AU773990B2

AU773990B2 - Compositions and therapeutic methods using morphogenic proteins, hormones and hormone receptors

Info

Publication number: AU773990B2
Application number: AU76191/00A
Authority: AU
Inventors: John C. Lee; Lee-Chuan C. Yeh
Original assignee: Stryker Corp
Current assignee: Stryker Corp
Priority date: 1999-09-27
Filing date: 2000-09-27
Publication date: 2004-06-10
Anticipated expiration: 2020-09-27
Also published as: AU7619100A; JP2003510338A; WO2001023563A3; WO2001023563A2; CA2385887A1; EP1220909A2

Description

WO 01/23563 PCT/US00/26528 COMPOSITIONS AND THERAPEUTIC METHODS USING MORPHOGENIC PROTEINS, HORMONES AND HORMONE RECEPTORS BACKGROUND OF THE INVENTION The Transforming Growth Factor-Beta superfamily represents a large number of evolutionarily conserved morphogenic proteins with diverse activities in growth, differentiation, tissue morphogenesis and repair. This superfamily includes osteogenic proteins and bone morphogenic proteins OPs and BMPs share a highly conserved, bioactive cysteine-rich domain near their C-termini and have a propensity to form homo- and hetero-dimers.

Many morphogenic proteins belonging to the BMP family have been described. Some were isolated using purification techniques on the basis of osteogenic activity. Others were identified and cloned by virtue ofDNA sequence homologies within conserved regions that are common to the BMP family. These homologs are referred to as consecutively numbered BMPs whether or not they have demonstrable osteogenic activity.

While several of the earliest members of the BMP family were identified by virtue of their ability to induce new cartilage and bone, a number of other BMPs have different or additional tissue-inductive capabilities. For example, BMP-12 and BMP-13 (identified by DNA sequence homology) reportedly induce tendon/ligament-like tissue formation in vivo (WO 95/16035). Several BMPs, including some of those originally isolated on the basis of their osteogenic activity, can induce neuron proliferation and promote axon regeneration (WO 95/05846; Liem et al., Cell, 82, pp. 969-79 (1995)). Thus, it appears that BMPs may have a variety of potential tissue-inductive capabilities whose final expression depends on a complex set of developmental and environmental cues.

Many of the mammalian BMPs have been recombinantly expressed as active homo- or heterodimers in a variety of host systems, making therapeutic treatments using morphogenic proteins feasible. Implantable osteogenic devices comprising mammalian osteogenic protein for promoting bone healing and regeneration have been described (see, Oppermann et al., U. S. Patent No. 5,354,557). Some osteogenic devices contain porous, biocompatible matrices that allow the diffusion of osteogenic proteins into the WO 01/23563 PCT/US00/26528 implantation site as well as the influx and efflux of progenitor cells. Osteogenic proteincoated prosthetic devices that enhance the bond strength between the prosthesis and existing bone have also been described (Rueger et al., U. S. Patent No. 5,344,654).

SUMMARY OF THE INVENTION This invention is based on the discovery that the tissue-inductive activity of a morphogenic protein can be enhanced by a hormone in the presence of a soluble receptor of the hormone.

Accordingly, this invention features a method for improving the tissue inductive capability of a morphogenic protein at a target locus in a mammal. In this method, the morphogenic protein and a first effective amount of a hormone and a second effective amount of a soluble receptor of the hormone are administered to the target locus, wherein the morphogenic protein is capable of inducing tissue formation when accessible to a progenitor cell in the mammal, and the hormone and the receptor in combination enhance that capability. The morphogenic protein, hormone and hormone receptor can be administered simultaneously to the target locus. Alternatively, the three components are administered separately, in any order: for instance, the morphogenic protein can be administered first, and then the hormone and hormone receptor are administered together; or the morphogenic protein and the hormone are administered together first, and then the hormone receptor is administered. In one embodiment, the morphogenic protein is administered via a nucleic acid a plasmid, a viral vector, or naked DNA) that comprises a sequence encoding the morphogenic protein and is capable of expressing the morphogenic protein in the appropriate progenitor cells of a patient.

The morphogenic protein may comprise a pair of subunits disulfide-bonded to produce a dimeric species, wherein at least one of the subunits comprises a polypeptide belonging to the BMP protein family. For instance, the morphogenic protein may comprise an amino acid sequence sufficiently duplicative of the amino acid sequence of a reference BMP such as BMP-2, BMP-3, BMP-4, BMP-5, BMP-6, BMP-7 BMP-8, BMP-9, BMP-I 1, BMP-12, BMP-13, COP-5, or COP-7, such that it has morphogenic activity similar to that of the reference BMP. In one preferred embodiment, the morphogenic protein is a homo- or heterodimer comprising a BMP-2 or BMP-7 (OP-1) subunit.

WO 01/23563 PCT/US00/26528 The morphogenic protein is capable of inducing tissue formation. For instance, it may be capable of inducing the progenitor cell to form tissue tendon/ligamentlike or neural-like tissue; or it may be an osteogenic protein that is capable of inducing the progenitor cell to form endochondral or intramembranous bone, or cartilage. The method of this invention thus can be used to induce tissue regeneration or repair in a variety of tissue defects such as bone, cartilage, soft tissue and neural tissue defects.

Hormones useful in this invention include but are not limited to cytokines interleukins 1 through 18), growth factors fibroblast growth factor, vascular endothelial growth factor, platelet-derived growth factor, TGF-P, or prostaglandin) or morphogenic proteins.

The invention also features pharmaceutical compositions and kits comprising a hormone and a soluble receptor thereof for improving the tissue inductive activity of a morphogenic protein. This invention also provides implantable morphogenic devices for inducing tissue formation in allogeneic and xenogeneic implants. Such devices comprise a morphogenic protein, a hormone and a soluble receptor thereof disposed within a carrier. Methods for inducing local tissue formation from a progenitor cell in a mammal using those compositions and devices are also provided. A method for accelerating allograft repair in a mammal using those morphogenic devices is provided. This invention also provides a prosthetic device comprising a prosthesis coated with a morphogenic protein, a hormone and a soluble receptor thereof, and a method for promoting in vivo integration of an implantable prosthetic device to enhance the bond strength between the prosthesis and the existing target tissue at the joining site. Methods for treating tissue degenerative conditions in a mammal using the pharmaceutical compositions are also provided.

Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Exemplary methods and materials are described below, although methods and materials similar or equivalent to those described herein can also be used in the practice or testing of the present invention. All publications and other references mentioned herein are incorporated by reference in their entirety. In case of conflict, the present specification, including definitions, will control. The materials, methods, and examples are illustrative only and not intended to be limiting.

'0 WO 01/23563 PCTIUS00/26528 Other features and advantages of the invention will be apparent from the following drawings, detailed description, and the claims.

BRIEF DESCRIPTION OF THE DRAWINGS Fig. 1 is a bar graph showing that a combination ofinterleukin 6 and soluble IL-6 receptor ("sTL-6R") significantly increases the ability of OP-1 to induce alkaline phosphatase activity in fetal rat calvaria cells. "OP" stands for "IL-6R" refers to "slL-6R." The parenthesized numbers indicate the protein concentrations (ng/ml) used in the assay; in the case of IL-6/sIL-6R combinations, the two numbers separated by a backslash in the parenthesis indicate the protein concentrations of IL-6 and sIL-6R, respectively.

Fig. 2 is a photograph showing results of a mineralized bone nodule formation assay using OP-1 and IL-6. Dark spots inside the wells represent mineralized bone nodules.

Fig. 3 is a photograph showing results of a mineralized bone nodule formation assay using OP-1, IL-6 and sIL-6R. Dark spots inside the wells represent mineralized bone nodules.

Fig. 4 is a bar graph showing the mRNA levels of BMPR-IA, BMPR-IB, ActR-I, and BMPR-II in various test groups. "sR" stands for sIL-6R. Values in the graph represent the means±SE of twelve Northern blots with RNA isolated from two different FRC cell preparations.

Fig. 5 is a bar graph showing that the AP activity in FRC cells transfected with the OP- -encoding pW24 plasmid is enhanced by exogenous sIL-6R alone or a combination of IL-6 and sIL-6R "IL6R" stands for sIL-6R. Values in the graph represent the mean±SE of five independent determinations with three different FRC cell preparations and two different DNA preparations. "IL-6/R refers to X ng/ml IL-6 and Y ng/ml sIL-6R.

DETAILED DESCRIPTION OF THE INVENTION In order that the invention herein described may be fully understood, the following detailed description is set forth.

WO 01/23563 PCT/US00/26528 The term "biocompatible" refers to a material that does not elicit detrimental effects associated with the body's various protective systems, such as cell and humoralassociated immune responses, inflammatory responses and foreign body fibrotic responses. This term also implies that no specific undesirable effects, cytotoxic or systemic, are caused by the material when it is implanted into the patient.

The term "BMP" refers to a protein belonging to the BMP family of the TGF-B superfamily of proteins defined on the basis of DNA and amino acid sequence homology. According to this invention, a protein belongs to the BMP family when it has at least 50% at least 70% or even 85%) amino acid sequence homology with a known BMP family member within the conserved C-terminal cysteine-rich domain that characterizes the BMP family. Members of the BMP family may have less than 50% DNA or amino acid sequence homology overall.

The term "morphogenic protein" refers to a protein having morphogenic activity. For instance, this protein is capable of inducing progenitor cells to proliferate and/or to initiate differentiation pathways that lead to the formation of cartilage, bone, tendon, ligament, neural or other types of tissue, depending on local environmental cues.

Thus, morphogenic proteins useful in this invention may behave differently in different surroundings. A morphogenic protein of this invention may comprise at least one polypeptide belonging to the BMP family.

The term "osteogenic protein" refers to a morphogenic protein that is capable of inducing a progenitor cell to form cartilage and/or bone. The bone may be intramembranous bone or endochondral bone. Most osteogenic proteins are members of the BMP family and are thus also BMPs. However, the converse may not be true.

According to this invention, a BMP identified by sequence homology must have demonstrable osteogenic or chondrogenic activity in a functional bioassay to be an osteogenic protein.

The terms "morphogenic activity," "inducing activity" and "tissue inductive activity" alternatively refer to the ability of an agent to stimulate a target cell to undergo one or more cell divisions (proliferation) that may optionally lead to cell differentiation.

Such target cells are referred to generically herein as progenitor cells. Cell proliferation is typically characterized by changes in cell cycle regulation and may be detected by a number of means which include measuring DNA synthetic or cellular growth rates. Early stages of WO 01123563 PCT/US00/26528 cell differentiation are typically characterized by changes in gene expression patterns relative to those of the progenitor cell; such changes may be indicative of a commitment towards a particular cell fate or cell type. Later stages of cell differentiation may be characterized by changes in gene expression patterns, cell physiology and morphology.

Any reproducible change in gene expression, cell physiology or morphology may be used to assess the initiation and extent of cell differentiation induced by a morphogenic protein.

The term "synergistic interaction" refers to an interaction in which the combined effect of two or more agents is greater than the algebraic sum of their individual effects.

The term "hormone/receptor pair" refers to a combination of a hormone and a soluble receptor thereof The hormone a cytokine. a growth factor, or a morphogenic protein) can be of any mammalian origin human, bovine, or murine). A soluble receptor of a hormone is a compound that binds specifically to the hormone, and can, for example, be a polypeptide containing only the hormone-binding domain an extracellular domain) of a native cellular receptor of the hormone, an antibody specific for the hormone, or a chemical compound that specifically interacts with the hormone. A soluble receptor can also be a compound a protein) containing a domain that specifically binds to the hormone and another domain that specifically binds to the native cellular receptor of the hormone such that the soluble receptor facilitates the binding of the hormone to its native cellular receptor; an example of such a soluble receptor is the IGFbinding protein.

Morphogenic proteins The morphogenic proteins of this invention are capable of stimulating a progenitor cell to undergo cell division and/or differentiation. They may belong to the TGF-1 protein superfamily, and include, but are not limited to, OP-1, OP-2, OP-3, BMP-2, BMP-3, BMP-3b, BMP-4, BMP-5, BMP-6, BMP-9, BMP-10, BMP- 1, BMP-12, BMP-13, BMP-14, BMP-15, GDF-1, GDF-2, GDF-3, GDF-5, GDF-6, GDF-7, GDF-8, GDF-9, GDF-10, GDF-11, GDF-12, DPP, Vg-1, Vgr-1, 60A protein, NODAL, UNIVIN, SCREW, ADMP, NEURAL, and TGF-P.

One of the preferred morphogenic proteins is OP-1. Nucleotide and amino acid sequences for hOP-1 are provided in SEQ ID NOs: 1 and 2, respectively. For ease of description, hOP-1 is recited as a representative morphogenic protein. It will be WO 01/23563 PCTIUSO/26528 appreciated by the ordinarily skilled artisan that OP-1 is merely representative of a family of morphogens.

Other useful morphogenic proteins also include polypeptides having at least at least 70% or even 85%) sequence homology with a known morphogenic protein, particularly with a known BMP within the conserved C-terminal cysteine-rich domain that characterizes the BMP protein family. These morphogenic proteins include biologically active variants of any known morphogenic protein, including variants containing conservative amino acid changes. For instance, useful morphogenic proteins include those containing sequences that share at least 70% amino acid sequence homology with the C-terminal seven-cysteine domain of hOP-1, which domain corresponds to the Cterminal 102-106 amino acid residues of SEQ ID NO:2. The C-terminal 102 amino acid residues corresponds to residues 330-431 of SEQ ID NO:2. In one embodiment of this invention, the morphogenic protein consists of a pair of subunits disulfide-bonded to produce a dimer, wherein at least one of the subunits comprises a recombinant polypeptide belonging to the BMP family.

As used herein, "amino acid sequence homology" is understood to include both amino acid sequence identity and similarity. Homologous sequences share identical and/or similar amino acid residues, where similar residues are conservative substitutions for, or "allowed point mutations" of, corresponding amino acid residues in an aligned reference sequence. Thus, a candidate polypeptide sequence that shares 70% amino acid homology with a reference sequence is one in which any 70% of the aligned residues are either identical to, or are conservative substitutions of, the corresponding residues in a reference sequence. Certain particularly preferred morphogenic polypeptides share at least at least 65%) amino acid sequence identity with the C-terminal seven-cysteine domain of human OP-1.

As used herein, "conservative substitutions" are residues that are physically or functionally similar to the corresponding reference residues. That is, a conservative substitution and its reference residue have similar size, shape, electric charge, chemical properties including the ability to form covalent or hydrogen bonds, or the like. Preferred conservative substitutions are those fulfilling the criteria defined for an accepted point mutation in Dayhoff et al., Atlas of Protein Sequence and Structure 5:345-352 (1978 Supp.). Examples of conservative substitutions are substitutions within the following .1 WO 01/23563 PCTUS00/26528 groups: valine, glycine; glycine, alanine; valine, isoleucine, leucine; aspartic acid, glutamic acid; asparagine, glutamine; serine, threonine; lysine, arginine, methionine; and phenylalanine, tyrosine. The term "conservative variant" or "conservative variation" also includes the use of a substituting amino acid residue in place of an amino acid residue in a given parent amino acid sequence, where antibodies specific for the parent sequence are also specific for, "cross-react" or "immuno-react" with, the resulting substituted polypeptide sequence.

Amino acid sequence homology can be determined by methods well known in the art. For instance, to determine the percent homology of a candidate amino acid sequence to the sequence of the seven-cysteine domain, the two sequences are first aligned.

The alignment can be made with, the dynamic programming algorithm described in Needleman et al., J. Mol. Biol. 48:443 (1970), and the Align Program, a commercial software package produced by DNAstar, Inc. The teachings by both sources are incorporated by reference herein. An initial alignment can be refined by comparison to a multi-sequence alignment of a family of related proteins. Once the alignment is made and refined, a percent homology score is calculated. The aligned amino acid residues of the two sequences are compared sequentially for their similarity to each other. Similarity factors include similar size, shape and electrical charge. One particularly preferred method of determining amino acid similarities is the PAM250 matrix described in Dayhoff et al., supra. A similarity score is first calculated as the sum of the aligned pairwise amino acid similarity scores. Insertions and deletions are ignored for the purposes of percent homology and identity. Accordingly, gap penalties are not used in this calculation. The raw score is then normalized by dividing it by the geometric mean of the scores of the candidate sequence and the seven-cysteine domain. The geometric mean is the square root of the product of these scores. The normalized raw score is the percent homology.

Morphogenic proteins useful herein include any known naturally occurring native proteins, including allelic, phylogenetic counterparts aid other variants thereof.

These variants include forms having varying glycosylation patterns, varying N-termini, and active truncated or mutated forms of a native protein. Useful morphogenic proteins also include those that are biosynthetically produced "muteins" or "mutant proteins") and those that are new, morphogenically active members of the general morphogenic family of proteins. Particularly useful sequences include those comprising the C-terminal 96 to 102 WO 01/23563 PCT/US00/26528 amino acid residues of: DPP (from Drosophila), Vg-1 (from Xenopus), Vgr- (from mouse), the OP1 and OP2 proteins Patent No. 5,011,691), as well as the proteins referred to as BMP-2, BMP-3, BMP-4 (WO 88/00205, U.S. Patent No. 5,013,649 and WO 91/18098), BMP-5 and BMP-6 (WO 90/11366), BMP-8 and BMP-9. Other proteins useful in the practice of the invention include active forms of OP1, OP2, OP3, BMP-2, BMP-3, BMP-3b, BMP-4, BMP-5, BMP-6, BMP-9, BMP-10, BMP-11, BMP-12, BMP-13, BMP-14, BMP-15, DPP, Vg-1, Vgr-1, 60A protein, GDF-1, GDF-2, GDF-3, GDF-6, GDF-7, GDF-8, GDF-9, and GDF-10, GDF-11, GDF-12, GDF-13, UNIVIN, NODAL, SCREW, ADMP, NEURAL, and TGF-P.

Osteogenic proteins useful as morphogenic proteins of this invention include those containing sequences that share greater than 60% identity with the seven-cysteine domain. In other embodiments, useful osteogenic proteins are defined as osteogenically active proteins having any one of the generic sequences defined herein, including OPX (SEQ ID NO:3) and Generic Sequences 7 (SEQ ID NO:4), 8 (SEQ ID NO:5), 9 (SEQ ID NO:6) and 10 (SEQ ID NO:7).

Generic Sequence 7 (SEQ ID NO:4) and Generic Sequence 8 (SEQ ID disclosed below, accommodate the homologies shared among preferred protein family members identified to date, including OP-1, OP-2, OP-3, BMP-2, BMP-3, BMP-4, BMP-6, 60A, DPP, Vg-1, Vgr-1, and GDF-1. The amino acid sequences for these proteins are described herein and/or in the art. The generic sequences include the identical amino acid residues shared by these sequences in the C-terminal six- or seven-cysteine skeletal domains (represented by Generic Sequences 7 and 8, respectively), as well as alternative residues for the variable positions within the sequences. The generic sequences provide an appropriate cysteine skeleton where inter- or intra-molecular disulfide bonds can form. Those sequences contain certain specified amino acids that may influence the tertiary structure of the folded proteins. In addition, the generic sequences allow for an additional cysteine at position 36 (Generic Sequence 7) or position 41 (Generic Sequence thereby encompassing the biologically active sequences of OP-2 and OP-3.

GENERIC SEQUENCE 7 Leu Xaa Xaa Xaa Phe Xaa Xaa Xaa Gly Trp Xaa Xaa Xaa Xaa Xaa Xaa WO 01/23563 PCTIUS00126528 1 5 10 Pro Xaa Xaa Xaa Xaa Ala Xaa Tyr Cys Xaa Gly Xaa Gys Xaa Xaa Pro Xaa Xaa 25 Xaa Xaa Xaa Xaa Xaa Xaa Asn His Ala Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa 35 40 45 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Cys Cys Xaa Pro Xaa Xaa Xaa Xaa Xaa Xaa 60 65 Xaa Xaa Leu Xaa Xaa .Xaa Xaa Xaa Xaa Xaa Val Xaa Leu Xaa Xaa Xaa Xaa Xaa 80 Met Xaa Val Xaa Xaa Cys Xa~a Cys Xaa (SEQ ID NO:4) wherein each Xaa is independently defined as follows means "residue"): Xaa at res.2 (Tyr or Lys); Xaa at res3 (Val or le); Xaa at res.4 (Ser, Asp or Glu); Xaa at res.6 (Arg, Gin, Ser, Lys or Ala); Xaa at res.7 (Asp or Giu); Xaa at res.8 (Leu, Val or le); Xaa at res. I1I (Gin, Leu, Asp, His, Asn or Ser); Xaa at res. 12 =(Asp, Mg, Asn or Glu); Xaa at res. 13 (Trp or Ser); Xaa at res. 14 (le or Val); Xaa at res.i1 (Ie or Val); Xaa at res. 16 (Ala or Ser); Xaa at res. 18 (Glu, Gin, Leu, Lys, Pro or Mrg); Xaa at res. 19 (Gly or Ser); Xaa at res.20 (Tyr or Phe); Xaa at res.2 1 (Ala, Ser, Asp, Met, His, Gin, Leu or Gly); Xaa at res.23 =(Tyr, Asn or Phe), Xaa at res.26 =(Glu, His, Tyr, Asp, Gin, Ala or Ser);- Xaa at res.28 =(Giu, Lys, Asp, Gin or Ala); Xaa at res.30 (Ala, Ser, Pro, Gin, Ie or Asn); Xaa at res.31 (Phe, Leu or Tyr); Xaa at res.333 (Leu, Val or Met); Xaa at res.3 4 (Asn, Asp, Ala, Thr or Pro);- Xaa at res.3 5 (Ser, Asp, Glu, Leu, Ala or Lys); Xaa at res.36 =(Tyr, Cys, His, Ser or le); Xaa at res.37 (Met, Phe, Gly or Leu); Xaa at res.38 (Asn, Ser or Lys); Xaa at res.39 (Ala, Ser, Gly or Pro); Xaa at res.40 (Thr, Leu or Ser); Xaa at res.44 (lie, Val or Thr); Xaa at resA45 (Val, Leu, Met or Ile); Xaa at res.46 (Gin or Mrg); Xaa at res.47 (Thr, Ala or Ser); Xaa at res.48 (Leu or le); Xaa at res.49 (Val or Met); Xaa at res.50 (His, Asn or Arg);, Xaa at (Phe, Leu, Asn, Ser, Ala or Val),- Xaa at res.52 Met, Asn, Ala, Val, Gly or Leu); Xaa at res.53 (Asn, Lys, Ala, Giu, Gly or Phe); Xaa at res.5 4 =(Pro, Ser or Val); Xaa at res.55 (Glu, Asp, Asn, Gly, Val, Pro or Lys); Xaa at res.56 (Thr, Ala, Val, Lys, Asp, Tyr, Ser, Gly, Ile or His); Xaa at res.57 (Val, Ala or le); Xaa at res.58 =(Pro or Asp); Xaa at res.59 (Lys, Leu or Giu); Xaa at res.60 (Pro, Val or Ala); Xaa at res.63 WO 01/23563 PCT/US00/26528 (Ala or Val); Xaa at res.65 (Thr, Ala or Glu); Xaa at res.66 (Gln, Lys, Arg or Glu); Xaa at res.67 (Leu, Met or Val); Xaa at res.68 (Asn, Ser, Asp or Gly); Xaa at res.69 (Ala, Pro or Ser); Xaa at res.70 (Ile, Thr, Val or Leu); Xaa at res.71 (Ser, Ala or Pro); Xaa at res.72 (Val, Leu, Met or Ile); Xaa at res.74 (Tyr or Phe); Xaa at res.

7 5 (Phe, Tyr, Leu or His); Xaa at res.76 (Asp, Asn or Leu); Xaa at res.77 (Asp, Glu, Asn, Arg or Ser); Xaa at res.78 (Ser, Gin, Asn, Tyr or Asp); Xaa at res.79 (Ser, Asn, Asp, Glu or Lys); Xaa at res.80 (Asn, Thr or Lys); Xaa at res.82 (Ile, Val or Asn); Xaa at res.84 (Lys or Arg); Xaa at res.85 (Lys, Asn, Gin, His, Arg or Val); Xaa at res.86 (Tyr, Glu or His); Xaa at res.87 (Arg, Gin, Glu or Pro); Xaa at res.88 (Asn, Glu, Trp or Asp); Xaa at res.90 (Val, Thr, Ala or Ile); Xaa at res.92 (Arg, Lys, Val, Asp, Gin or Glu); Xaa at res.93 (Ala, Gly, Glu or Ser); Xaa at res.95 (Gly or Ala); and Xaa at res.97 (His or Arg).

Generic Sequence 8 (SEQ ID NO:5) includes all of Generic Sequence 7 and in addition includes the following five amino acid at its N-terminus: Cys Xaa Xaa Xaa Xaa (SEQ ID NO:8), wherein Xaa at res.2 (Lys, Arg, Ala or Gin); Xaa at res.3 (Lys, Arg or Met); Xaa at res.4 (His, Arg or Gin); and Xaa at res.5 (Glu, Ser, His, Gly, Arg, Pro, Thr, or Tyr). Accordingly, beginning with residue 7, each "Xaa" in Generic Sequence 8 is a specified amino acid as defined as for Generic Sequence 7, with the distinction that each residue number described for Generic Sequence 7 is shifted by five in Generic Sequence 8.

For example, "Xaa at res.2 (Tyr or Lys)" in Generic Sequence 7 corresponds to Xaa at res.7 in Generic Sequence 8.

Generic Sequences 9 (SEQ ID NO:6) and 10 (SEQ ID NO:7) are composite amino acid sequences of the following proteins: human OP-1 hOP-2, hOP-3, hBMP-2, hBNPiP-3, hBMP-4, hBMP-5, hBMP-6, hBMP-9, hBMPl0, hBMP-] 1, Drosophila 60A, Xenopus Vg- 1, sea urchin UNIVIN, hCDMP- I (mouse GDF-5 or hCDMP-2 (mGDF-6, hBMP-13), hCDMP-3 (mGDF-7, hBMP-12), mGDF-3, hGDF-1, mGDF-1, chicken DORSALIN, DPP, Drosophila SCREW, mouse NODAL, mGDF-8, hGDF-8, mGDF-9, mGDF-10, hGDF-1 1, mGDF-i 1, hBMP-15, and rat BMP3b.

Like Generic Sequence 7, Generic Sequence 9 accommodates the C-terminal six-cysteine skeleton and, like Generic Sequence 8, Generic Sequence 10 accommodates the C-terminal seven-cysteine skeleton.

-II-

WO 01/23563 WO 0123563PCT1USOO/26528 GENERIC SEQUENCE 9 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa 1 5 10 Pro Xaa Xaa Xaa Xaa Xaa Xaa Xaa Cys Xaa Gly Xaa Cys Xaa Xaa Xaa Xaa 20 25 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa 40 45 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa. Xaa Cys Xaa Pro Xaa Xaa Xaa 60 Xaa Xaa Xaa Xaa Xaa Leu Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa 75 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Cys Xaa Cys Xaa (SEQ ID NO:.6) 90 wherein each Xaa is independently defined as follows: Xaa at res. I =(Phe, Leu or Glu); Xaa at res.2 (Tyr, Phe, His, Arg, Thr, Lys, Gin, Val or Glu); Xaa at res.3 (Val, le, Leu or Asp); Xaa at res.4 (Ser, Asp, Glu, Asn or Phe);- Xaa at res. 5 (Phe or Glu); Xaa at res.6 (Arg, Gin, Lys, Ser, Giu, Ala or Asn); Xaa at res.7 (Asp, Giu, Leu, Ala or Gin); Xaa at res.8 (Leu, Val, Met, le or Phe); Xaa at res.9 (Gly, His or Lys); Xaa at res. (Trp or Met); Xaa at res. I11 (Gin, Leu, His, Glu, Asn, Asp, Ser or Gly); Xaa at res. 12= (Asp, Asn, Ser, Lys, Arg, Giu or His); Xaa at res. 13 (Trp or Ser); Xaa at res. 14 =(le or Val); Xaa at res.i1 (le or Val); Xaa at res. 16 (Aia, Ser, Tyr or Trp); Xaa at res.i1 (Giu, Lys, Gin, Met, Pro, Leu, Arg, His or Lys); Xaa at res. 19 (Gly, Glu, Asp, Lys, Ser, Gin, Arg or Phe); Xaa at res.20 (Tyr or Phe);- Xaa at res.21 (Ala, Ser, Gly, Met, Gin, His, Giu, Asp, Leu, Asn, Lys or Thr);, Xaa at res.22 (Ala orPro); Xaa at res.23 =(Tyr, Phe, Asn, Ala or Arg); Xaa at res.24 (Tyr, H-is, Giu, Phe or Arg); Xaa at res.26 (Giu, Asp, Ala, Ser,. Tyr, His, Lys, Arg, Gin or Giy); Xaa at res.28 (Giu, Asp, Leu, Val, Lys, Giy, Thr, Ala or Gin); Xaa at res.30 (Ala, Ser, Ilie, Asn, Pro, Glu, Asp, Phe, Gin or Leu); Xaa at res.3 I (Phe, Tyr, Leu, Asn, Gly or Arg); Xaa at res.32 (Pro, Ser, Ala or Val); Xaa at res.33 (Leu, Met, Giu. Phe or Val); Xaa at res.34 (Asn, Asp, Thr, Gly, Ala, Arg, Leu or Pro); Xaa at res.35 (Ser, Ala, Giu, Asp, Thr, Leu, Lys, Gin or His); Xaa at res.36 (Tyr, His, Cys, le, Arg, Asp, Asn, Lys, Ser, Glu or Giy); Xaa at res.37 (Met, Leu, Phe, Val, Giy or Tyr), Xaa at res.38 (Asn, Glu, Thr, Pro, Lys, His, Gly, Met, Val or WO 01/23563 PCT/USOO/26528 Arg); Xaa at res.39 (Ala, Ser, Gly, Pro or Phe); Xaa at res.40 (Thr, Ser, Leu, Pro, His or Met); Xaa at res.41 (Asn, Lys, Val, Thr or Gin); Xaa at res.42 (His, Tyr or Lys); Xaa at res.43 (Ala, Thr, Leu or Tyr); Xaa at res.44 (lie, Thr, Val, Phe, Tyr, Met or Pro); Xaa at res.45 (Val, Leu, Met, lie or His); Xaa at res.46 (Gin, Arg or Thr); Xaa at res.47 (Thr, Ser, Ala, Asn or His); Xaa at res.48 (Leu, Asn or Xaa at res.49 (Vat, Met, Leu, Pro or le); Xaa at resSO0 (His, Asn, Arg, Lys, Tyr or Gin); Xaa at res.51 (Phe, Leu, Ser, Asn, Met, Ala, Arg, Glu, Gly or Gin); Xaa at res.52 (le, Met, Leu, Val, Lys, Gin, Ala or Tyr), Xaa at res.53 (Asn, Phe, Lys, Giu, Asp, Ala, Gin, Gly, Leu or Vat); Xaa at res.54 (Pro, Asn, Ser, Val or Asp); Xaa at res.55 =(Giu, Asp, Asn, Lys, Mg, Ser, Gly, Thr, Gin, Pro or His); Xaa at res.56 (Thr, His, Tyr, Ala, le, Lys, Asp, Ser, Gly or Arg); Xaa at res.57 (Vat, lie, Thr, Ala, Leu or Ser); Xaa at res.58 =(Pro, Gly, Ser, Asp or Ala); Xaa at res.59 (Lys, Leu, Pro, Ala, Ser, Giu, Arg or Gly); Xaa at (Pro, Ala, Val, Thr or Ser); Xaa at res.61 (Cys, Vai or Ser); Xaa at res.63 (Ala, Val or Thr); Xaa at res.65 (Thr, Ala, Giu, Vat, Giy, Asp or Tyr); Xaa at res.66 =(Gin, Lys, Giu, Mrg or Val); Xaa at res.67 (Leu, Met, Thr or Tyr); Xaa at res.68 (Asn, Ser, Gly, Thr, Asp, Giu, Lys or Val); Xaa at res.69 (Ala, Pro, Giy or Ser); Xaa at res.70 (le, Thr, Leu or Val); Xaa at res.71 =(Ser, Pro, Ala, Thr, Asn or Gly); Xaa at res.72 =(Val, lie, Leu or Met);- Xaa at res.74 (Tyr, Phe, Arg, Thr, Tyr or Met); Xaa at res.75 (Phe, Tyr, His, Leu, lie, Lys, Gin or Vat); Xaa at res.76 (Asp, Leu, Asn or Giu);- Xaa at res.77 =(Asp, Ser, Arg, Asn, Giu, Ala, Lys, Giy or Pro); Xaa at res.78 (Ser, Asn, Asp, Tyr, Ala, Giy, Gin, Met, Giu, Asn or Lys); Xaa at res.79 (Ser, Asn, Giu, Asp, Vat, Lys, Gly, Gin or Mrg); Xaa at res.80 (Asn, Lys, Thr, Pro, Vat, Ie, Ara., Ser or Gin); Xaa at res.81 (Val, Ilie, Tbr or Ala); Xaa at res.82 =(lie, Asn, Vai, Leu, Tyr, Asp or Ala);- Xaa at res.83 (Leu, Tyr, Lys or Ilie); Xaa at res.84 =(Lys, Arg, Asn, Tyr, Phe, Thr, Glu or Gly); Xaa at res.85 =(Lys, Mrg, His, Gin, Asn, Glu or Vat); Xaa at res.86 (Tyr, His, Giu. or lie); Xaa at res.87 (Mg, Giu, Gin, Pro or Lys); Xaa at res.88 (Asn, Asp, Ala, Giu, Giy or Lys); Xaa at res. 89 (Met or Ala); Xaa at res. 90 =(Vat, le, Ala, Thr, Ser or Lys); Xaa at res. 91 (Val or Ala); Xaa at res.92 (Mrg, Lys, Gin, Asp, Gtu, Val, Ala, Ser or Thr); Xaa at res.93 (Ala, Ser, Giu, Gly, Mrg or Thr); Xaa at res.95 (Gly, Ala or Thr); and Xaa at res.97 (His, Mrg, Gly, Leu or Ser). Further, after res.53 in rat BMIP3b and mGDF-1Q there i s an Ile; after res. 54 in GDF-1I there is a Thr; after res. 54 in BMP3 there is a Val; ;WO 01/23563 PCT/US00/26528 after res.78 in BMP-8 and DORSALIN there is a Gly;, after res.37 in hGDF-1 there are Pro, Gly, Gly, and Pro.

Generic Sequence 10 (SEQ ID NO:7) includes all of Generic Sequence 9 and in addition includes the following five amino acid residues at its N-terminus: Cys Xaa Xaa Xaa Xaa (SEQ ID NO:9), wherein Xaa at res.2 (Lys, Arg, Gin, Ser, His, Glu, Ala, or Cys); Xaa at res.3 (Lys, Arg, Met, Lys, Thr, Leu, Tyr, or Ala); Xaa at res.4 (His, Gin, Arg, Lys, Thr, Leu, Val, Pro, or Tyr); and Xaa at res.5 (Gin, Thr, His, Arg, Pro, Ser, Ala, Gln, Asn, Tyr, Lys, Asp, or Leu). Accordingly, beginning at res.6, each "Xaa" in Generic Sequence 10 is a specified amino acid defined as for Generic Sequence 9, with the distinction that each residue number described for Generic Sequence 9 is shifted by five in Generic Sequence 10. For example, "Xaa at res. 1 (Phe, Leu or Glu)" in Generic Sequence 9 corresponds to Xaa at res.6 in Generic Sequence As noted above, certain preferred bone morphogenic proteins useful in this invention have greater than 60%, preferably greater than 65%, identity with the C-terminal seven-cysteine domain of hOP-1. These particularly preferred sequences include allelic and phylogenetic variants of the OP-1 and OP-2 proteins, including the Drosophila protein. Accordingly, in certain particularly preferred embodiments, useful proteins include active proteins comprising dimers having the generic amino acid sequence "OPX" (SEQ ID NO:3), which defines the seven-cysteine skeleton and accommodates the homologies between several identified variants of OP-1 and OP-2. Each Xaa in OPX is independently selected from the residues occurring at the corresponding position in the C-terminal sequence of mouse or human OP-1 or OP-2.

OPX

Cys Xaa Xaa His Glu Leu Tyr Val Ser Phe Xaa Asp Leu Gly Trp Xaa Asp Trp 1 5 10 Xaa Ile Ala Pro Xaa Gly Tyr Xaa Ala Tyr Tyr Cys Glu Gly Glu Cys Xaa Phe Pro 25 30 Leu Xaa Ser Xaa Met Asn Ala Thr Asn His Ala Ile Xaa Gin Xaa Leu Val His Xaa 45 50 Xaa Xaa Pro Xaa Xaa Val Pro Lys Xaa Cys Cys Ala Pro Thr Xaa Leu Xaa Ala WO 01/23563 WO 0123563PCTIUSOO/26528 65 Xaa Ser Val Leu Tyr Xaa Asp Xaa Ser Xaa Asn Val Ile Leu Xaa Lys Xaa Mrg 80 85 Asn Met Vat Vai Xaa Ala Cys Giy Cys His (SEQ ID NO:3) 95 100 wherein Xaa at res.2 (Lys or Arg); Xaa at res.3 (Lys or Arg); Xaa at res. I I (Arg or Gin); Xaa at res. 16 (Gin or Leu); Xaa at res. 19 (Ile or Vai); Xaa at res.23 =(Glu or Gin); Xaa-at res.26 (Ala or Ser);- Xaa at res.35 (Ala or Ser);, Xaa at res.39 (Asn or Asp), Xaa at res.41 (Tyr or Cys); Xaa at resSO0 (Val or Leu);, Xaa at res.52 (Ser or Thr); Xaa at res. 56 (Phe or Leu); Xaa at res. 57 (le or Met); Xaa at res. 58 (Asn or Lys); Xaa at res.60 (Glu, Asp or Asn); Xaa at res.61 (Thr, Ala or Vai); Xaa at (Pro or Ala); Xaa at res.71 (Gin or Lys), Xaa at res.73 (Asn or Ser); Xaa at (le or Thr); Xaa at res.80 (Phe or Tyr); Xaa at res.82 (Asp or Ser); Xaa at res.84= (Ser or Asn);- Xaa at res.89 (Lys or Mrg); Xaa at res.9i (Tyr or His); and Xaa at res.97 =(Arg or Lys).

In another embodiment, the morphogenic proteins comprise species of the generic amino acid sequence 1 10 20 30 40 CXXXX LXVX FXDXGWXXWXXX PXG-XXAXYCX GXCXX PXXXXXXXXNHAXX 60 70 80 90 100 QXXVXXXNXXXX PXXCCXPXXXXXXXXLXXXXXXXVXLXXYXXMXVXXCXCX (SEQ ID NO: or residues 6-102 of SEQ rD NO: 10, where the letters indicate the amino acid residues of standard single letter code, and the Xs represent any amino acid residues. Cysteine residues are highlighted.

Preferred amino acid sequences within the foregoing generic sequence (SEQ ID NO: 10) are: 1 10 20 30 40 s0 LYVDFRDVGWNDW IVAPPGYHAFYCHGECPFLADHLNS-NHAIV K S S L QE VIS EFD Y E AAY MPESMKAS VI F EK I DN L N S Q ITK FP T 7 WO 01/23563 PCT/US00/26528 A S K 70 80 90 100

QTLVNSVNPGKIPKACCVPTELSAISMLYLDENENVVLKNYQDMVVEGCGCR

SI HAI SEQV EP EQMNSLAI FFNDQDK I RK EE T DA H H RF T S K DPV V Y N S H RN RS N S K P E and 1 10 20 30 40

CKRHPLYVDFRDVGWNDWIVAPPGYHAFYCHGECPFPLADHLNSTNHAIV

RRRS K S S L QE VIS E FD Y E A AY MPESMKAS VI KE FE K I DN L N S Q ITK F P TL Q A S K 70 80 90 100

QTLVNSVNPGKIPKACCVPTELSAISMLYLDENENVVLKNYQDMVVEGCGCR

SI HAI SEQV EP EQMNSLAI FFNDQDK I RK EE T DA H H RF T S K DPV V Y N S H RN RS N S K P E wherein each of the amino acids arranged vertically at each position in the sequence may be used alternatively in various combinations (SEQ ID NO: 10). These generic sequences have 6 or 7 cysteine residues where inter- or intra-molecular disulfide bonds can form. These sequences also contain other critical amino acids that influence the tertiary structure of the proteins.

In still another embodiment, useful morphogenic proteins comprise an amino acid sequence encoded by a nucleic acid that hybridizes, under low, medium or high stringency hybridization conditions, to DNA or RNA encoding reference morphogenic protein coding sequences. Exemplary reference sequences include the C-terminal sequences defining the conserved seven-cysteine domains of OP-1, OP-2, BMP-2, BMP-4, BMP-6, 60A, GDF-3, GDF-5, GDF-6, GDF-7, and the like. High stringent hybridization conditions are herein defined as hybridization in 40% formamide, 5X SSPE, Denhardt's Solution, and 0.1% SDS at 37 0 C overnight, and washing in 0.1X SSPE, 0.1% SDS at 50 0 C. Standard stringency conditions are well characterized in commercially available, standard molecular cloning texts. See, for example, Molecular Cloning, A Laboratory Manual, 2nd Ed., ed. by Sambrook et al. (Cold Spring Harbor Laboratory Press 1989); DNA Cloning, Volumes I and II N. Glover ed., 1985); Oligonucleotide WO 01/23563 PCT/US00/26528 Synthesis J. Gait ed., 1984); Nucleic Acid Hybridization D. Hames S. J. Higgins eds. 1984); and B. Perbal, A Practical Guide To Molecular Cloning (1984).

Suitable in vitro, ex vivo and in vivo bioassays known in the art, including those described herein, may be used to ascertain whether a new BMP-related gene product has a morphogenic activity. Expression and localization studies defining where and when the gene is expressed may also be used to identify potential morphogenic activities. Nucleic acid and protein localization procedures are well known to those of skill in the art (see, Ausubel et al., eds. Current Protocols in Molecular Cloning, Greene Publishing and Wiley Interscience, New York, 1989).

Many of the identified BMPs are osteogenic and can induce bone and cartilage formation when implanted into mammals. Some BMPs identified based on sequence homology to known osteogenic proteins possess other morphogenic activities and a combination of a hormone and a soluble receptor thereof may be used to enhance those activities. For example, BMP-12 and BMP-13 reportedly induce ectopic formation of tendon/ligament-like tissue when implanted into mammals (Celeste et al., WO 95/16035).

Using this bioassay, a skilled practitioner can readily identify one or more combinations of hormones and soluble receptors thereof that can stimulate the ability of the BMP to induce tendon/ligament-like tissue formation.

Certain BMPs which are known to be osteogenic can also induce neuronal cell differentiation. Embryonic mouse cells treated with BMP-2 or OP-I differentiate into astrocyte-like (glial) cells, and peripheral nerve regeneration using BMP-2 has been reported (Wang et al., WO 95/05846). In addition, BMP-4, BMP-5 and OP-1 are expressed in epidermal ectoderm flanking the neural plate. Ectopic recombinant BMP-4 and OP-1 proteins can induce neural plate cells to initiate dorsal neural cell fate differentiation (Liem et al., Cell, 82, pp. 969-79 (1995)). At the spinal cord level, OP-1 and other BMPs can induce neural crest cell differentiation. It is suggested that OP-1 and these BMPs can induce many or all dorsal neural cell types, including roof plate cells, neural crest cells, and commissural neurons, depending on localized positional cues.

That several osteogenic proteins originally derived from bone matrix are involved in neural development suggests that these and other members of the BMP family have additional tissue inductive properties that are not yet disclosed. It is envisioned that the hormone/receptor combinations set forth in this invention can be used to enhance new WO 01/23563 PCT/US00/26528 or known tissue inductive properties of various known morphogenic proteins. It is also envisioned that the invention described herein will be useful for stimulating tissue inductive activities of new morphogenic proteins as they are identified in the future.

Production of Morphogenic Proteins The morphogenic proteins of this invention can be derived from a variety of sources. For instance, they may be isolated from natural sources, recombinantly produced, or chemically synthesized.

A. Naturally Derived Morphogenic Proteins The morphogenic proteins of the invention can be purified from tissue sources, mammalian tissue sources, using well known techniques. See, e.g., Oppermann et al., U.S. Patent Nos. 5,324,819 and 5,354,557. If a purification protocol is unpublished, as for a newly identified morphogenic protein, conventional protein purification techniques immunoaffinity) may be performed in combination with morphogenic activity assays. Such assays allow the trace of the morphogenic activity through a series of purification steps.

B. Recombinantly Expressed Morphogenic Proteins In another embodiment of this invention, the morphogenic protein is produced by expressing an appropriate recombinant DNA molecule in a host cell. The DNA and amino acid sequences of many BMPs and OPs have been reported, and methods for their recombinant production are published and otherwise known to those of skill in the art. For a general discussion of cloning and recombinant DNA technology, see Ausubel et al., supra; see also Watson et al., Recombinant DNA, 2d ed. 1992 Freeman and Co., New York).

The DNA sequences encoding bovine and human BMP-2 (formerly BMP- 2A) and BMP-4 (formerly BMP-2B), and processes for recombinantly producing the corresponding proteins are described in U.S. Patent Nos. 5,011,691, 5,013,649, 5,166,058 and 5,168,050. The DNA and amino acid sequences of human and bovine BMP-5 and BMP-6, and methods for their recombinant production, are disclosed in U.S. Patent Nos.

5,106,748, and 5,187,076, respectively; see also U.S. Patent Nos. 5,011,691 and 5,344,654. Methods for OP-1 recombinant expression are disclosed in Oppermann et al., U.S. Patent Nos. 5,011,691 and 5,258,494. For an alignment of BMP-2, BMP-4, BMP-6 and OP-l (BMP-7) amino acid sequences, see WO 95/16034. DNA sequences WO 01/23563 PCT/US00/26528 encoding BMP-8 are disclosed in WO 91/18098, and DNA sequences encoding BNMP-9 in WO 93/00432. DNA and deduced amino acid sequences encoding BMP-10 and BMP-11 are disclosed in WO 94/26893, and WO 94/26892, respectively. DNA and deduced amino acid sequences for BMP-12 and BMP-13 are disclosed in WO 95/16035. The above patent disclosures, which describe DNA and amino acid sequences, and methods for producing the BMPs and OPs encoded by those sequences, are incorporated herein by reference.

To clone genes that encode new BMPs, OPs and other morphogenic proteins identified in extracts by bioassay, methods entailing "reverse genetics" may be employed. Such methods start with a protein of known or unknown function to obtain the gene that encodes that protein. Standard protein purification techniques may be used as an initial step. If enough protein can be purified to obtain a partial amino acid sequence, a degenerate DNA probe capable of hybridizing to the DNA sequence that encodes that partial amino acid sequence may be designed, synthesized and used as a probe to isolate full-length clones that encode that or a related morphogenic protein.

Alternatively, a partially-purified extract containing the morphogenic protein may be used to raise antibodies directed against that protein. Morphogenic protein-specific antibodies may then be used as a probe to screen expression libraries made from cDNAs (see, Broome and Gilbert, Proc. Nail. Acad. Sci. US.A., 75, pp. 2746-49 (1978); Young and Davis, Proc. Natl. Acad. Sci. 80, pp. 31-35 (1983)).

For cloning and expressing new BMPs, OPs and other morphogenic proteins identified based on DNA sequence homology, the homologous sequences may be cloned and sequenced using standard recombinant DNA techniques. With the DNA sequence available, a DNA fragment encoding the morphogenic protein may be inserted into an expression vector selected to work in conjunction with a desired host expression system. The DNA fragment is cloned into the vector such that its transcription is controlled by a heterologous promoter in the vector, preferably a promoter which may be optionally regulated.

Some host-vector systems appropriate for the recombinant expression of BMPs and OPs are disclosed in the references cited above. Useful host cells include but are not limited to bacteria such as E. coli, yeasts such as Saccharomyces and Picia, insects cells and other primary, transformed or immortalized eukaryotic cultured cells. Preferred eukaryotic host cells include CHO, COS and BSC cells (see below).

WO 01/23563 PCT/US00/26528 An appropriate vector is selected according to the host system selected.

Useful vectors include but are not limited to plasmids, cosmids, bacteriophage, insect and animal viral vectors, including those derived from retroviruses and other single and doublestranded DNA viruses.

In one embodiment of this invention, the morphogenic protein may be derived from a recombinant DNA molecule expressed in a prokaryotic host. Using recombinant DNA techniques, various fusion genes have been constructed to induce recombinant expression of naturally sourced osteogenic sequences in E. coli (see, e.g., Oppermann et al., U. S. Patent No. 5,354,557, incorporated herein by reference). Using analogous procedures, DNAs comprising truncated forms of naturally sourced morphogenic sequences may be prepared as fusion constructs linked by a sequence coding for the acid labile cleavage site (Asp-Pro) to a leader sequence (such as the "MLE leader") suitable for promoting expression in E. coli.

In another embodiment of this invention, the morphogenic protein is expressed using a mammalian host-vector system transgenic production or tissue culture production). A morphogenic protein so expressed may resemble more closely the naturally occurring protein. While the glycosylation pattern of the recombinant protein may sometimes differ from that of the natural protein, such differences are often not essential for biological activity of the recombinant protein. Techniques for transfection, expression and purification of recombinant proteins are well known in the art. See, Ausubel et al., supra, and Bendig, Genetic Engineering, 7, pp. 91-127 (1988).

Mammalian DNA vectors should include appropriate sequences to promote expression of the gene of interest. Such sequences include transcription initiation, termination and enhancer sequences; efficient RNA processing signals such as splicing and polyadenylation signals; mRNA-stabilizing sequences; translation-enhancing sequences Kozak consensus sequence); protein-stabilizing sequences; and when desired, sequences that enhance protein secretion.

Restriction maps and sources of various exemplary expression vectors designed for OP-1 expression in mammalian cells have been described in U.S. Patent No.

5,354,557. Each of these vectors employs a full-length hOP-1 cDNA sequence inserted into the pUC-18 vector. It will be appreciated by those of skill in the art that DNA sequences encoding truncated forms of morphogenic proteins may also be used, provided t WO 01/23563 PCT/US00/26528 that the expression vector or host cell provides the sequences necessary to direct processing and secretion of the expressed protein.

Useful promoters include, but are not limited to, the SV40 early and late promoters, the adenovirus major late promoter, the mouse metallothionein-I ("mMT") promoter, the Rous sarcoma virus long terminal repeat the mouse mammary tumor virus ("MMTV") LTR, and the human cytomegalovirus major intermediate-early promoter. For instance, a combination of the CMV or MMTV promoter with an enhancer sequence from the RSV LTR has been found to be particularly useful in expressing human osteogenic proteins.

Preferred DNA vectors also include a marker gene neomycin or DHFR) and means for amplifying the copy number of the gene of interest. DNA vectors may also comprise stabilizing sequences ori- or ARS-like sequences and telomere-like sequences), or may alternatively be designed to favor directed or non-directed integration into the host cell genome.

One method of gene amplification in mammalian cell systems is the use of the selectable dihydrofolate reductase (DHFR) gene in a dhfr cell line. Generally, the DHFR gene is provided on the vector carrying the gene of interest, and addition of increasing concentrations of the cytotoxic drug methotrexate (MTX) leads to amplification of the DHFR gene copy number, as well as that of the gene physically associated with it.

DHFR as a selectable, amplifiable marker gene in transfected Chinese hamster ovary (CHO) cell lines is particularly well characterized in the art. Other useful amplifiable marker genes include the adenosine deaminase (ADA) and glutamine synthetase (GS) genes.

Gene amplification can be further enhanced by modifying marker gene expression regulatory sequences enhancer, promoter, and transcription or translation initiation sequences) to reduce the levels of marker protein produced. Lowering the level of DHFR transcription increases the DHFR gene copy number (and the physicallyassociated gene) to enable the transfected cell to adapt to growth in even low levels of methotrexate 0.1 pM MTX). Preferred expression vectors such as pH754 and pH752 (Oppermann et al., U. S. Patent No. 5,354,557, Figs. 19C and D) have been manipulated, using standard recombinant DNA technology, to create a weak DHFR promoter. As will be appreciated by those skilled in the art, other useful weak promoters, -21- :WO 01/23563 PCT/US00/26528 different from those disclosed herein, can be constructed using standard methods. Other regulatory sequences also can be modified to achieve the same effect.

Another gene amplification scheme relies on the temperature sensitivity (ts) ofBSC40-tsA58 cells transfected with an SV40 vector. Temperature reduction to 33°C stabilizes the temperature-sensitive SV40 T antigen, which leads to the excision and amplification of the integrated transfected vector DNA, thereby amplifying the physicallyassociated gene of interest.

The choice of cells/cell lines depends on the needs of the skilled practitioner.

Monkey kidney cells (COS) provide high levels of transient gene expression and are thus useful for rapidly testing vector construction and the expression of cloned genes. COS cells expressing the gene of interest can be established by transfecting the cells with, an vector carrying the gene. Stably transfected cell lines, on the other hand, can be used for long term production of morphogenic proteins. By way of example, both CHO cells and BSC40-tsA58 cells can be used as host cells. Recombinant OP-1 has been expressed in three different cell expression systems: COS cells for rapidly screening the functionality of the various expression constructs, CHO cells for the establishment of stable cell lines, and BSC40-tsA58 cells as an alternative means of producing recombinant OP-1 protein.

Several bone-derived osteogenic proteins (OPs) and BMPs are found as homo- and heterodimers comprising interchain disulfide bonds in their active forms. For instance, BMP-2, BMP-4, BMP-6 and BMP-7 (OP-1) originally isolated from bone are bioactive as either homodimers or heterodimers. The ability of OPs and BMPs to form heterodimers may confer additional or altered morphogenic activities on morphogenic proteins. Heterodimers may exhibit qualitatively or quantitatively different binding affinities than homodimers for OP and BMP receptors. Altered binding affinities may in turn result in differential activation of receptors that mediate different signalling pathways, ultimately leading to different biological activities. Altered binding affinities can also be manifested in a tissue or cell type-specific manner, thereby inducing only particular progenitor cell types to undergo proliferation and/or differentiation.

The dimeric proteins can be isolated from the culture media and/or refolded and dimerized in vitro to form biologically active compositions. Heterodimers can be formed in vitro by combining separate, distinct polypeptide chains. Alternatively, heterodimers can be formed in a single cell by co-expressing nucleic acids encoding -22- WO 01/23563 PCT/US00/26528 separate, distinct polypeptide chains. See, WO 93/09229 and U.S. Patent No.

5,411,941, for exemplary protocols for heterodimer protein production.

C. In Vivo Expression of Morphogenic Proteins The morphogenic protein of the invention can also be produced in vivo in a patient. To achieve this, an expression vector comprising a promoter operatively linked to a coding sequence of the morphogenic protein may be introduced into progenitor cells in the patient. Alternatively, one can isolate the appropriate progenitor cells from the patient, transfect or transduce the cells with the expression vector, and re-introduce the treated cells to the patient at a desired locus.

Vectors A nucleic acid construct according to this invention is derived from a nonreplicating linear or circular DNA or RNA vector, or from an autonomously replicating plasmid or viral vector. Alternatively, the construct is integrated into the host genome.

Any vector that can transfect or transduce the desired progenitor cell may be used.

Preferred vectors are viral vectors, including those derived from replication-defective retroviruses (see, W089/07136; Rosenberg et al., N. Eng. J. Med. 323(9): 570-578 (1990)), adenovirus (see, Morsey et al., J. Cell. Biochem., Supp. 17E (1993)), adenoassociated virus (Kotin et al., Proc. Natl. Acad. Sci. USA 87:2211-2215 (1990)), replication-defective herpes simplex viruses (HSV; Lu et al., Abstract, page 66, Abstracts of the Meeting on Gene Therapy, Sept. 22-26, 1992, Cold Spring Harbor Laboratory, Cold Spring Harbor, New York), vaccinia virus (Mukherjee et al., Cancer Gene Ther. 7:663-70 (2000)), and any modified versions of these vectors. Methods for constructing expression vectors are well known in the art. See, Sambrook et al., Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory, 2nd Edition, Cold Spring Harbor, New York, 1989).

Expression Control Sequences In these vectors, expression control sequences are operably linked to the nucleic acid sequence encoding the morphogenic protein useful in this invention. For eukaryotic cells, expression control sequences may include a promoter, an enhancer, such as one derived from an immunoglobulin gene, SV40, cytomegalovirus, etc., and a polyadenylation sequence. A nucleic acid construct of this invention may also contain an internal ribosome entry site and an intron that may be desirably located between WO 01/23563 PCT/US00/26528 the promoter/enhancer sequence and the morphogenic protein-coding sequence. Selection of these and other common vector elements are conventional. See, Sambrook et al, supra; Ausubel et al., Current Protocols in Molecular Biology, John Wiley Sons, New York, (1989); and references cited therein.

In one embodiment of the present invention, high-level constitutive expression is desired. Exemplary promoters for this purpose include, without limitation, the retroviral Rous sarcoma virus (RSV) LTR promoter/enhancer, the cytomegalovirus (CMV) immediate early promoter/enhancer (see, Boshart et al, Cell 41:521-530 (1985)), the SV40 promoter, the dihydrofolate reductase promoter, the cytoplasmic p-actin promoter, the phosphoglycerol kinase (PGK) promoter. Useful promoters for BMP expression in osteoblasts also include the Type 1 collagen gene promoter and the CBFA gene promoter. Useful promoters for BMP expression in chondrocytes and chondroblasts include the Type 11 collagen gene promoter and the Type X collagen gene promoter. In another embodiment, the native transcription-regulatory elements of the desired morphogenic protein can be used.

Using the guidance provided by this application, one of skill in the art may make a selection among the above expression control sequences and modified versions thereof without departing from the scope of this invention.

Administration of Nucleic Acid Constructs The nucleic acid constructs of this invention may be formulated as a pharmaceutical composition for use in any form of transient and/or stable gene transfer in vivo and in vitro. The composition comprises at least the nucleic acid construct and a pharmaceutically acceptable carrier such as saline. Other aqueous and non-aqueous sterile suspensions known to be pharmaceutically acceptable carriers and well known to those of skill in the art may be employed also. The construct may be used for in vivo and ex vivo gene therapy, in vitro protein production and diagnostic assays.

The nucleic acid construct can be introduced into target cells as naked DNA, or by, liposome fusion (see, Nabel et al., Science 249:1285-8 (1990); Ledley, JPediatrics 110:1-8 and 167-74 (1987); Nicolau et al., Proc NatlAcad Sci USA 80:1068-72 (1983)), erythrocyte ghosts, or microsphere methods (microparticles; see, e.g., United States patent 4,789,734; United States patent 4,925,673; United States patent WO 01/23563 PCT/US00/26528 3,625,214; Gregoriadis, Drug Carriers in Biology and Medicine, pp. 287-341, Academic Press, 1979).

If the nucleic acid construct is viral-based, it can also be packaged as a virion which then is used to transduce a cell an autologous T cell isolated from a patient) in vitro. The infected cell is then introduced into the patient. Alternatively, the recombinant virus may be administered to a patient directly, locally at the tissue defect site; or intravenously, intraperitoneally, intranasally, intramuscularly, subcutaneously, and/or intradermally, as determined by one skilled in the gene therapy art. A slow-release device, such as an implantable pump, may be used to facilitate delivery of the recombinant virus to a cell. Where the virus is administered to a subject, the specific cells to be infected may be targeted by controlling the method of delivery. The treatments of the invention may be repeated as needed, as determined by one skilled in the art.

Dosages of the nucleic acid construct of this invention in gene therapy will depend primarily on factors such as the condition being treated. The dosage may also vary depending upon the age, weight and health of the patient. For example, an effective human dosage of a BMP-coding virus is generally in the range of from about 0.5 ml to 50 ml of saline solution containing the virus at concentrations of about 1 x 10x, x 1 1, x 109, 1 x 1010, 1 x 10' 1 1 x 10, 1 10x, 1 10 14 1 x 101, or 1 x 1016 viral particles per dose administered. The dosage will be adjusted to balance the corrective benefits against any adverse side effects. The levels of expression of BMP may be monitored to determine the type and frequency of dosage administration.

D. Synthetic Non-native Morphogenic Proteins In another embodiment of this invention, a morphogenic protein may be prepared synthetically. Morphogenic proteins prepared synthetically may be native, or may be non-native proteins, those not otherwise found in nature.

Non-native morphogenic proteins can be made by mutating native morphogenic proteins. Methods for making mutations that favor refolding and/or assembling subunits into forms that exhibit greater morphogenic activity have been described. See, U.S. Patent No. 5,399,677.

Non-native morphogenic proteins can also be synthesized using a series of consensus sequences S. Patent No. 5,324,819). These consensus sequences were designed based on partial amino acid sequence data obtained from native osteogenic WO 01/23563 PCTIUS00/26528 products and on their homologies with other proteins reportedly having a presumed or demonstrated developmental function. Several biosynthetic consensus sequences (called consensus osteogenic proteins or "COPs") have been expressed as fusion proteins in prokaryotes. Purified fusion proteins may be cleaved, refolded, combined with a hormone and a soluble receptor thereof, implanted in an established animal model and examined for their bone- and/or cartilage-inducing activity. Certain preferred synthetic osteogenic proteins comprise one or both of two synthetic amino acid sequences designated (SEQ ID NO: 11) and COP7 (SEQ ID NO: 12).

The amino acid sequences of COP5 and COP7 are shown below, as set forth in Oppermann et al., U. S. Patent Nos. 5,011,691 and 5,324,819, which are incorporated herein by reference:

LYVDFS-DVGWDDWIVAPPGYQAFYCHGECPFPLAD

COP7 LYVDFS-DVGWNDWIVAPPGYHAFYCHGECPFPLAD

HFNSTN--H-AVVQTLVNSVNSKI--PKACCVPTELSA

COP7 HLNSTN--H-AVVQTLVNSVNSKI--PKACCVPTELSA ISMLYLDENEKVVLKYNQEMVVEGCGCR (SEQ ID NO: 11) COP7 ISMLYLDENEKVVLKYNQEMVVEGCGCR (SEQ ID NO:12) In these amino acid sequences, the dashes are used as fillers only to line up comparable sequences in related proteins. Differences between the aligned amino acid sequences are highlighted.

In one embodiment of this invention, the morphogenic protein is a synthetic osteogenic protein comprising a partial or complete sequence of a generic sequence described above (SEQ ID NO:4, 5, 6, 7, or 10) such that it is capable of inducing tissue formation when properly folded and implanted in a mammal. For instance, the synthetic protein can induce bone formation from osteoblasts when implanted in a favorable environment; or it can promote cartilage formation when implanted in an avascular locus or when co-administered with an inhibitor of full bone development.

-26- WO 01/23563 PCT/US00/26528 In another embodiment, the synthetic morphogenic protein of this invention comprises a sequence sufficiently duplicative of a partial or complete sequence of a COP, COP5 (SEQ ID NO: 11) or COP7 (SEQ ID NO:12). Biosynthetic COP sequences are believed to dimerize during refolding and appear not to be active when reduced. Both homodimeric and heterodimeric COPs are contemplated in this invention. In certain embodiments, this synthetic protein is less than about 200 amino acids long.

These and other synthetic non-native osteogenic proteins may be used in concert with a hormone/receptor pair and tested using in vitro, ex vivo or in vivo bioassays for progenitor cell induction and tissue regeneration. The proteins in conjunction with the hormone/receptor pairs of this invention are envisioned to be useful for the repair and regeneration of bone, cartilage, tendon, ligament, neural and potentially other types of tissue.

Homologous Proteins Having Morphogenic Activity The morphogenic proteins useful in this invention may be produced by recombinant expression of DNA sequences isolated based on homology with the osteogenic COP consensus sequences described above. Synthetic COP DNA sequences may be used as probes to retrieve related DNA sequences from a variety of species (see, e.g., Oppermann et al., U.S. Patent Nos. 5,011,591 and 5,258,494, which are incorporated herein by reference).

Morphogenic proteins encoded by a gene that hybridizes with a COP sequence probe are assembled into two subunits disulfide-bonded to produce a heterodimer or homodimer capable of inducing tissue formation when implanted into a mammal.

Recombinant BMP-2 and BMP-4 have been shown to have cross-species osteogenic activity as homodimers and as heterodimers assembled with OP-I subunits.

Morphogenic protein-encoding genes that hybridize to synthetic COP sequence probes include genes encoding Vgl, inhibin, DPP, OP-1, BMP-2 and BMP-4. Vgl is a known Xenopus laevis morphogenic protein involved in early embryonic patterning. Inhibin is another developmental gene that is a member of the BMP family of proteins from Xenopus laevis. DPP is an amino acid sequence encoded by a Drosophila gene responsible for development of the dorso-ventral pattern. OP-1, BMP-2 and BMP-4 are osteogenic proteins that can induce cartilage, bone and neural tissue formation.

WO 01123563 PCT/US00/26528 In another embodiment of this invention, a morphogenic protein may comprise a polypeptide encoded by a nucleic acid that hybridizes under stringent conditions to an "OPS" nucleic acid probe (Oppermann et al., U.S. Patent No. 5,354,557). "OPS" standing for OP-1 "short" refers to the portion of the human OP-1 protein defining the conserved 6 cysteine skeleton in the C-terminal active region (97 amino acids; SEQ ID NO:2, residues 335-431).

One example of a stringent hybridization condition is hybridization in 4X SSC at 65 0 C (or 10 0 C higher than the calculated melting temperature for a hybrid between the probe and a nucleic acid sequence containing no mis-matched base pairs), followed by washing in 0.1X SSC at the hybridization temperature. Another stringent hybridization condition is hybridization in 50% formamide, 4X SSC at 42°C.

Thus, in view of this disclosure, the skilled practitioner can readily design and synthesize genes, or isolate genes from cDNA or genomic libraries that encode amino acid sequences having morphogenic activity. These genes can be expressed in prokaryotic or eukaryotic host cells to produce large quantities of active osteogenic or otherwise morphogenic proteins. The recombinant proteins may be in native, truncated, mutant, fusion, or other active forms capable of inducing formation of bone, cartilage, or other types of tissue, as demonstrated by in vitro and ex vivo bioassays and in vivo implantation in mammals, including humans.

Hormones and Receptors Thereof A hormone/receptor pair of this invention is capable of stimulating the ability of a morphogenic protein to induce tissue formation from a progenitor cell. In a method of this invention, the tissue inductive activity of a morphogenic protein in a mammal is improved by co-administering effective amounts of a hormone and a soluble receptor thereof. Alternatively, the morphogenic protein and the hormone/receptor pair are administered sequentially. It has been found that the synergism between a morphogenic protein and a hormone/receptor pair is preserved even if the morphogenic protein is administered 4 to 8 hours before the hormone/receptor pair. The morphogenic protein, the hormone, and the hormone receptor can also be administered separately.

One or more hormone/receptor pairs can be selected for use in concert with one or more morphogenic proteins according to the desired tissue type to be induced and the site at which the treatment will be administered. The particular choice of a WO 01/23563 PCT/US00/26528 morphogenic protein(s)/hormone(s)/receptor(s) combination and the relative concentrations at which they are combined may be varied systematically to optimize the tissue type induced at a selected treatment site using the procedures described herein.

Hormones useful in this invention include, but are not limited to, interleukins 1 throughl8, fibroblast growth factor, vascular endothelial growth factor, platelet-derived growth factor, TGF-P, and prostaglandins El and E2). It may be preferred that the target cell has a cell-surface receptor for the hormone. The hormones can also be morphogenic proteins such as GDFs; as a result, the composition of this invention will contain two morphogenic proteins and a soluble receptor of one of these proteins.

One preferred hormone/receptor pair of this invention is IL-6/slL-6R. IL-6 is a member of a subfamily of multifunctional hormones. It appears to play a role in both bone formation and bone resorption by affecting mitogenesis of target cells and regulating the synthesis of other local factors. Clinical studies show that IL-6 is involved in a variety of diseases, such as fibrous dysplasia, osteopenia, osteoporosis and Paget's disease.

Recombinant full length human IL-6 (26 kD) expressed from E. coli can be obtained from Sigma (St. Louis, MI) and Promega (Madison, WI). Recombinant slL-6R produced from baculovirus and containing the entire extracellular domain (residues 1-339; 38 kD) of human IL-6R can be obtained from Sigma and R&D Systems (Minneapolis, MN). See also Examples 1 and 2, infra. Active allelic, species or other variants of these IL-6 and sIL-6 products can also be used.

The hormone or the hormone receptor of this invention can be associated with an agent that is capable of increasing the hormone's or receptor's bio-activity, e.g., synthesis, half-life, bio-availability, and reactivity with other bio-molecules such as binding proteins and receptors. These agents may contain carrier molecules such as proteins and lipids.

The hormone and hormone receptor are present in amounts capable of synergistically stimulating the tissue inductive activity of the morphogenic protein in a mammal. The relative concentrations of morphogenic protein, hormone and hormone receptor that optimally induce tissue formation may be determined empirically by the skilled practitioner using the procedures described herein.

Progenitor Cells WO 01/23563 PCTUS00/26528 The progenitor cell that is induced to proliferate and/or differentiate by the morphogenic protein of this invention is preferably a mammalian cell. Examples of useful progenitor cells are mammalian chondroblasts, osteoblasts and neuroblasts, all earlier developmental precursors thereof, and all cells that develop therefrom prechondroblasts and chondrocytes). The progenitor cell may be induced to form one or more tissue types such as endochondral or intramembranous bone, cartilage, tendon/ligament-like tissue, neural tissue and kidney tissue. The specific morphogenic activity exhibited by a morphogenic protein will depend in part on the type of the progenitor cell as well as the treatment site. These variables may be tested empirically.

Morphogenic proteins are highly conserved throughout evolution, and nonmammalian progenitor cells are likely to be stimulated by same- or cross-species morphogenic proteins and hormone/receptor combinations. It is thus envisioned that where schemes are available for implanting xenogeneic cells into humans without adverse immunological reactions, non-mammalian progenitor cells stimulated by morphogenic protein and a hormone/receptor pair according to the procedures set forth herein will be useful for tissue regeneration and repair in humans.

Testing Morphogenic Activity To identify a hormone/receptor pair capable of stimulating the tissue inductive activity of a chosen morphogenic protein, an appropriate assay is selected.

Initially, in vitro assays can be performed. A useful in vitro assay may monitor a nucleic acid or protein marker whose expression is known to correlate with the associated cell differentiation pathway. See, Examples 3 and 4 of United States Patent No.

5,854,207, Lee et al.; and Examples 1 and 2, infra.

Examples 1 and 2, infra, describe experiments using OP-I to identify and to optimize an effective concentration of IL-6 and sIL-6R. OP-1 is known to have osteogenic and neurogenic activity. Thus, to identify a hormone/receptor pair having synergistic effects with OP-1, one can conduct an in vitro assay that examines the expression of a molecular marker, an osteogenic- or a neurogenic-associated marker, in appropriate progenitor cells.

One useful assay for testing potential hormone/receptor pairs with OP-1 for osteogenic activity is the alkaline phosphatase enzymatic assay. AP is an osteoblast differentiation marker in primary osteoblastic fetal rat calvarial cells. The OP-1- WO 01/23563 PCT/US00/26528 stimulated AP activity results from increased steady-state AP mRNA levels. Other useful protein markers for monitoring osteogenic activity of a composition include, but are not limited to, type I collagen, osteocalcin, osteopontin, bone sialoprotein and PTH-dependent cAMP levels.

An AP assay is performed generally as follows. First, a hormone/receptor pair is identified by picking various concentrations and ratios of the hormone and hormone receptor and testing them in the absence and presence of a morphogenic protein. Second, the amounts of hormone and hormone receptor required to achieve optimal, preferably synergistic, tissue induction in concert with the morphogenic protein is determined by generating dose response curves.

Optionally, additional hormone/receptor pairs that further stimulate or otherwise alter the morphogenic activity induced by a morphogenic protein and a first hormone/receptor pair may be identified and a new multi-factor dose response curve generated. See, Example 5 of United States Patent 5,854,207.

Bone Induction Assays The various morphogenic compositions and devices of this invention can also be evaluated with ex vivo or in vivo bioassays. A rat bioassay for bone induction may be used to monitor osteogenic activity of osteogenic proteins in concert with one or more hormone/receptor pairs. See, Sampath et al., Proc. Natl. Acad. Sci. USA, 80, pp.

6591-95 (1983), and United States Patent No. 5,854,207, Example 7. Rat bioassays are useful as the first step in moving from in vitro studies to in vivo studies.

Large animal efficacy models for osteogenic device testing are known in the art. Exemplary models are the feline femoral model, the rabbit ulnar model, the dog ulnar model and the monkey model. See, U. S. Patent Nos. 5,354,557, and 5,854,207 (Examples 10 and 11 therein).

In general, about 500-1000ng of active morphogenic protein and about 200ng of active hormone and active hormone receptor are combined with 25mg of a carrier matrix for rat bioassays. In larger animals, typically about 0.8-1mg of active morphogenic protein per gram of carrier is combined with about 100ng or more of an active hormone and hormone receptor. The optimal ratios of morphogenic protein to hormone and of hormone to hormone receptor for a specific tissue type may be determined empirically by -31- W\ Al n/12Z PCT/US00/26528 those of skill in the art according to the procedures set forth herein. Greater amounts may be used for large implants.

Tendon/ligament-like tissue formation bioassay Assays for monitoring tendon and ligament-like tissue formation induced by morphogenic proteins are known in the art. See, Celeste et al., WO 95/16035, hereby incorporated by reference. Such assays can be used to identify hormone/receptor pairs that stimulate tendon/ligament-like tissue formation by BMP-12, BMP-13 or other morphogenic proteins in a particular treatment site. The assays may also be used to optimize concentrations and treatment schedules for therapeutic tissue repair regiments.

These assays may be used to test various combinations of morphogenic protein and hormone/receptor combinations, and to produce an in vivo dose response curve for determining the effective relative concentrations of morphogenic proteins and hormones/receptors.

Neural Assays The osteogenic proteins BMP-4 and BMP-7 (OP-1) can induce ventral neural plate explants to undergo differentiation into dorsal neural cell fates (Liem et al., Cell, 82, pp. 969-79 (1995)). Molecular markers of dorsal cell differentiation are described in Liem et al. These markers include PAX3 and MSX, whose expression delineates an early stage of neural plate cell differentiation; DSL-1, a BMP-like molecule delineating differentiation of dorsal neural plate cells at a stage after neural tube closure; and SLUG protein, whose expression after neural tube closure defines pre-migratory neural crest cells.

Expression of these dorsal markers can be induced in ventral neural plate explants by ectopic BMP4 and OP-1.

A peripheral nerve regeneration assay using BMP-2 has been described (Wang et al., WO 95/05846, hereby incorporated by reference). The assay involves the implantation of neurogenic devices in the vicinity of severed sciatic nerves in rats. This procedure may be used to assess the ability of a putative hormone/receptor pair to enhance the neuronal inductive activity of homo- and heterodimers of morphogenic proteins having neurogenic activity, such as BMP-2, BMP-4, BMP-6 and OP-1, or of any selected neurogenic protein/hormone/hormone receptor combinations.

Pharmaceutical Compositions WO 01/23563 PCT/US00126528 The pharmaceutical compositions of this invention contain at least one at least 2, 3 or 5) morphogenic protein, and at least one at least 2 or 3) hormone/receptor pair. These compositions are capable of inducing tissue formation when administered, implanted, into a patient. The compositions will be administered at an effective dose to induce the particular type of tissue at the desired treatment site.

Determination of a preferred pharmaceutical formulation and a therapeutically efficient dose regiment for a given application is well within the skill of the art. Factors that need to be considered include, for example, the administration mode, the condition and weight of the patient, the extent of desired treatment and the tolerance of the patient for the treatment.

Doses expected to be suitable starting points for optimizing treatment regiments are based on the results of in vitro assays, and ex vivo or in vivo assays. Based on the results of such assays, a range of suitable morphogenic protein and hormone/receptor concentration ratios can be selected to test at a treatment site in animals and then in humans.

The pharmaceutical compositions of this invention may be in a variety of forms. These include, for example, solid, semi-solid and liquid forms such as tablets, pills, powders, liquids, suspensions, suppositories, gels, pastes, and other injectable and infusible solutions. The preferred form depends on the intended mode of administration and therapeutic application. Modes of administration may include oral, parenteral, subcutaneous, intravenous, intralesional or topical administration. In most cases, the pharmaceutical compositions of this invention will be administered in the vicinity of or at the treatment site in need of tissue regeneration or repair.

The pharmaceutical compositions of this invention may, for example, be placed into sterile, isotonic formulations with or without co-factors which stimulate uptake or stability. For example, the compositions may contain a formulation buffer comprising mg/ml citric acid monohydrate, 2.7 mg/ml trisodium citrate, 41 mg/ml mannitol, 1 mg/ml glycine and 1 mg/ml polysorbate 20. This solution can be lyophilized, stored under refrigeration and reconstituted prior to administration with sterile Water-For-Injection

(USP).

The compositions may also include pharmaceutically acceptable carriers well known in the art. See, for example, Remington's Pharmaceutical Sciences, 16th Edition, WO 01/23563 PCT/US00/26528 1980, Mac Publishing Company. Such pharmaceutically acceptable carriers may include other medicinal agents, carriers, genetic carriers, adjuvants, and excipients such as human serum albumin or plasma preparations. The compositions may be in the form of a unit dose and will usually be administered as a dose regiment that depends on the particular tissue treatment.

The pharmaceutical compositions of this invention may also be administered in form of a morphogenic device using, for example, microspheres, liposomes, other microparticulate delivery systems or sustained release formulations placed in, near, or otherwise in communication with affected tissues or the bloodstream bathing those tissues.

Liposomes containing the polypeptide mixtures of this invention can be prepared by well-known methods. See, e.g. DE 3,218,121; Epstein et al., Proc. Nail.

Acad. Sci. 82, pp. 3688-92 (1985); Hwang et al., Proc. Natl. Acad. Sci. 77, pp. 4030-34 (1980); U.S. Patent Nos. 4,485,045 and 4,544,545. Ordinarily the liposomes are of the small (about 200-800 Angstroms) unilamellar type in which the lipid content is greater than about 30 mol.% cholesterol. The proportion of cholesterol is selected to control the optimal release rate of the polypeptides of interest.

The polypeptide mixtures of this invention may also be attached to liposomes containing other biologically active molecules to modulate the rate and characteristics of tissue induction. Such attachment may be accomplished by cross-linking agents such as heterobifunctional cross-linking agents that have been widely used to couple toxins or chemotherapeutic agents to antibodies for targeted delivery. Conjugation to liposomes can also be accomplished using the carbohydrate-directed cross-linking reagent 4-(4-maleimidophenyl) butyric acid hydrazide. See, Duzgunes et al., J. Cell. Biochem.

Abst., Suppl. 16E 77 (1992).

Morphogenic Devices The pharmaceutical compositions of this invention can additionally contain an implantable, biocompatible carrier. Such compositions are also called morphogenic devices. The carrier functions as a sustained release delivery system for the therapeutic proteins and protects the proteins from non-specific proteolysis. The carrier may be biodegradable in vivo. A sustained release carrier may contain semipermeable polymer matrices in the form of shaped articles, suppositories or capsules. Such a carrier can be made of polylactides Patent No. 3,773,319; EP 58,481), copolymers of L-glutamic WO 01/23563 PCT/US00/26528 acid and ethyl-L-glutamate (Sidman et al., Biopolymers, 22, pp. 547-56 (1985)); poly(2hydroxyethyl-methacrylate) or ethylene vinyl acetate (Langer et al., J. Biomed. Mater. Res., pp. 167-277 (1981); Langer, Chem. Tech., 12, pp. 98-105 (1982)).

The carrier may also serve as a temporary scaffold and substratum for recruitment of migratory progenitor cells and their subsequent anchoring and proliferation, until replaced by new bone or other appropriate tissue. For example, the carrier may contain a biocompatible matrix made up of particles or otherwise having the desired.

porosity or microtexture. The pores will permit migration, anchoring, differentiation and proliferation of the relevant progenitor cells. The particle size may be within the range of 70gm-850um, 70im-420lm or 150pm-420m. A particulate matrix may be fabricated by close packing particulate materials into a shape spanning the tissue defect to be treated. Various matrices known in the art can be employed. See, U.S. Patent Nos. 4,975,526, 5,162,114 and 5,171,574, and WO 91/18558, all of which are herein incorporated by reference.

Useful matrix materials include but are not limited to collagen; celluloses, including carboxymethyl cellulose; homo- or co-polymers of glycolic acid, lactic acid, and butyric acid, including derivatives thereof; and ceramics, such as hydroxyapatite, tricalcium phosphate and other calcium phosphates. See, U.S. No. 5,854,207, col. 25, line 59, through col. 27, line 6. Various combinations of these or other suitable matrix materials may be useful as determined by the assays set forth herein. The choice of material depends in part on its in vivo dissolution rate. In bones, the dissolution rates can vary according to whether the implant is placed in cortical or trabecular bone.

Other useful matrices include particulate, demineralized, guanidineextracted, allogenic bone; and specially treated, particulate, protein-extracted, demineralized xenogenic bone. See, Example 6 of U.S. Patent No. 5,854,207. Such xenogenic bone powder matrices may be treated with proteases such as trypsin. Preferably, the xenogenic matrices are treated with one or more fibril-modifying agents to increase the intraparticle intrusion volume (porosity) and surface area. Useful modifying agents include solvents such as dichloromethane, trichloroacetic acid, acetonitrile and acids such as trifluoroacetic acid and hydrogen fluoride. A preferred fibril-modifying agent is in the form of a heated aqueous medium, preferably an acidic aqueous medium having a pH less than about 4.5, most preferably having a pH between about 2 and 4, inclusive. The acidic WO 01/23563 PCT/US00/26528 aqueous medium can, for instance, be 0.1% acetic acid with a pH of about 3. Heating demineralized, delipidated, guanidine-extracted bone collagen in an aqueous medium at elevated temperatures at about 37°C-65°C, preferably at about 45°C-60°C) for approximately one hour is generally sufficient to achieve the desired surface morphology.

It is hypothesized that the heat treatment alters the collagen fibrils, resulting in an increase in the particle surface area.

Xenogenic bone matrices can be used in a variety of clinical settings. In addition to its use as a matrix for bone formation in various orthopedic, periodontal, and reconstructive procedures, the matrix also may be used as a sustained release carrier, or as a collagenous coating for orthopedic or general prosthetic implants.

Demineralized guanidine-extracted xenogenic bovine bone contains a mixture of additional materials that may be fractionated further using standard biomolecular purification techniques. For example, bone extracts can be fractionated by chromatography, and the various extract fractions corresponding to the chromatogram peaks can be added back together to an active matrix. Doing so may remove inhibitors of bone or tissue-inductive activity, thereby improving matrix properties.

Besides morphogenic proteins and hormone/receptor pairs, the morphogenic devices of this invention may additionally contain other hormones and trophic agents. The devices may also contain antibiotics, chemotherapeutic agents, enzymes, enzyme inhibitors and other bioactive agents. These ingredients may be adsorbed onto or dispersed within the carrier, and will be released over time at the implantation site as the carrier material is slowly absorbed.

General Consideration of Matrix Properties Factors influencing the performance of a matrix include matrix geometry, particle size (if the matrix is made up of particles), the methodology for combining the matrix and morphogenic proteins, the degree of both intra- and inter-particle porosity, the presence of mineral, and the presence of surface charge. For example, studies have shown that, in bone induction using OP-1 and a morphogenic protein stimulating factor, perturbation of the matrix charge by chemical modifications can abolish bone inductive responses. Particle size also influences the quantitative response of new bone, with sizes between 70Rm and 420m capable of eliciting the maximum response. Further, contamination of the matrix with bone mineral may inhibit bone formation. Individual WO 01/23563 PCT/US00/26528 heavy metal concentrations in a bone matrix can be reduced to less than about 1 ppm by the methods described herein.

The sequential cellular reactions at the interface of the bone matrix and an osteogenic protein implant are complex. The multi-step cascade includes: binding of fibrin and fibronectin to the implanted matrix, migration and proliferation ofmesenchymal cells, differentiation of the progenitor cells into chondroblasts, cartilage formation, cartilage calcification, vascular invasion, bone formation, remodeling, and bone marrow differentiation. A successful matrix is capable of accommodating each of these steps.

The matrix may be shaped as desired in anticipation of surgery or shaped by the physician or technician during surgery. It has been shown that new bone is formed essentially with the dimensions of the implanted device. In the case where the matrix material is biodegradable in vivo, the matrix material is slowly absorbed by the body and is replaced by new bone in the shape of, or very nearly the shape of, the implant. Thus, the matrix is preferably shaped to span a tissue defect and to take the desired form of the new tissue. For example, in the case of bone repair of a non-union defect, it is desirable to use dimensions that span the non-union, and the new bone will eventually fill the defect.

The matrix may be a shape-retaining solid made of loosely-adhered particulate material, collagen. Alternatively, the matrix may be a molded, porous solid, or an aggregation of close-packed particles held in place by surrounding tissue.

Masticated muscle or other tissue may also be used. Large allogenic bone implants can act as a carrier for the matrix if their marrow cavities are cleaned and packed with particles containing dispersed osteogenic protein and hormone/receptor pair.

The matrix may also take the form of a paste or a hydrogel. "Hydrogel" refers to a three dimensional network of cross-linked hydrophilic polymers in the form of a gel. The gel is substantially composed of water, for instance, greater than 90% water.

Hydrogel matrices can carry a net positive or net negative charge, or may be neutral. A typical net negative charged matrix is alginate. Hydrogels carrying a net positive charge are, for example, extracellular matrix components such as collagen and laminin. Examples of commercially available extracellular matrix components include MATRIGEL T and

VITROGEN

T M 'Example of a net neutral hydrogel are highly cross-linked polyethylene oxide and polyvinyl alcohol.

Prosthetic Devices WO 01/23563 PCT/US00/26528 This invention also features an implantable prosthetic device comprising at least one morphogenic protein and at least one hormone/receptor pair at therapeutic amounts and ratios. The device can be used in conjunction with a composition containing the same or other morphogenic protein or hormone/receptor pair. The prosthetic device may be made from a material containing metal or ceramic. Exemplary prosthetic devices are hip devices, screws, rods and titanium cages for spine fusion. The device is implanted in a mammal a human) at a locus where the target tissue and the surface of the prosthetic device are maintained at least partially in contact for a time sufficient to permit enhanced tissue growth between the target tissue and the device.

The osteogenic composition may be disposed on the prosthetic implant on a surface region that is to be positioned next to a target tissue in the mammal. Preferably, the mammal is a human patient. The composition is disposed in an amount sufficient to promote enhanced tissue growth into the implant or onto its surface. The amount of the composition to be used may be determined empirically by using bioassays such as those described herein and in Rueger et al., U.S. Patent No. 5,344,654, which is incorporated herein by reference. Preferably, animal studies are performed to optimize the concentration of the ingredients in the device before a similar prosthetic device is used in a human patient.

The prosthetic devices will be useful for repairing orthopedic defects, injuries or anomalies in the treated mammal.

Utility of Morphogenic Compositions and Devices The compositions, devices and methods of this invention will permit a physician to treat a variety of tissue injuries, tissue degenerations, and other diseased tissue conditions. The compositions and devices can ameliorate or remedy these conditions by stimulating local tissue formation or regeneration.

The devices of this invention may be implanted at the desired locus in a mammal such that the implant is accessible to the appropriate progenitor cells of this mammal. The devices may be used alone or in combination with other therapies for tissue repair and regeneration.

The morphogenic devices of this invention may also be implanted in or surrounding a joint for use in cartilage and soft tissue repair, or in or surrounding nervous system-associated tissue for use in neural regeneration and repair. The tissue specificity of the particular morphogenic protein or combination of morphogenic proteins with other -38- WO 01/23563 PCT/US00/26528 biological factors will determine the cell types or tissues that will be amenable to such treatments and can be selected by one skilled in the art. The ability to enhance morphogenic protein-induced tissue regeneration by co-administering a hormone/receptor pair according to the present invention is thus not believed to be limited to any particular cell-type or tissue.

The osteogenic compositions and devices of this invention will permit the physician to obtain predictable bone, ligament and/or cartilage formation using less osteogenic protein to achieve at least about the same extent of bone or cartilage formation.

The oteogenic compositions and devices of this invention may be used to treat more effectively the injuries, anomalies and disorders that have been described in the prior art of osteogenic devices. These include, for example, forming local bone in fractures, non-union fractures, fusions and bony voids such as those created in tumor resections or those resulting from cysts; treating acquired and congenital craniofacial and other skeletal or dental anomalies (see Glowacki et al., Lancei, 1, pp. 959-63 (1981)); performing dental and periodontal reconstructions where lost bone replacement or bone augmentation is required such as in ajaw bone; and supplementing alveolar bone loss resulting from periodontal disease to delay or prevent tooth loss (see Sigurdsson et al., J Periodontol., 66, pp. 511-21 (1995)).

An osteogenic device of this invention that comprises a matrix comprising allogenic bone may also be implanted at a site in need of bone replacement to accelerate allograft repair and incorporation in a mammal. Another potential clinical application of the improved osteogenic devices of this invention is in cartilage repair, for example, following joint injury or in the treatment of osteoarthritis. The ability to enhance the cartilageinducing activity of morphogenic proteins by co-administering a hormone/receptor pair may permit faster or more extensive tissue repair and replacement using the same or lower levels of morphogenic proteins.

The morphogenic compositions and devices of this invention will be useful in treating certain congenital diseases and developmental abnormalities of cartilage, bone and other tissues. For example, homozygous OP-1-deficient mice die within 24 hours after birth due to kidney failure (Luo et al., J. Bone Min. Res., 10 (Supp. pp. S163 (1995)).

Kidney failure in these mice is associated with the failure to form renal glomeruli due to lack ofmesenchymal tissue condensation. OP-1-deficient mice also have various skeletal -39- WO 01/23563 PCT/US00/26528 abnormalities associated with their hindlimbs, rib cage and skull, are polydactyl, and exhibit aberrant retinal development. These results, in combination with those discussed above concerning the ability of OP-1 to induce differentiation into dorsal neural cell fates, indicate that OP-1 plays an important role in epithelial-mesenchymal interactions during development. It is anticipated that the compositions, devices and methods of this invention will be useful for ameliorating these and other developmental abnormalities.

Developmental abnormalities of the bone may affect isolated or multiple regions of the skeleton or of a particular supportive or connective tissue type. These abnormalities often require complicated bone transplantation procedures and orthopedic devices. The tissue repair and regeneration required after such procedures may occur more quickly and completely with the use of morphogenic compositions, devices and methods of this invention.

Examples of heritable conditions, including congenital bone diseases, for which use of the morphogenic compositions and devices of this invention will be useful include osteogenesis imperfecta, the Hurler and Marfan syndromes, and several disorders of epiphyseal and metaphyseal growth centers such as is presented in hypophosphatasia, a deficiency in alkaline phosphatase enzymatic activity.

Inflammatory joint diseases may also benefit from the improved methods, compositions and devices of this invention. These diseases include but are not limited to rheumatoid and psoriatic arthritis, bursitis, ulcerative colitis, regional enteritis, Whipple's disease, ankylosing spondylitis (also called Marie Strumpell or Bechterew's disease), and the so-called "collagen diseases" such as systemic lupus erythematosus (SLE), progressive systemic sclerosis (scleroderma), polymyositis (dermatomyositis), necrotizing vasculitides, Sjogren's syndrome (sicca syndrome), rheumatic fever, amyloidosis, thrombotic thrombocytopenic purpura and relapsing polychondritis. Heritable disorders of connective tissue include Marfan's syndrome, homocystinuria, Ehlers-Danlos syndrome, osteogenesis imperfecta, alkaptonuria, pseudoxanthoma elasticum, cutis laxa, Hurler's syndrome, and myositis ossificans progressiva.

Examples The following are examples which illustrate the morphogenic compositions and devices of this invention, and methods used to characterize them. These examples WO 01/23563 PCT/US00/26528 should not be construed as limiting. They are included for purposes of illustration and the present invention is limited only by the claims.

Example 1 Fig. 1 shows the effects of 11-6 sIL-6R, and mixtures of recombinant human IL-6 and recombinant human sIL-6R respectively, on the OP-I-induced AP activity in FRC cells. Confluent FRC cells were treated with the indicated agent(s) for 24 hrs. The concentrations of agent(s) used (ng/ml) are indicated in parentheses. For IL-6/R, the molar ratio of the two was maintained at about 1.2, and their respective amounts are indicated also in parentheses. Total AP activity was determined spectrophotometrically.

Total cellular protein was determined by the Bradford Assay. Specific AP activity was calculated as AP/protein unit. AP activity values were normalized to that of 150ng/ml OP- 1 1) and represent the means of 8-12 independent determinations using 3 different FRC cell preparations.

As shown in Fig. 1, IL-6 alone in the concentration range tested did not stimulate the basal AP activity. SIL-6R alone stimulated the basal AP activity slightly; however, the stimulation did not seem to be sIL-6R dose-dependent.

Fig. 1 further demonstrates that IL-6 potentiates the OP-1-induced AP activity in a dose-dependent manner. A maximum of about 2-fold stimulation was observed SIL-6R also potentiated the OP-1-induced AP activity in a dose-dependent manner. A higher fold (about 3.5-fold; p<0.

0 2 of stimulation than observed with L-6 was achieved.

The effect of IL-6/R on the OP-i-induced AP activity was also examined.

At the highest tested dose of 1L-6 plus its soluble receptor (100ng/ml IL-6 and 125ng/ml sIL-6R), the OP-1-induced AP activity was synergistically enhanced by about 10-fold. This enhancement was reproducible. However, at the lower dose range, the IL-6/R combination did not appear to stimulate beyond what was achieved by either IL-6 or its receptor alone; on the contrary, the combination appeared to suppress AP activity.

Example 2 Fig. 2 shows that IL-6 alone enhanced OP-1 action in a mineralized bone nodule formation assay. FRC cells were grown in aMEN (supplemented with 5% FBS, ug/ml gentamycin, 100 pg/ml ascorbic acid and 5 mM 3-glycerolphosphate), and treated -41- .1 WO 01/23563 PCT/US00/26528 for various durations of time with solvent vehicle, 200ng/ml OP-1, or 200ng/ml OP-1 plus IL-6 at various concentrations. The culture media were replenished with the same treatment agent(s) every three days. Progress of nodule formation was monitored every three days. After a total of 15 days, cells were fixed with formalin and photographed.

As seen in Fig. 3, IL-6/R also enhanced OP- 's ability to induce the formation of mineralized bone nodules.

Example 3 To determine whether IL-6/R effects its synergy with OP-1 by directly stimulating OP-1 responsive cells or by increasing the number of OP-1 responsive cells, primary cultures of FRC were used as a model system, in which AP activity levels were used as a biochemical marker of OP-1 responsiveness. Histochemical data showed that the number of AP positive cells in cultures treated with IL-6/R (40 ng/ml IL-6 and 50 ng/ml sIL-6R) and OP-1 (200 ng/ml) was similar to that in cultures treated with OP-1 alone (200 ng/ml). However, the AP activity level was higher in the former cultures than the latter cultures. IL-6 alone (40 ng/ml) did not stimulate AP positive cells; and sIL-6R alone ng/ml) or IL-6R (40 ng/ml IL-6 and 50 ng/ml sIL-6R) stimulated AP positive cells to a smaller extent, as compared to the combination of L-6R and OP-1. These data suggest that IL-6/R's synergistic effect on OP-1 results from IL-6/R's direct stimulation of OP-1 responsive cells.

Example 4 To investigate whether IL-6/R stimulates the expression of OP-1 receptors on FRC cells, the mRNA levels of three BMP type I receptors (BMPR-IA, BMPR-IB, and ActR-l) and one BMP type II receptor (BMPR-II) were measured by Northern blot analysis.

Briefly, confluent FRC cells were treated for 48 hours with a vehicle; (2) 200 ng/ml OP-1; 40 ng/ml IL-6 and 50 ng/ml sIL-6R; or 200 ng/ml OP-1, 40 ng/ml IL-6, and 50 ng/ml sIL-6R. Total RNA was isolated using the TRI reagent (Sigma) and loaded onto an AGAROSE GTG (FMC) gel containing formaldehyde. Northern blots were prepared and probed with 32P-labeled cDNA encoding for the various BMPRs. These probes hybridized only to mRNA. The radioactive bands were detected and quantified using a PHOSPHORIMAGER (Molecular Dynamics, Sunnyvale, CA). To normalize the WO 01/23563 PCT/US00/26528 band intensity of the BMPR bands, the blots were also probed with an oligonucleotide for the 18S rRNA.

The mRNA levels in control FRC cells, OP-I-treated cells, LL-6/R-treated cells, and (OP-1 IL-6/R)-treated cells were compared (Fig. The data showed that OP-1 did not affect the mRNA level of the type I receptors, but stimulated the BMPR-II mRNA level by about 2.2 fold. Likewise, IL-6/R did not alter the mRNA expression level of the type I receptors, but increased the BMPR-II mRNA level by about 1.5-fold. In the presence of OP-1 and IL-6/R, the mRNA level of the type I receptors was not significantly changed; however, the BMPR-II mRNA level was almost 3-fold higher than the control.

These results suggest that IL-6/R can stimulate the osteogenic activity of OP-1 by elevating BMPR-II mRNA expression.

Example The OP-1 protein used in Examples 1-5 was provided exogenously to the test cells. To investigate whether the same IL-6/R synergistic effect would be observed when the OP-1 protein was expressed intracellularly in test cells, FRC cells were transfected with pW24, a plasmid carrying an OP-1 coding sequence under the control of the CMV promoter.

Briefly, confluent FRC cells were transfected with pW24 (2 ig/ml). After recovery, the transfected cells were treated with exogenous sIL-6R alone or IL-6/R for 24 hours. Then the total AP activity levels were determined (Fig. The data showed that the levels of OP-I-induced AP activity in pW24transfected cells were enhanced by sIL-6R in a dose-dependent manner. At a concentration of 75 ng/ml, sIL-6R stimulated the OP-1-induced AP activity by as much as 4 fold.

The data also showed that the levels of OP-i-induced AP activity in pW24transfected cells were also enhanced by IL-6/R in a dose-dependent manner. A stimulation of the OP-1-induced AP activity was observed when IL-6/R was applied to the test cells at concentrations of 60 ng/ml for IL-6 and 75 ng/ml for sIL-6R.

EDITORIAL NOTE APPLICATION NUMBER 76191/00 The following sequence listing pages 1 10 are part of the description. The claims pages follow on pages 44 46 WO 01123563 WO 0123563PCT/USOO/26528 SEQUENCE LISTING <110> STRYKER CORPORATION <120> COMPOSITIONS AND THERAPEUTIC METHODS I PROTEINS, HORMONES AND HORMONE RECEPT( :130> STK-4 <140> <141> <150> 60/156,261 <151> 1999-09-27 <160> 12 <170> Patentln Ver. 2.1 <210> 1 <211> 1822 <212> DNA <213> Homo sapiens <220> <221> CDS <222> (49) (1341) <400> 1 ggtgcgggcc cggagcccgg agcccgggta gcgcgtagag JSING MORPHOGENIC

)RS

cgc Arg ccc Pro gag Glu cgg Arg ccg Pro ctg Leu gcg ccg Ala Pro tcc gcc Ser Ala atc cac Ile His atc ctc Ile Leu ggc aag Gly Lys atg gcg Met Ala ccggcgcg atg cac gtg Met His Val gtg gcg ctc tgg gca Val Ala Leu Trp Ala ttc agc ctg gac aac Phe Ser Leu Asp Asn cgc agc cag gag cgg Arg Ser Gin Glu Arg ggc ttg ccc cac cgc Gly Leu Pro His Arg gca ccc atg ttc atg Ala Pro Met Phe Met ggC ggc ggg ccc ggc Giy Gly Gly Pro Gly WO 01/23563 WO 0123563PCT(USOO/26528 ggc Gly 100 ccc Pro atg Met cac His cca Pro tac Tyr 180 cag Gin gac Asp ate Ile gge Gly aag Lys 260 ttc Phe cgg Arg tte Phe gc Ala agc Ser 135 tac Tyr gaa Giu gaa Glu cag Gin acc Thr 215 ace Thr etc Leu ggc Gly get Ala ggg Gly 295 ttc Phe etc Leu gae Asp gat Asp egg Arg 175 egg Arg gat Asp tgg Trp eeg Pro eag Gin 255 cag Gin cac His ege Arg 633 681 729 777 825 873 921 969 1017 aag aac eag gaa gee ctg egg atg gce aae gtg gea gag aac age age Lys Asn Gin Giu Ala Leu Arg Met Ala Asn Val Ala Giu Asn Ser Ser 310 315 320 WO 01/23563 WO 0123563PCTIUSOO/26528 3/10 aag aag cac Lys Lys His age gac Ser Asp 325 cag agg cag gcc Gin Arg Gin Ala gag ctg Glu Leu 335 geg ect Ala Pro tat gtc age ttc Tyr Val Ser Phe gac ctg ggc tgg Asp Leu Gly Trp, gac tgg atc atc Asp Trp Ile Ile gaa ggc tac Glu Gly Tyr tac tac tgt Tyr Tyr Cl's ggg gag tgt gee Gily Glu Cys Ala ect etg aac tee Pro Leu Asn Ser aac gec acc Asn Ala Thr ccg gaa aeg Pro Glu Thr 390 gee ate gtg Ala Ile Val ctg gte eae Leu Val His tte atc aae Phe Ile Asn 385 etc aat gcc Leu Asn Ala 1065 1113 1161 1209 1257 1305 1351 ccc aag ccc Pro Lys Pro gcg ccc aeg Ala Pro Thr ate tee Ile Ser 405 gte ete tac tte Val Leu Tyr Phe gae age tee aac Asp Ser Ser Asn Ile Leu Lys Lys tagctcctcc aga aae atg gtg Arg Asn Met Val egg gee tgt gge Arg Ala Cys Gly tge eae Cys His 430 gagaattcag gaaccagcag tgtgagagta atccaatgaa geataaagaa cgtttccaga ggegtggcaa etgtaataaa aeeetttggg accaaetgcc ttaggaaaea eaagatccta aaatggccgg ggtaattatg ggggtgggea tgtcacaata gccaagttt t ttttgtgaga tgageageat caagetgtge gceaggtcat agegeetace eattggtgtc aaacgaatga tetggateet cettceete atggcttttg aggcaaaacc tggctgggaa age eaggcca tgtgcgaaag atgaaaaaaa eeattgctcg cetatceca atcagttttt tageaggaaa gtctcageca eeeagcegtg gaaaat tgac aaaaaaaaaa eettggeeag actttaaagg eagtggeagc aaaaaaeaae tgeacggact ggaggaaggg ccggaagttc 1411 1471 1531 1591 1651 1711 1771 1822 <210> 2 <211> 431 <212> PRT <213> Homo sapiens <400> 2 Met His Val Arg Ser Leu Arg Ala Ala Ala Pro His Ser Phe Val Ala 1 5 10 Leu Trp, Ala Pro Leu Phe Leu Leu Arg Ser Ala Leu Ala Asp Phe Ser 25 WO 01/23563 PTUO/62 PCT[USOO/26528 Leu Asp Asn Glu Val His Ser Ser Phe 40 Arg Pro Leu Gly 100 Pro Met His Pro Tyr 180 Gin Asp Ile Gly Lys 260 Phe Arg Lys Ser Glu Arg Asp Gin Pro Vai Pro Glu 165 Ile Val Ser Thr Leu 245 Leu Met Ser Asn Asp 325 Met Pro Leu Giy Leu Met Arg 150 Gly Arg Leu Arg Ala 230 Gin Ala Val Thr Gin 310 Gin Gin His Tyr Phe Al a Ser 135 Tyr Giu Giu Gin Thr 215 Thr Leu Gly Ala Gly 295 Glu Arg Arg Leu Asn Ser Ser 120 Phe His Ala Arg Giu 200 Leu Ser Ser Leu Phe 280 Ser Al a Gin Glu Gln Ala Tyr 105 Leu Val His Val Phe 185 His Trp Asn Val Ile 265 Phe Lys Leu Ala 4/10 Ile Ile Gly Met 90 Pro Gin Asn Arg Thr 170 Asp Leu Ala His Glu 250 Gly Lys Gin Arg Cys 330 His Arg Arg Leu Lys 75 Ala Tyr Asp Leu Glu 155 Ala Asn Gly Ser Trp 235 Thr Arg Aia Arg Met 315 Lys Ser liS Val Lys Ser Val 140 Phe Aila Giu Arg Glu 220 Val Leu His Thr Ser 300 Ala Lys Ile Asn Giu Ala His 125 Giu Arg Glu Thr Giu 205 Glu Val Asp Gly Giu 285 Gin Asn His Leu Arg Ser Leu ser Glu Val 110 Phe His Phe Phe Phe 190 Ser Gly Asn Gly Pro 270 Val Asn Val1 Glu Gly Aia Gly Phe Leu Asp Asp Arg 175 Arg Asp Trp Pro Gin 255 Gin His Ary Ala Leu 335 Pro Gly Ser Thr Lys Leu 160 Ile Ile Leu Leu Arg 240 Ser Asn Phe Ser Giu 320 Tyr WO 01/23563 PCT/USOO/26528 5/10 Val Ser Phe Arg Asp Leu Gly Trp Gln Asp Trp Ile Ile Ala Pro Glu 340 345 350 Gly Tyr Ala Ala Tyr Tyr Cys Glu Gly Giu Cys Ala Phe Pro Leu Asn 355 360 365 Ser Tyr Met Asn Ala Thr Asn His Ala Ile Val Gln Thr Leu Val His 370 375 380 Phe Ile Asn Pro Glu Thr Val Pro Lys Pro Cys Cys Ala Pro Thr Gln 385 390 395 400 Leu Asn Ala Ile Ser Val Leu Tyr Phe Asp Asp Ser Ser Asn Val Ile 405 410 415 Leu Lys Lys Tyr Arg Asn Met Val Val Arg Ala Cys Gly Cys His 420 425 430 <210> 3 <211> 102 <212> PRT <213> Artificial Sequence <220> <223> Description of Artificial Sequence: OPX <220> <223> Each Xaa is independently selected from a group of one or more specified amino acids as defined in the specification.

<400> 3 Cys Xaa Xaa His Glu Leu Tyr Val Ser Phe Xaa Asp Leu.Gly Trp Xaa 1 5 10 Asp Trp Xaa Ile Ala Pro Xaa Gly Tyr Xaa Ala Tyr Tyr Cys Giu Gly 25 Glu Cys Xaa Phe Pro Leu Xaa Ser Xaa Met Asn Ala Thr Asn His Ala 40 Ile Xaa Gin Xaa Leu Val His Xaa Xaa Xaa Pro Xaa Xaa Val Pro Lys 55 Xaa Cys Cys Ala Pro Thr Xaa Leu Xaa Ala Xaa Ser Val Leu Tyr Xaa 70 75 Asp Xaa Ser Xaa Asn Val Ile Leu Xaa Lys Xaa Arg Asn Met Val Val 90 Xaa Ala Cys Gly Cys His 100 <210> 4 <211> 97 <212> PRT WO 01/23563 ~VO 0123563PCT[USOO/26528 <213> Artificial Sequence <220> <223> Description of Artificial Sequence: Generic-Seq-7 <220> <223> Each Xaa is independently selected from a group of one or more specified amino acids as defined in the specification.

<400> 4 Leu Xaa Xaa Xaa Phe Xaa Xaa Xaa Gly Trp Xaa Xaa Xaa Xaa Xaa Xaa 1 5 10 Pro Xaa Xaa Xaa Xaa Ala Xaa Tyr Cys Xaa Gly Xaa Cys Xaa Xaa Pro 2S Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Asn His Ala Xaa Xaa Xaa Xaa Xaa 40 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Cys Cys Xaa Pro 55 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Leu Xaa Xaa Xaa Xaa Xaa Xaa Xaa 70 75 Val Xaa Leu Xaa Xaa Xaa Xaa Xaa Met Xaa Val Xaa Xaa Cys Xaa Cys 90 Xaa <210> <211> 102 <212> PRT <213> Artificial Sequence <220> <223> Description of Artificial Sequence: Generic-Seq-8 <220> <223> Each Xaa is independently selected from a group of one or more specified amino acids as defined in the specification.

<400> Cys Xaa Xaa Xaa Xaa Leu Xaa Xaa Xaa Phe Xaa Xaa Xaa Gly Trp Xaa 1 5 10 Xaa Xaa Xaa Xaa Xaa Pro Xaa Xaa Xaa Xaa Ala Xaa Tyr Cys Xaa Gly 25 Xaa Cys Xaa Xaa Pro Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Asn His Ala 40 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa so 55 WO 01/23563 PCT/US00126528 7/10 Xaa Cys Cys Xaa Pro Xaa Xaa Xaa Xaa Xaa xaa Xaa Xaa Leu xaa Xaa 70 75 Xaa Xaa Xaa Xaa Xaa Val xaa Leu Xaa Xaa Xaa Xaa Xaa Met Xaa Val 90 Xaa Xaa Cys Xaa Cys Xaa 100 <210> 6 <211> 97 <212> PRT <213> Artificial Sequence <220> <223> Description of Artificial Sequence: Generic-Seq-9 <220> <223> Each Xaa is independently selected from a group of one or more specified amino acids as defined in the specification.

<400> 6 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa 1 5 10 Pro Xaa Xaa Xaa Xaa Xaa Xaa Xaa Cys Xaa Gly Xaa Cys Xaa Xaa Xaa 25 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa 40 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Cys Xaa Pro 55 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Leu Xaa Xaa Xaa Xaa Xaa Xaa Xaa 70 75 Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Cys Xaa Cys 90 Xaa <210> 7 <211> 102 <212> PRT <213> Artificial Sequence <220> <223> Description of Artificial Sequence: <220> <223> Each Xaa is independently selected from a group of one or more specified amino acids as defined in the specification.

a WO 01/23563 PCT/US00/26528 <400> 7 Cys Xaa 1 Xaa Xaa Xaa Cys Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Pro Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa Xaa <210> 8 <211> <212> PRT <213> Artificial Sequence <220> <223> Description of Artificial Sequence: Synthetic Peptide <220> <223> Each Xaa is independently selected from a group of one or more specified amino acids as defined in the specification.

<400> 8 Cys Xaa Xaa Xaa Xaa 1 <210> 9 <211> <212> PRT <213> Artificial Sequence <220> <223> Description of Artificial Sequence: Synthetic Peptide <220> <223> Each Xaa is independently selected from a group of one or more specified amino acids as defined in the specification.

v f..

*W001/23563 PCT/[JSOO/26528 <400> 9 Cys Xaa Xaa Xaa Xaa 1. <210> <211> 102 <212> PRT <213> Artificial Sequence <220> <223> Description of Artificial acid sequence <220> <223> Each Xaa may be any amino <400> Cys Xaa Xaa Xaa Xaa Leu Xaa Val 1 5 Xaa Trp Xaa Xaa Xaa Pro Xaa Gly Xaa Cys Xaa Xaa Pro Xaa Xaa Xaa Xaa Xaa Gin Xaa Xaa Val Xaa Xaa Xaa Cys Cys Xaa Pro Xaa Xaa Xaa 70 Xaa Xaa Xaa Xaa Xaa Val Xaa Leu Xaa Xaa Cys Xaa Cys Xaa 100 Sequence: Generic amino acid residue Xaa Phe Xaa I Xaa Xaa Ala Xaa Xaa Xaa Xaa Asn Xaa Xaa Xaa Xaa Xaa Xaa Tyr <210> 11 <211> 96 <212> PRT <213> Artificial Sequence <220> <223> Description of Artificial Sequence: Synthetic amino acid (COPS) <400> 11 Leu Tyr Val Asp Phe Ser Asp Val Gly Trp Asp Asp Trp Ile Val Ala 1 5 10 Pro Pro Gly Tyr Gin Ala Phe Tyr Cys His Gly Glu Cys Pro Phe Pro 25 Leu Ala Asp His Phe Asn Ser Thr Asn His Ala Val Val Gin Thr Leu 40 1. WO 01/23563 PCT/USOO/26528 10/10 Val Asn Ser Vai Asn Ser Lys Ile Pro Lys Ala Cys Cys Val Pro Thr 55 Giu Leu Ser Ala Ile Ser Met Leu Tyr Leu Asp Giu Asn Glu Lys Val 70 75 Val Leu Lys Tyr Asn Gin Glu Met Val Val Glu Giy Cys Giy Cys Arg 90 <210> 12 <211> 96 <212> PRT <213> Artificial Sequence <220> <223> Description of Artificial amino acid (COP7) <400> 12 Leu Tyr Val Asp Phe Ser Asp Val 1 5 Pro Pro Gly Tyr His Ala Phe Tyr Leu Ala Asp His Leu Asn Ser Thr Val Asn Ser Val Asn Ser Lys Ile Giu Leu Ser Ala Ile Ser Met Leu Val Leu Lys Tyr Asn Gln Glu Met Sequence: Synthetic Gly Trp Cys His Asn His Pro Lys Tyr Leu Val Val

Claims

01-12-2001 US0026528 What is claimed is: I. A method for improving the tissue inductive capability of a morphogenic protein at a target locus in a mammal, the method comprising administering to the target locus the morphogenic protein and a first effective amount of a hormone and a second effective amount of a soluble receptor of the hormone, wherein the morphogenic protein is capable of inducing tissue formation when accessible to a progenitor cell in the mammal, and the hormone and the receptor in combination enhance that capability.
2. The method of claim 1, wherein the morphogenic protein comprises a pair of subunits disulfide-bonded to produce a dimeric species, wherein at least one of the subunits comprises a polypeptide belonging to the BMP protein family.
3. The method of claim 1, wherein the morphogenic protein is an osteogenic protein.
4. The method of claim 3, wherein the osteogenic protein is capable of inducing the progenitor cell to form endochondral or intramembranous bone. The method of claim 3, wherein the osteogenic protein is capable of inducing the progenitor cell to form cartilage.
6. The method of claim 1, wherein the morphogenic protein is capable of inducing the progenitor cell to form tissue tendon/ligament-like or neural-like tissue.
7. The method of claim 1, wherein the morphogenic protein comprises an amino acid sequence at least 85% homologous to the amino acid sequence of BMP-2, BMP- 3, BMP-4, BMP-5, BMP-6, BMP-7 BMP-8, BMP-9, BMP-10, BMP-11, BMP-12, BMP-13, COP-5, or COP-7.
8. The method of claim 7, wherein the morphogenic protein comprises a polypeptide selected from the group consisting of OP-1, BMP-2, BMP-4 and BMP-6. -44- AMENDED SHEET FMPFANGS/ I 1. AllSI)IUCKS/H I 1. I 9: 11 01-12-2001 US0026528
9. The method of claim 8, wherein the morphogenic protein is OP-1. The method of claim 2, wherein the dimer is a homo- or heterodimer comprising a BMP-2 or BMP-7 (OP-1) subunit.
11. The method of claim 1, wherein the hormone is interleukin 6 (IL-6).
12. The method of claim 7, wherein the hormone is IL-6.
13. The method of claim 9, wherein the hormone is IL-6.
14. The method of claim 1, wherein the morphogenic protein, the hormone, and the hormone receptor are administered simultaneously to the target locus. The method of claim 1, wherein the morphogenic protein, the hormone, and the hormone receptor are administered separately to the target locus.
16. The method of claim 1, wherein the hormone and the hormone receptor are administered simultaneously to the target locus.
17. The method of claim 1, wherein the target locus is a jaw bone defect site.
18. The method of claim 1, wherein the target locus is a site of bone defect selected from the group consisting of a fracture, a non-union fracture, a critical size defect, a non-critical size defect, an osteochondral defect, a fusion and a bony void.
19. The method of claim 1, wherein the target locus has a tissue degenerative condition. The method of claim 1, wherein the target locus is a cartilage or soft tissue defect site.
21. The method of claim 1, wherein the target locus is a neural tissue defect site. AMENDED SHEET EMPFANGoLcii i. viL. L:V7 1. V 1 2: 11 fnVVIiV4iJA.LL I I ,601-12-2001US262 US0026528
22. The method of claim 1, wherein the morphogenic protein is administered in a matrix-comprising carrier. 2.3. The method of claim 22, wherein the canrier comprises allogenic bone.
24. The method of claim 1, Wherein the morphogemc protein is administered via a nucleic acid, the nucleic acid comprising a sequence encoding the morphogenic protein and capable of expressing the morphogenic protein in the progenitor cell. -46- AMENDED SHEET EMPFANGULL11 ULL. L V 2 :11