EP4572780A2 - Th2 vaccine-based prevention and treatment of inflammation in obesity - Google Patents
Th2 vaccine-based prevention and treatment of inflammation in obesityInfo
- Publication number
- EP4572780A2 EP4572780A2 EP23855592.4A EP23855592A EP4572780A2 EP 4572780 A2 EP4572780 A2 EP 4572780A2 EP 23855592 A EP23855592 A EP 23855592A EP 4572780 A2 EP4572780 A2 EP 4572780A2
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- European Patent Office
- Prior art keywords
- amino acids
- vector
- nucleic acid
- mice
- polypeptide
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K39/0005—Vertebrate antigens
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
- A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P3/00—Drugs for disorders of the metabolism
- A61P3/04—Anorexiants; Antiobesity agents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P3/00—Drugs for disorders of the metabolism
- A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
- A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- C07K14/46—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates
- C07K14/47—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates from mammals
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/51—Medicinal preparations containing antigens or antibodies comprising whole cells, viruses or DNA/RNA
- A61K2039/53—DNA (RNA) vaccination
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
- A61K2039/55505—Inorganic adjuvants
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/57—Medicinal preparations containing antigens or antibodies characterised by the type of response, e.g. Th1, Th2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/70—Multivalent vaccine
Definitions
- the composition further comprises an adjuvant.
- described herein is a method for eliciting a Type 2 immune response directed at inflammation related to obesity, for preventing or treating inflammation in obesity, and/or for preventing or treating disease associated with metabolic obesity in a subject.
- the method comprises administering to the subject a composition comprising a nucleic acid molecule, polypeptide, or composition described herein.
- the disease associated with metabolic obesity is cancer.
- the cancer is breast cancer.
- the disease associated with metabolic obesity is non-alcoholic fatty liver disease (NAFLD), metabolic-associated fatty liver disease (MAFLD), or pre-diabetes.
- the subject is human.
- the subject is suspected of having, or has been diagnosed with obesity, a disease associated with metabolic obesity, cancer, such as pre-diabetes/insulin insensitivity, breast cancer, MAFLD, or NAFLD.
- BRIEF DESCRIPTION OF THE DRAWINGS [0017] FIGS.1A-1D.
- IL-10-selective epitopes can be identified from aberrantly expressed proteins in adipose tissue in obesity. Th ratio when stimulated with the indicated epitope from (1A) FABP4, (1B) DUSP1 (1C) ATGL or (1D) PAI1.
- FIGS.2A-2D Overexpressed antigens identified in human obese adipose tissue are also overexpressed in the adipose tissue of obese mice.
- FIGS.3A-3F Representative Western blot of cell lysate for the indicated antigen from mice fed a high fat diet (HFD) or normal chow diet (NCD). ⁇ / ⁇ Tubulin was used as a loading control.
- FIGS.3A-3F IL-10-secreting epitopes identified via in vitro screening generated a Th2-selective response after immunization with each single antigen.
- FIGS.6A-6D AdVac increased glucose sensitivity and reduced insulin resistance in obese mice.
- ITT Insulin tolerance test
- n 20 mice/group; **p ⁇ 0.01,***p ⁇ 0.001, ****p ⁇ 0.0001 (compared to control obese).
- FIGS.7A-7D AdVac reduced CD8+ T cell and increased T-regulatory cell levels in the adipose tissue of obese mice.
- Percent CD4+/FOXP3+ T-regulatory cells from (7C) adipose tissue or (7D) spleen from lean mice or obese mice immunized with Alum or AdVac.
- FIGS.8A-8F ADVac metabolically reprograms the adipose tissue microenvironment.
- FIGS.9A-9B Obese TgMMTV-neu develop a greater number of tumors with a faster growth rate than lean TgMMTV-neu mice.
- FIGS.10A-10C AdVac immunization decreases CD8+ T-cells in mammary tissue, lowers serum leptin levels, and results in significant tumor inhibition in obese Tg-MMTV-neu mice.
- 10A Percent CD8+ T-cells in viable lymphocytes derived from mammary fat from the indicated treatment group.
- the term “comprising” is intended to mean that the compositions and methods include the recited elements, but do not exclude others.
- the transitional phrase “consisting essentially of” (and grammatical variants) is to be interpreted as encompassing the recited materials or steps “and those that do not materially affect the basic and novel characteristic(s)” of the recited embodiment.
- the term “consisting essentially of” as used herein should not be interpreted as equivalent to “comprising.”
- Consisting of shall mean excluding more than trace elements of other ingredients and substantial method steps for administering the compositions disclosed herein. Aspects defined by each of these transition terms are within the scope of the disclosure herein.
- a linker refers to an amino acid sequence that connects two proteins, polypeptides, peptides, domains, regions, or motifs and may provide a spacer function compatible with interaction of the two sub-binding domains so that the resulting polypeptide retains a specific binding affinity to a target molecule or retains signaling activity.
- a linker is comprised of about two to about 35 amino acids, for instance, or about four to about 20 amino acids or about eight to about 15 amino acids or about 15 to about 25 amino acids.
- nucleic acid sequence or “polynucleotide” refers to nucleotides of any length which are deoxynucleotides (i.e. DNAs), or derivatives thereof; ribonucleotides (i.e. RNAs) or derivatives thereof; or peptide nucleic acids (PNAs) or derivatives thereof.
- the terms include, without limitation, single-stranded, double-stranded, or multi-stranded DNA or RNA, genomic DNA, cDNA, DNA-RNA hybrids, oligonucleotides (oligos), or other natural, synthetic, modified, mutated or non-natural forms of DNA or RNA.
- the term “vector” refers to, without limitation, a recombinant genetic construct or plasmid or expression construct or expression vector that retains the ability to infect and transduce non-dividing and/or slowly-dividing cells and integrate into the target cell’s genome.
- the vector may be derived from or based on a wild-type virus. Aspects of this disclosure relate to an adeno-associated virus vector, an adenovirus vector, and a lentivirus vector.
- expression control element refers to any sequence that regulates the expression of a coding sequence, such as a gene.
- Exemplary expression control elements include but are not limited to promoters, enhancers, microRNAs, post- transcriptional regulatory elements, polyadenylation signal sequences, and introns.
- Expression control elements may be, without limitation, constitutive, inducible, repressible, or tissue-specific.
- a “promoter” is a control sequence that is a region of a polynucleotide sequence at which initiation and rate of transcription are controlled. It may contain genetic elements at which regulatory proteins and molecules may bind such as RNA polymerase and other transcription factors.
- expression control by a promoter is tissue-specific.
- An “enhancer” is a region of DNA that can be bound by activating proteins to increase the likelihood or frequency of transcription.
- Non-limiting exemplary enhancers and posttranscriptional regulatory elements include the CMV enhancer and WPRE.
- multicistronic or “polycistronic” or “bicistronic” or tricistronic” refers to mRNA with multiple, i.e., double or triple coding areas or exons, and as such will have the capability to express from mRNA two or more, or three or more, or four or more, etc., proteins from a single construct. Multicistronic vectors simultaneously express two or more separate proteins from the same mRNA.
- the two strategies most widely used for constructing multicistronic configurations are through the use of 1) an IRES or 2) a 2A self- cleaving site.
- an “IRES” refers to an internal ribosome entry site or portion thereof of viral, prokaryotic, or eukaryotic origin which are used within polycistronic vector constructs.
- an IRES is an RNA element that allows for translation initiation in a cap- independent manner.
- self-cleaving peptides or “sequences encoding self- cleaving peptides” or “2A self-cleaving site” refer to linking sequences which are used within vector constructs to incorporate sites to promote ribosomal skipping and thus to generate two polypeptides from a single promoter, such self-cleaving peptides include without limitation, T2A, and P2A peptides or sequences encoding the self-cleaving peptides.
- “Homology” or “identity” or “similarity” refers to sequence similarity between two peptides or between two nucleic acid molecules.
- Homology can be determined by comparing a position in each sequence which may be aligned for purposes of comparison. When a position in the compared sequence is occupied by the same base or amino acid, then the molecules are homologous at that position. A degree of homology between sequences is a function of the number of matching or homologous positions shared by the sequences. An “unrelated” or “non-homologous” sequence shares less than 40% identity, or alternatively less than 25% identity, with one of the sequences of disclosed herein. [0036] Percent similarity or percent complementary of any of the disclosed sequences may be determined, for example, by comparing sequence information using the GAP computer program, version 6.0, available from the University of Wisconsin Genetics Computer Group (UWGCG).
- UWGCG University of Wisconsin Genetics Computer Group
- the GAP program utilizes the alignment method of Needleman and Wunsch (1970). Briefly, the GAP program defines similarity as the number of aligned symbols (i.e., nucleotides or amino acids) which are similar, divided by the total number of symbols in the shorter of the two sequences.
- the preferred default parameters for the GAP program include: (1) a unary comparison matrix (containing a value of 1 for identities and 0 for non- identities) for nucleotides, and the weighted comparison matrix of Gribskov and Burgess (1986), (2) a penalty of 3.0 for each gap and an additional 0.10 penalty for each symbol in each gap; and (3) no penalty for end gaps.
- Nucleotide sequence refers to a heteropolymer of deoxyribonucleotides, ribonucleotides, or peptide-nucleic acid sequences that may be assembled from smaller fragments, isolated from larger fragments, or chemically synthesized de novo or partially synthesized by combining shorter oligonucleotide linkers, or from a series of oligonucleotides.
- protein As used herein, the terms “protein”, “peptide”, and “polypeptide” refer to amino acid subunits, amino acid analogs, or peptidomimetics. The subunits may be linked by peptide bonds.
- the subunit may be linked by other bonds, e.g., ester, ether, etc.
- amino acid refers to either natural and/or unnatural or synthetic amino acids.
- recombinant expression system or “recombinant expression vector” refers to a genetic construct for the expression of certain genetic material formed by recombination.
- effective amount or “therapeutically effective amount” or “prophylactically effective amount”, refer to an amount of an active agent described herein that is effective to provide the desired/intended result and/or biological activity.
- an effective amount of a composition described herein is an amount that is effective to result in remission or slowing the progression of disease, and/or to improve or to ameliorate symptoms of and/or to treat disease.
- an equivalent or a biologically equivalent of such is intended within the scope of this disclosure.
- biological equivalent thereof is intended to be synonymous with “equivalent thereof” when referring to a reference small molecule, polypeptide, protein, polynucleotide, nucleic acid, oligonucleotide, antisense, or miRNA even those reference molecules having minimal homology while still maintaining desired structure or functionality. Unless specifically recited herein, it is contemplated that any nucleic acid, polynucleotide, oligonucleotide, antisense, miRNA, polypeptide, or protein mentioned herein also includes equivalents thereof.
- an equivalent intends at least about 70% homology or identity, or at least 80 % homology or identity and alternatively, or at least about 85 %, or alternatively at least about 90 %, or alternatively at least about 95 %, or alternatively 98 % percent homology or identity and exhibits substantially equivalent biological activity to the reference protein, polypeptide or nucleic acid.
- an equivalent thereof is a polynucleotide that hybridizes under stringent conditions to the reference polynucleotide or its complement.
- the polypeptide and/or polynucleotide sequences are provided herein for use in gene and protein transfer and expression techniques described herein.
- Such sequences provided herein can be used to provide the expression product as well as substantially identical sequences that produce a protein that has the same biological properties.
- These “biologically equivalent” or “biologically active” or “equivalent” polypeptides are encoded by equivalent polynucleotides as described herein. They may possess at least 60%, or alternatively, at least 65%, or alternatively, at least 70%, or alternatively, at least 75%, or alternatively, at least 80%, or alternatively at least 85%, or alternatively at least 90%, or alternatively at least 95% or alternatively at least 98%, identical primary amino acid sequence to the reference polypeptide when compared using sequence identity methods run under default conditions. Specific polynucleotide or polypeptide sequences are provided as examples of particular embodiments.
- an equivalent polynucleotide is one that hybridizes under stringent conditions to the reference polynucleotide or its complement or in reference to a polypeptide, a polypeptide encoded by a polynucleotide that hybridizes to the reference encoding polynucleotide under stringent conditions or its complementary strand.
- an equivalent polypeptide or protein is one that is expressed from an equivalent polynucleotide.
- “Hybridization” refers to a reaction in which one or more polynucleotides react to form a complex that is stabilized via hydrogen bonding between the bases of the nucleotide residues.
- the hydrogen bonding may occur by Watson-Crick base pairing, Hoogstein binding, or in any other sequence-specific manner.
- the complex may comprise two strands forming a duplex structure, three or more strands forming a multi-stranded complex, a single self-hybridizing strand, or any combination of these.
- a hybridization reaction may constitute a step in a more extensive process, such as the initiation of a PC reaction, or the enzymatic cleavage of a polynucleotide by a ribozyme.
- Examples of stringent hybridization conditions include: incubation temperatures of about 25°C to about 37°C; hybridization buffer concentrations of about 6x SSC to about 10x SSC; formamide concentrations of about 0% to about 25%; and wash solutions from about 4x SSC to about 8x SSC.
- Examples of moderate hybridization conditions include: incubation temperatures of about 40°C to about 50°C; buffer concentrations of about 9x SSC to about 2x SSC; formamide concentrations of about 30% to about 50%; and wash solutions of about 5x SSC to about 2x SSC.
- high stringency conditions include: incubation temperatures of about 55°C to about 68°C; buffer concentrations of about lx SSC to about 0.1x SSC; formamide concentrations of about 55% to about 75%; and wash solutions of about lx SSC, 0.1x SSC, or deionized water.
- hybridization incubation times are from 5 minutes to 24 hours, with 1, 2, or more washing steps, and wash incubation times are about 1, 2, or 15 minutes.
- SSC is 0.15 M NaCl and 15 mM citrate buffer. It is understood that equivalents of SSC using other buffer systems can be employed.
- beneficial or desired results can include one or more, but are not limited to, alleviation or amelioration of one or more symptoms of disease associated with metabolic obesity, diminishment of same, stabilized (i.e., not worsening) state of the condition (including disease), delay or slowing of the condition (including disease), progression, amelioration or palliation of a condition (including disease), states of and remission of (whether partial or total) disease associated with metabolic obesity, whether detectable or undetectable.
- the term "isolated” means that a naturally occurring DNA fragment, DNA molecule, coding sequence, or oligonucleotide is removed from its natural environment, or is a synthetic molecule or cloned product.
- the DNA fragment, DNA molecule, coding sequence, or oligonucleotide is purified, i.e., essentially free from any other DNA fragment, DNA molecule, coding sequence, or oligonucleotide and associated cellular products or other impurities.
- the term “cell” as used herein refers to either a prokaryotic or eukaryotic cell, optionally obtained from a subject or a commercially available source.
- Cells treated, transfected, transformed, or otherwise in contact with compositions and/or nucleic acid molecules disclosed herein include without limitation, cells of a human, non-human animal, mammal, or non-human mammal, including without limitation, cells of murine, canine, or non-human primate species.
- Cells treated, transfected, transformed, or otherwise in contact with compositions and/or nucleic acid molecules disclosed herein are, without limitation, T cells, antigen-presenting cells, and other suitable host cells.
- the term "subject" includes any human or non-human animal.
- non-human animal includes all vertebrates, e.g., mammals and non-mammals, such as non-human primates, horses, sheep, dogs, cows, pigs, chickens, and other veterinary subjects.
- a or “an” means at least one, unless clearly indicated otherwise.
- to “prevent” or “protect against” a condition or disease means to hinder, reduce or delay the onset or progression of the condition or disease.
- encode refers to a polynucleotide which is said to “encode” a polypeptide, an mRNA, or an effector RNA if, in its native state or when manipulated by methods well known to those skilled in the art, can be transcribed and/or translated to produce the effector RNA, the mRNA, or an mRNA that can for the polypeptide and/or a fragment thereof.
- the antisense strand is the complement of such a nucleic acid, and the encoding sequence can be deduced therefrom.
- expression refers to the process by which polynucleotides are transcribed into mRNA and/or the process by which the transcribed mRNA is subsequently translated into peptides, polypeptides, or proteins. If the polynucleotide is derived from genomic DNA, expression may include splicing of the mRNA in a eukaryotic cell. The expression level of a gene may be determined by measuring the amount of mRNA or protein in a cell or tissue sample; further, the expression level of multiple genes can be determined to establish an expression profile for a particular sample.
- the term “functional” may be used to modify any molecule, biological, or cellular material to intend that it accomplishes a particular, specified effect.
- the term “about,” as used herein when referring to a measurable value such as an amount, level or concentration, for example and without limitation, is meant to encompass variations of 20%, 10%, 5%, 1 %, 0.5%, or even 0.1 % of the specified amount, or fold differences in levels of a quantifiable comparison with a standard or control or reference material, such as 1-fold, 2-fold, 3-fold, 4-fold...10-fold, 100-fold, etc. of the specified level of comparison.
- AAV adeno-associated virus
- the nucleic acid sequence encodes a polypeptide that comprises a combination of one or more epitopes.
- the encoded polypeptide comprises one or more of the epitopes listed in Table 1.
- the polypeptide comprises the first nine epitopes listed in Table 1.
- the polypeptide comprises one or more of the epitopes listed in the latter portion of Table 1 as candidates for inclusion in an ADVac vaccine.
- the polypeptide comprises 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, or more of the epitopes listed in Table 1.
- the Env gene which determines the host range, may be derived from the genes encoding xenotropic, amphotropic, ecotropic, polytropic (mink focus forming) or 10A1 murine leukemia virus env proteins, or the Gibbon Ape Leukemia Virus (GALV env protein, the Human Immunodeficiency Virus env (gp160) protein, the Vesicular Stomatitus Virus (VSV) G protein, the Human T cell leukemia (HTLV) type I and II env gene products, chimeric envelope gene derived from combinations of one or more of the above env genes or chimeric envelope genes encoding the cytoplasmic and transmembrane of the above env gene products and a monoclonal antibody directed against a specific surface molecule on a desired target cell.
- GLV env protein Gibbon Ape Leukemia Virus
- gp160 Human Immunodeficiency Virus env
- VSV Vesicular Stomatitus
- Similar vector-based systems may employ other vectors such as sleeping beauty vectors or transposon elements.
- the resulting packaged expression systems may then be introduced via an appropriate route of administration, discussed in detail with respect to the method aspects disclosed herein.
- Polypeptides [0077] Also provided is a polypeptide that includes one or more epitopes of MCPyV.
- the polypeptide is selected from the group consisting of: (a) amino acids 53-67 of FABP4; (b) amino acids 29-43 of DUSP1; (c) amino acids 94-108, 120-134, 158-172, 186-200, 270-284 and/or 288-302 of PAI-1; (d) amino acids 93-107, 213-227 and/or 374-388 of ATGL; (e) amino acids 276-295 of HIF1a; (f) amino acids 388-402 and/or 545-558 of IGF-1R; and (g) an amino acid sequence having at least 90% identity with any one of the foregoing.
- the amino acid sequences of these epitopes are listed in Table 1.
- the epitopes selected include an amino acid sequence having at least 90% identity with any one of the amino acid sequences listed in Table 1.
- the polypeptide comprises a combination of at least three, four, five, six, or more of the epitopes listed in Table 1.
- the polypeptide comprises at least one of each of (a), (b), (c), (d), (e), and (f).
- the polypeptide further comprises one or more linker sequences disposed between the epitopes.
- compositions may comprise buffers such as neutral buffered saline, phosphate buffered saline and the like; carbohydrates such as glucose, mannose, sucrose or dextrans, mannitol; proteins; polypeptides or amino acids such as glycine; antioxidants; chelating agents such as EDTA or glutathione; adjuvants (e.g., aluminum hydroxide); and preservatives.
- buffers such as neutral buffered saline, phosphate buffered saline and the like
- carbohydrates such as glucose, mannose, sucrose or dextrans, mannitol
- proteins polypeptides or amino acids such as glycine
- antioxidants chelating agents such as EDTA or glutathione
- adjuvants e.g., aluminum hydroxide
- preservatives e.g., aluminum hydroxide
- Compositions of the disclosure may be formulated for administration as a vaccine, for example, with the inclusion of an adjuvant.
- the method comprises administering to a subject in need thereof a composition as described herein.
- a composition as described herein Such compositions are formulated to deliver a therapeutically effective amount of the epitopes, as described herein. Determination of amounts and appropriate means of administration are determined under the guidance of a treating physician, taking into account an individual patient’s condition.
- Administration and Dosage [0084] The compositions and/or nucleic acid molecules disclosed herein are administered in any suitable manner, often with pharmaceutically acceptable carriers.
- compositions, compounds, molecules, nucleic acids, and vectors in the context of the present invention are available, and, although more than one route can be used to administer a particular composition, a particular route can often provide a more immediate and more effective reaction than another route.
- the dose administered to a patient should be sufficient to result in a beneficial therapeutic response in the patient over time, or to inhibit disease progression.
- the composition is administered to a subject in an amount sufficient to elicit an effective response and/or to alleviate, reduce, cure or at least partially arrest symptoms and/or complications from the disease.
- a therapeutically effective dose An amount adequate to accomplish this is defined as a "therapeutically effective dose.”
- Routes, order and/or frequency of administration of the therapeutic compositions disclosed herein, as well as dosage, will vary from individual to individual, and may be readily established using standard techniques. In general, an appropriate dosage and treatment regimen provides the active compound(s) in an amount sufficient to provide therapeutic and/or prophylactic benefit. Such a response can be monitored by establishing an improved clinical outcome in treated patients as compared to non-treated patients.
- EXAMPLES [0087] The following examples are presented to illustrate the present invention and to assist one of ordinary skill in making and using the same. The examples are not intended in any way to otherwise limit the scope of the invention.
- Example 1 Type I adipose inflammation reflects an adaptive immune response driving metabolic dysregulation.
- the inflammatory infiltrate found in adipose tissue of “metabolically obese” individuals is an adaptive Type I T-cell mediated response that drives metabolic dysfunction.
- 1 Infiltration of CD8 T-cells into fat is an early event.
- 2 Type I cytokines secreted by CD8 T-cells upregulate costimulatory molecules on enlarged adipocytes which, as antigen presenting cells, provide antigenic peptides to CD4 and CD8 T-cells, further stimulating Type I T-cell activation.
- 3-5 Thus, inflamed adipocytes vaccine against adipocyte associated proteins.
- Type I CD4 T-cells become essential to maintaining inflammation. 6,7
- the resulting effector and memory T-cells generated compete for glucose and fatty acids which leads to metabolic dysfunction in both the adipose tissue and the T-cells themselves.
- 8 T-cells are not able to maintain immune surveillance
- 9 and secretion of adipokines promotes epithelial to mesenchymal and malignant transformations.
- 10,11 Losing weight does not solve the problem.
- Immunologic memory prevents inflammation from resolving even if an individual becomes normal weight. Studies in formerly obese mice show that serum cytokine expression and proinflammatory genes in the mammary fat pad are similar to those in currently obese mice and much higher than in lean controls. 12,13 Further, T-cell metabolic defects are not fully corrected with weight loss.
- Example 2 Development of a vaccine that drives Type T-cells to inflammatory adipose tissue.
- This Example demonstrates the development of a vaccine that can drive Type II T-cells to inflammatory adipose tissue.
- Validation of the signature in an independent set of 85 cases and 170 matched controls resulted in an area under the curve (AUC) of 0.812 (CI 0.755-0.870).
- Antigen identification Antigens were identified by searching on key words: [(“obese” OR “fat” OR “obesity) AND (“inflammation” OR “inflammatory” OR “immune” OR “immunogenic”) AND (“overexpression”) NOT (“macrophage” OR “neutrophil” OR “innate” OR “monocyte” OR “granulocyte” OR “myeloid” OR “dendritic”) NOT (“nervous system” OR “endocrine system” OR “muscular system” OR “hepatic”) NOT (“expressed in brown adipose tissue”) in PubMed, retrieving 19 candidates.
- Targets were prioritized if they were associated with hypoxia and/or metabolic syndrome. The final 10 candidates identified are listed in Table 3.
- Human subjects Sample collection was approved by the University of Washington (UW) Human Subjects Division.
- PBMC Peripheral blood mononuclear cells
- Analysis of peptide-specific T-cell responses Peptides, predicted to promiscuously bind human MHCII, were selected using web based algorithms as previously described (Table 3) (2). The peptides were constructed and purified by high-performance liquid chromatography (>90% pure; CPC Scientific).
- Human PBMC were evaluated by ELISPOT for antigen-specific IFN-gamma ( ⁇ ) or IL-10 production as previously described (3) using 10 ⁇ g/ml peptides.
- Mouse splenic cells were evaluated by ELISPOT for antigen-specific cytokine secretion as published, with the following modifications; splenic cells were incubated with antigens for 72hr and spots were developed with the AEC substrate kit (BD Biosciences) (2). Positive responses were defined by a statistically significant difference (p ⁇ 0.05) between the mean number of spots in the experimental wells and the mean number from no antigen control wells, all performed with 4 replicates.
- mice were fasted 4h prior to the metabolic studies.
- mice were injected with 1g glucose per kg body weight and for the insulin tolerance test mice, mice were injected with 0.75 U per kg body weight human insulin (Eli Lilly).
- Glucose concentration was measured on a glucometer (Freestyle Freedom Lite) from blood collected pre-injection and at 30, 60 and 120 min after injection.
- Lipidomics Ten mg of frozen adipose samples were homogenized in 15% water, 60% methanol, and 25% dichloromethane. The mixture was vortexed for 5 s and 25 ⁇ L of the isotope labeled internal standards mixture were added to the tube.
- the lipid molecular species were measured using multiple reaction monitoring (MRM) and positive/negative polarity switching. Positive ion mode detected lipid classes SM/DAG/CE/CER/DCER/HCER/DCER/TAG and negative ion mode detected lipid classes LPE/LPC/PC/PE/FFA. A total of 1070 lipids and fatty acids were targeted in the analysis. Data were acquired and processed using Analyst 1.6.3 and Lipidomics Workflow Manager 1.0.5.0. [0119] Aqueous metabolomics. Ten mg of frozen adipose tissue was homogenized in 80% Methanol: 9% PBS: 11% H2O. After centrifugation, aqueous extracts were collected and dried at 30°C in a Speed-Vac.
- MRM multiple reaction monitoring
- Epididymal adipose tissue was collected, weighed and put in a C-tube (Miltenyi) containing 5ml DMEM supplemented with 10mg/mL BSA, 0.03mg/mL Liberase Blendzyme 3 (Worthington) and 50 U/mL DNase, then incubated in the gentleMACs dissociator using the manufacturer’s “mTDK1” program.
- the aqueous slurry was filtered and the red blood cells were lysed.
- the washed cells (1-2x10 6 ) were incubated with a live/dead stain (FVS450; ThermoFisher), washed and incubated with an FC-receptor blocking antibody to reduce non-specific binding.
- the cells were stained with fluorochrome-conjugated monoclonal antibodies for phenotyping analyses.
- the cells were surface-stained with CD3 PE-Cy7, CD4 BV605 and CD8 APC-Cy7.
- the cells were stained with FOXP3 Alex 488 according to eBioscience‘s FOXP3 staining protocol.
- the % of CD8+ cells were analyzed among viable lymphocytes.
- FOXP3 positive cells was analyzed among CD3+CD4+ T cells. Only data from samples counting >350 cells are included.
- Vaccination Mice were immunized subcutaneously using a 26 1 ⁇ 2 G needle.
- Cultures were stimulated with 2.5nM TNFa daily for 5 days and confirmed to be inflammatory (increased activation of NFKb), insulin resistant (decreased expression of IRS-1) and had a decreased expression of adiponectin.
- Adipose tissue was collected and homogenized using a mechanical sonicator, and the lipid layer was removed. Cell lysates were separated by SDS/PAGE (4) and Western blot performed.
- Antibodies used were rabbit anti-mouse IGF-IR (2 ⁇ g/mL; Genetex), rabbit anti- mouse ATGL (1 ⁇ g/mL; Genetex), rabbit anti-mouse PAI-1 (5 ⁇ g/mL; Genetex) goat anti-mouse FABP4 (1 ⁇ g/ml; Santa Cruz Biotech), rabbit anti-mouse HIF1a (2 ⁇ g/mL; abcam), HRP- conjugated goat anti-rabbit and rabbit anti-goat (diluted 1:10,000; Invitrogen).
- Serum ELISA Measurement of Serum Amyloid A was performed with the SAA Mouse ELISA kit (Invitrogen).
- IL-6 and Leptin were performed with the respective Mouse Duoset ELISAs (Rand D Systems). Cholesterol was measured with the HDL and LDL/VLDL Quantification Kit and triglycerides were measured with the TG Quantification Kit (LS Bio). All ELISAs were performed according to the manufacturer’s directions. [0124] Statistical analysis. Data are expressed as mean + standard error of the mean (SEM). Statistical analysis was performed with Prism 7.0 or 8.0 software (GraphPad). Statistical comparisons between 2 groups were conducted by unpaired, two-tailed t-test. Statistical comparisons between 3 or more groups were conducted by one-way ANOVA followed by a Tukey posthoc analysis to determine statistical significance.
- IL-10-selective epitopes can be identified from aberrantly expressed proteins in adipose tissue in obesity. We sought to identify candidate antigens as targets for inclusion in a multi-epitope, multi-antigen anti-inflammatory vaccine. IFN- ⁇ and IL-10-inducing epitopes were determined from the candidate antigens (Table 3). We have previous determined IL-10 selective epitopes for IGF-IR (p388-402 and p545-558) and HIF1a (p276-295) (4, 5).
- One of six epitopes from FABP4 (p53--67; Fig.1A), 1/5 epitopes in DUSP1 (p29-43; Fig 1B), 2/5 epitopes from ATGL (p93-107, p213-227 and p374-388; Fig 1C) and 6/8 epitopes from PAI-1 (p94-108, p120-134, p158-172, p186-200, p270-284 and p288-302) were identified as inducing primarily IL-10 in PBMC (Fig.1D). No Th2-selective epitopes were identified in IGF-1, 11BHSDB1, SEMA3E or SOCS3. These antigens were not considered further.
- the multi-antigen adipose directed vaccine generated a selective IL-10 response to all antigens in the majority of mice.
- a pool of PAI-1-p94-108 and PAI-1-p158- 172 epitopes (p ⁇ 0.001 for all; Fig.3D), a pool of ATGL-p213-227 and ATGL-p374-388 epitopes (p ⁇ 0.01 for all; Fig.3E) or a pool of IGF-IR-p545 and IGF-IR-p388 epitopes (p ⁇ 0.0001 for all; Fig.3F) generated a significantly increased antigen-specific IL-10 response for each epitope as compared to control. No IFN- ⁇ response was detected with any epitope after vaccination.
- AdVac decreased metabolites in adipose tissue associated with glucose insensitivity and insulin resistance. Adipocytes have been shown to be regulators of glucose homeostasis and can modulate systemic energy balance through alterations in their own metabolism (Rosen, et al. Nature.2006; 14;444(7121):847-53).
- Gluconeogenesis results in the generation of glucose from non-carbohydrate carbon substrates and may aid in providing the high levels of glucose needed for the abnormal metabolism of cancer cells.
- An increase in glycolysis has been shown to be a key metabolic pathway promoting metastasis in breast cancer.
- Fig.8C-8F there were four metabolites in the top pathways that were no different than the levels observed in lean untreated mice.
- Obese TgMMTV-neu develop a greater number of tumors with a faster growth rate than lean TgMMTV-neu mice.
- Fig.9A is a Kaplan-Meier curve demonstrating percent tumor free in obese (lower line) and lean (upper line) mice at 30 weeks. Tumor growth rate (mm 3 /day) for lean or obese mice is shown in Fig.9B.
- AdVac restores insulin sensitivity, reduces systemic leptin levels and results in the development of fewer tumors in obese Tg-MMTV-neu mice. Similar to the diet induced obesity (DIO) model, we observed increased glucose sensitivity in the AdVac-immunized group as compared to the control in obese Tg-MMTV-neu mice. A GTT revealed that the glucose level in the blood before the test was significantly lower in the immunized group as compared to the control (p ⁇ 0.0001).
- the immunized group exhibited less insulin resistance than the control as there was significantly less glucose detected in the blood at every time point measured (p ⁇ 0.0001 for all).
- There was significantly less leptin detected in the serum of mice vaccinated with ADVac as compared to control (Alum; p 0.024; Fig 10B).
- Example 3 Confirming the efficacy and safety of a breast cancer prevention vaccine targeting inflammatory adipocytes.
- Two transgenic mouse models can be used to validate the efficacy of ADVac. First, one can use the TgMMTV-neu mouse, a model of luminal B breast cancer. 7,8 Since mice are not born with lesions, the goal is primary breast cancer prevention. The second model is the TgC3(1)-Tag (C3T) representing “basal like” TNBC. 9 C3T mice are born with DCIS, thus, vaccination would represent breast cancer interception.
- TgMMTV-neu mouse a model of luminal B breast cancer. 7,8 Since mice are not born with lesions, the goal is primary breast cancer prevention.
- the second model is the TgC3(1)-Tag (C3T) representing “basal like” TNBC. 9 C3T mice are born with DCIS, thus, vaccination would represent breast cancer interception.
- mice receiving ADVac will be immunized with 100 ug of each epitope 4 times at 10-14-day intervals starting when the mice become obese.
- Booster vaccines will be given every 6 weeks until study end. Mice will be sacrificed when their tumor reaches 1000mm 3 or at 52 weeks if tumor free.
- Secondary endpoints include the rate of tumor growth in mice developing tumors to ensure ADVac does not accelerate tumor proliferation and multiplicity of mammary tumor development.
- Spleens will be collected at the end of the experiment to assess ADVac antigen specific immunity using IL-10 ELISPOT. Samples of visceral and mammary adipose tissue and tumors will be collected and stored. We will include 30 mice per group. Employing a similar experimental design as described for the TgMMTV-neu model, we will test ADVac immunization in the C3T mouse model using a similar schema for the groups.
- the C3T tumors develop earlier and grow faster than those in the TgMMTV-neu so we will begin vaccination 1 week after starting the animals on the specific diets. The anticipated primary outcome is that we would prevent tumor in 25% of vaccinated mice. 10 Similar analysis will be performed as described for the TgMMTV-neu.
- Immune cells play a critical role in the propagation of adipose inflammation and generation of metabolic dysfunction. 11 We observe significant differences in the incidence of palpable tumors in the TgMMTV-neu mice immunized with ADVac at 31 weeks. For this reason, we will add 10 mice to TgMMTV-neu groups 1-4 described above to collect visceral and mammary adipose and tumor at 31 weeks for the experiments described below.
- mice cohorts We expect samples from the following mice cohorts; (1) tumor bearing lean, (2) tumor bearing obese, (3) tumor bearing obese given the adjuvant control vaccine, (4) ADVac immunized obese protected from tumor growth, and (5) ADVac immunized obese developing tumor despite vaccination.
- ECAR and OCR The relative functional relevance of ECAR and OCR in will be confirmed by forcing the cell to respire using glucose analog 2-deoxy glucose (2-DG) or oligomycin (ATP synthase inhibitor) and rotenone+antimycin A (complex I and II inhibitors) to shut down mitochondrial respiration.
- Trifluoromethoxy carbonylcyanide phenylhydrazone will be used to drive the respiratory chain to function at maximum capacity by collapsing the proton gradient for measuring the cellular spare respiratory capacity (SRC) over basal OCR.
- Etomoxir will be used to inhibit fatty acid oxidation for further confirmation of fatty acids as the primary nutrient source. Metabolic functions of T-cells will be correlated with the metabolites in corresponding tissues.
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