AU727683B2 - Cloned glutamic acid decarboxylase - Google Patents

Description

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Regulation 3.2

AUSTRALIA

Patents Act 1990 COMPLETE SPECIFICATION FOR A STANDARD PATENT

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Name of Applicant: Actual Inventor(s): REGENTS OF THE UNIVERSITY OF

CALIFORNIA

TOBIN, Allan J ERLANDER, Mark G KAUFMAN, Daniel L Address for Service: -DAVIES eOLLISEN-GAVEPaen-ti r L6tl Ccll--I C .1"ins Str..t, M bourne, 3000.

Zakm~n r~qw 204 1f Invention Title: CLONED GLUTAMC ACID DECARBOXYLASE The following statement is a full description of this invention, including the best method of performing it known to me/us: -1I- 9506l6,q:'oper~ejh,8877l. 167,1 CLONED GLUTAMIC ACID DECARBOXYLASE 1. FIELD OF THE INVENTION The present invention relates to the use of recombinant DNA technology for the transformation of a host organism with glutamic acid decarboxylase (GAD) for the expression of GAD polypeptides. Also encompassed are methods of using GAD polypeptides diagnostically and therapeutically in autoimmune disease.

2. DESCRIPTION OF THE BACKGROUND ART Insulin-dependent diabetes mellitus (IDDM; type I diabetes) is one of the most common metabolic disorders. In the United States, IDDM affects 15 approximately one in 300 to 400 people, and epidemiological studies suggest that its incidence is increasing. The disease results from the autoimmune destruction of the insulin-producing 3-cells of the pancreas. More specifically, the preonset stage is characterized by "insulitis", in which lymphocytes infiltrate the pancreatic islets and selectively destroy the 3- 20 cells. The typical IDDM presentation of hyperglycemia appears only after at least 80% of the insulin-producing 3-cells are lost. The remaining 3-cells are destroyed during the next few years.

Although insulin therapy allows most IDDM patients to lead normal lives, this replacement is imperfect and does not completely restore metabolic homeostasis. Thus, severe complications which result in dysfunctions of the eye, kidney, heart and other organs are common in IDDM patients undergoing insulin therapy.

-1 WO 92/05446 PCT/LUS91/O.W'72 2.

Because of this, it is highly desirable to extend the latency period through administration of immunosuppressant drugs) between the start of O-cell destruction and the actual requirement of insulin replacement when 80% of the O-cells are destroyed). Therefore, a diagnostic test which determines the beginning of O-cell destruction would allow the clinician to administer immunosuppressant drugs (Silverstein, et al., New England Journal of Medicine, 319:599-604, 1988) to extend this latency period and thus significantly delay the onset of insulin replacement side effects.

Many IDDM patients have sera which contain antibodies to a 64kD molecule (Baekkeskov, et al., J.Clin.lnvest., 79:926-934, 1987; Atkinson, et al., Lancet, 335:1357-1360, 1990), to islet cell cytoplasmic (ICA) molecules or islet cell surface (ICSA) molecules (Bottazzo, et al, Lancet, 1:668-672, 1980), or to insulin (Palmer, et Science, 222:1137-1139, 1983; Atkinson, et al., Diabetes, 35:894-898, 1986).

Atkinson and coworkers (Atkinson, et al., Lancet, 335:1357-1360, 1990) have demonstrated that the presence of antibodies to the 64kD molecule in human sera appears to be the earliest and most reliable indicator that onset of IDDM symptoms will eventually occur.

Recently, Baekkeskov and coworkers established that the 64kD molecule and glutamic acid decarboxylase (GAD) have several antigenic epitopes in common 20 and thus they may be identical or very similar molecules. Although this identification is an important finding, the use of this information as a diagnostic tool for predicting IDDM is quite cumbersome and limited unless knowledge of the molecular biology of GAD is known. Consequently, the cloning and subsequent production of large quantities of the 64kD molecule, or a GAD molecule which is 25 antigenically substantially identical to the 64kD molecule, will allow the development of a diagnostic kit designed to predict IDDM. The present invention provides a means for accomplishing this result.

oo ooe *oo *oo* 3 SUMMARY OF THE INVENTION In a first aspect, the present invention provides a method of detecting autoantibodies to human GAD which comprises: contacting a sample with an isolated recombinant non-full length GAD polypeptide wherein said non-full length GAD polypeptide contains at least one epitope for autoantibodies to human GAD; incubating the components of step for a period of timna and under conditions sufficient for said autoantibodies to bind to the nonfull length GAD polypeptide; separating the autoantibodies bound to the non-full length GAD 15 polypeptide from the sample; and S. detecting the presence of the autoantibodies bound to the polypeptide.

20 In a second aspect, the present invention provides a method of ameliorating S. an autoimmune response in a patient which comprises: administering to the patient a therapeutically effective amount of a recombinantly produced GAD polypeptide, wherein the recombinantly produced GAD polypeptide binds with a receptor.

Throughout this specification the word "comprise", or variations such as "comprises" or "comprising", will be understood to imply the inclusion of a stated element, integer or step, or group of elements, integers or steps, but not the exclusion of any other element, integer or step, or group of elements, integers or steps.

WO 92/05446 PCT/US91/0672 DESCRIPTION OF THE DRAWINGS FIGURE 1 probes.

FIGURE 2 GADs.

FIGURE 3 GADs.

FIGURE 4 FIGURE 5 FIGURE 6

GAD

FIGURE 7 Cloning strategy for obtaining GAD, and GAD, 7 specific cDNA DNA sequence and corresponding amino acid sequence for rat DNA sequence and corresponding amino acid sequence for human Comparison of rat GAD, and human GAD, amino acid sequences.

GAD

6 and GAD7 cDNAs hybridize to different size RNAs.

Southern blots hybridized with cDNA probes specific for GAD 6 and Immunological identification of GAD., and GAD,.

eeoc e oooo* o oooo oeeo o* oooo DETAILED DESCRIPTION OF THE INVENTION The present invention relates to the manipulation of genetic materials by recombinant procedures which make possible the production of polypeptides possessing part or all of the primary structural conformation for one or more of the epitopes for binding autoantibodies to glutamic acid decarboxylase.

5

(GAD

5 These polypeptides are highly useful for the immunological detection of autoantibodies reactive with them, since such autoantibodies are indicative of autoimmune diseases such as insulin dependent diabetes mellitus and "stiff man" WO 92/05446 PCT/US91/06872 syndrome. These polypeptides can also be used for purposes of screening drugs, such as those that alter GAD function, and for generation of polyclonal and monoclonal antibodies which, in turn, can be used diagnostically to detect GAD,.

The development of specific DNA sequences encoding eukaryotic GAD, polypeptide for splicing into DNA vectors can be accomplished using a variety of techniques. For example, altemative methods which can be employed include (1) the isolation of a double stranded DNA sequence from the genomic DNA of the eukaryote; the chemical manufacture of a DNA sequence to provide the necessary codons for the polypeptide of interest; and the in vitro synthesis of a double stranded DNA sequence by reverse transcription of mRNA isolated from a eukaryotic donor cell. In the latter case, a double stranded DNA complement of mRNA is eventually formed which is generally referred to as cDNA.

The manufacture of DNA sequences is frequently the method of choice when the entire sequence of amino acid residues of the desired polypeptide product is known. When the entire sequence of amino acid residues of the desired polypeptide is not known, the direct manufacture of DNA sequences is not possible and the method of choice is the formation of cDNA sequences. Among the standard procedures for isolating cDNA sequences of interest is the formation of plasmid-carrying cDNA libraries which are derived from reverse transcription of mRNA which is abundant in donor cells that have a high level of genetic Sexpression. When used in combination with polymerase chain reaction technology, even rare expression products can be cloned. In those cases where Ssignificant portions of the amino acid sequence of the polypeptide are known, the Sproduction of labeled single or double stranded DNA or RNA probe sequences 5 duplicating a sequence putatively present in the target cDNA may be employed in DNA/DNA hybridization procedures which are carried out on cloned copies of the cDNA which have been denatured into a single stranded form (Jay, et al., Nucleic Acid Research, 11:2325, 1983).

o* o e*o *o eep *p g *neg WO 92/05446 PCT/ US91 /04872 6.

Hybridization procedures are useful for the screening of recombinant clones by using labeled mixed synthetic oligonucleotide probes wherein each is potentially the complete complement of a specific DNA sequence in the hybridization sample which includes a heterogeneous mixture of denatured double stranded DNA. For such screening, hybridization is preferably performed on either single stranded DNA or denatured double stranded DNA. These procedures are particularly useful in the detection of cDNA clones derived from sources where an extremely low amount of mRNA sequences relating to the polypeptide of interest are present.

In other words, by using stringent hybridization conditions directed toward avoidance of non-specific binding, it is possible, for example, to allow the autoradiographic visualization of a specific cDNA clone by the hybridization of the target DNA to that single probe in the mixture which is its complete complement (Wallace, et al., Nucleic Acid Research, 2:879, 1981).

In addition, a GAD cDNA library can be screened by injecting the various cDNAs into oocytes, allowing sufficient time for expression of the cDNA gene products to occur, and testing for the presence of the desired cDNA expression product, for example, by using antibody specific for GAD.s polypeptide or by using functional assays for GAD, enzymatic activity.

Alternatively, a cDNA library can be screened indirectly for GAD, peptides having at least one epitope using antibodies to GAD, (Chang and Gottlieb, J.Neurosci., 8:2123, 1988). Such antibodies can be either polyclonally or monoclonally derived S"and used to detect expression product indicative of the presence of GAD, cDNA.

Preferred are antibodies directed to an epitope found in the first 100 amino acids of the N-terminal portion of GAD,.

Of the three above-noted methods for developing specific DNA sequences for use in recombinant procedures, the use of genomic DNA isolates, is the least common This is especially true when it is desirable to obtain the microbial expression of mammalian polypeptides because of the presence of introns.

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•ca,• .oo oo* WO 92/05446 PCT/US91/06872 7.

The present invention provides novel polypeptides of GAD, which have part or all of the primary structural conformation, that is, a continuous sequence of amino acid residues, having at least one epitope for antibodies to GAD,.

It is possible to use the polypeptide fragments of the invention rather than intact GAD, to detect autoantibodies to GAD,. The term "polypeptide," as applied to GAD, polypeptide, denotes any sequence of amino acids having an epitope for autoantibodies to GAD,, wherein the sequence of amino acids is encoded by all or part of the cDNA sequences of the invention.

The polypeptides resulting from microbial expression of the DNA sequences of the invention can be further characterized by their freedom from association with other eukaryotic polypeptides or other contaminants which might otherwise be associated with GAD, in its natural cellular environment or in such extracellular fluids as plasma or urine.

Studies by the present inventors unequivocally establish that GAD, and GAD 6 are encoded by distinct genes and are not produced, for example, by post-transcriptional or post-translational modification of a common genomic sequence. Evidence proving that GAD, and GAD, are encoded by different genes include: the largest contiguous sequence of exact identity between GAD, and GAD,. cDNAs is only 17 nucleotides in length, cDNAs from GADg 20 and GAD, do not cross hybridize with each other's or with each other's mRNA under low stringency conditions (2.0 x SSC, 0.01% SDS, 230C), and GAD, and GAD, cDNAs do not cross hybridize with isolated genomic clones encoding GAD7 and GAD,, respectively.

The term "host" is meant to include not only prokaryotes, but also such eukaryotes as yeast, filamentous fungi, as well as plant and animal cells which can replicate 'and express an intron-free DNA sequence of eukaryotic GADs. However.

0*o* 'prokaryotes are preferred as the host organism.

WO 92/05446 PCT/US91/06S72 8.

The term "prokaryotes" is meant to include all bacteria which can be transformed or transfected with the gene for the expression of GADs. Prokaryotic hosts may include gram negative as well as gram positive bacteria such as, for example, E.

coil, S. typhimurium, Serratia marcescens and Bacillus subtilis.

A recombinant DNA molecule coding for the GAD65 polypeptides can be used to transform or transfect the host using any of the techniques commonly known to those of ordinary skill in the art. Especially preferred is the use of a plasmid or a virus containing the GAD6 coding sequence for purposes of prokaryotic transformation or transfection, respectively.

Methods for preparing fused, operably linked genes and expressing them in bacteria are well-known in the art (Maniatis, et al., Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, 1989). The genetic constructs and methods described therein can be utilized for expression of GADs in prokaryotic hosts.

15 In general, expression vectors containing promotor sequences which facilitate the efficient transcription of the inserted eukaryotic genetic sequence are used in connection with the host. The expression vector typically contains an origin of replication, a promoter, and a terminator, as well as specific genes which are capable of providing phenotypic selection of the transformed cells. The 20 transformed prokaryotic hosts can be grown in fermentors and cultured according to techniques known in the art to achieve optimal cell growth. The polypeptides of the invention can then be isolated from the grown medium, cellular lysates, or cellular membrane fractions.

The isolation and purification of the microbially expressed polypeptides of the 25 invention may be by any conventional means such as, for example, preparative *i chromatographic separations and immunological separations such as those involving the use of monoclonal or polyclonal antibody.

WO *2/05446 PCT/US91/06872 9.

By having provided the sequence of amino acid residues of GAD5, the present invention provides for the manufacture of DNA sequences which code for the host expression of polypeptide analogs or derivatives of GAD, which differ from naturally-occurring forms in terms of the identity or location of one or more amino acid residues and which share some or all of the epitopes of naturally-occurring polypeptide forms.

The novel DNA sequences of the invention include all sequences useful in providing the expression in prokaryotic or eukaryotic host cells of polypeptides which have at least a part of the primary structural conformation for one or more epitopes capable of reacting with autoantibodies to GAD, which are comprehended by: the DNA sequence as set forth in Figures 2 or 3 or their complementary strands; DNA sequences which hybridize to DNA sequences defined in or fragments thereof; and DNA sequences which, but for the degeneracy of the genetic code, would hybridize to DNA sequences defined in (a) and above. Specifically comprehended in are genomic DNA sequences which encode allelic variant forms of GAD,. Part specifically comprehends the manufacture of DNA sequences which encode GAD,, GAD, fragments, and GAD, analogs wherein the DNA sequences thereof may incorporate codons which facilitate translation of mRNA in non-vertebrate hosts.

Since the cDNA sequence of the invention encodes essentially the entire human or rat GAD. molecule, it is now a matter of routine to prepare, subclone, and express smaller polypeptide fragments of cDNA from this or a corresponding cDNA sequence which would encode as few as one ep'tope for autoantibodies to human or rat GAD,. The presence of such an epitope on a cloned polypeptide can then 25 be confirmed using, for example, sera from a patient with autoantibodies to GAD,.

An example of such a smaller peptide is the first approximately 100 amino acids from the N-terminus of GAD, (shown in Figure This amino acid sequence is essentially absent from GAD 67 WO 92/05446 PCT/US91/0 872 The GAD, of the invention is particularly suited for use in immunoassays in which it can be utilized in liquid phase or bound to a solid phase carrier. In addition, GAD, used in these assays can be detectably labeled in various ways.

Examples of immunoassays which can utilize the GAD, of the invention are competitive and non-competitive immunoassays in either a direct or indirect format.

Examples of such immunoassays are the radioimmunoassay (RIA), the sandwich (immunometric assay) and the Western blot assay. Detection of antibodies which bind to the GAD, of the invention can be done utilizing immunoassays which run in either the forward, reverse, or simultaneous modes, including immunohistochemical assays on physiological samples. The concentration of GAD, which is used will vary depending on the type of immunoassay and nature of the detectable label which is used. However, regardless of the type of immunoassay which is used, the concentration of GAD, utilized can be readily determined by one of ordinary skill in the art using routine experimentation.

15 The GAD6 of the invention can be bound to many different carriers and used to detect the presence of antibody specifically reactive with the polypeptide.

Examples of well-known carriers include glass, polystyrene, polyvinyl chloride, polypropylene, polyethylene, polycarbonate, dextran, nylon, amyloses, natural and modified celluloses, polyacrylamides, agaroses, and magnetite. The nature of the carrier can be either soluble or insoluble for purposes of the invention. Those skilled in the art will know of other suitable carriers for binding GAD,, or will be able to ascertain such, using routine experimentation.

There are many different labels and methods of labeling known to those of ordinary skill in the art. Examples of the types of labels which can be used in the present invention include enzymes, radioisotopes, colloidal metals, fluorescent compounds, chemiluminescent compounds, and bioluminescent compounds.

*o.o.o WO 9/05446 PCT/LS91/06872 11.

Alternatively, the polypeptide of the invention can be used to detect antibodies to GAD, by measuring GAD enzymatic activity. For example, GAD, and a specimen suspected of having antibodies to GAD, can be incubated for a period of time and under conditions sufficient to allow binding to occur between GAD, and the antibodies. The reaction product is precipitated and then tested for GAD enzymatic activity.

For purposes of the invention, the antibody which binds to GAD, of the invention may be present in various biological fluids and tissues. Any sample containing a detectable amount of antibodies to GAD. can be used. Normally, a sample is a liquid such as urine, saliva, cerebrospinal fluid, blood, serum and the like, or a solid or semi-solid such as tissue, feces and the like.

The materials for use in the assay of the invention are ideally suited for the preparation of a kit. Such a kit may comprise a carrier means being compartmentalized to receive in close confinement one or more container means 15 such as vials, tubes and the like, each of the container means comprising one of the separate elements to be used in the method. For example, one of the container means may comprise GAD, bound to a carrier. A second container may comprise soluble, detectably-labeled second antibody, in lyophilized form or in solution.

20 In addition, the carrier means may also contain a plurality of containers each of which comprises different, predetermined amounts of GAD,. These latter containers can then be used to prepare a standard curve into which can be interpolated the results obtained from the sample containing the unknown amount of autoantibodies to GADs.

25 In using the kit all the user has to do is add, to a container, a premeasured amount of a sample containing a measurable, yet unknown amount of autoantibodies to GAD, to be detected, a premeasured amount of carrier-bound WO 92/05446 PCT/US911/6872 12.

GAD, present in the first container, and a premeasured amount of the detectably labeled second antibody present in the second container. Alternatively, the nondetectably labeled GAD, can be provided attached to the container to which the sample and the detectably labeled second antibody are added. After an appropriate time for incubation, an immune complex is formed and is separated from the supematant fluid, and the immune complex or the supernatant fluid are detected, as by radioactive counting or addition of an enzyme substrate, and color development.

The term "ameliorate" denotes a lessening of the detrimental effect of the autoimmune response in the patient receiving therapy. The term "therapeutically -effective" means that the amount of GAD, polypeptide used is of sufficient quantity to ameliorate the cause of disease due to the autoimmune response.

The recombinant GAD, polypeptides of the invention can also be used therapeutically in patients having an autoimmune response to GAD,. Such 15 therapy can be accomplished by, for example, the administration of recombinant GADs polypeptide. Such administration can utilize unlabeled as well as labeled GAD, polypeptide. When unlabeled GAD, polypeptide is utilized advantageously, it would be in a form wherein, for example, the GAD, polypeptides are in fragments which are too small to stimulate an immune response, but large enough to bind, or block, the continuance of the autoimmune response. For example, GAD, could be digested enzymatically into epitope-sized peptides (typically 5-12 amino acids in length) and thereby bind to Fab binding portions present in the body fluids, or on the surface of immune cells, of the patient with autoimmune disease.

Alternatively, the recombinant GAD, polypeptides of the invention could be administered labeled with a therapeutic agent. These agents can be coupled either directly or indirectly to the GAD, polypeptides of the invention. One example of indirect coupling is by use of a spacer moiety. These spacer moieties, WO 92/05446 PCT/US91/06872 13.

in turn, can be either insoluble or soluble (Diener, et al., Science, 231:148, 1986) and can be selected to enable drug release from the GAD, polypeptide at the target site. Examples of therapeutic agents which can be coupled to the GAD, polypeptides of the invention for immunotherapy are drugs, radioisotopes, lectins, and toxins.

The drugs with which can be conjugated to the GAD, polypeptides of the invention include compounds which are classically referred to as drugs such as mitomycin C, daunorubicin, and vinblastine.

In using radioisotopically conjugated GAD, polypeptides of the invention for immunotherapy, certain isotopes may be more preferable than others depending on such factors as leukocyte distribution as well as stability and emission.

Depending on the autoimmune response, some emitters may be preferable to others. In general, a and 0 particle-emitting radioisotopes are preferred in immunotherapy. Preferred are short range, high energy a emitters such as 212 Bi.

15 Examples of radioisotopes which can be bound to the GAD, polypeptides of the invention for therapeutic purposes are 12 5 1311, Cu, 2 2 Bi, 2 1 1 At 2 12 Pb, 4 7 Sc, '0Pd and 'lRe.

Lectins are proteins, usually isolated from plant material, which bind to specific sugar moieties. Many lectins are also able to agglutinate cells and stimulate 20 lymphocytes. However, ricin is a toxic lectin which has been used immunotherapeutically. This is accomplished by binding the a-peptide chain of ricin, which is responsible for toxicity, to the antibody molecule to enable site specific delivery of the toxic effect.

Toxins are poisonous substances produced by plants, animals, or microorganisms 25 that, in sufficient dose, are often lethal. Diphtheria toxin is a substance produced by Corynebacterium diphtheria which can be used therapeutically. This toxin consists of an a and B subunit which under proper conditions can be separated.

WO 92/05446 PCT/US91 06872 14.

The toxic A component can be bound to GAD, polypeptide and used for site specific delivery to a leukocyte expressing a receptor for GAD6 polypeptide.

Other therapeutic agents which can be coupled to the GAD, polypeptides of the invention, as well as ex vivo and in vivo therapeutic protocols, are known, or can be easily ascertained, by those of ordinary skill in the art.

The dosage ranges for the administration of the GAD, polypeptides of the invention are those large enough to produce the desired effect in which the symptoms or cellular destruction of the autoimmune response are ameliorated.

The dosage should not be so large as to cause adverse side effects, such as unwanted cross-reactions, anaphylactic reactions, and the like. Generally, the dosage will vary with the age, condition, sex, and extent of the disease in the patient and can be determined by one of skill in the art. The dosage can be adjusted by the individual physician in the event of any counterindications.

Dosage can vary from about 0.1mg/m 2 to about 2000mg/m 2 preferably about S 15 0.1mg/m 2 to about 500mg/m 2 /dose, in one or more dose administrations daily, for one or several days.

The GAD, polypeptides of the invention can be administered parenterally by injection or by gradual perfusion over time. The GAD, polypeptides of the Sinvention can be administered intravenously, intraperitoneally, intra-muscularly, 20 subcutaneously, intracavity, or transdermally.

Preparations for parenteral administration include sterile aqueous or non-aqueous solutions, suspensions, and emulsions. Examples of non-aqueous solvents are propylene glycol, polyethylene glycol, vegetable oils such as olive oil, and injectable organic esters such as ethyl oleate. Aqueous carriers include water, 25 alcoholic/aqueous solutions, emulsions or suspensions, including saline and buffered media. Parenteral vehicles include sodium chloride solution, Ringer's dextrose, dextrose and sodium chloride, lactated Ringer's, or fixed oils.

WO092/05446 PCT/US91/06872 Intravenous vehicles include fluid and nutrient replenishers, electrolyte replenishers (such as those based on Ringer's dextrose), and the like. Preservatives and other additives may also be present such as, for example, antimicrobials, anti-oxidants, chelating agents, and inert gases and the like.

The invention also relates to a method for preparing a medicament or pharmaceutical composition comprising the GAD, polypeptides of the invention, the medicament being used for therapy of autoimmune response to GAD,.

The above disclosure generally describes the present invention. A more complete understanding can be obtained by reference to the following specific examples which are provided herein for purposes of illustration only and are not intended to limit the scope of the invention.

EXAMPLE 1 CLONING AND EXPRESSION OF GAD,, A. RECOMBINANT DNA PROCEDURES 15 In order to obtain cDNA probes specific for GAD, and GAD 6 7 total RNA was extracted from adult rat brain by guanidine isothiocyanate-cesium gradient using the method of Chirgwin, et al. (Biochemistry, 18:5294, 1979). Poly RNA was purified on oligo dT cellulose, using the protocol by Bethesda Research Laboratories (BRL). First strand synthesis was performed by using MMLV-reverse 20 transcriptase (BRL), with conditions suggested, except that poly d(N)-mers (Pharmacia) were used as primers. This cDNA-RNA mixture was heat inactivated at 65 C for 15 min and stored at -200C. For PCR, 1/50 of the sample was added to the 100pl reaction. Degenerate oligonucleotides were synthesized (Applied :Biosystems) to encode the underlined common amino acid sequences of feline (from cDNA) (Kobayashi, et al., J.Neurosci., 7:2768, 1987) and rat (from peptides) WO 92/05446 PCT/US91/04872 16.

(Chang and Gottlieb, J.Neurosci., 8:2123, 1988) GAD (Figure The sequence of each degenerate oligonucleotide contained one strand of the DNA sequence recognized by either Sstl and Hindll oligo) or Sstl and Sstll (3'-end oligo). These primers were used for selective amplification by polymerase chain reaction of the generated cDNA template as described by Gould, et al.

(Proc.Natl.Acad.Sci.,USA, 86:1934, 1989). PCR products were subcloned into Hindlll/Sstl double digested Bluescript SK vector (Stratagene), transformed into (BRL), and plated by standard methods (Maniatis, et al., Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, 1989).

Cqlony hybridization was done with an 5'-32P end labeled oligonucleotide specific to feline GAD (Kobayashi, et al., J.Neurosci., Z:2768, 1987). End labeling of oligonucleotide, hybridization conditions, and washing conditions were done as described (Wallace, et al., in Guide to Molecular Cloning Techniques; Berger, et al., Eds. in Methods of Enzymology; Abelson, et al., Eds. Academic Press, Inc., San Diego, 432-442, 1987), except that the nitrocellulose filters were washed at for 15 min. Colonies which were positive and negative in the hybridization were individually picked and grown overnight in Terrific Broth (Tartof, et al., Focus, 9:12, 1987). DNA was isolated using a boiling method (Maniatis, et al., Molecular 20 Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, 1989) and templates were denatured by 0.2N NaOH and purified by Sephacryl S400 spun columns (Pharmacia). Sequencing of denatured double stranded template was by the chain-termination method (Sanger, et al., Proc.Natl.Acad.Sci.,USA, 74:5463, 1977) using the T7-sequencing kit (Pharmacia).

25 As shown in Figure 1, PCR-generated rat GAD, and GADy 7 cDNAs were used as probes to screen a lambda ZAP (Stratagene) rat hippocampus library provided by S. Heinemann (Salk Institute) by standard techniques (Maniatis, et al., Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, 1989). A 2400 nucleotide GAD, cDNA (the largest clone) was isolated and WOt 92/05446 PCT/LS91/06872 17.

subcloned by "zapping" as described by Stratagene. When a rat GAD 67 cDNA was obtained which was smaller than a 3.2kb rat GAD 6 7 cDNA clone already on hand, the larger cDNA was sequenced. Exo III deletions (Henikoff, Gene, 28:351, 1984) were made in both directions for GAD, and GAD, and templates were prepared and sequenced as described above. Anchored PCR (Frohman, et al., Proc.Natl.Acad.Sci.,USA 85:8998, 1988) was done to clone the remaining of GADG and GAD,7 mRNAs which were not represented in the original cDNA clones isolated in the library screening. Sequencing of these clones revealed that neither GADes nor GAD6y mRNAs contained any further initiation codons (AUGs) in frame with the previously designated initiation codons of the original cDNA clones.

EXAMPLE 2 CHARACTERIZATION OF CLONED GAD, A. NORTHERN BLOT HYBRIDIZATION t.

15 Two PCR-derived cDNA probes were hybridized to Northern blots containing rat brain RNA in order to determine whether the GAD 67 and GAD, cDNAs were derived from two different mRNAs. RNA was extracted as described in Example 1. Poly RNA was separated by electrophoresis in formaldehyde and transferred onto Biotrans (ICN) membranes, and hybridization was performed as described by 20 Well, et a. (J.Neurosci., 16:311, 1986), except that 100pl/ml of poly was added.

Probes were labeled to approximately 109 dpm/ig by the oligolabeling procedure of Feinberg and Vogelstein (Anal.Biochem., 132:6, 1983). Identical results were :.:::subsequently obtained with full-length clones of GAD, and GAD, 6 cDNAs.

As shown in Figure 5, lanes 1 and 2 contain 1ig of poly selected RNA 25 extracted from rat cerebellum. Lane 1 was hybridized to a cDNA probe for the rat *Qoe WO 92/05446 PCT/L'S91/0(872 18.

cognate of feline GAD 67 (Kobayashi, et J.Neurosci., 7:2768, 1987) and lane 2 with a cDNA probe for the rat peptide sequence (which corresponds to GAD,).

The cDNA probe for the rat peptide sequence hybridized to a 5.7kb RNA, while the cDNA probe for the rat cognate of our feline cDNA, hybridized to a 3.7kb RNA.

This demonstrates that GAD, and GAD 67 are not derived from the same mRNA.

B. GENOMIC HYBRIDIZATION OF GAD,AND GAD,, In order to investigate the possibility that GAD6, and GAD, arise from separate genes, cDNAs of both GAD, and GAD, were hybridized to DNA blots containing genomic DNA.

For Southern blots, genomic DNA was extracted from rat liver as described (Kaiser, et al., in DNA Cloning, vol.1, A Practical Approach, D.M. Glover ed., IRL Press, Oxford, .38-40, 1985). DNA (10 g/sample) was digested to completion with EcoRI and Hindlll using conditions recommended by the suppliers (BRL, Gaithersburg, MD). DNA fragments were separated by electrophoresis at 1.5v/cm for 16 hrs in 15 0.8% agarose. The DNA was then transferred to Zeta-Probe membranes (Bio-Rad), hybridized, and washed, as described by Gatti, et al. (Biotechniques, 2:148, 1984), except that 5sg/ml Carnation dried milk was substituted for Denhardt's solution.

Probes for Southern blots were labeled as described in Example 1, above.

i. As shown in Figure 6, genomic DNA digested with Hindlll and EcoRI are in lanes 1 and 3 and lanes 2 and 4, respectively. GAD 6 7 cDNA was hybridized to lanes 1 and 2, whereas GAD, cDNA was hybridized to lanes 3 and 4. Numbers along the side of the gel are the DNA fragment sizes in kilobases.

SThis data shows that the two cDNAs hybridize to genomic fragments of different sizes. In addition, the greatest contiguous stretch of identical nucleotide sequence f W@ 92/05446 PCT/LS91/068-2 19.

of GAD, and GAD 67 cDNAs is only 17 nucleotide bases in length. Thus, GAD 67 and GAD, are encoded by two distinct genes.

C. ENZYMATIC COMPARISON OF GAD, AND GAD,, Studies were done comparing the effect of PLP on the activity of GAD 67 and GAD,. In so doing, both cDNAs were subcloned into vectors that allowed their expression in bacteria (Studier, et al., J.Mol.Biol., 189:113,1986). Overexpression of "fusionless" GAD, and GAD, was accomplished by subcloning GADs cDNA into the Ncol site of pET-8c and GAD, cDNA into the Nhel site of pET-5c vectors (Studier, et al., J.Mol.Biol., 189:113, 1986).

To obtain compatible sticky ends for correct in-frame subcloning of both cDNAs, selective amplification was performed by PCR using conditions suggested by United States Biochemical (USB), with 200pM dNTPs and 1.5mM MgCI 2 in the mixture and annealing at 550C with 20 cycles to decrease infidelity of AmpliTAQ (USB). Primers specific for GAD6, and GAD 67 contained one DNA strand of the 15 Ncol and Spel recognition sites, respectively. Since there is a Nhel restriction site within the coding region of GAD, 7 Spel (which is compatible with Nhel) was used.

PCR products were subcloned into their respective pET vectors, transformed into DH5 and plated as described (Maniatis, et al., Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, 1989). Colonies were picked and grown overnight in LB broth with 50pg/ml ampicillin. Subclones with correct orientation were transformed into BL21(DE3) strain (Studier, et al., J.Mol.Biol., 189:113, 1986) for overexpression. As a negative control, the pET-8C vector with no insert was transformed and subsequently induced. Single colonies were picked, grown, induced by 1mM isopropyl-B-D-thiogalacto-pyranoside (IPTG), and analyzed on SDS-PAGE gels as described (Sambrook, et al., Molecular WO 92/05446 PCT/US91/06872 Cloning a Laboratory Manual, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, 17.15-17.16, 1989).

To measure GAD activity, we induced 10ml cultures of bacteria at ODoo-0.5 with 1mM IPTG. Two hours after induction, bacteria was spun down and resuspended and sonicated in 1ml of homogenizing buffer (1 mM phenylmethylsulfonyl fluoride (PMSF), 1mM 2-aminoethylisothiouronium bromide (AET), and 60mM potassium phosphate, pH After sonication, cell debris was removed by centrifugation and protein concentration was measured (Bradford, Anal.Biochem., 72:248, 1986) in the supematant (supematant was stored in aliquots at -70 0 Brain homogenates were prepared as described (Legay, et al., J.Neurochem., 46:1478, 1986). GAD activity was measured as described (Krieger, et al., J.Neurochem., 33:299, 1984) with 0.2mM PLP present or absent and 20pl of brain homogenate or bacterial lysate in the incubation mixture. Production of 1CO 2 in bacterial lysates was linear with respect to time of incubation and protein concentration.

oooo.

WO 92/05446 WC92/546PC'T/US9I /068712 21.

TABLE 1 GAD S~ecific ActivitXa PLP PLP Fold Increase in Induct ion Source BL2l(DE3) pET-8c BL2l(DE3) pET-GAD., 12 0.4 115 3 9±1I BL21(DE3) pET-GAD 6 7 160 2 773 61 389 8 216 2 Rat Brain 131 5 acpms of "4C0 2 /A9 protein/hr of triplicates S.E.M.

As shown in Table 1, bacterial lysates containing GAD 6 or GAD 6 7 catalyze the conversion of 4 C]-glutamate to GABA and 14 C0 2 PLP stimulates the enzymatic activity of GAD65 more than GAD 67 This greater stimulation probably reflects the faster cycling of GAD., through the inactivation cycle proposed by Martin and coworkers (Martin, CeII.MoI.NeurobioL., 7:237, 1987).

This fast er cycling suggests that GAD65 contributes more to the pool of apo-GAD that exists in vivo (Miller, et af., Brain Res.BuI., S(Suppl.2):89, 1980). Thus, in vivo, PLP appears to regulate GAD.5 activity more than GAD 67 activity.

activity in bacterial lysates is similar to the five-fold PLP stimulation of GAD activity found in synaptosomes prepared from rat substantia nigra (Miller, et J.Neurochem., 33:533, 1979). Because both GADs are more dependent upon WO 92/05446 PCT/US91/0e872 22.

added PLP in bacteria than is the GAD activity in crude rat brain homogenates, the endogenous PLP concentration of bacteria lysates may be less than rat brain homogenates.

D. IMMUNOLOGICAL IDENTIFICATION OF GAD,, AND GAD, 7 Rat brain homogenates and bacterial lysates were extracted as described above.

Equal volumes of loading buffer were added to each sample as described (Harlow, et al., Antibodies, A Laboratory Manual, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, 1988). Proteins were separated by electrophoresis in a acrylamide gel in SDS and electrophoretically transferred to nitrocellulose (Harlow, et al., Antibodies, A Laboratory Manual, Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, 1988). The unreacted sites were blocked with a phosphate Sbuffered saline (PBS) solution containing 2% bovine serum albumin (fraction 1% gelatin, and 1% Triton-X-100 at 42 C for one hr. After washing, the nitrocellulose filter was then cut into three sections and incubated with the following primary S. 15 antibodies: lanes 1 to 4 with a 1/200 dilution of the antiserum of Oertel, et al.

(Neuroscience, 6:2689, 1981), which recognizes both GAD 67 and GAD,; lanes 5-8 with a 1/2000 dilution of K-2 antiserum, which recognizes only GAD67; lanes 9-12 with a 1/2000 dilution of GAD-6 monoclonal antibody, which is specific for (Chang, et al., J.Neurosci., 8:2123, 1988). All fitters were extensively washed and appropriate secondary antibodies were incubated and washed. Bound antibodies were detected with 11l-labeled protein A and autoradiography. Each lane ~contained the following: lanes 1, 5, and 9 are BL21(DE3) pET-GAD7; lanes 2, 6, and 10 are BL21(DE3) pET-GADs; lanes 3, 7, and 11 are rat brain homogenate; and lanes 4, 8, and 12 are BL21(DE3) pET-8c.

The immunoblots of bacterially produced GADs and GAD 67 demonstrated that GADe indeed corresponds to the smaller GAD in brain extracts, and GAD, to the larger form (Figure Previous work has demonstrated the correspondence of WOi 92/05446 PCT/US91/068"2 23.

GAD

67 to the larger GAD for feline GADgy, and for mouse GAD 67 (Katarova, et al., Eur.J.Neurosci., 2:190, 1990; 235, 1987). The mobilities of bacterially produced GADss and GAD 67 (as detected with the antiserum of Oertel, et al. (Neuroscience, 6:2689, 1981) are identical to the immunoreactive doublet seen in rat brain homogenate.

The smaller molecular weight and larger molecular weight forms of GAD in rat brain are thus identical in antigenicity and size to the products of GAD, and

GAD

6 cDNAs, respectively. Consequently, the two GADs in rat brain are GAD, and GAD 6 From this data it can also be concluded that the molecular identity of the reported PLP-dependent and PLP-independent GADs by Tapia (Bayon, et al., J.Neurochem., 29:519, 1977) are GADs and GAD, 7 respectively. Martin and coworkers (Spink, et al., Brain Res., 421:235, 1987) have reported the existence of four kinetically different forms of rat brain GAD. However, immunoblotting experiments (with the antisera used here) of these forms have not been reported.

15 E. DISTRIBUTION OF GAD,, and GAD, IN RNAs IN BRAIN TISSUE Experiments were done to determine the distribution of GAD, and GAD,7 in RNAs in cerebellum using in situ hybridization.

Transcripts of, respectively, 3.2kb and 2.3kb from GADs and GAD 67 cDNAs, were radiolabeled with 'S according to Wuenschell, et al. (Proc.Natl.Acad.Sci.,USA, 20 83:6193, 1986) procedure. Hydrolyzed fragments of 200 bp were hybridized to coronal sections of a rat cerebellum. Animals were anesthetized under halothane and decapitated. The brain was rapidly frozen in dry ice and coronal frozen sections (12pm) were fixed for 30 min in freshly prepared 4% formaldehyde in phosphate-buffered saline (PBS; 130mM NaCI, 10mM Na phosphate, pH The tissue was dehydrated through graded ethanol solutions and stored at -70 C.

t= WO 92/05446 PCT/US91/0s872 24.

In order to increase tissue permeability, the sections were submitted to the following pretreatments: rehydration through graded ethanol solutions (5 min each in 95%, 85%, 70%, 50%, and 30% ethanol); PBS (5 min); 0.02N HCI (10 min); PBS min); 0.01% Triton N-101 in PBS (1 min); PBS (2 x 5 min); 1pg/ml proteinase K (7.5 min); and glycine (to inhibit proteinase K) in PBS (3 x 5 min). Proteinase K was digested for 30 min at 37'C before use. Sections were then incubated at 37°C in 50% formamide, 750mM NaCI, 25mM EDTA, 0.2% SDS, 0.02% BSA, 0.002% Ficoll, 0.02% polyvinylpyrrolidone, 250/g/ml yeast tRNA, 250pg/ml poly A, and 25mM PPES (pH 6.8).

For the hybridization, 100mM DTT, 10% dextran sulfate, and sense or antisense 3S-RNA were added to the prehybridization solution. An aliquot (50pl) of the hybridization solution containing about 3 ng (106 cpm) of probe (sense or antisense) was added onto the slides. Each slide was coverslipped and incubated for 16 hrs at 50*C, following which the siliconized coverslips were removed by brief washing in 4 x SSC (1 x SSC 150mM NaCI, 60mM Na citrate, pH Sections were then treated with ribonuclease A (50pg/ml in 0.5M NaCI, 10mM Na thiosulfate, ImM EDTA, 10mM TrisHCL, pH 8.0) for 20 min at 37 C and rinsed for 2 hrs at room temperature in 2 x SSC, 10mM Na thiosutfate, for 30 min at 55 C.

*Sections were dehydrated in ethanol, delipidated in xylene, coated with Kodak NTB2 emulsion and exposed for 10 days at 40C. The emulsion was developed with Kodak D19, and the tissue counterstained with cresyl violet.

0 Autoradiographic grains were detected using reflected polarized light and grain numbers, densities, nd cell areas were determined with an Analytic Imaging Concepts image analyzer system. Due to the low background level, the criteria for defining a cell "labeled" was based on the presence of more than 5 clustered grains. The GAD labeled cells were found scattered throughout the brain, enabling the measurement of the number of grains over individual cells. The boundary of the cell and the area covered by a grain allowed the calculation of the number of wo '42/05446 PCT/US91/06872 grains per cell. This analysis was done at a high magnification (800X), using both reflected polarized light and transmitted light to simultaneously visualize the stained cell and the superimposed grains. Numbers are means S.E.M. of cells.

TABLE 2

GRAINS/CELL

C.J RNA GCAD-mRNA CELL TYPE Purkinj e Golgi II Basket Stellate 172 34 (87)" 96 8 (80) 61 12 (102) 55 15 (65) 43 2 64 9 16 1 (57) 18 3 (37) 15 0 1 *O oO o oooo oooo o*o oooo *ooooo _o *o *o 20 ooo oo *o S.E.M.(n) In all neuronal types GAD.7 mRNA levels are greater. The observations with in-situ hybridization are consistent with previous findings (Nitsch, J.Neurochem., 34:822, 1980; Denner, et aL., J.Neurochem., 44:957, 1985; Itoh, et al., Neurochem. Res.

6:1283, 1981) that the ratio of PLP dependent to independent GAD activities in the cerebellum is one of the lowest in brain regions tested. In addition, as shown in Table 2, the order of amounts for GAD 67 mRNA is Purkinje Golgi II Basket Stellate cells; in contrast, for GADs mRNA, this order is Golgi II Purkinje Basket Stellate cells.

The expression of GADs and GAD, 7 mRNAs thus differs among classes of neurons. The contribution of each to total GAD activity in turn affects how GABA production is regulated. For example, the substantia nigra contains one of the WO 92/05446 PCT/US91/06872 26.

highest ratios of PLP-dependent to PLP-independent GAD activities (Nitsch, J.

Neurochem., 34:822, 1980). Increasing GABA concentration in the substantia nigra by local injection of inhibitors of GABA catabolism is especially effective in reducing seizure susceptibility (Gale, Fed. Proc., 44:2414, 1985). Experimental animals undergoing seizures induced by PLP-antagonists may therefore be unable to inhibit seizure propagation because of inhibition of GAD. particularly in nerve terminals within the substantia nigra.

F. SUBCELLULAR LOCATION OF GAD,, AND GAD,, The distribution of GAD6 and GAD 67 was evaluated in the S 2 and synaptosome subcellular fractions. S 2 is a high speed supernatant consisting of the cytosol of all cells in the brain, while the synaptosomal fraction consists primarily of nerve endings (Gray, et al., J. Anat., Lohd, 96:79, 1962). For these studies, whole rat brain fractionation was performed as described by Booth and Clark (Booth, et al., Biochem. 176:365, 1978). Protein concentrations were determined by Schaffner and Weissman (Schaffner, et al., Anal. Biochem. 56:502, 1973). Samples were prepared as described (Kaiser, et al., DNA Cloning, Vol. I, A Practical Approach, D.M. Glover ed. (IRL Press, Oxford, 1985, pp. 38-40), and immunoblotting was oe done as described above using GAD-6 monoclonal antibody and K-2 antiserum.

Equal amounts of protein (16/pg) were added to each lane. Autoradiography 20 showed a linear response of increasing amount of 125 -protein A bound to antibody with protein concentrations of 1, 3, 10, 30, 100pgs with both K-2 antiserum and GAD-6 monoclonal antibody (data not shown).

The results showed that GAD6y was present in equal amounts in both fractions.

Since the S 2 fraction contains the cytosolic proteins of glial (as well as other nonneuronal) and neuronal cells, the concentration of GAD, 7 must be greater in neuronal cell bodies than in nerve endings. In contrast, the concentration of GAD.s was greater in synaptosomes than in S 2 These subcellular fractionation experiments suggest that, in contrast to GAD6, a much greater fraction of GAD 6 7 WO 92/05446 PCT/US91/06872 27.

is present in cell bodies of neurons than in nerve terminals. Thus, subcellular fractionation, like immunohistochemistry, shows that GAD, and GAD 6 7 have different subcellular distributions.

In vivo experiments utilizing inhibitors of GABA synthesis and degradation have suggested that the GABA pool in neuronal cell bodies is different from that in the nerve terminals (ladarola, et al., Mol. Cell. Biochem., 39:305, 1981). GABA produced by GAD, may be involved more in cellular metabolism (for example, in the GABA shunt) and in dendrodendritic synapses. The dendrites of granule cells in the olfactory bulb, which form dendrodendritic synapses with mitral dendrites (Shepard, Physiol. Rev., 52:864, 1972) and probably release GABA (McLennan, Blin Res., 29:177-184, 1971), label intensely with K-2 antiserum. While not shown here, it has also been found greater GAD, than GAD6 mRNA levels (2-3 fold) in the olfactory bulb. This distribution is consistent with the reported finding that most GAD activity in the olfactory bulb is present in S 2 and P, (crude nuclear S 15 pellet) and not in synaptosomes (Quinn, et al., J. Neurochem., 35:583, 1980).

The differing subcellular distributions of GADes and GAD 67 could result from cytoskeletal anchoring or from some unknown protein targeting mechanism. Some cytoskeletal proteins have distributions that resemble GADes and GAD 67 For example, in cultured sympathetic neurons Peng, et al. (J Cell. Biol., 102:252, 1986), 20 demonstrate that 84% of tau is in axons while 100% of MAP-2 is in cell bodies and dendrites. In addition, 43kd protein, a cytoskeletal protein, is thought to anchor the acetylcholine receptor to the underlying membrane cytoskeleton (Flucher, et al., Neuron, 3:163, 1989).

o• o.eo WO 92/05446 PCT/LS91/ 6872 28.

EXAMPLE 3 DETECTION OF GAD AUTOANTIBODIES IN CUNICAL SPECIMENS A. MATERIALS AND METHODS 1. Patient Specimens. Sera from four groups of individuals were selected from a previous study by Atkinson and co-workers (Atkinson, et al., Lancet, 335:1357- 1360, 1990). These groups consisted of: Group 1 new onset IDD patients diagnosed according to the established National Diabetes Data Group (NDDG) criteria (Gleichman, et al., Diabetes, 36:578-584, 1987) that had been referred to the University of Florida, Diabetes Clinics; Group 5 randomly selected islet cell cytoplasmic antibody (ICA) negative non-diabetic controls without any known family history of autoimmune disease; Group 13 individuals whose sera had been collected 3 to 66 months prior to their documented clinical onsets of IDD; Group non-diabetic controls and relatives, and those who were studied prior to their onsets of IDD; and Group 3 patients at risk for IDDM, but where onset has not yet occurred. This latter group had been ascertained through ongoing prospective ICA screening studies of more than 5000 first degree relative of IDD probands, and 8200 individuals from the general population (of which 4813 were school children).

2. Islet Cell Autoaritibodies. ICA were assayed by indirect immunofluorescence on blood group O cryocut pancreatic (Atkinson, et al., Lancet, 335:1357-1360, 20 1990). All results were interpreted on coded samples, with control negative and positive sera in each batch. The degrees of ICA positivity were analyzed with the guidelines established by the Immunology Diabetes Workshop (IDW) for the standardization of ICA (Gleichman, et al., Diabetes, 36:578-584, 1987). All positive sera were titered by end point dilution, and the Juvenile Diabetes Foundation (JDF) WO 92/05446 PCT/US91/06872 15 29.

units were determined by reference to a standard serum previously calibrated to the international JDF standard of 80 units. In the studies reported here, a positive ICA result was defined by replicate titers of 10 JDF units or greater.

3. HLA DR Typing. HLA DR typing was performed as adapted from the method described by Van Rood and Van Leuwen (Nature, 262:795-797, 1976), using DR trays (One Lamda Laboratories, Los Angeles, CA).

4. Human Islet Cells. Human pancreatic islets were isolated from cadaveric pancreases and maintained in vitro as previously described (Ricordi, et al., Diabetes, 37:413-420, 1988). The islet cells were metabolically labeled with 3S methionine (Amersham, Arlington Heights, IL) in vitro (95% air/5%CO2).

Islet Cell Extractions and Immunoprecipitations. Islet cells were extracted as previously described by Atkinson, et'a. (Lancet, 335:1357-1360, 1990) with the following modifications. For immunoprecipitation studies, the islet cell lysates were predeared twice by incubation (2h, 40C) with either control, IDD serum (100pl), or GAD-6 (Chang, et J.Neuro, 8:2123-2130, 1988) (11l in 99pl of Tris buffer (Atkinson, et al., Lancet, 335:1357-1360, 1990) for every 1000 islets. Immune complexes were then absorbed (1h 4"C) with an excess of protein A Sepharose CL-4B (Pharmacia, NJ). Aliquot volumes representing 1000 islet cells containing unbound (precleared) lysate were then incubated (12h, 4°C) with either IDD or control sera 2 5 p1), or GAD-6 (Chang, et al., J.Neuro, 8:2123-2130, 1988) (1pl in 25u1 Tris buffer). Following another incubation with protein A Sepharose CL-4B (1h, 4 the complexes were then washed 5 times with 50mM Tris HCL (pH 7.4) with 0.1% SDS, 1.0% Triton X-114, and 2mM EDTA, and then washed again one time in double distilled water. The protein A Sepharose CL-4B was then boiled in Laemmli sample buffer (Laemmli, Nature, 227.680-685, 1970), and the samples were subjected to SDS-PAGE and fluororadiography (Kodak, X-omat AR5) using Enhance (New England Nuclear). Alternatively, the autoradiographs were analyzed by a BETAGEN (Boston, MA) analyzer. Both 64KA positive and negative sera were r

F

OI

1 WO 92/05446 PCT/ULS91/08t72 used in each assay, to serve as interassay controls. All fluororadiographs were analyzed and rated as positive or negative after comparison with the known interassay controls. Positive serum samples were designated as 1 when a sample resulted in immunoprecipitation of a low intensity 64,000 M x band, 2 if a moderate intensity band was observed and 3 if the intensity of the immunoprecipitated protein was high. A similar rating procedure was employed for the intensity of bands corresponding to immunoprecipitated 3S-GAD6s and 3S-GAD.y.

6. Immunoprecipitations. Immunoprecipitation of bacterial lysates containing 3S-GADs or MS-GADgy, and GAD from human brain homogenate, was completed as described above in immunoprecipitation studies of human islet cell extractions.

7. GAD Assays. Human brain homogenates were incubated with patient sera as described above in human islet cells. After absorption and washes, the protein A agarose slurry was aliquoted into three equal volumes and GAD activity was measured as described (Krieger, et al., Neurochem. 33:299, 1984). Briefly, Protein 15 A agarose beads were incubated with (1 14 C)-glutamate (Amersham) in a designated incubation mixture (Krieger, et al., Neurochem. 33:299, 1984) and production of 14

CO

2 was quantitated by a liquid scintillation counter.

8. Production of "S-GAD, and "S-GAD,. Rat GADs and GAD 67 cDNAs were subcloned into a bacterial expression system as previously described. Labeling 20 of eS-GADs was completed by pulsing IPTG induced bacterium (growing in Minimal Media) for 15 minutes with TRAN MS-label (ICN). Cultures were then spun down and resuspended and sonicated in 1ml of homogenizing buffer (1mM phenylmethylsulfonyl fluoride (PMSF), 1mM 2.aminoethylisothiouronium Bromide (AET) and 60mM potassium phosphate, pH After sonication, cell debris was removed by centrifugation and protein concentration was measured (Bradford, Anal.Biochem., 72:248, 1986) in the supernatant (supernatant was stored in aliquots at

I

WO'92/05446 WO '20446PT/US9 1/06872?' B. IMMUNOREACTIVnlY OF IDDM SPECIMENS Sera from patients with I0DM were tested for the ability to precipitate GAD from human brain homogenates.

0 '0 SERA FROM IDDM PATIENTS IlCUNOPRECIPITATE CAD ACTIVITY Pre-IDDM CAD Activity' Patient IDDM Period' 64K 2

JDF

3 C~m's DA *S >24 3 164 13,762 DC 3 20 1.719 RS 5 3 40 588 NL 0 2 80 440 DM1 >1 2 10 184 C -nfl 0 0 280 c na 0 0 285 c na 0 0 325 C -na 0 0 '275 C na 0 0 270 3Expressed as months 2 64K titers as described in Experimental Methods 'The islet cell antibody test as expressed in Juvenile Diabetes Foundation (JDF) units Not adjusted for background At risk for diabetes (also, failed glucose test) na -Not applicable 00 k-1 WO 92/05446 PCT/US91/06872 33.

As shown in Table 3, the sera of four (out of five) at risk for IDDM or IDDM patients bound significantly greater amounts of enzymatically active GAD of human brain extracts than sera from control patients. In addition, sera from one of the patients was drawn in a pre-IDDM period, thus autoantibodies to GAD are present prior to the onset of IDDM symptoms (see C below).

Further experiments (results not presented) showed that the sera of two at risk IDDM patients (DA, DC) immunoprecipitated recombinantly produced "S-GAD, whereas recombinantly produced "S-GAD 6 7 was only recognized by sera of patient DA (and to a lesser degree than "S-GAD). Subsequent studies have found larger titers of GAD, autoantibodies than GAD, are present in sera of IDDM patients with neuropathic complications (not shown here).

Additional studies using patient DA sera showed the presence of antibodies which recognize specific polypeptides produced in human pancreatic islet cells.

Electrophoretic analysis of the bound polypeptides demonstrated the presence of autoantibodies to a 64kD component, as previously shown by others in human IDDM (Baekkeskov, et al., Nature, 298:167-169, 1982) and in animal models (Baekkeskov, et al., Science, 24:1348-1350, 1984; Atkinson, et al., Diabetes, 37:1587-1590, 1988). Prior absorption of these sera with GAD-6 monoclonal, which recognized GAD, but not GAD,, or with bacterially produced GAD6, abolished the ability of the sera to recognize the 64kD pancreatic polypeptide. The epitopes recognized by autoantibodies to the 64kD autoantigen are thus present in GADU, *indicating that the autoantigen is indeed GAD 5 In order to investigate the predictive value of GAD,, sera drawn from oatients prior to onset of clinical manifestation of IDDM were tested for autoantibodies to GADs.

*e TABLE 4 IDDM PATIENTS ANALYZED FOR AUTOANTIBODLES PRIOR TO THE ONSET OFIDIEASE Patient Sex

M

F

M

M

H

F

H

F

M

M

F

F

lIlA 3,2 4,5 2.1 2,4 N. D.

4,6 6.1 3,4 3,3 3,3 4, X 4,6 Age Onset' 17 38 5 11 23 15 34 14 12 5 Pre -IDD Period 2 41 34 34 6 3 25 42 8 9

JDF

0 0 160 320 0 N. D.

64W -CD, CD ~~7 Age of IDDM onset expressed as months 2 The time interval between sera drawn and IDDH onset expressed as months 3 1 lowest; 2 medium; and 3 highest band intensities N.D. -not determined WO 92/05446 PCT/US91/06872 As shown in Table 4, 9 out of 12 specimens were immunoreactive with 3S-GAD,. In addition, two patients (JA and VC) were immunoreactive to GAD7, but not GAD, under these conditions. Therefore, in combination, autoantibodies to GAD, and GAD, were present in 11 out of 12 of these patients sera.

This finding suggests that although autoantibodies to GAD, are more common than autoantibodies to GAD,, the use of both recombinant GADs (GAD, and GAD.) in an assay would allow for greater predictability of IDDM. Previous tests of these sera (Atkinson, et al., Langet, 335:1357-1360, 1990) demonstrated that 11 out of 12, or 92%, immunoreacted with the "S-64kD molecule from human pancreatic islet cells. The serum which contained detectable autoantibodies to the 64kD molecule and not GAD, was a serum which contained the lowest titer (OF for the 64kD molecule. Thus, the false negative obtained was due to a lack of sensitivity in this assay. Furthermore, this assay predicted IDDM in one patient (BR) who was negative for 64K.

These results show that the 64kD molecule identified in i-cells of human pancreas is identical in size and antigenicity to rat GAD,. Furthermore, sera drawn from patients prior to IDDM onset contain autoantibodies to GAD,. Consequently, the GAD, recombinant molecule is of great utility as a diagnostic tool for predicting SIDDM. The ability of a physician to' diagnose IDDM prior to actual symptoms will S 20 no doubt result in a greater extension of time before insulin therapy is needed.

The sensitivity of such immunoassays will improve with the use of a recombinant GAD, of human origin which represents the GAD form present in #-cells of the pancreas.

The invention now being fully described, it will be apparent to one of ordinary skill 25 in the art that many changes and modifications can be made without departing from the spirit or scope of the invention.

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Claims (17)

1. A method of detecting autoantibodies to human GAD which comprises: contacting a sample with an isolated recombinant non-full length GAD polypeptide wherein said non-full length GAD polypeptide contains at least one epitope for autoantibodies to human GAD; incubating the components of step for a period of time and under conditions sufficient for said autoantibodies to bind to.he non- full length GAD polypeptide; separating the autoantibodies bound to the non-full length GAD "i polypeptide from the sample; and *e detecting the presence of the autoantibodies bound to the polypeptide.

2. The method of claim 1 wherein the non-full length GAD polypeptide is 20 isolated recombinant non-full length GAD 7

3. The method of claim 1 wherein the non-full length GAD polypeptide is isolated recombinant non-full length GADs.

4. The method according to claim 1 wherein the non-full length GAD polypeptide is a mixture of isolated recombinant non-full length GAD,, and isolated recombinant non-full length GAD, 7 The method according to any one of claims 1 to 4 wherein the detecting utilizes a detectably labeled protein capable of binding to the autoantibody.

6. The method of claim 5 wherein the binding protein is a detectably labeled second antibody. 37

7. The method of claim 5 or claim 6 wherein the detectable label is selected from the group consisting of a radioisotope, a fluorescent compound, a colloidal metal, a chemiluminescent compound, a bioluminescent compound and an enzyme.

8. A method of ameliorating an autoimmune response in a patient which comprises: administering to the patient a therapeutically effective amount of a recombinantly produced GAD polypeptide, wherein the recomfbnantly produced GAD polypeptide binds with a receptor.

9. The method of claim 8 wherein the recombinantly produced GAD polypeptide is recombinantly produced GAD,,. The method of claim 8 wherein the recombinantly produced GAD polypeptide is recombinantly produced GAD, 5

11. The method of claim 8 wherein the recombinantly produced GAD 20 polypeptide is a mixture of recombinantly produced GAD,, and recombinantly produced GAD, 7

12. The method according to any one of claims 8 to 11 wherein the recombinantly produced GAD polypeptide is a recombinantly produced human GAD polypeptide.

13. The method according to any one of claims 8 to 12 wherein the receptor is selected from the group consisting of an antibody and T-helper cells.

14. The method according to any one of claims 8 to 13 wherein the autoimmune disease is selected from the group consisting of IDDM and stiff- man disease.

15. The method according to any one of claims 8 to 14 wherein the RA administration is parenteral. 38

16. The method of claim 15 wherein the parenteral administration is by subcutaneous, intramuscular, intraperitoneal, intracavity, transdermal, or intravenous injection.

17. The method according to any one of claims 8 to 16 wherein said administration is at a dosage of 0.01 mg/kg/dose to 2000 mg/kg/dose.

18. The method according to any one of claims 8 to 17 wherein the recombinantly produced GAD polypeptide is therapeutically labeled

19. The method of claim 18 wherein the therapeutic label is selected from the group consisting of a radioisotope, a drug, a lectin, and a toxin. Dated this sixteenth day of October 2000. The Regents of the University of California Patent Attorneys for the Applicant: F B RICE CO