JP2019508451A - 線維症又は線維症関連疾患を治療及び診断するための手段及び方法 - Google Patents
線維症又は線維症関連疾患を治療及び診断するための手段及び方法 Download PDFInfo
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- QORWJWZARLRLPR-UHFFFAOYSA-H tricalcium bis(phosphate) Chemical compound [Ca+2].[Ca+2].[Ca+2].[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O QORWJWZARLRLPR-UHFFFAOYSA-H 0.000 description 1
- LENZDBCJOHFCAS-UHFFFAOYSA-N tris Chemical compound OCC(N)(CO)CO LENZDBCJOHFCAS-UHFFFAOYSA-N 0.000 description 1
- 208000029729 tumor suppressor gene on chromosome 11 Diseases 0.000 description 1
- 238000002604 ultrasonography Methods 0.000 description 1
- 241001529453 unidentified herpesvirus Species 0.000 description 1
- 241001430294 unidentified retrovirus Species 0.000 description 1
- 230000003827 upregulation Effects 0.000 description 1
- 239000002525 vasculotropin inhibitor Substances 0.000 description 1
- 239000013603 viral vector Substances 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
- 230000004584 weight gain Effects 0.000 description 1
- 235000019786 weight gain Nutrition 0.000 description 1
- 239000000080 wetting agent Substances 0.000 description 1
- QYEFBJRXKKSABU-UHFFFAOYSA-N xylazine hydrochloride Chemical compound Cl.CC1=CC=CC(C)=C1NC1=NCCCS1 QYEFBJRXKKSABU-UHFFFAOYSA-N 0.000 description 1
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Abstract
【選択図】なし
Description
配列は以下を示す。
配列番号1:マウスコラーゲン18
配列番号2:ヒトコラーゲン18
配列番号3:マウスコラーゲン18のNC-1ドメイン
配列番号4:ヒトコラーゲン18のNC-1ドメイン
配列番号5:マウスFcドメイン
配列番号6:ヒトFcドメイン
配列番号7:マウススーパースタチン
配列番号8:マウスフィブロネクチンモチーフ
配列番号9:マウスN末端亜鉛結合ドメインエンドスタチン
配列番号10:ヒトN末端亜鉛結合ドメインエンドスタチン
配列番号11:マウスRGDモチーフ
配列番号12:ヒトRGDモチーフ
配列番号13:ヒトスーパースタチン
配列番号14:1位及び3位においてHisがAlaによって置き換えられたヒトスーパースタチン
配列番号15:7位においてGlnがCysによって置き換えられたヒトスーパースタチン
配列番号16:「RGD」モチーフが「RAD」モチーフによって置き換えられたヒトスーパースタチン
配列番号17:マウスフィブロネクチンのインテグリン結合モチーフ
配列番号18:mエンドスタチン(マウス)
配列番号19:hエンドスタチン(ヒト)
配列番号20:mP1ペプチド(マウス、N末端)
配列番号21:エンドスタチンのE4ペプチド(ヒト、C末端)
配列番号22:エンドスタチンのhP1ペプチド(ヒト、N末端)
配列番号23:エンテロキナーゼ切断部位
配列番号24:野生型ヒトIgG1のFc配列
配列番号25:Fc配列「ノブ」を含むヒトIgG1 Fc:S354C/T366W
配列番号26:Fc配列「ホール」を含むヒトIgG1 Fc Y349C/T366S/L368A/Y407V
配列番号27:NC-1-エンテロキナーゼ部位-リンカー-「ノブ」変異(S354C/T366W)を有するヒトIgG1のFc
配列番号28:「ホール」変異Y349C/T366S/L368A/Y407Vを有するヒトIgG1のFc
配列番号29:「ノブ」変異(S354C/T366W)を有するヒトIgG1のFc-リンカー-エンテロキナーゼ部位-NC-1
配列番号30:「ホール」変異Y349C/T366S/L368A/Y407Vを有するヒトIgG1のFc
図1:コラーゲンXVIII及びFc-エンドスタチンのトポロジー、並びに、異なる組織におけるエンドスタチン分子の生理学的サイズ。(A)コラーゲンXVIIIの構造は、シグナルペプチド、frizzledドメイン、三重らせんリピート、NC1ドメインからなる。ESモチーフは、NC1との関係において生理学的に三量体化している。(B)IgG Fcドメインに対する2つのESドメインの合成の概略図。(C、D)エンドスタチンの内容物が、イムノブロットによってマウスの脳、骨格筋、心臓、腎臓、精巣及び肝臓の組織の抽出物中並びに血清中に見出された。画像は、Kuo, C.J.、ら、Oligomerization-dependent regulation of motility and morphogenesis by the collagen XVIII NC1/endostatin domain. J Cell Biol、2001. 152(6): p.1233-46.; Sasaki, T.ら、Structure, function and tissue forms of the C-terminal globular domain of collagen XVIII containing the angiogenesis inhibitor endostatin. EMBO J、1998. 17(15): p.4249-56から転載された。
Fc-エンドスタチン(Fc-Endo)は、ヒトIgGのFc領域に対するエンドスタチンの融合タンパク質である。それは、エンドスタチンと比べて有意に改善された薬物動態及び生物学的効率を示す[Lee, T.Y.ら、Linking antibody Fc domain to endostatin significantly improves endostatin half-life and efficacy. Clin Cancer Res、2008. 14(5): p.1487-93]。更に、Fc-エンドスタチンにおける、2つのエンドスタチン単量体分子のIgG Fcドメインに対する融合は、分子の合成的二量体化をもたらす(図1B)。興味深いことに、エンドスタチンのオリゴマー化は、これまでに分子に追加の特性を与えることが示されていた[Sudhakar, A.ら、Human tumstatin and human endostatin exhibit distinct antiangiogenic activities mediated by alpha v beta 3 and alpha 5 beta 1 integrins. Proc Natl Acad Sci U S A、2003. 100(8): p.4766-71]。注目すべきは、コラーゲン18(NC-1)の天然の非コラーゲン領域は、それぞれプロテアーゼ感受性のヒンジ領域及び三量体化領域上に連結した3つのエンドスタチン単量体からなる(図1A)。したがって、単量体エンドスタチンは、元の三量体分子の最終的なタンパク質分解断片と考えることができる。実際、単量体エンドスタチンより大きい断片は、異なる組織及び血清中に生理学的に見出された(図1C)。同じ文脈において、本発明者は、オリゴマー化はFc-エンドスタチン及びNC-1のフィブロネクチン(FN)への結合の前提であるが、一方でエンドスタチン単量体はFNに結合しないことを示した(WO2013/026913)。FNは線維症の病因において重要な役割を果たすと認識されており、広範囲の下流の及び関連する線維症促進性シグナル伝達カスケードを導く。例えば、FNは、線維化促進に関連するインテグリンアルファ5(ITGA5B)及びαVβ3に結合すると報告されている[Torres, P.H.、G.L. Sousa、及びP.G. Pascutti、Structural analysis of the N-terminal fragment of the antiangiogenic protein endostatin: a molecular dynamics study. Proteins、2011. 79(9): p.2684-92]。したがって、例えばFc-エンドスタチンを介するエンドスタチンのオリゴマー化は、その多面的な機能に影響を及ぼす可能性がある。
マウスを、照射の3日前から試験の終了まで、5日ごとに100μg/マウスの用量で皮下送達するmFc-エンドスタチン(Bergersら、Science 284(5415)、p.808-812、1999に記載されるような、マウス免疫グロブリンのγ-2a鎖のFc断片に融合した配列番号18に記載されるマウスエンドスタチン)で処理した。並行して、エンドスタチンペプチド群に、照射に加えてmP1エンドスタチン(N末端、配列番号20)又はE4(若しくはCE4)ペプチド(C末端、配列番号21、Yamaguchi, Y.ら、A peptide derived from endostatin ameliorates organ fibrosis. Sci Transl Med、2012. 4(136): p.136ra71を参照)のいずれかを、100μg/マウス/b.i.の用量で皮下投与した。対照群をPBS、mFc-エンドスタチン、mP1エンドスタチン又はE4ペプチド単独で処理し、照射を全く受けなかった。
全胸部照射は、以前に記載されているものに修正を加えて実施した(Abdollahi、J. Exp.Med. 2005、http://www.ncbi.nlm.nih.gov/pubmed/15781583)。
照射前(IR前)及び照射後(IR後)4週間ごとに、定量的CT撮影のための臨床PET/CTスキャナー(Biograph mCT、Siemens)を適用した。CT撮影は、イソフルラン(isoflurace)麻酔(2%イソフルラン、2リットル/分の酸素)下で行った。CT部分の標準プロトコールは以下の通りであった:80kV、80mA、0.6mmのピッチ、0.6mmのスライス厚、及び取得時間32秒。画像は、フィルタカーネルH50s(Siemens)を用いて138×138mm2の体軸横断の視野に512×512マトリックスとして再構成し、ここで3匹の動物を1回のスキャンに含めた。X線曝露は、視野全体で約4mGy/スキャンであり、およそ1mGy/動物未満であった。
式中、
Fc-エンドスタチン及びmP1エンドスタチンは、肺線維症を阻害し、生存期間を延長した
光子20Gy全胸部照射(実施例3を参照)と組み合わせてFc-エンドスタチン(Fc-Endo)、N末端エンドスタチンペプチド(mP1)、又はC末端エンドスタチンE4ペプチド(CE4)(図2を参照)によってマウスを処理した。マイクロCT撮影は、20Gy照射組織における拡散したすりガラス状陰影及び構造的歪みを明らかにし、塊状の間質性線維症の発生を示した。重度の線維性肺実質もまた、CE4と組み合わせた照射群において見られた。対照的に、顕著に減少した線維症がFc-Endo及びmP1処理群で観察された(図3)。
肺線維症に付随する症状として、肺機能の低下を全ての群において調査した(図4A、B)。IR単独群は、対照群と比べて有意に高いpCO2及び低いpHを有し(それぞれP<0.05、P<0.001)、呼吸の重篤な障害に起因する慢性の呼吸性アシドーシスを示している。対照的に、これらの測定は、Fc-Endo-又はmP1+X処理群と対照群との間で有意に異ならず(それぞれP>0.05、P>0.05)、これらの群における好ましい呼吸機能を明らかにした。
異常なECMのリモデリングは、肺線維症の特徴である。本発明者は、テネイシンC、コラーゲンI及びIII、エラスチン、フィブリリン、α-アクチン並びにMMPを含む様々な重要なECMタンパク質が、Fc-Endo+Xによって転写レベルで抑制又は「スイッチオフ」されることを見出した(図5A)。このことに呼応して、免疫組織化学結果は、20Gy照射肺に対してFc-エンドスタチン+Xにおいて、M2マクロファージ流入の低減を示唆した(図5B)。
Fc-エンドスタチンは炭素イオンにより誘発される肺線維症を阻害した
光子誘発肺線維症を阻害する点において、Fc-エンドスタチンが他のエンドスタチンペプチド断片よりも有効であったことを考慮して、本発明者は、高LET炭素照射に誘発される線維症を調節するFc-エンドスタチンの有効性を次に検討した。
Fc-エンドスタチン処理を受けたマウスは、炭素照射肺における線維症促進性M2マクロファージ(CD206及びCLL22陽性)の明らかな低減を有した(図7A)。光子照射肺におけるエンドスタチン効果に伴って、FGF2誘導及びCD31タンパク質レベルの消失の逆転が、炭素照射単独に対してFc-Endo+C12.5の後に見出された(図7B)。更に、Fc-エンドスタチン処理は、炭素照射肺における上昇した抗線維性HGFタンパク質レベルをもたらした(P<0.05)(図7C)。
本発明者は、Fc-エンドスタチン(Fc-Endo)及びN末端エンドスタチン(mP1エンドスタチン)ペプチドが、光子又は炭素イオン照射により誘発される肺線維症の有効な阻害剤であることを見出した。生存、放射線学的、生理学的、組織学的検査、M2マクロファージ極性化及びTh2バイアス免疫、ECM組成、細胞型交替などの点で、Fc-エンドスタチンはmP1よりも優れていた。これは、この化合物の抗癌活性について報告されているように、より長い半減期(曝露)を有するFc-エンドスタチンの改善された薬物動態の結果であり得る[Lee, T.Y.ら、Linking Antibody Fc Domain to Endostatin Significantly Improves Endostatin Half-life and Efficacy. Clinical Cancer Research、2008. 14(5): p.1487-1493]。代替的に、異なる作用機序が、Fc-エンドスタチンの抗線維症効果を制御し得る。エンドスタチンが生理学的に三量体であるコラーゲン18非コラーゲンドメイン1(NC-1)のタンパク質分解断片であることを考慮すると、Fcコンジュゲーションを介するエンドスタチンの二量体化は、この内在性タンパク質のより生理学的な相関物を表し得る。興味深いことに、エンドスタチンの血漿レベルは、肺線維症を有する患者において増強していることが見出された。本発明者は、合成二量体としてのFc-エンドスタチンがフィブロネクチン(FN)に結合することができるが、エンドスタチン単量体は結合しないことを以前に示している(WO2013026913を参照)。FNは線維症進行の開始及び摂動に中心的役割を果たすと考えられている[To, W.S.及びK.S. Midwood、Plasma and cellular fibronectin: distinct and independent functions during tissue repair. Fibrogenesis Tissue Repair、2011. 4: p.21]。したがって、FNに対するFc-エンドスタチンの結合が、広範囲の下流の抗線維症シグナル伝達カスケードをもたらすことを推測することが魅力的である。
エンドスタチンの抗線維症効果が、Yamaguchiら、2012、前掲によって提案されるようにそのC末端断片に限定されることが、おそらくないという可能性があることを、本発明者は以前に示した。E4ペプチド含有領域であるエンドスタチンC末端を詳しく調べると、分子の仮定された抗線維症効果について機序の説明を提供し得る、この断片と潜在的なタンパク質相互作用パートナーとを結びつける明白な構造的特徴は示されない。E4活性の欠如に関する別の説明は、それらの急性マウス線維症モデルとは対照的に、本発明者は、線維症の発生が遅く(照射後24週を超える)、かつヒトにおける病態生理学により近く類似している慢性の動態に従う放射線誘発肺線維症モデルを使用したことであり得る。
- Corning、96ウェルEIA/RIA高結合、ポリスチレン、平底、透明、非滅菌#3590
- BSA(Sigma Aldrich #A7030 IgGフリー)
- 組換えhMMP-2 (R&D #902-MP-010) PBS中、>1μg/ml
- 組換えhMMP-9 (R&D #911-MP-010) PBS中、>1μg/ml
- R7012 a.p.(抗エンドスタチン抗体)
- ABTS(Rockland #ABTS-100)
- ペルオキシダーゼコンジュゲートAffini Pureヤギ抗ウサギIgG(H+L)(Jackson Immuno Research#111-035-003 2.0ml)
- hFN(R&D #1918FN-02M)
- 組換えヒトVEGF165 (R&D Systems a biotechne brand #293-VE-010/CF)
プロテインゲル:
- Page Ruler Plus Prestained Protein Ladder (Thermo Scientific #26619)
- SDS page 4-20%:
Mini- Protean TGX Precast Protein Gels (BioRad #4561094)
- エンテロキナーゼ、軽鎖、ブタ(GenScript #Z01003)
Claims (18)
- 線維症若しくは線維症関連疾患、血管内皮増殖因子(VEGF)関連疾患、又はマトリックスメタロプロテイナーゼ(MMP)関連疾患の治療、緩和又は予防における使用のための、(i)コラーゲン18の少なくとも2つのNC-1単量体、又は(ii)コラーゲン18の少なくとも2つのエンドスタチンドメイン、又は(iii)コラーゲン18エンドスタチンドメインの少なくとも2つのN末端ペプチド、を含むタンパク質オリゴマー。
- 前記タンパク質オリゴマーがフィブロネクチン、VEGF、MMP-2、及び/又はMMP-9に結合する、請求項1に記載の使用のためのタンパク質オリゴマー。
- ヒトコラーゲン18のNC-1単量体が、オリゴマー化ドメイン、ヒンジ領域、及び/又はエンドスタチンドメイン若しくは前記エンドスタチンドメインの断片、並びに場合により、ヒンジ領域内の組換えプロテアーゼ切断部位を含む、請求項1又は2に記載の使用のためのタンパク質オリゴマー。
- コラーゲン18のエンドスタチンドメインが配列番号18若しくは配列番号19のアミノ酸配列から選択されるか、又はコラーゲン18エンドスタチンドメインのN末端ペプチドが配列番号18若しくは配列番号19のアミノ酸残基1〜132由来のアミノ酸配列から選択される、請求項1又は2に記載の使用のためのタンパク質オリゴマー。
- コラーゲン18のNC-1単量体、コラーゲン18のエンドスタチンドメイン、又はコラーゲン18エンドスタチンドメインのN末端ペプチドにおいて、フィブロネクチンのPHSRNモチーフ及び/又はRGDモチーフを更に含む、請求項1〜4のいずれか1項に記載の使用のためのタンパク質オリゴマー。
- ヒトコラーゲン18のNC-1単量体、コラーゲン18のエンドスタチンドメイン、又はコラーゲン18エンドスタチンドメインのN末端ペプチドが、天然又は異種のオリゴマー化ドメインを含む、請求項1〜5のいずれか1項に記載の使用のためのタンパク質オリゴマー。
- 天然のオリゴマー化ドメインが、コラーゲン18の非三重らせん三量体化ドメインである、請求項6に記載の使用のためのタンパク質オリゴマー。
- 異種のオリゴマー化ドメインが、Fcドメイン、人工オリゴマー化ドメイン、又はFcドメインと人工オリゴマー化ドメインの両方からなる群から選択されるオリゴマー化ドメインである、請求項6に記載の使用のためのタンパク質オリゴマー。
- Fcドメインが、IgG由来であり、好ましくはヒトIgG1又はノブイントゥーホール(KiH)操作ヒトIgG1由来である、請求項8に記載の使用のためのタンパク質オリゴマー。
- 人工オリゴマー化ドメインが、グルタミンがシステインによって置き換えられる単一の変異をコラーゲン18のエンドスタチンドメインの7位に含む、請求項8に記載の使用のためのタンパク質オリゴマー。
- アンジオスタチン、トロンボスポンジン、抗PD-1/PD-L1抗体、又は、線維症若しくは線維症関連疾患、VEGF関連疾患又はMMP関連疾患に利用される別の療法を更に含む、請求項1〜10のいずれか1項に記載の使用のためのタンパク質オリゴマー。
- 線維症又は線維症関連疾患が、皮膚の線維症、好ましくは強皮症;ケロイド又はケロイド瘢痕;肥厚性瘢痕;限局性強皮症;移植片対宿主病の結果としての線維症;上皮下線維症;心内膜心筋線維症;子宮線維症;骨髄線維症;後腹膜線維症;腎性全身性線維症;手術後の瘢痕;喘息;肝硬変/肝線維症;異常な創傷治癒の結果としての線維症;糸球体腎炎;多巣性線維硬化症(multifocal fibrosclerosis);放射線誘発線維症、好ましくは放射線誘発肺炎又は放射線誘発肺線維症;化学療法誘発又は薬物誘発線維症、例えば、mTOR又はEGFRキナーゼ阻害の結果として;通常又は特発性肺線維症;自己免疫疾患の結果としての線維症、例えば、ループス、腫瘍内及び癌関連の線維症/線維形成、臓器線維症が続く慢性炎症、例えばウイルス刺激又は移植を介する;慢性腎疾患、長期透析又は糖尿病の最終段階としての臓器線維症からなる群から選択される、請求項1〜11のいずれか1項に記載の使用のためのタンパク質オリゴマー。
- 血管内皮増殖因子(VEGF)関連疾患が、VEGFレベルの脱調節に依存する良性の病態生理学的状態、例えば湿性黄斑変性症、子宮内膜症、気管支喘息及び糖尿病、増強されたVEGF誘導性血管透過性(例えば、脳組織の照射後の増強された透過性、「放射線壊死」)、血管緊張の変化(例えば、高血圧)、関節リウマチなど、並びに悪性VEGF依存性疾患、例えば腎細胞癌及び他のVEGF依存的腫瘍、腹水のVEGF依存性発生、免疫系のVEGF依存性抑制、例えば骨髄(bone marrow)由来細胞(BMDC)、骨髄(myeloid)由来サプレッサー細胞(MdSC)、又は未成熟樹状細胞の動員及び微小環境教育などである、請求項1〜11のいずれか1項に記載の使用のためのタンパク質オリゴマー。
- マトリックスメタロプロテイナーゼ(MMP)関連疾患が、MMP活性化が病態生理に寄与する良性及び悪性の疾患、例えば、神経膠芽細胞腫、膵臓癌、肺癌のような高い局所治療失敗率を有する腫瘍において固有に顕在化する局所腫瘍浸潤及び癌転移のプロセスの間のMMPの活性化、並びに、治療に誘導される選択圧に関連して獲得されたMMP活性化の増強(例えば、放射線療法後の腫瘍低酸素及び線維症)、自己免疫疾患及び慢性炎症性疾患における顕著な免疫反応である、請求項1〜11のいずれか1項に記載の使用のためのタンパク質オリゴマー。
- タンパク質オリゴマーが0.1〜1mg/kg/日の濃度で投与される、請求項1〜14のいずれか1項に記載の使用のためのタンパク質オリゴマー。
- タンパク質オリゴマーが静脈内、頭蓋内/髄腔内、硝子体内、皮下、又は腹腔内に投与される、請求項1〜15のいずれか1項に記載の使用のためのタンパク質オリゴマー。
- タンパク質オリゴマーが、抗線維症活性、抗血管新生活性、抗浸潤/抗転移活性、血管透過性低減活性、抗炎症及び抗腫瘍化活性からなる群から選択される1つ以上の生物活性を有する、請求項1〜16のいずれか1項に記載の使用のためのタンパク質オリゴマー。
- 線維症若しくは線維症関連疾患、血管内皮増殖因子(VEGF)関連疾患、又はマトリックスメタロプロテイナーゼ(MMP)関連疾患の検出及び/又は診断のための診断用組成物としての使用のための、(i)コラーゲン18の少なくとも2つのNC-1単量体、(ii)コラーゲン18の少なくとも2つのエンドスタチンドメイン、又は(iii)コラーゲン18エンドスタチンドメインの少なくとも2つのN末端ペプチド、を含むタンパク質オリゴマー。
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