JP7393565B2 - 肺送達のためのアデノ随伴バリアント、製剤および方法 - Google Patents
肺送達のためのアデノ随伴バリアント、製剤および方法 Download PDFInfo
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Description
本出願は、その開示全体が参照により本明細書に組み込まれる、2020年4月27日出願の米国仮特許出願第63/016,246号、および2020年10月6日出願の米国仮特許出願第63/088,432号の優先権を主張するものである。
2021年4月26日またはその前後に作成され、ファイルサイズが約186KBである、「090400-5013-WO-Sequence-Listing」という表題のコンピュータ可読テキストファイルは、本出願の配列表を含有し、その全体が参照により本明細書に組み込まれる。
アデノ随伴ウイルス(AAV)に基づく遺伝子送達ベクターは、いくつかの疾患標的に対する前臨床的疾患モデルおよび最近ではヒト臨床試験の両方において有望性が実証されている。野生型AAVは非病原性であり、また、いかなる公知の疾患との病因学的関連性も有さないので、AAVに基づくベクターは非常に安全である。さらに、AAVにより、肝臓、筋肉、肺、網膜、および脳を含めた多数の組織での高度に効率的な遺伝子送達および持続的な導入遺伝子発現の能力がもたらされる。
一部の実施形態では、(i)配列番号12のカプシドタンパク質を含むカプシドと、(ii)5’から3’に、(a)AAV2末端反復、(b)プロモーター、(c)ヒト嚢胞性線維症膜コンダクタンス調節因子(CFTR)タンパク質またはヒトCFTRタンパク質配列のアミノ酸708~759を欠く生物活性のある短縮型CFTRタンパク質をコードするヌクレオチド配列、(d)ポリアデニル化配列および(e)AAV2末端反復を含む核酸とを含む組換えアデノ随伴ウイルス(rAAV)ベクターが本明細書で提供される。
を含む。
本発明の実施形態において、例えば以下の項目が提供される。
(項目1)
(i)配列番号12のカプシドタンパク質を含むカプシドと、(ii)5’から3’に、(a)AAV2末端反復、(b)プロモーター、(c)ヒト嚢胞性線維症膜コンダクタンス調節因子(CFTR)タンパク質または前記ヒトCFTRタンパク質配列のアミノ酸708~759を欠く生物活性のある短縮型CFTRタンパク質をコードするヌクレオチド配列、(d)ポリアデニル化配列および(e)AAV2末端反復を含む核酸とを含む組換えアデノ随伴ウイルス(rAAV)ベクター。
(項目2)
ヒトCFTRをコードする前記ヌクレオチド配列が、配列番号43のヌクレオチド配列またはそれと少なくとも80%、少なくとも85%、少なくとも90%、少なくとも95%、少なくとも97%、少なくとも98%もしくは少なくとも99%同一の配列を有する、項目1に記載のrAAVウイルス。
(項目3)
前記プロモーターが、構成的プロモーター、必要に応じてCMV即時型/初期エンハンサー/プロモーターの短縮バージョンである、項目1または2に記載のrAAVウイルス。
(項目4)
前記プロモーターが、組織特異的プロモーターであり、好ましくは、前記プロモーターが、前記核酸の肺細胞における優先的発現を指示する、項目1または2に記載のrAAVウイルス。
(項目5)
前記プロモーターが、CMV173プロモーターであり、ヒトCFTRをコードする前記ヌクレオチド配列に作動可能に連結している、項目1または2に記載のrAAVウイルス。
(項目6)
前記CMV173プロモーターが、配列番号44の配列を有する、項目5に記載のrAAVウイルス。
(項目7)
前記核酸が、配列番号45のヌクレオチド配列を含む、項目1に記載のrAAVウイルス。
(項目8)
それを必要とする対象において嚢胞性線維症またはそれに関連する肺疾患を処置するための方法であって、前記対象に、項目1から7のいずれか一項に記載の、治療有効量の感染性rAAVを投与するステップを含み、好ましくは、前記対象に、上気道炎症、異常な上皮サイトカインシグナル伝達およびIgEレベルの上昇から必要に応じて選択される嚢胞性線維症の1つまたは複数の特徴を好転させるために効果的な量の前記rAAVを投与する、方法。
(項目9)
前記rAAVが、前記対象に、肺(気管支)および/または経鼻投与によって、好ましくは吸入によって投与され、好ましくは単回用量で投与される、項目8に記載の方法。
(項目10)
前記rAAVが、前記対象に、1×10 13 ~5×10 15 ベクターゲノム(vg)の間、より好ましくは1×10 14 ~1×10 15 vgの間の1つまたは複数の用量で投与される、項目8または9に記載の方法。
(項目11)
嚢胞性線維症またはそれに関連する肺疾患の処置における使用のための、項目1から7のいずれか一項に記載のrAAV。
(項目12)
嚢胞性線維症またはそれに関連する肺疾患の処置のための医薬の製造における使用のための、項目1から7のいずれか一項に記載のrAAV。
(項目13)
項目1から7のいずれか一項に記載のrAAV、ならびに、約10mM~約50mMのクエン酸塩、約70mM~約150mMのNaClおよび必要に応じて界面活性物質、好ましくは非イオン界面活性物質、例えばPluronic F-68、より好ましくは約0.005%Pluronic F68を含む緩衝液であって、pHが約6.0である緩衝液を含む、吸入に適した医薬組成物。
(項目14)
約20mM~約50mMのクエン酸塩、約85mM~約125mMのNaClおよび約0.005%Pluronic F68を含み、pHが約6.0である、項目13に記載の医薬組成物。
(項目15)
約20mMのクエン酸塩、約125mMのNaClおよび約0.005%Pluronic F68を含み、pHが約6.0である、項目14に記載の医薬組成物。
(項目16)
1ml当たり10 11 ~10 14 ベクターゲノム(vg)を含む、項目13から15のいずれか一項に記載の医薬組成物。
(項目17)
約1×10 13 ~約9×10 13 vg/ml、好ましくは約2×10 13 ~6×10 13 vg/ml、より好ましくは約2×10 13 vg/mlを含む、項目16に記載の医薬組成物。
(項目18)
エアロゾル化送達に適した液剤/懸濁剤の形態であるか、またはエアロゾル剤として製剤化されたものであるか、および/または吸入用剤形である、項目13から17のいずれか一項に記載の医薬組成物。
(項目19)
それを必要とする対象において嚢胞性線維症またはそれに関連する肺疾患を処置するための方法であって、前記対象に、項目13から18のいずれか一項に記載の医薬組成物を投与するステップを含む、方法。
(項目20)
異種核酸を肺細胞に送達する方法であって、前記肺細胞を、(i)配列番号12のカプシドタンパク質を含むカプシドと、(ii)遺伝子産物をコードするヌクレオチド配列を含む異種核酸とを含むrAAVビリオンと接触させるステップを含み、それによって、前記遺伝子産物を前記肺細胞において発現させる、方法。
(項目21)
前記異種核酸が、ヒト嚢胞性線維症膜コンダクタンス調節因子(CFTR)タンパク質または前記ヒトCFTRタンパク質配列のアミノ酸708~759を欠く生物活性のある短縮型CFTRタンパク質をコードするヌクレオチド配列を含む、項目20に記載の方法。
(項目22)
前記異種核酸が、配列番号45の配列またはそれと少なくとも80%、少なくとも85%、少なくとも90%、少なくとも95%、少なくとも97%、少なくとも98%もしくは少なくとも99%同一の配列を含む、項目21に記載の方法。
(項目23)
前記肺細胞が、気道上皮細胞である、項目20から22のいずれか一項に記載の方法。
(項目24)
前記上皮細胞が、肺胞上皮細胞、気管支(一次、二次または三次)上皮細胞または気管上皮細胞である、項目23に記載の方法。
(項目25)
前記肺細胞が、肺胞上皮1型(AECI)または2型(AECII)細胞である、項目24に記載の方法。
(項目26)
前記肺細胞が、平滑筋細胞または内皮細胞である、項目20から22のいずれか一項に記載の方法。
(項目27)
肺疾患を処置するための方法であって、それを必要とする対象に、(i)配列番号12として記載されているアミノ酸配列を含むカプシドタンパク質を含むカプシドと、(ii)1種もしくは複数のプロモーターに作動可能に連結した1種もしくは複数の遺伝子産物をコードするヌクレオチド配列を含む異種核酸とを含む、治療有効量の組換えAAV(rAAV)を投与するステップ、または、前記対象に、前記rAAVを含む医薬組成物を投与するステップを含む、方法。
(項目28)
前記肺疾患が、慢性閉塞性肺疾患(COPD)、特発性肺線維症(IPF)、肺動脈性肺高血圧症、肺高血圧症、肺がん(原発性、続発性および転移性)、サーファクタント欠乏症、ウイルスおよび/または細菌感染症、嚢胞性線維症、急性気管支炎、肺炎(ウイルス性、細菌性、および真菌性肺炎を含む)、気道感染症(咽頭炎、クループ、アスペルギルス、コクシジオイデス症、ハンタウイルス肺症候群、およびヒストプラスマ症を含む)、化学性および過敏性肺炎、結核および他のマイコバクテリア感染症(これだけに限定されないが、mycobacterium aviumを含む)、サルコイドーシス、呼吸器合胞体ウイルス、肺水腫、急性呼吸窮迫症候群(ARDS)、塵肺症(炭塵肺、石綿肺、および珪肺症を含む)、間質性肺疾患(サルコイドーシスおよび自己免疫疾患を含む)、肺塞栓症、胸水、胸膜炎、中皮腫、気胸、急性気管支炎、細気管支炎(閉塞性細気管支炎を含む)、乳児突然死症候群、睡眠時無呼吸、気管支拡張症、気管支肺異形成症、特発性器質化肺炎、電子たばこまたはベイピングの使用に関連する肺損傷(EVALI)、中東呼吸器症候群(MERS)、原発性線毛機能不全症、重症急性呼吸器症候群(SARS)、アルファ-1-抗トリプシン欠損症、喘息、間質性肺疾患、ならびにCOVID-19(2019年新型コロナウイルス感染症)から選択される、項目27に記載の方法。
(項目29)
前記肺疾患が、慢性閉塞性肺疾患(COPD)または特発性肺線維症(IPF)である、項目28に記載の方法。
(項目30)
前記肺疾患が、COPDであり、前記rAAVが、必要に応じて、アルファ-1-抗トリプシン、アルファ-1-抗キモトリプシン、アルファ-1-マクログロブリン、マトリックスメタロプロテイナーゼ1(MMP1)、マトリックスメタロプロテイナーゼ12(MMP12)、ミクロソームエポキシドヒドロリアーゼ、CYP1A1、グルタチオンS-トランスフェラーゼ、ヘムオキシゲナーゼ-1、TGF-ベータ-1、TNF-アルファ、IL-1複合体、IL-8、IL-13、ヒト白血球抗原(HLA-B7およびBw16)、ビタミンD結合タンパク質、およびベータ-2-アドレナリン作動性受容体から選択される1種または複数の遺伝子を標的とする遺伝子産物をコードする異種核酸を含む、項目29に記載の方法。
(項目31)
前記肺疾患が、IPFであり、前記rAAVが、必要に応じて、SFTPA1(サーファクタントA1)およびカベオリン-1から選択される1種または複数の遺伝子を標的とする遺伝子産物をコードする異種核酸を含む、項目29に記載の方法。
(項目32)
前記肺疾患が、アルファ-1-抗トリプシン欠損症であり、前記rAAVが、機能的なアルファ-1-抗トリプシンをコードする異種核酸を含む、項目28に記載の方法。
(項目33)
前記rAAVまたは医薬組成物が、肺、気管支内、鼻腔内、気管内、および/または気管支内投与によって投与される、項目27から32のいずれか一項に記載の方法。
(項目34)
前記rAAVの約10 12 ~10 15 ベクターゲノム(vg)の少なくとも1つの用量が、前記対象に投与される、項目27から33のいずれか一項に記載の方法。
(項目35)
前記対象が、約1×10 13 ~約5×10 15 vg、好ましくは約1×10 14 vg~約1×10 15 vgを投与される、項目34に記載の方法。
(項目36)
アミノ酸708~759を欠き、ヒトにおける発現のためにコドン最適化されている、生物活性のあるヒトCFTRタンパク質をコードする核酸であって、配列番号43として記載されているヌクレオチド配列またはそれと少なくとも80%、少なくとも85%、少なくとも90%、少なくとも95%、少なくとも97%、少なくとも98%もしくは少なくとも99%同一の配列を含む、核酸。
(項目37)
配列番号43として記載されているヌクレオチド配列を含むまたはそれからなる、項目36に記載の核酸。
(項目38)
項目36または37に記載の核酸、および前記核酸配列に作動可能に連結しており、前記核酸配列に対して異種である発現制御配列を含む、発現カセット。
(項目39)
前記発現制御配列が、配列番号44として記載されているヌクレオチド配列を有するCMV173プロモーターを含む、項目38に記載の発現カセット。
(項目40)
5’から3’に、(a)AAV2末端反復、(b)CMV173プロモーター、(c)コドン最適化された配列番号43の遺伝子、(d)AAV2末端反復を含む、項目38または39に記載の発現カセット。
(項目41)
(c)と(d)の間にSV40ポリアデニル化配列をさらに含む、項目40に記載の発現カセット。
定義
各試料についての中和抗体(NAb)力価は感染力を血清の非存在下で測定された値の37%まで低下させるために必要な血清の体積分率の逆数として報告される。次いで、等体積量の3種の個々の血清試料を混合することによって3種の血清プール(α=A+F+G、β=B+H+M、およびγ=I+J+N)を生成した。
(実施例2)
霊長類の肺に対する遺伝子治療における使用に適したカプシドバリアントの同定
(実施例3)
配列番号12のバリアントカプシドタンパク質を有するカプシドおよびレポーター導入遺伝子(EGFP)をコードする核酸を含むrAAVは、カニクイザルへのレポーター遺伝子のエアロゾル送達により特徴付けられた。血清をプレスクリーニングして、試験物品カプシドに対する既存の中和抗体に対してセロネガティブである動物を同定した。動物(n=3)は、臨床的に関連する作動ネブライザーであるAeroEclipseIIデバイスを使用して送達された、rAAVの実行可能な最大用量を受けた。
(実施例4)
(実施例5)
(実施例6)
ヒト細胞における4D-710のin vitroおよびex vivo特徴付け
(実施例7)
カニクイザルの肺への4D-710のエアロゾル送達についての用量範囲およびパイロット安全性研究
Claims (28)
- 組換えアデノ随伴ウイルス(rAAV)ベクターを含む、対象における肺細胞への異種核酸の送達における使用のための組成物であって、前記rAAVベクターが、(i)配列番号12に示されるアミノ酸配列、または配列番号12と少なくとも90%同一であって、かつ配列番号12のアミノ酸番号に基づいてアミノ酸469におけるThrおよびアミノ酸598におけるAlaを含むアミノ酸配列を含むカプシドタンパク質を含むカプシドと、(ii)遺伝子産物をコードするヌクレオチド配列を含む前記異種核酸とを含み、前記組成物は、肺、気管支内、鼻腔内、気管内、および/または気管支内投与によって前記対象に投与され、前記カプシドタンパク質が抗AAV抗体による中和に対して耐性であることを特徴とする、組成物。
- 前記肺細胞が、気道上皮細胞、平滑筋細胞、および内皮細胞から選択される、請求項1に記載の使用のための組成物。
- 前記気道上皮細胞が、基底細胞、杯細胞または線毛気道上皮細胞である、請求項2に記載の使用のための組成物。
- 前記気道上皮細胞が、肺胞上皮1型(AECI)、肺胞上皮2型(AECII)細胞、気管支上皮細胞または気管上皮細胞である、請求項3に記載の使用のための組成物。
- 前記組成物が、エアロゾル剤として製剤化されている、請求項1から4のいずれか一項に記載の使用のための組成物。
- 前記組成物が、ネブライザーにより投与されることを特徴とする、請求項1から5のいずれか一項に記載の使用のための組成物。
- 前記組成物が、1ml当たり前記rAAVの1011~1014ベクターゲノム(vg)を含む、請求項1から6のいずれか一項に記載の使用のための組成物。
- 前記遺伝子産物をコードする前記ヌクレオチド配列が、プロモーターに作動可能に連結している、請求項1から7のいずれか一項に記載の使用のための組成物。
- 前記プロモーターが、構成的プロモーターである、請求項8に記載の使用のための組成物。
- 前記プロモーターが、組織特異的プロモーターを含む、請求項8に記載の使用のための組成物。
- 前記異種核酸が、配列番号43に示されるヌクレオチド配列、またはそれと少なくとも90%同一の配列を含み、前記ヌクレオチド配列が、ヒト嚢胞性線維症膜コンダクタンス調節因子(CFTR)タンパク質配列のアミノ酸708~759を欠く生物活性のある短縮型CFTRタンパク質をコードする、請求項1~10のいずれか一項に記載の使用のための組成物。
- 前記異種核酸が、配列番号43と少なくとも95%同一の配列のヌクレオチド配列を含む、請求項1~11のいずれか一項に記載の使用のための組成物。
- 前記異種核酸が、配列番号43に示されるヌクレオチド配列を含む、請求項1~11のいずれか一項に記載の使用のための組成物。
- 前記カプシドタンパク質が、配列番号12と少なくとも95%同一なアミノ酸配列を含む、請求項1~13のいずれか一項に記載の使用のための組成物。
- 前記カプシドタンパク質が、配列番号12に示されるアミノ酸配列を含む、請求項1~13のいずれか一項に記載の使用のための組成物。
- 配列番号12に示されるアミノ酸配列、または配列番号12と少なくとも90%同一であり、かつ配列番号12のアミノ酸番号に基づいてアミノ酸469におけるThrおよびアミノ酸598におけるAlaを含むアミノ酸配列を含むカプシドタンパク質を含むカプシドと組み合わせて使用するための医薬組成物であって、前記カプシドタンパク質が抗AAV抗体による中和に対して耐性であり、前記医薬組成物が、配列番号43に示されるヌクレオチド配列またはそれと少なくとも90%同一の配列を含む核酸を含み、前記ヌクレオチド配列が、ヒト嚢胞性線維症膜コンダクタンス調節因子(CFTR)タンパク質配列のアミノ酸708~759を欠く生物活性のある短縮型CFTRタンパク質をコードする、医薬組成物。
- rAAVベクターを含む医薬組成物であって、前記rAAVベクターが、(i)配列番号12、または配列番号12と少なくとも90%同一であって、かつ配列番号12のアミノ酸番号に基づいてアミノ酸469におけるThrおよびアミノ酸598におけるAlaを含むアミノ酸配列のカプシドタンパク質を含み、前記カプシドタンパク質が抗AAV抗体による中和に対して耐性である、カプシドと、(ii)CFTRまたはヒトCFTRタンパク質配列のアミノ酸708~759を欠く生物活性のある短縮型CFTRタンパク質をコードするヌクレオチド配列を含む異種核酸とを含み、前記ヌクレオチド配列は、発現制御配列に作動可能に連結しており、前記CFTRタンパク質をコードするヌクレオチド配列は、配列番号43に示されるヌクレオチド配列と少なくとも90%同一である、医薬組成物。
- 前記CFTRタンパク質をコードする前記ヌクレオチド配列が、配列番号43に示されるヌクレオチド配列と少なくとも95%同一である、請求項17に記載の医薬組成物。
- 前記CFTRをコードする前記ヌクレオチド配列が、配列番号43に示されるヌクレオチド配列を含む、請求項18に記載の医薬組成物。
- 前記発現制御配列が構成的プロモーターを含み、好ましくは、前記構成的プロモーターはCMV173である、請求項17から19のいずれか一項に記載の医薬組成物。
- 前記組成物が、吸入のために製剤化されているかまたは吸入に好適である、請求項16から20のいずれか一項に記載の医薬組成物。
- クエン酸塩を含む緩衝液に製剤化されている、rAAVウイルスを含む医薬組成物であって、前記rAAVウイルスが、(i)配列番号12に示されるアミノ酸配列、または配列番号12と少なくとも90%同一のアミノ酸配列を含むカプシドタンパク質を含み、前記カプシドタンパク質が抗AAV抗体による中和に対して耐性である、カプシドと、(ii)遺伝子産物をコードするヌクレオチド配列を含む異種核酸とを含み、前記異種核酸が、配列番号43に示されるヌクレオチド配列、またはそれと少なくとも90%同一の配列を含み、前記ヌクレオチド配列が、ヒト嚢胞性線維症膜コンダクタンス調節因子(CFTR)タンパク質配列のアミノ酸708~759を欠く生物活性のある短縮型CFTRタンパク質をコードする、医薬組成物。
- 前記rAAVウイルスが、10mM~50mMのクエン酸塩、70mM~150mMのNaClおよび必要に応じて界面活性物質を含む緩衝液に製剤化されている、請求項22に記載の医薬組成物。
- 20mM~50mMのクエン酸塩、85mM~125mMのNaClおよび約0.005%Pluronic F68を含み、pHが6.0である、請求項23に記載の医薬組成物。
- 20mMのクエン酸塩、125mMのNaClおよび0.005%Pluronic F68を含み、pHが6.0である、請求項24に記載の医薬組成物。
- 前記CFTRタンパク質をコードする前記ヌクレオチド配列は、配列番号43に示されるヌクレオチド配列と同一である、請求項22から25のいずれか一項に記載の医薬組成物。
- 前記医薬組成物が、肺、気管支内、鼻腔内、気管内、および/または気管支内投与によって投与されることを特徴とする、嚢胞性線維症の処置における使用のための請求項16から26のいずれか一項に記載の医薬組成物。
- 嚢胞性線維症の処置のための医薬の製造のための請求項16から26のいずれか一項に記載の医薬組成物の使用であって、前記医薬組成物は、肺、気管支内、鼻腔内、気管内、および/または気管支内投与のためのものである、使用。
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