce food intake by an animal and reduce body weight gain. 10 EXAMPLE 13 CELL WASTING ATTENDANT CANCER AND AIDS The present example demonstrates the utility of the present invention for use as a preparation that will prevent or 15 inhibit cell wasting, particularly cell wasting associated with the diseased states of AIDS and cancer. Cachexia is a condition characterized by wasting, emaciation, feebleness and inanition. It was recently 20 reported that the levels of both ghrelin peptide and ghrelin mRNA in the stomach were up-regulated in a mouse model of cancer cachexia. In cachectic mice with increased plasma levels of IL-l$, the plasma concentrations of ghrelin also increased with the progression of cachexia. 25 This result suggests that a close relationship might exist between the ghrelin dynamics and the cachectic process mediated by IL-1. IL-lP is an anorexigenic substance, just like CCK, leptin, gastrin-related protein and bombesin, and antagonizes the actions of ghrelin. 30 Asakawa et al. reported that parenterally administered IL l decreased NPY mRNA expression in the hypothalamus and pre-proghrelin mRNA expression in the 'stomach, and that intraperitoneally administered ghrelin inhibited the 35 severity of IL-1@-induced anorexia. H. pylori infection is known to be a major pathogenetic factor in the development of gastritis, peptic ulcer disease and gastric malignancy.
WO 2006/015445 PCT/AU2005/001211 - 70 Attachment of H. pylori to the gastric mucosa induces inflammation, which is associated with the release of various cytokines, including IL-1P. 5 It has been observed clinically that H. pylori eradication is often followed by improvement of some nutritional parameters, such as the body weight and the serum levels of total cholesterol, total protein and albumin. H. pylori infection has been reported to be capable of modifying the 10 plasma and gastric ghrelin dynamics in Mongolian gerbils. In humans, however, H. pylori infection has been reported not to be associated with any changes of the plasma ghrelin levels, although eradication of H pylori has been shown by some to be associated with increases of the plasma ghrelin 15 levels. It is proposed that H. pylori may be used as a carrier to provide amylin to a patient in need thereof, by, for example, acting to provide secretion of ghrelin to the 20 gastric mucosa. In some embodiments, the Helicobacter vector will be constructed that include a sequence encoding amylin, amylin analogs, and/or-derivatives thereof, and amylin agonists (including calcitonins, calcitonin gene related peptides, and analogs therefore), so as to decrease 25 ghrelin levels. Amylin antagonists can increase ghrelin levels. Modulation of the effective levels of amylin, with amylin, amylin agonists, or other like compounds that decrease the 30 effective level of amylin, may inhibit, or stimulate in the case of antagonists and antibodies, ghrelin secretion. Hence, some embodiments of the method are directed to modulating endogenous levels of ghrelin by increasing the effective level of amylin or amylin agonists in the body, 35 by direct or indirect means, or by decreasing the effective level of amylin using amylin antagonists or inhibiting amylin production.
WO 2006/015445 PCT/AU2005/001211 - 21 EXAMPLE 14 TREATMENT OF GAUCHERS DISEASE The present example demonstrates the utility of the 5 invention for use as a treatment for a disease resulting from an enzyme deficiency, such as Gaucher's disease. Gaucher's disease is the most common lysosomal storage disorder in humans, and results from a deficiency of the enzyme, glucocerebrosidae (GC). (Nolta et al., (1992), J. 10 Clin. Invest. 90 (2):342-348). Enzyme replacement therapy is provided with a Helicobacter vaccine construct that comprises a sequence encoding chemical chaperones. (Sawker et al., (2002), PNAS USA 15 99(24): 15428-15433) or glucocerebrosidae. An enhanced level of functional P-glycosidase (P-Glu, glucocerebrosidase) may thus be obtained. In particular, a sequence encoding the chemical chaperone deoxynojirimycin (NN-DNJ) may be used in the H. pylori construct and 20 administered to the patient orally or intragastrically. As part of yet another embodiment, a Helicobacter-based construct is provided comprising a vector having a non Helicobacter pharmacologically active molecule of interest, 25 in this case, encoding glucocerebrosidase (GC). Retroviral mediated transfer of glucocerebrosidase cultured Gaucher bone marrow is described as one approach for treating Gauchers disease in Nolta et al. (1992). However, this approach is extremely invasive. Alternative enzyme 30 replacement therapy employing the Helicobacter-based constructs of the present invention that include a sequence encoding for the deficient enzyme, glucocerebrosidase, provides a much more attractive and less expensive alternative to such a therapy. 35 WO 2006/015445 PCT/AU2005/001211 - 72 EXAMPLE 16 The present example is presented to demonstrate the utility of the present invention to provide a useful preparation 5 that is suitable for treating and or inhibiting a bacterial induced malignancy, such as lymphoma, particularly MALT lymphoma, using a vaccination preparation comprising the Helicobacter vector and/or plasmid vectors as described herein. 10 Sutton et al. (2004) (Vaccine, 22 (20): 2541-6) report protection against a bacteria-induced malignancy, specifically primary gastric MALT lymphoma, as a result of vaccination/immunization of an animal against Helicobacter 15 felis. Therefore, the H. pylori constructs of the present disclosure that include a vector and/or plasmid vector suitable for providing an immunizing preparation against other than H. felis may also be used to provide vaccination protection against a bacterial-induced malignancy, and in 20 particular, against primary gastric MALT lymphoma. All documents, patents, journal articles and other materials cited in the present application are hereby incorporated by reference. 25 Although the present invention has been fully described in conjunction with several embodiments thereof with reference to the accompanying drawings, it is to be understood that various changes and modifications may be apparent to those 30 skilled in the art. Such changes and modifications are to be understood as included within the scope of the present invention as defined by the appended claims, unless they depart therefrom.
WO 2006/015445 PCT/AU2005/001211 - 73 BIBLIOGRAPHY The following references are specifically incorporated herein by reference. 5 1. U.S. 6,570,004- Blaser et al (2003). 2. U.S. 6,680,179 Collins et al. 3. U.S. 6,383,496 - Curtiss et al (2002). 4. U.S. 6,150,170 - Powell et al. (2000). 10 5. U.S. 6,410,012 - Seizmore et al. (2002). 6. U.S. 6,550.419 - Hone et al. (2002). 7. U.S. 6,531,313 - Goudsmit et al. (2003). 8. U.S. 6,682,729 - Powell et al (2004). 9. U.S. Patent Publication 2005/0075298A1 - Chen et al. 15 (2005). 10. U.S. Patent Publication 2002/0176848Al - Seizemore et al (2002). 11. U.S. Patent Publication 2005/0096288 Al - Guevara et al. (2005). 20 12. U.S. Patent Publication 2004/0236072 Al - Olmsted et al. (2004). 13. U.S. Patent Publication 2004/0203039 Al - Hensel et al. (2004). 14. U.S. Patent Publication 2004/0005325 Al - Kusters et 25 al.(2004). 15. U.S. Patent Publication 2002/0032152 Al - Torossian (2002). 16. U.S. Patent Publication 2003/0170264 Al - Turner et al. (2003). 30 17. U.S. Patent Publication 2003 0204068- Blasec et al (2003). 18. U.S. Patent Publication 2002/0161192 Al- Meyer et al (2002). 19. WO 96/33274 - Covacci et al. (1996). 35 20. WO 99/21959 - Ellis et al. (1999). 21. WO 01/94599 - Burman et al. (2001). 22. WO 2005 021026 - Baron, et al. (2005).
WO 2006/015445 PCT/AU2005/001211 - 74 23. Graham et al (2002), Gastroenterology, 123:1637-1648. 24. Liu et al (2005), World Journal Gastroenterology, 11(14): 2154-2156. 25. Conway, BR (2005), Curr. Pharm. Res., 11(6) 775-90. 5 26. Sawker et al (2002), PNAS USA, 99(24): 15428-15433. 27. Sutton, P et al (2004), Vaccine, 22(20): 2541-6. 28. Kang et al (2005), World Journal Gastroenterology, 11(3): 454-456. 29. Moschos et al (2004), Immunology and Cell Biology, 10 82(6): 628-637. 30. Reddy et al (2004), International Journal Antimicrob. Agents, 24(6): 536-47. 31. Bai et al. (2003), Sheng Wugong Cheng Xu Bao, 19(4) :433-8. 15 32. Nolta et al. (1992), Journal of Clin. Invest, 90(2): 342-348. 33. Shi et al. (2005), Helicobacter, 10(1): 71-9. 34. Deml et al. (2005), Infection Immunity, 73(8): 4732 42. 20 35. Cosima et al. (2005), Trends in Immunology, 26(4): 199-207. 36. Velin et al. (2005), Gastroenterology, 129(1): 142 155. 37. Kong et al. (2000), Nucleic Acids Research, 28(17) 25 3216-3223. 38. Mao et al. (2003), World Journal of Gastroenterology, 9(7): 1529-1536. 39. Chu et al. (2005), World Journal of Gastroenterology, 11(23): 3518-22. 30 40. Kathy Parton. (2000), Institute of Veterinary, Animal and Biomedical Sciences, "Helicobacter mustelae as vector for biological control in stoats" Wildlife Health and Conservation Research Program; Landcare Research (Funding Body). 35 41. Forrester N.T., Parton, K. (2000), New Zealand Veterinary Journal, 48: 65-69. Title, "Isolation of Helicobacter mustelae from ferrets in New Zealand".
WO 2006/015445 PCT/AU2005/001211 - 75 42. Spranger et al. (2005), Br. Nutr., 93 (6):765-71. 43. Garbom et al. (2004), Infect Immun., 72(3): 1333-1340. 44. Tschop et al. (2000) Nature, 407:908-13. 45. Choi et al (2003), Edocrinology, 144 (3). 5 46. Remington's Pharmaceutical Sciences, 20 th edition, Mack Publishing Company. 47. Jones et al (2005) Nat. Med. 11 (7): 786-90.

Claims (35)

1. A composition comprising a Helicobacter molecular construct having a Helicobacter sequence and a non 5 Helicobacter sequence encoding a non-Helicobacter pharmacologically active molecule of interest.
2. A composition according to claim 1, wherein the Helicobacter is Helicobacter pylori. 10
3. A composition according to claim 1 or claim 2, wherein the pharmacologically active molecule of interest is heterologous to the Helicobacter pylori species. 15
4. A composition according to any one of claims 1 to 3, further comprising a promoter sequence.
5. A composition according to any one of claims 1 to 4, wherein the pharmacologically active molecule of 20 interest is ghrelin, amylin or an analog thereof.
6. A composition according to any one of claims 2 to 5, wherein the Helicobacter pylori is attenuated Helicobacter pylori. 25
7. A composition according to any one of claims 2 to 6, wherein the pharmacologically active molecule of interest comprises a protein, peptide or nucleic acid molecule. 30
8. A vaccine comprising a composition according to claim 4 and a pharmacologically acceptable carrier solution. 35
9. A vector plasmid comprising a composition according to claim 4. WO 2006/015445 PCT/AU2005/001211 - 77 10. A composition comprising a vaccine, wherein said vaccine comprises a Helicobacter vector plasmid comprising: (a) a Helicobacter nucleotide sequence comprising a promoter sequence capable of controlling 5 expression of a sequence encoding a non-Helicobacter pharmacologically active molecule of interest; and (b) a sequence encoding a non-Helicobacter pharmacologically active molecule of interest.
10
11. A composition according to claim 10, further comprising an adjuvant.
12. A composition according to claim 10 or claim 11, further described as suitable for delivery to the mucosa. 15
13. A composition according to any one of claims 10 to 12, wherein the non-Helicobacter pharmacologically active molecule of interest is a protein, peptide or nucleic acid molecule. 20
14. A composition according to any one of claims 10 to 12, wherein the non-Helicobacter pharmacologically active molecule of interest is ghrelin, amylin or an antagonist or analog thereof. 25
15. A method of preparing an immunogenic composition comprising a non-Helicobacter immunogen comprising: (a) providing a culture comprising Helicobacter pylori cells transformable with a plasmid vector; 30 (b) introducing into said culture a plasmid vector comprising a promoter sequence and a sequence encoding a non-Helicobacter immunogen under suitable conditions to provide transformed Helicobacter pylori cells, and 35 (c) selecting transformed cells that express said non-Helicobacter immunogen to provide an immunogenic composition, WO 2006/015445 PCT/AU2005/001211 - 78 wherein said promoter sequence is capable of controlling the expression of the sequence encoding the non Helicobacter immunogen. 5
16. A method according to claim 15, wherein the promoter sequence comprises an inducible promoter.
17. A method according to claim 15 or claim 16, further comprising a non-antibiotic resistance gene marker. 10
18. A method according to claim 15, wherein the promoter is constitutively expressed in Helicobacter pylori. 15
19. A method according to claim 15, the promoter is an arabinose inducible promoter.
20. A method according to any one of claims 15 to 19, wherein the Helicobacter pylori is strain 26695. 20
21. A method according to any one of claims 15 to 20, wherein the plasmid vector is further defined as comprising an operon construct. 25
22. A method of treating an animal comprising the steps of: (a) providing a composition according to any one of claims 10 to 14; and (b) administering to the animal an effective 30 amount of said composition.
23. A method according to claim 22, wherein the animal is a human. 35
24. A method according to claim 22, wherein the treated animal has an enhanced immune response. WO 2006/015445 PCT/AU2005/001211 - 79
25. A method according to any one of claims 22 to 24, wherein the composition is administrated at a mucosal surface of the animal. 5
26. A method according to any one of claims 22 to 25, wherein one or more effective amounts of the composition are administered to the animal.
27. A composition comprising a recombinant cell 10 comprising a sequence encoding a non-Helicobacter pylori pharmacologically active molecule of interest comprising: (a) at least one non-Helicobacter sequence encoding a pharmacologically active molecule of interest; and 15 (b) a Helicobacter sequence having a promoter sequence capable of controlling expression of the non Helicobacter sequence, wherein the recombinant cell is capable of expressing said nucleic acid or causing the expression of the nucleic acid 20 molecule in a target cell.
28. A composition according to claim 27, wherein the nucleotide sequence encoding the recombinant cell further comprises a secretory signal polypeptide. 25
29. A composition according to claim 27, wherein said recombinant cell is a recombinant Helicobacter pylori.
30. A composition according to claim 29, wherein the 30 recombinant Helicobacter pylori is pTM103-8.
31. A composition comprising a recombinant Helicobacter pylori comprising: (a) a sequence encoding a fusion protein 35 comprising a non-Helicobacter pharmacologically active molecule of interest and a Helicobacter sequence; and WO 2006/015445 PCT/AU2005/001211 - 80 (b) an inducible Helicobacter pylori promoter sequence.
32. A plasmid vector comprising a composition 5 according to claim 31.
33. A pharmaceutical composition comprising as an active ingredient the plasmid vector of claim 32, together with a pharmaceutically acceptable dilute, carrier, 10 adjuvant or combination thereof.
34. A method for preparing a recombinant Helicobacter pylori comprising: (a) providing a culture of Helicobacter pylori; 15 and (b) providing a plasmid vector according to claim 32 to the culture to provide recombinant Helicobacter pylori, wherein said recombinant Helicobacter pylori are capable of 20 expressing or causing expression of said non-Helicobacter pharmaceutically active molecule in a target cell.
35. A composition according to claim 31, wherein said recombinant Helicobacter further comprises a second nucleic 25 acid molecule encoding an immunomodulatory polypeptide, wherein said recombinant Helicobacter is capable of expressing said second nucleic acid molecule in a target cell.
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