JP2012508247A - 蛋白尿腎疾患の病因における可溶性uPARの役割 - Google Patents
蛋白尿腎疾患の病因における可溶性uPARの役割 Download PDFInfo
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Abstract
【選択図】なし
Description
本出願は、その全体が引用により本明細書に取り込まれる、2008年11月6日出願
の米国仮特許出願第61/111,873号を基礎とする優先権を主張する。
本発明の実施態様は、ウロキナーゼ受容体(uPAR)、特に、可溶性ウロキナーゼ受容体(suPAR)を変調及び/又は抑制する薬剤を含む発見に関する。したがって、本発明の方法は、例えば、蛋白尿症によって特徴づけられる腎臓疾患又は障害を治療するために用いられる場合がある。
本明細書で用いられる用語は、特定の実施態様をただ説明するだけの目的であり、本発明を限定することを意図するものではない。本明細書で用いられるところの単数形の「1つ(a)」、「1つ(an)」及び「前記又は該(the)」は、状況が別に明示される場合を除いて、複数形も含むことが意図される。さらに、詳細な説明及び/又は特許請求の範囲のいずれかで用いられる「含む(including)」、「含む(includes)」、「有する(having)」、「有する(has)」、「有する(with)」又はそれらの変形(variants)の用語である限り、かかる用語は前記用語の「含む」と類似するやり方で含むことが意図される。
蛋白尿症は、濾過の細胞機構に含まれる構造タンパク質の変化によって、主に引き起こされる場合がある。蛋白尿症の病態生理学的原因は、(1)糸球体基底膜、足細胞又はスリット膜のような「糸球体濾過ユニット」を形成する構造の遺伝的に決定された障害か、(2)自己免疫過程により直接的に生じたか、細菌により間接的に誘発されたかのいずれかによる炎症過程か、(3)薬剤により生じた糸球体の損傷か、(4)進行性尿細管間質性傷害の最終結果として、最終的に生じるネフロン全体の機能の喪失かの主要なグループに大別される。
1.本発明の他の実施態様は、標的結合剤又は本発明の抗uPAR抗体を用いて血清又は細胞と接触させ、その後、uPARの存在の検出することにより、細胞中のuPARの発現と関連した状態を診断するための方法を含む。好ましい状態は、足細胞疾患又は足細胞障害、蛋白尿症、糸球体疾患、膜性糸球体腎炎、巣状分節性糸球体腎炎、微小変化群、ネフローゼ症候群、子癇前症、子癇、腎臓損傷、膠原病性血管疾患、ストレス、激しい運動、良性起立性(体位性)蛋白尿症、巣状分節性糸球体硬化症(FSGS)、IgA腎症、IgM腎症、膜性増殖性糸球体腎炎、膜性腎症、サルコイドーシス、アルポート症候群、糖尿病、薬物が原因である腎臓損傷、ファブリー病、感染、アミノ酸尿症、ファンコニー症候群、高血圧性腎硬化症、間質性腎炎、鎌状赤血球貧血、血色素尿症、多発性骨髄腫、ミオグロビン尿、糖尿病性腎症(DN)、ループス腎炎、ウェゲナー肉芽腫症又は糖原病I型を含む腎臓疾患を含む。
1.さらに他の実施態様は、本発明の標的結合剤又は抗uPAR抗体の有効量を患者に投与することによって、患者における、uPARの発現に関連する疾患又は状態を治療する方法を含む。標的結合剤又は本発明の抗uPAR抗体は、単独か、追加抗体又は化学療法剤又は放射線治療との組み合わせかで投与される場合がある。例えば、uPAR抗体のモノクローナルか、オリゴクローナルか、ポリクローナルかの混合物は、それらに関連した疾患の状態又は疾患の兆候を抑制することを示す薬剤と組み合わせて投与される場合がある。前記方法はin vivoで行われる場合があり、前記患者は好ましくはヒト患者である。好ましい実施態様では、前記方法は、足細胞疾患又は足細胞障害、蛋白尿症、糸球体疾患、膜性糸球体腎炎、巣状分節性糸球体腎炎、微小変化群、ネフローゼ症候群、子癇前症、子癇、腎臓損傷、膠原病性血管疾患、ストレス、激しい運動、良性起立性(体位性)蛋白尿症、巣状分節性糸球体硬化症(FSGS)、IgA腎症、IgM腎症、膜性増殖性糸球体腎炎、膜性腎症、サルコイドーシス、アルポート症候群、糖尿病、薬物が原因である腎臓損傷、ファブリー病、感染、アミノ酸尿症、ファンコニー症候群、高血圧性腎硬化症、間質性腎炎、鎌状赤血球貧血、血色素尿症、多発性骨髄腫、ミオグロビン尿、糖尿病性腎症(DN)、ループス腎炎又はウェジナー肉芽腫症又は糖原病I型を含む腎臓疾患の治療に関する。
好ましい実施態様では、蛋白尿症を特徴とする疾患又は障害の診断のためのバイオマーカー及び/又は蛋白尿症を特徴とする疾患又は障害を発症するリスクを有する人の同定のためのバイオマーカーはuPARか、ダイナミンか、シナプトポジンか、それらのバリアント(variants)、変異体又は断片かを含む。
好ましい実施態様では、モジュレーター、すなわち、uPAR発現、機能分解を変調し、及び/又はウロキナーゼ受容体分子の活性又は発現か、その合成経路かに直接的に作用する、候補又は試験化合物か、候補又は試験薬剤(例えば、タンパク質、ペプチド、ペプチドミメティクス、ペプトイド、小分子、類似物又はその他の薬物)かを同定するための方法(本明細書中、「スクリーニングアッセイ」とも称される)が提供される。このように同定された化合物は、標的遺伝子産物の活性を変調するか、タンパク質又はペプチドの半減期を延長するか、細胞分裂を調節するか等のため用いられる場合があり、治療プロトコルにおいては、標的遺伝子産物の生物学的機能を詳しく述べるためか、標的遺伝子相互作用を破壊する化合物を同定するためかに用いられる場合がある。
コンビナトリアルケミストリーの開発は、数百個ないし数千個の個々の化合物の迅速で、経済的な合成を可能にする。これらの化合物は、有効性のスクリーニングのために設計された低分子の中規模のライブラリーで配置されることが典型的である。コンビナトリアル法は、新規化合物を同定するために適切な偏りのないライブラリーを作成するために用いられる場合がある。さらに、作成される場合がある低分子の多様性のないライブラリーは、以前に決定された生物学的活性を有する片親の化合物に由来する。どちらの場合にも、重要な酵素の阻害剤のようなコンビナトリアルケミストリーによって作成される、治療上の適切な生体分子を特異的に標的化するための有効なスクリーニングシステムを欠くことが、それらの資源を最適に使用することを妨げる。
低分子テスト化合物は、最初は有機又は無機の化学ライブラリーのメンバーの場合がある。本明細書で用いられるところの「低分子」は、約3,000ダルトン未満の分子量の有機又は無機の低分子を指す。前記低分子は、天然物又はコンビナントリアル化学ライブラリーのメンバーとなる。多様な分子のセットは、電荷、芳香族性、水素結合、可動性、サイズ、側鎖の長さ、疎水性及び剛性のような様々な作用を網羅するために用いられるべきである。低分子を合成するのに適切なコンビナントリアル法は、Obrecht及びVillalgordo、Solid−Supported Combinatorial and Parallel Synthesis of Small−Molecular−Weight Compound Libraries、Pergamon−Elsevier Science 有限会社(1998)に示されるように当業者に知られ、「スプリット・アンド・プール(split and pool)」合成法又は「パラレル(parallel)」合成法と、固相及び液相法と、エンコード法(例えば、Czarnik、Curr. Opin. Chem. Bio., 1:60 (1997)を参照せよ。)とのようなものを含む。さらに、低分子ライブラリーの多くは商業的に入手可能である。
本発明の実行は、従来の生物学の方法、ソフトフェア及びシステムを用いる場合もある。本発明のコンピューターソフトフェア製品は、本発明の前記方法の論理ステップを実施するためのコンピューターで実行可能な命令を有する、コンピューターで読取り可能な媒体を含むことが典型的である。適切なコンピューターで読取り可能な媒体は、フロッピーディスク、CD−ROM/DVD/DVD−ROM、ハードディスクドライブ(hard−disk drive)、フラッシュメモリ(flash memory)、ROM/RAM、磁気テープ等を含む。前記コンピューターで実行可能な命令は、適切なコンピューター言語か、複数の言語の組み合わせかで書き込まれる場合がある。基本的な計算生物学の方法は、例えば、Setubalら、Introduction to Computational Biology Methods(PWS出版社、ボストン、1997)と、Salzbergら(編)、Computational Methods in Molecular Biology(Elsevier、アムステルダム、1998)と、Rashidi及びBuehler、Bioinformatics Basics:Application in Biological Science and Medicine(CRC出版、ロンドン2000)と、Ouelette及びBzevanis Bioinformatics:A Practical Guide for Analysis of Gene and Proteins(Wiley&Sons社、第2版、2001)とに説明される。米国特許第6,420,108号公報明細書を参照せよ。
本明細書中で説明された方法により同定された組成物又は薬剤は、任意の適切な処方でヒトを含む動物に投与される場合がある。例えば、タンパク質分解を変調するための組成物は、薬学的に許容可能な担体か、生理食塩水又は緩衝塩水溶液のような希釈剤かで処方される場合がある。適切な担体及び希釈剤は、投与の様式及び経路と、標準的な薬務とにもとづいて選択される場合がある。典型的な薬学的に許容可能な担体及び希釈剤と、医薬品の処方とは、レミントンの薬学と、この分野の標準的な教科書と、UPS/NFとで知られる場合がある。別の物質が、前記組成物を安定化及び/又は保護するために組成物に添加される場合がある。
組成物を単独で投与することを可能にする一方、医薬品の処方として提供することが好ましい。活性成分が、前記処方の10重量%であるが、好ましくは5重量%を超えない量であり、より好ましくは0.1重量%から1重量%程度の量を含む場合があるが、局所投与では、0.001重量%から10重量%まで、例えば、処方の1重量%から2重量%までを含む場合がある。本発明の局所処方は1種類又は2種類以上の許容されるこれらの担体と及び任意の別の治療成分とともに活性成分を含む。担体は、処方のその他の成分と適合する意味で「許容され」、受容者に無害でなければならない。
以下の非限定的な例は、本発明の選択された実施態様を例示するために役立つ。比率の変化と、示された構成要素の要素の変更とが当業者に明らかとなるであろうし、本発明の実施態様の技術的範囲内であると理解されるであろう。
材料及び方法:
Claims (28)
- 可溶性ウロキナーゼ受容体(suPAR)の活性及び/又は機能を抑制する、及び/又は、可溶性及び/又は膜結合型ウロキナーゼ受容体(uPAR)の発現及び/又はin vivoでウロキナーゼ受容体と関連する経路を変調する、薬剤の有効量を必要とする患者に投与するステップと、腎疾患又は腎障害を治療するステップとを含むことを特徴とする、腎疾患又は腎障害を治療する方法。
- 前記腎疾患又は腎障害は、足細胞疾患又は足細胞障害、蛋白尿症、糸球体疾患、膜性糸球体腎炎、巣状分節性糸球体腎炎、微小変化群、ネフローゼ症候群、子癇前症、子癇、腎臓損傷、膠原病性血管疾患、ストレス、激しい運動、良性起立性(体位性)蛋白尿症、巣状分節性糸球体硬化症(FSGS)、IgA腎症、IgM腎症、膜性増殖性糸球体腎炎、膜性腎症、サルコイドーシス、アルポート症候群、糖尿病、薬物が原因である腎臓損傷、ファブリー病、感染、アミノ酸尿症、ファンコニー症候群、高血圧性腎硬化症、間質性腎炎、鎌状赤血球貧血、血色素尿症、多発性骨髄腫、ミオグロビン尿、糖尿病性腎症(DN)、ループス腎炎、ウェゲナー肉芽腫症又は糖原病I型を含むことを特徴とする、請求項1に記載の方法。
- 可溶性及び/又は膜結合型ウロキナーゼ受容体の活性、発現及び/又は機能の阻害剤は、核酸、ウロキナーゼ受容体変異体、オリゴヌクレオチド、ポリヌクレオチド、ペプチド、ポリペプチド、抗体、低分子、有機分子又は無機分子を含むことを特徴とする、請求項1に記載の方法。
- ウロキナーゼ受容体変異体は、野生型可溶性ウロキナーゼ受容体分子の発現か、機能か、活性かを阻害することを特徴とする、請求項1に記載の方法。
- 前記可溶性ウロキナーゼ受容体阻害剤は、抗体か、アプタマーか、アンチセンスオリゴヌクレオチドか、天然の薬剤か、合成薬剤か、これらの組み合わせかを含むことを特徴とする、請求項1に記載の方法。
- アンチセンスオリゴヌクレオチドは、アンチセンスRNAか、アンチセンスDNAか、キメラアンチセンスオリゴヌクレオチドか、改変された結合を含むアンチセンスオリゴヌクレオチドか、干渉RNA(RNAi)か、短鎖干渉RNA(siRNA)か、マイクロ干渉RNA(miRNA)か、短鎖の一過的(temporal)RNA(stRNA)又は短鎖のヘアピンRNA(shRNA)か、低分子RNA誘導型の遺伝子活性化(RNAa)か、低分子活性化RNAs(saRNAs)か、これらの組み合わせかを含むことを特徴とする、請求項5に記載の方法。
- 可溶性ウロキナーゼ受容体に特異的である抗体は、可溶性ウロキナーゼ受容体の機能又は活性を阻害又は抑制することを特徴とする、請求項1に記載の方法。
- 関連する経路における可溶性ウロキナーゼ受容体の活性、発現及び/又は機能の抑制は、αvβ3インテグリン活性化、GTPase、Rac及び/又はその他の関連する分子及び経路を抑制することを特徴とする、請求項1に記載の方法。
- in vivoで、可溶性ウロキナーゼ受容体、機能及び/又は活性を変調する薬剤を同定する方法であって、
前記可溶性ウロキナーゼ受容体を1種類又は2種類以上の薬剤と接触させるステップと、
前記可溶性ウロキナーゼ受容体分子の物理的変化又は化学的変化を測定するステップと、
in vivoで、uPAR−Lの発現、機能及び/又は活性を変調する薬剤を同定するステップとを含むことを特徴とする、方法。 - 物理的変化は、前記suPAR分子への結合か、suPAR分子における立体配座の変化か、1種類又は2種類以上の分子への結合活性の消失か、これらの組み合わせかを含むことを特徴とする、請求項9に記載の方法。
- 化学的変化は、核酸の修飾か、アミノ酸の修飾か、スプライシングか、断片化(fragmenting)か、グリコシル化か、分解か、結合形成か、結合切断か、これらの組み合わせかを含むことを特徴とする、請求項9に記載の方法。
- 正常対照と比較して、前記薬剤がin vivoでのsuPARの活性又は発現を低下させることを特徴とする、請求項9に記載の方法。
- 可溶性ウロキナーゼ受容体分子(suPAR)の発現、機能及び/又は活性を変調する薬剤を同定する方法であって、
腎臓細胞又は腎臓細胞株を培養するステップと、
前記細胞を1種類又は2種類以上の薬剤と接触させるステップと、
suPAR、発現、機能又は活性を測定するステップと、
可溶性ウロキナーゼ受容体分子(suPAR)、発現、機能及び/又は活性を変調する薬剤を同定するステップとを含むことを特徴とする、方法。 - 正常対照と比較して、前記可溶性ウロキナーゼ受容体分子(suPAR)が薬剤によって少なくとも10%抑制されることを特徴とする、請求項13に記載の方法。
- 正常対照と比較して、前記可溶性ウロキナーゼ受容体分子(suPAR)が薬剤によって少なくとも約50%抑制されることを特徴とする、請求項10に記載の方法。
- 正常対照と比較して、前記可溶性ウロキナーゼ受容体分子(suPAR)が薬剤によって100%抑制されることを特徴とする、請求項10に記載の方法。
- 正常対照と比較して、前記薬剤が、可溶性ウロキナーゼ受容体分子(suPAR)の発現、機能及び/又は活性を少なくとも約1倍低下させることを特徴とする、請求項10に記載の方法。
- 正常対照と比較して、前記薬剤が、可溶性ウロキナーゼ受容体分子(suPAR)の発現、機能及び/又は活性を少なくとも約5倍低下させることを特徴とする、請求項10に記載の方法。
- 正常対照と比較して、前記薬剤が、可溶性ウロキナーゼ受容体分子(suPAR)の発現、機能及び/又は活性を1000倍まで低下させることを特徴とする、請求項10に記載の方法。
- 医薬品組成物、及び/又は、1種類又は2種類以上の可溶性ウロキナーゼ受容体分子(suPAR)阻害剤、及び/又は、可溶性ウロキナーゼ受容体分子(suPAR)の発現、機能及び/又は活性の低下を抑制する薬剤を治療上の有効量含むことを特徴とする組成物。
- 蛋白尿を特徴とする疾患又は障害の診断、及び/又は、蛋白尿を特徴とする疾患又は障害を発症するリスクを有する人の同定のためのバイオマーカーであって、
可溶性又は膜結合型ウロキナーゼ受容体分子(suPAR)か、そのバリアント、変異体又は断片かを含むことを特徴とする、バイオマーカー。 - 蛋白尿を特徴とする疾患又は障害を発症するリスクを有する人の同定は、少なくとも1つのバイオマーカーか、その断片かを検出することを特徴とする、請求項21に記載のバイオマーカー。
- 正常対照と比較して、蛋白尿を特徴とする疾患又は障害の発症が、可溶性ウロキナーゼ受容体(suPAR)分子の増大と関連づけられることを特徴とする、請求項21に記載のバイオマーカー。
- ウロキナーゼ受容体(suPAR)か、その変異体、バリアント、断片、誘導体又は類似体かに特異的であることを特徴とする、抗体又はアプタマー。
- 患者からの生物学的試料を、検出可能な標識抗suPAR抗体と接触させるステップと、患者の可溶性ウロキナーゼ受容体(suPAR)を測定するステップとを含むことを特徴とする、患者の可溶性ウロキナーゼ受容体(suPAR)を測定するためのアッセイ。
- 患者の可溶性suPARは、足細胞疾患又は足細胞障害、蛋白尿症、糸球体疾患、膜性糸球体腎炎、巣状分節性糸球体腎炎、微小変化群、ネフローゼ症候群、子癇前症、子癇、腎臓損傷、膠原病性血管疾患、ストレス、激しい運動、良性起立性(体位性)蛋白尿症、巣状分節性糸球体硬化症(FSGS)、IgA腎症、IgM腎症、膜性増殖性糸球体腎炎、膜性腎症、サルコイドーシス、アルポート症候群、糖尿病、薬物が原因である腎臓損傷、ファブリー病、感染、アミノ酸尿症、ファンコニー症候群、高血圧性腎硬化症、間質性腎炎、鎌状赤血球貧血、血色素尿症、多発性骨髄腫、ミオグロビン尿、糖尿病性腎症(DN)、ループス腎炎、ウェゲナー肉芽腫症又は糖原病I型を含む疾患の発症と関係づけられることを特徴とする、請求項25に記載のアッセイ。
- 患者又は患者の試料の可溶性uPARを検出するステップと、患者又は患者の試料のsuPAR量を腎臓疾患又は足細胞の消失と関係づけるステップと、腎臓疾患の患者を診断するステップとを含むことを特徴とする、腎臓疾患の患者を診断する方法。
- 前記腎臓疾患は、足細胞疾患又は足細胞障害、蛋白尿症、糸球体疾患、膜性糸球体腎炎、巣状分節性糸球体腎炎、微小変化群、ネフローゼ症候群、子癇前症、子癇、腎臓損傷、膠原病性血管疾患、ストレス、激しい運動、良性起立性(体位性)蛋白尿症、巣状分節性糸球体硬化症(FSGS)、IgA腎症、IgM腎症、膜性増殖性糸球体腎炎、膜性腎症、サルコイドーシス、アルポート症候群、糖尿病、薬物が原因である腎臓損傷、ファブリー病、感染、アミノ酸尿症、ファンコニー症候群、高血圧性腎硬化症、間質性腎炎、鎌状赤血球貧血、血色素尿症、多発性骨髄腫、ミオグロビン尿、糖尿病性腎症(DN)、ループス腎炎、ウェゲナー肉芽腫症又は糖原病I型を含むことを特徴とする、請求項27に記載の方法。
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