JP2016510763A - 関節損傷の治療のためのペプチドおよび組成物 - Google Patents
関節損傷の治療のためのペプチドおよび組成物 Download PDFInfo
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Abstract
Description
本出願は、2013年3月8日に出願された米国仮特許出願第61/775,400号および2014年2月10日に出願された米国仮特許出願第61/938,123号の優先権および利益を主張するものであり、そのそれぞれの出願の全体を参照により本明細書に組み込んだものとする。
変形性関節症(OA)は、最も一般的な筋骨格障害である。現在、およそ4千万人の米国人が罹患しており、老齢人口および平均余命の増加の結果として、その数は今後20年間で6千万人に増加して、OAが障害の第4の主要な原因なることが予想される。OAは、関節軟骨(関節に対して潤滑および緩衝もたらす細胞および基質(マトリックス)を含む)ならびに関節軟骨の下にある軟骨下骨の両方を含む関節のゆっくりとした変性性の破壊が特徴である。OAは、さまざまな病因的因子の結果と考えることができる。例えば、OAは異常な生体力学的ストレスまたは関節軟骨もしくは骨の遺伝学的もしくは後天的な異常によって引き起される場合がある。現行のOA治療法としては、経口NSAIDすなわち選択的シクロオキシゲナーゼ2(COX−2)阻害剤による痛みの緩和、副腎皮質ステロイド薬およびヒアルロナンなどの薬剤を用いた関節内(IA)注射、ならびに外科的アプローチが挙げられる。
本発明は、例えば、野生型ANGPTL3よりも安定で、タンパク質分解および酵素分解を受けにくいなどの改善された薬学的特性をもつ新規のアンジオポエチン様3(ANGPTL3)ポリペプチドおよびタンパク質バリアントの特定に関する。関節損傷または関節傷害の治療のための医薬組成物および方法ならびに哺乳動物の関節炎、関節損傷もしくは関節傷害を改善または予防する方法も提供される。
本発明は、少なくとも部分的には、間葉系幹細胞の軟骨細胞分化を刺激し、プロテアーゼ(例えば、トリプシン様プロテアーゼ)による切断に対して抵抗性のあるアンジオポエチン様ポリペプチド3(ANGPTL3)の特定に基づくものである。WO2011/008773は、関節炎および関節傷害を治療または予防するため、さらに間葉系細胞から軟骨細胞への分化を誘導するためのANGPTL3ペプチド組成物ならびにペプチド組成物の使用について記載している。本発明者らは、野生型ANGPTL3タンパク質は、プロテアーゼの切断(clipping)を受けやすく、不安定であることがわかり、この影響を軽減する配列バリアント(sequence variant)を特定した。それにより、本発明は、軟骨を修復するための改善されたペプチド組成物を提供する。特に、野生型ANGPTL3ポリペプチドと比較した場合にプロテアーゼ抵抗性が増加した、本発明に従って改変されたANGPTL3ペプチドが提供される。関節、軟骨組織もしくは軟骨に隣接する組織(cartilage proximal tissue)または全身的に本発明のポリペプチドを投与することによって関節炎もしくは関節傷害を予防または改善するANGPTL3ポリペプチドの投与のための組成物および方法も提供される。さらに、本発明は、軟骨細胞への間葉系幹細胞の分化の誘導ための組成物および方法を提供する。
「プロテアーゼ抵抗性」という用語は、本明細書中で使用される場合、ポリペプチドを対応する非改変の野生型ポリペプチドよりもトリプシン様プロテアーゼによる切断を受けにくくさせる改変を含むポリペプチドを指す。特定の実施形態において、プロテアーゼ抵抗性ポリペプチドは、未変性の野生型ペプチド配列と比較して、RまたはK残基にアミノ酸置換があるANGPTL3ポリペプチドである。
アンジオポエチン様3は、分泌因子のアンジオポエチン様ファミリーのメンバーである。アンジオポエチン様3は、大部分が肝臓で発現し、シグナルペプチド、N末端のコイルドコイルドメイン(CCD)およびC末端のフィブリノーゲン(FBN)様ドメインからなるアンジオポエチンの特徴的構造を有する。アンジオポエチン様3は、αV/β3インテグリンに結合することが示され、FBN様ドメイン単独で内皮細胞接着およびインビボにおける血管形成を誘導するのに十分であった(Camenisch et al., J. Biol. Chem. 277: 17281-17290, 2002)。内在性ANGPTL3は、一般にインビボにおいてアミノ末端フラグメントとカルボキシ末端フラグメントに切断される。上で概要が示され、本明細書においてさらに記載されるとおり、本発明は、軟骨形成活性を有するさまざまなプロテアーゼ抵抗性ANGPTL3タンパク質の使用を意図する。
本発明はまた、本発明のプロテアーゼ抵抗性ポリペプチドをコードする核酸ならびにプロテアーゼ抵抗性ポリペプチドの発現のための発現ベクターおよび宿主細胞を提供する。他の態様において、本発明は、本発明のポリペプチドをコードするポリヌクレオチドならびにそのようなポリヌクレオチドを含む発現ベクターおよび宿主細胞を提供する。一部の実施形態において、本ポリヌクレオチドは、宿主細胞における発現のために最適化される。一部の実施形態において、本発明は、ヒト患者の関節炎または関節傷害を改善または予防する方法を提供し、この方法は、患者の関節に本発明のポリペプチドをコードする発現ベクターを投与するステップを含み、その結果、本ポリペプチドの発現が患者の関節炎または関節傷害を改善または予防する。一部の実施形態において、患者は、関節炎または関節傷害がある。一部の実施形態において、個人は、関節炎または関節傷害ではないがそのリスクがある。一部の実施形態において、関節炎は、変形性関節症、外傷性関節炎または自己免疫性関節炎である。
提供される本発明の方法は、対象に治療有効量の本発明のポリペプチドを投与するステップを含む、対象を治療する方法を含み、対象は、関節損傷もしくは関節炎があるか、またはそのリスクがある。本発明はまた、ヒト患者の関節炎または関節傷害を改善または予防する方法を提供し、この方法は、患者の関節に有効量の本発明のポリペプチドを含む組成物を投与するステップ含み、それにより患者の関節炎または関節傷害を改善または予防する。一部の実施形態において、患者は、関節炎または関節傷害がある。一部の実施形態において、個人は、関節炎または関節傷害ではないがそのリスクがある。一部の実施形態において、関節炎は、変形性関節症、外傷性関節炎または自己免疫性関節炎である。一部の実施形態において、投与される本組成物は、ヒアルロン酸をさらに含む。
提供されるポリペプチドを含む治療効果のある組成物は本発明の範囲内であり、特に、安定性およびプロテアーゼ抵抗性が向上したいくつかのポリペプチド配列の特定に照らして考えられる。したがって、別の態様において、本発明は、治療有効量の本発明のポリペプチドを含む医薬組成物を提供する。特定の実施形態において、医薬組成物は、薬学的または生理学的に許容される担体をさらに含む。一部の実施形態において、医薬組成物は、ヒアルロン酸またはその誘導体をさらに含む。
本発明のタンパク質または本発明のポリペプチドをコードする核酸を冒された関節に送達するために任意の方法が使用されてもよい。本発明の実施において、組成物は、非経口投与されてもよい、例えば、関節内(すなわち、関節中)、静脈内、筋肉内、皮下に注入;インフュージョンまたは例えば、膜、基質、デバイスなどとして移植されてもよい。注入、インフュージョンまたは移植されるとき、送達は、適切な組織または関節に向けられてもよく、送達は、直接的なボーラス投与送達または継続的な送達であってもよい。一部の実施形態において、冒された関節に極めて接近した場所にある適切な組織に送達されてもよい。一部の実施形態において、拡散または徐放性ボーラス投与(timed release bolus)により送達されてもよい。一部の実施形態において、本ポリペプチドが投与される治療の対象物、例えば、関節の近くに制御放出システム(例えば、ポンプ)が配置されてもよい。他の実施形態において、組成物は、摂取、例えば、吸入または経口送達に関して選択されてもよい。
O−結合型グリコシル化を排除し、生物物理学的なタンパク質の性質決定を容易にするために、さまざまなN末端短縮型変異体(N-terminal truncation mutant)を構築した。プロテアーゼ抵抗性ペプチドを特定するために、ペプチドのC末端領域に対応するヒトAngptl3ペプチドフラグメントのさまざまな位置にアミノ酸置換を導入した。図1は、ヒトAngptl3における変異の位置を示す。Hisタグを含む構築物を最初に作製した。変異体タンパク質は、以下のものとした:225−460 K423Q(225KQ)、225−460 S424T(225ST)、226−460 K423Q(226KQ)、226−460 K423S(226KS)、228−460 K423Q(228KQ)、228−460 S424T(228ST)、233−460 K423Q(233KQ)、233−460 K423S(233KS)、241−460 K423Q(241KQ)、241−460 K423S(241KS)、241−460 Kdel(241Kdel)、242−460 K423Q(242KQ)、242−460 K423S(242KS)および242−460 Kdel(242Kdel)。
αVβ3インテグリン 作製されたペプチド225KQ、228KQ、233KQ、241KQおよび242KQを、αVβ3インテグリンとの結合についてインビトロにおいて試験した。簡単にいえば、Maxisorpプレートを、2μg/mlのインテグリンαVβ3によりコーティングし、各種濃度の(示した)ポリペプチド構築物を添加した。抗ANGPTL3mAbに続く西洋ワサビペルオキシダーゼ結合ヤギ抗マウスIgG抗体の添加によって結合したペプチドを検出した。試験したペプチドすべてがインテグリン結合能力を保持するか、またはそれが改善された。結合データからそれぞれについてのEC50を求め、結果を表2に示す。
細胞培養および分化。 ヒト骨髄由来の初代間葉系幹細胞(hMSCs)をFACSにより選別し、CD29、CD44、CD166およびCD105陽性が98%超であり、CD45陽性が0.1%未満であることが証明された。継代数2〜8の細胞を実験のために使用した。ヒト軟骨内在MSC(hCR−MSC)は、ヒト初代関節軟骨細胞に由来するものとし、これを、1つの細胞に分け、MSCGMでクローン的に増殖させ、軟骨形成、骨形成および脂肪生成分化によりMSCと確認した。細胞をFACSにより選別し、CD166およびCD105陽性が98%超であることが証明された。hCR−MSCを最大20回継代培養し、細胞プロファイル、増殖または分化速度に変化がないことが確認された。
マウス外科的急性傷害モデル。 C57BL/6マウス(n=12/群)の右膝の前十字靱帯(ACL)、内側半月脛骨靱帯(medial meniscal tibial ligament)(MMTL)および内側側副靭帯(MCL)に外科的切断を行って膝関節を不安定にし、それにより、OA表現形にした。これは、過去に示されたモデルGlasson, S.S., et al., Osteoarthritis Cartilage 15, 1061 (2007)を変更したものである。ANGPTL3処置の治療上の利益の可能性を評価するために、手術後の15週間、図6Aに示したとおり、17〜19週目は1週間に1回、mANGPTL3用量=200ng/膝でマウスの関節内に投与した。脛骨プラトーの量的評価を0〜4段階で行った。0は正常であり、5は重篤な変形性関節症(軟骨の全層破壊)である。各マウスから2つの切片を、2人の独立した観察者が盲検的に等級付けした(図6B)。
構築物のインビボにおける効力を評価するために、ラット外科的傷害モデルをまた使用した。まず、モデルおよび評価を、Gerwin N. et al. Osteoarthritis Cartilage. Suppl 3: S24 (2010)に過去に記載されたとおりに行った。簡単にいえば、膝関節の皮膚を剪毛し、内側側副靭帯(MCL)を切開により切り離し、MCLを安定化させ、メスを使用して半月板の遠位の切断を行った。手術の1、2および3週間後にタンパク質構築物またはビヒクル対照を節腔内に注入し、その後、手術の4および6週間後に関節を採取し、切片を作った。上記のとおりの組織修復の量化のために、大腿および脛骨プラトーに対する組織学的な関節の重症度のスコアリングを行った。6週間の分析に関するデータを示す。
Claims (50)
- 表1の配列の群から選択されるアミノ酸配列と少なくとも95%のアミノ酸配列同一性を有するアミノ酸配列を含む単離ポリペプチドであって、前記ポリペプチドは、配列番号1を参照して決定される423位がKまたはR以外の極性アミノ酸であるアミノ酸を含み、前記ポリペプチドは、軟骨形成活性がある、ポリペプチド。
- 前記ポリペプチドが、配列番号30、配列番号31、配列番号32、配列番号33、配列番号34、配列番号35、配列番号36、配列番号37、配列番号38、配列番号39、配列番号40、配列番号41、配列番号65、配列番号66、配列番号67、配列番号68、配列番号69、または配列番号70のいずれか1つのアミノ酸配列と少なくとも95%の配列同一性を有するアミノ酸配列を含む、請求項1に記載のポリペプチド。
- 前記ポリペプチドが、配列番号14、配列番号15、配列番号16、配列番号17、配列番号18、配列番号19、配列番号20、配列番号21、配列番号22、配列番号23、配列番号24、配列番号25、配列番号26、配列番号27、配列番号28、配列番号29、配列番号58、配列番号59、配列番号60、配列番号61、配列番号62、配列番号63、または配列番号64のいずれか1つのアミノ酸配列と少なくとも95%の配列同一性を有するアミノ酸配列を含む、請求項2に記載のポリペプチド。
- 前記ポリペプチドが、配列番号30、配列番号31、配列番号32、配列番号33、配列番号34、配列番号35、配列番号36、配列番号37、配列番号38、配列番号39、配列番号40、配列番号41、配列番号65、配列番号66、配列番号67、配列番号68、配列番号69、または配列番号70のいずれか1つのアミノ酸配列を含む、請求項1に記載のポリペプチド。
- 前記ポリペプチドが、配列番号14、配列番号15、配列番号16、配列番号17、配列番号19、配列番号20、配列番号21、配列番号22、配列番号24、配列番号25、配列番号26、配列番号27、配列番号28、配列番号29、配列番号58、配列番号59、配列番号60、配列番号61、配列番号62、配列番号63、または配列番号64のいずれか1つのアミノ酸配列を含む、請求項4に記載のポリペプチド。
- 前記ポリペプチドが、配列番号30、配列番号31、配列番号32、配列番号33、配列番号34、配列番号35、配列番号36、配列番号37、配列番号38、配列番号39、配列番号40、配列番号41、配列番号65、配列番号66、配列番号67、配列番号68、配列番号69、または配列番号70のいずれか1つのアミノ酸配列と少なくとも95%の配列同一性を有する、請求項1に記載のポリペプチド。
- 前記ポリペプチドが、配列番号14、配列番号15、配列番号16、配列番号17、配列番号18、配列番号19、配列番号20、配列番号21、配列番号22、配列番号23、配列番号24、配列番号25、配列番号26、配列番号27、配列番号28、配列番号29、配列番号58、配列番号59、配列番号60、配列番号61、配列番号62、配列番号63、または配列番号64のいずれか1つのアミノ酸配列と少なくとも95%の配列同一性を有する、請求項6に記載のポリペプチド。
- 前記ポリペプチドが、表1の配列の群から選択されるアミノ酸配列である、請求項1に記載のポリペプチド。
- 前記ポリペプチドが、配列番号30、配列番号31、配列番号32、配列番号33、配列番号34、配列番号35、配列番号36、配列番号37、配列番号38、配列番号39、配列番号40、配列番号41、配列番号65、配列番号66、配列番号67、配列番号68、配列番号69、および配列番号70のいずれか1つである、請求項8に記載のポリペプチド。
- 前記ポリペプチドが、配列番号14、配列番号15、配列番号16、配列番号17、配列番号19、配列番号20、配列番号21、配列番号22、配列番号24、配列番号25、配列番号26、配列番号27、配列番号28、配列番号29、配列番号58、配列番号59、配列番号60、配列番号61、配列番号62、配列番号63、または配列番号64のいずれか1つである、請求項9に記載のポリペプチド。
- 前記423位のアミノ酸はQもしくはSであるか、または前記423位のアミノ酸は欠失している、請求項1〜10のいずれか一項に記載のポリペプチド。
- 前記423位のアミノ酸はQである、請求項1〜10のいずれか一項に記載のポリペプチド。
- 前記423位のアミノ酸はSである、請求項1〜10のいずれか一項に記載のポリペプチド。
- 前記ポリペプチドがペグ化されている、請求項1から11のいずれか一項に記載のポリペプチド。
- 前記ポリペプチドが、ヒト血清アルブミン(HSA)、免疫グロブリン重鎖定常領域(Fc)、ポリヒスチジン、グルタチオンSトランスフェラーゼ(GST)、チオレドキシン、プロテインA、プロテインGもしくはマルトース結合タンパク質(MBP)またはそのフラグメントのいずれかと融合している、請求項1から14のいずれか一項に記載のポリペプチド。
- 前記異種ペプチドは、前記ポリペプチドのアミノ末端において融合している、請求項15に記載のポリペプチド。
- 前記異種ペプチドは、前記ポリペプチドのカルボキシ末端において融合している、請求項15に記載のポリペプチド。
- 請求項1から17のいずれか一項に記載のポリペプチドを含む医薬組成物。
- ヒアルロン酸またはその誘導体をさらに含む、請求項18に記載の医薬組成物。
- 経口用サケカルシトニン、SD−6010(iNOS阻害剤)、ビタミンD3(コレカルシフェロール)、コラーゲン加水分解物、FGF18、BMP7、酢酸ルサラチド、アボカドダイズ不けん化物(ASU)、カルトゲニン、ステロイドおよび非ステロイド系抗炎症剤(NSAID)からなる群から選択される薬剤をさらに含む、請求項18に記載の医薬組成物。
- 患者において関節炎または関節損傷を治療、改善または予防する方法であって、前記方法は、前記患者の関節に治療有効量の請求項18に記載の医薬組成物を投与するステップを含み、それにより、前記患者において関節炎または関節損傷を治療、改善または予防する、方法。
- 前記患者は、関節炎または関節損傷がある、請求項21に記載の方法。
- 前記患者は、関節炎または関節損傷のリスクがある、請求項21に記載の方法。
- 前記関節炎は、変形性関節症、外傷性関節炎または自己免疫性関節炎である、請求項22または請求項23に記載の方法。
- 前記組成物は、ヒアルロン酸をさらに含む、請求項21から24のいずれか一項に記載の方法。
- 冒された関節への外科的手技をさらに含む、請求項21から25のいずれか一項に記載の方法。
- 前記医薬組成物を投与するステップは、外科的手技の間または後に行われる、請求項21から24のいずれか一項に記載の方法。
- 前記医薬組成物を投与するステップは、骨髄刺激、軟骨置換、自家軟骨細胞移植(ACI)、マトリックス誘導自家軟骨細胞移植(matrix-induced autologous chondrocyte implantation)(MACI)のいずれか1つと併せて行われる、請求項26に記載の方法。
- 前記医薬組成物を投与するステップは、1つまたは複数の追加の軟骨形成因子と併せて行われる、請求項21〜26のいずれか一項に記載の方法。
- 前記医薬組成物を投与するステップは、マトリックスまたは生体適合性の足場において行われる、請求項21〜26のいずれか一項に記載の方法。
- 間葉系幹細胞の軟骨細胞への分化を誘導する方法であって、前記方法は、間葉系幹細胞を有効量の請求項1から17のいずれか一項に記載のポリペプチドと接触させて前記間葉系幹細胞の軟骨細胞への分化を誘導するステップを含む、方法。
- 前記方法はインビボにおいて行われ、前記幹細胞はヒト対象中に存在する、請求項31に記載の方法。
- 前記対象は、関節炎または関節損傷がある、請求項32に記載の方法。
- 前記対象は、関節炎または関節損傷のリスクがある、請求項32に記載の方法。
- 前記関節炎は、変形性関節症、外傷性関節炎または自己免疫性関節炎である、請求項33または請求項34に記載の方法。
- 対象の冒された関節への外科的手技をさらに含む、請求項32から35のいずれか一項に記載の方法。
- 前記ポリペプチドを投与するステップは、外科的手技の間または後に行われる、請求項32から35のいずれか一項に記載の方法。
- 前記ポリペプチドを投与するステップは、1つまたは複数の追加の軟骨形成因子と併せて行われる、請求項32〜35のいずれか一項に記載の方法。
- 前記ポリペプチドを投与するステップは、骨髄刺激、軟骨置換、自家軟骨細胞移植(ACI)、マトリックス誘導自家軟骨細胞移植(MACI)のいずれか1つと併せて行われる、請求項36に記載の方法。
- 前記ポリペプチドを投与するステップは、マトリックスまたは生体適合性の足場において行われる、請求項36に記載の方法。
- 対象を治療する方法であって、前記方法は、前記対象に治療有効量の請求項1から17のいずれか一項に記載のポリペプチドを投与するステップを含み、前記対象は関節損傷もしくは関節炎があるか、またはそのリスクがある、方法。
- 前記患者は、関節炎または関節損傷がある、請求項41に記載の方法。
- 前記患者は、関節炎または関節損傷のリスクがある、請求項41に記載の方法。
- 前記関節炎は、変形性関節症、外傷性関節炎または自己免疫性関節炎である、請求項42または請求項43に記載の方法。
- ヒアルロン酸を投与するステップをさらに含む、請求項41から44のいずれか一項に記載の方法。
- 冒された関節への外科的手技をさらに含む、請求項41から45のいずれか一項に記載の方法。
- 前記ポリペプチドを投与するステップは、外科的手技の間または後に行われる、請求項41から45のいずれか一項に記載の方法。
- 前記ポリペプチドを投与するステップは、骨髄刺激、軟骨置換、自家軟骨細胞移植(ACI)、マトリックス誘導自家軟骨細胞移植(MACI)のいずれか1つと併せて行われる、請求項46に記載の方法。
- 前記ポリペプチドを投与するステップは、1つまたは複数の追加の軟骨形成因子と併せて、またはそれに加えて行われる、請求項41〜46のいずれか一項に記載の方法。
- 前記ポリペプチドを投与するステップは、マトリックスもしくは生体適合性の足場とともに、またはそれに加えられる、請求項41〜46のいずれか一項に記載の方法。
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JP2022501406A (ja) * | 2018-10-03 | 2022-01-06 | ノバルティス アーゲー | アンジオポエチン様3ポリペプチドの持続送達 |
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JP2019535707A (ja) * | 2016-11-14 | 2019-12-12 | ノバルティス アーゲー | 軟骨損傷および関節炎の処置のための方法および組成物 |
JP2022501406A (ja) * | 2018-10-03 | 2022-01-06 | ノバルティス アーゲー | アンジオポエチン様3ポリペプチドの持続送達 |
JP7336513B2 (ja) | 2018-10-03 | 2023-08-31 | ノバルティス アーゲー | アンジオポエチン様3ポリペプチドの持続送達 |
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