KR20130103486A - 당뇨병 및 대사성 장애의 치료를 위한 제약학적 복합 조성물 및 방법들 - Google Patents
당뇨병 및 대사성 장애의 치료를 위한 제약학적 복합 조성물 및 방법들 Download PDFInfo
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- KR20130103486A KR20130103486A KR1020137004330A KR20137004330A KR20130103486A KR 20130103486 A KR20130103486 A KR 20130103486A KR 1020137004330 A KR1020137004330 A KR 1020137004330A KR 20137004330 A KR20137004330 A KR 20137004330A KR 20130103486 A KR20130103486 A KR 20130103486A
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Abstract
본 출원은 당뇨병 및 기타 대사성 장애들을 앓는 환자에게 투여하기 위한 제약학적 조성물을 제공하며, 이 조성물은 a) 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태, 및 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태를 포함한다.
Description
본 발명은 당뇨병 및 기타 대사성 장애들의 질환을 치료 및 예방하는데 이용할 수 있는 의학 분야에 관계한다.
진성 당뇨병(Diabetes Mellitus)은 고혈당증 (혈액내 높은 수준의 당)을 특징으로 하는 만성적 건강 이상이다. 혈당 수준의 지속적인 증가는 당뇨병-관련된 합병증들 이를 테면, 신장 손상, 시력 상실, 심장 질환, 그리고 발 궤양의 위험이 증가된다.
두 가지 주요 유형의 당뇨병이 있다: 유형 1 당뇨병 및 유형 2 당뇨병. 유형 1 당뇨병에서, 췌장이 인슐린을 생산하지 못하기 때문에 고혈당증이 발생한다. 이러한 유형의 당뇨병은 보통 어린이 및 젊은 성인에서 나타난다. 유형 2 당뇨병에서, 췌장은 인슐린을 생산할 수 있지만, 신체의 요구에 적절하게 부응하지 못한다. 문제는 신체가 인슐린에 적절하게 반응하지 못하고, 이는 다시 세포에 의해 흡수되는 포도당의 감소로 이어지고, 결과적으로 혈당 수준이 비정상적으로 상승되는 결과를 초래한다. 수년간 췌장의 과도한 노동으로 인하여, 췌장은 궁극적으로 기능부전을 나타내고, 이의 인슐린을 생산하는 능력이 고갈되고, 이때 유형 2 당뇨병을 가진 환자는 인슐린 요법을 필요로 할 수 있다.
췌장에 의해 생산되는 천연 호르몬인 인슐린은 혈류로부터 포도당을 세포 내부로 운반한다. 따라서, 인슐린의 주요 업무는 세포로 포도당의 운반을 조절하고, 이로 인하여 혈당 수준을 낮추는 것이다.
인슐린의 작용은 혈장 막에서 발견되는 이종이량체 수용체의 활성화를 통하여 조절된다. 인슐린 수용체는 2개의 세포외 알파-소단위와 2개의 막통과 베타-소단위, 이들 두 단위는 이황화 결합에 의해 연결된 구성을 가지는 당단백질이다. Ullrich et al., Nature, 313:756-61, 1985. 알파-소단위들은 인슐린-결합 도메인을 함유하고, 그리고 베타-소단위의 세포내 부분은 인슐린-조절된 티로신 단백질 키나제(고-에너지 집단을 제공자(통상 ATP)로부터 수용자로 이동하는 것을 촉매하는 효소)를 함유한다.
인슐린 분자는 췌장의 베타 세포에 의해 방출되어, 세포에 도달하고, 인슐린은 대부분의 세포 표면에 있는 인슐린 수용체에 결합한다. 인슐린이 일단 결합되면, 인슐린 수용체 베타-소단위의 고유한 포스포트란스퍼라제 기능이 활성화되고, 많은 세포내 단백질의 티로신 포스포릴화를 초래한다. 인슐린 수용체가 활성화된 후, 포스포릴화 과정은 포도당 저장을 증가시키고, 결과적으로 혈당 수준이 감소된다.
적극적인 의지가 있는 대부분의 환자들의 경우조차도 주의를 요하는 인슐린 요법으로 장기간에 걸쳐 포도당 수준을 효과적으로 조절하기란 어렵다. 따라서, 질환 및 대사성 장애들을 치료하기 위하여, 원하는 치료 효과를 가진 새로운 약물이 지속적으로 요구된다.
산화질소 (NO)는 상이한 생물학적 프로세스의 신호생성에 작용하는 것으로 나타난 기체 분자다. 내피-유도된 NO는 혈관 색조 및 혈관과 연관된 질환의 조절에 주요한 분자인 것으로 확인되었다. NO는 단세포 흡착, 혈소판 응집 및 혈관 평활근 증식을 포함하는, 죽상경화증 플락 형성에 관련된 많은 공정을 억제한다. 내피 NO의 또다른 중요한 역할은 이의 고유한 대사 산물 및 지질 및 지단백질의 산화 산물에 의해 유도된 산화 스트레스로부터 혈관 벽을 보호하는 것이다. 내피 기능이상은 아테롬성 죽상경화증의 매우 초기 단계에서 발생된다. 따라서, 국소 NO 이용성의 결함은 인간에서 아테롬성 죽상경화증을 가속화시키는 최종 공통 경로일 수 있다. 혈관 내피에서 이의 역할에 추가적으로, NO 이용가능성은 지단백질의 대사를 조절하는 것으로 나타났다. NO 대사 산물들의 혈장 농도와 혈장의 전체 그리고 저 밀도 지단백질[LDL] 콜레스테롤 수준 사이에 부정적 상관관계가 보고되었으며, 반면 고밀도 지단백질[HDL]은 과다콜레스테롤혈증 피험자에서 혈관 기능을 개선시킨다. NO의 상실은 질환의 발생에 상당한 영향을 가진다. 진성 당뇨병은 죽상경화증 질환의 가속화된 발달에 의해 주로 야기되는 이환율 및 치사율의 증가와 연관있다. 더욱이, 당뇨병은 손상된 간 기능을 가진다고 보고한다. 인슐린 저항성이 기도 염증을 유도한다고 제한된 바 있다. Habib et al., Nitric Oxide Measurement From Blood To Lungs, Is There A Link? Pak J Physiol 2007;3(1).
산화질소는 산화질소 신타아제 (NO 신타아제)에 의해 L-아르기닌으로부터 내피에 의해 합성된다. NO 신타아제는 구조성 형태 (cNOS) 및 유도성 형태 (iNOS)를 비롯한 상이한 아형 (isoform)으로 발생한다. 구조성 형태는 정상 내피 세포, 뉴런 및 일부 다른 조직 내에 존재한다.
동종요법 기술에 의해 강화된 항체의 극히 희석된 (또는 초저용량) 형태의 치료 효과가 본 특허 출원의 발명자, Dr. Oleg I. Epshtein에 의해 발견되었다. U.S. Patent No. 7,582,294에서는 전립선 특이적 항원 (PSA)에 대한 항체의 동종요법적으로 활성화된 형태의 투여에 의해 양성 전립선 비대증 또는 전립선염을 치료하기 위한 약제를 개시한다.
U.S. Patent No. 7,700,096에서는 내피 NO-신타아제에 대한 항체의 동종요법적으로 강화된 형태를 개시하고 청구한다. 내피 NO-신타아제에 대한 항체의 동종요법적으로 강화된 형태는 상품명 Impaza® 하에 Russian Federation 및 기타 국가에서 시판된다.
요약
한 측면에서, 본 발명에서는 당뇨병 및 기타 대사성 장애들을 앓는 환자에 투여를 위한 제약학적 조성물을 제시하고, 상기 조성물은 a) 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태를 포함한다.
한 측면에서, 당뇨병 및 기타 대사성 장애들을 앓는 환자에 투여를 위한 제약학적 조성물은 a) 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태를 포함한다.
본 발명의 이러한 측면의 한 변형에서, 제약학적 조성물은 a) 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태를 포함하고, 이때 인슐린 수용체 분자는 최소한 하나의 알파 소단위 및 최소한 하나의 베타 소단위를 포함한다.
한 변형에서, 본 발명의 이러한 측면의 제약학적 조성물은 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태 또는 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태를 고형 운반체 상에서 주입된 C12, C30, 및 C200 동종요법 희석액의 혼합물 형태로 포함한다. C12, C30, 및 C200 동종요법 희석액의 혼합물 형태의 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태는 그 다음 고형 운반체에 주입시킬 수 있다.
또다른 변형에서, 본 발명의 이러한 측면의 제약학적 조성물은 고형 운반체 상에 주입된 C12, C30, 및 C200 동종요법 희석액의 혼합물 형태로 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태를 포함한다. 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태 또는 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태는 C12, C30, 및 C200 동종요법 희석액의 혼합물 형태로, 후속적으로 고형 운반체 상에 주입시킬 수 있다.
바람직하게는, 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태 또는 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태는 단일클론, 다중클론 또는 천연 항체이며, 더욱 바람직하게는, 다중클론 항체다. 본 발명의 이러한 측면의 한 변형에서, 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태 또는 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태는 연속 백진법 희석과 함께, 매 희석액의 진탕(shaking)에 의해 준비된다.
바람직하게는, 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태는 단일클론, 다중클론 또는 천연 항체이고, 더욱 바람직하게는, 다중클론 항체이다. 본 발명의 이러한 측면의 한 변형에서, 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태는 연속 백진법 희석과 함께, 매 희석액의 진탕(shaking)에 의해 준비된다.
또다른 측면에서, 본 발명은 유형 I, 당뇨병을 앓고 있는 환자를 치료하는 방법을 제공하는데, 이 방법은 a) 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태의 복합물을 이 환자에게 투여하는 것을 포함한다.
또다른 측면에서, 본 발명은 유형 I, 당뇨병을 앓고 있는 환자를 치료하는 방법을 제공하는데, 이 방법은 a) 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태의 복합물을 이 환자에게 투여하는 것을 포함한다.
또다른 측면에서, 본 발명은 유형 II, 당뇨병을 앓고 있는 환자를 치료하는 방법을 제공하는데, 이 방법은 a) 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태의 복합물을 이 환자에게 투여하는 것을 포함한다.
또다른 측면에서, 본 발명은 유형 II, 당뇨병을 앓고 있는 환자를 치료하는 방법을 제공하는데, 이 방법은 a) 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태의 복합물을 이 환자에게 투여하는 것을 포함한다.
또다른 측면에서, 본 발명은 포유동물에서 혈당 수준을 감소시키는 방법을 제공하는데, 이 방법은 a) 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태의 복합물을 이 포유동물에게 투여하는 것을 포함한다.
또다른 측면에서, 또다른 측면에서, 본 발명은 포유동물에서 혈당 수준을 감소시키는 방법을 제공하는데, 이 방법은 a) 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태의 복합물을 이 포유동물에게 투여하는 것을 포함한다.
또다른 측면에서, 본 발명은 포유동물에서 인슐린 저항성을 치료하는 방법을 제공하는데, 이 방법은 a) 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태의 복합물을 이 포유동물에게 투여하는 것을 포함한다.
또다른 측면에서, 본 발명은 포유동물에서 인슐린 저항성을 치료하는 방법을 제공하는데, 이 방법은 a) 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태의 복합물을 이 포유동물에게 투여하는 것을 포함한다.
본 발명의 이러한 측면의 한 변형에서, 인간 인슐린 수용체의 베타 소단위의 C-말단 단편 또는 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태의 1 내지 2 단위 약형의 투여, 그리고 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태의 1 내지 2 단위 약형의 투여를 제공하는데, 각 단위 약형은 1일 1회 내지 4회 투여된다. 바람직하게는, 각 항체의 활성화된-강화된 형태의 1 내지 2 단위 약형은 1일 2회 투여된다.
도 1 - 스트렙토조토신-유도된 진성 당뇨병을 가진 쥐의 혈액 혈장 포도당 수준에 있어서 테스트된 조제물의 효과를 설명한다.
도 2 - 스트렙토조토신-유도된 진성 당뇨병을 가진 쥐의 내당 테스트에 있어서 농도-시간 곡선 아래 면적(AUC) 지표상에서 14일 시점의 주사에 대한 테스트된 조제물의 효과를 설명한다.
도 3 - 자발적 비-인슐린-의존성 진성 당뇨병을 가진 쥐의 혈액 혈장 포도당 수준에 있어서 테스트된 조제물의 효과를 설명한다. .
도 4 - 자발적 비-인슐린-의존성 진성 당뇨병을 가진 쥐의 내당 테스트에 있어서 농도-시간 곡선 아래 면적(AUC) 지표상에서 28일 시점의 주사에 대한 테스트된 조제물의 효과를 설명한다. .
도 5 - IR Ab + NOS Ab 조제물의 복용 배경에 대항하여 유형 1 진성 당뇨병을 가진 환자에서 포도당 및 글리콜화된 헤모글로빈 수준의 역학 설명.
도 6 - IR Ab + NOS Ab 조제물의 복용 배경에 대항하여 유형 2 진성 당뇨병을 가진 환자에서 포도당 및 글리콜화된 헤모글로빈 수준의 역학 설명.
도 2 - 스트렙토조토신-유도된 진성 당뇨병을 가진 쥐의 내당 테스트에 있어서 농도-시간 곡선 아래 면적(AUC) 지표상에서 14일 시점의 주사에 대한 테스트된 조제물의 효과를 설명한다.
도 3 - 자발적 비-인슐린-의존성 진성 당뇨병을 가진 쥐의 혈액 혈장 포도당 수준에 있어서 테스트된 조제물의 효과를 설명한다. .
도 4 - 자발적 비-인슐린-의존성 진성 당뇨병을 가진 쥐의 내당 테스트에 있어서 농도-시간 곡선 아래 면적(AUC) 지표상에서 28일 시점의 주사에 대한 테스트된 조제물의 효과를 설명한다. .
도 5 - IR Ab + NOS Ab 조제물의 복용 배경에 대항하여 유형 1 진성 당뇨병을 가진 환자에서 포도당 및 글리콜화된 헤모글로빈 수준의 역학 설명.
도 6 - IR Ab + NOS Ab 조제물의 복용 배경에 대항하여 유형 2 진성 당뇨병을 가진 환자에서 포도당 및 글리콜화된 헤모글로빈 수준의 역학 설명.
본 발명은 첨부된 청구항에 관하여 정의된다. 청구항에 대하여, 하기의 상용구는 관련 정의를 제공한다.
본 명세서에서 이용된 바와 같이, 용어 "항체"은 다른 분자의 특정한 공간적 및 극성 구조에 특이적으로 결합하고, 따라서 상기 구조와 상보성인 것으로 정의되는 면역글로불린을 의미할 것이다. 청구항에서 언급된 항체는 완전한 면역글로불린 또는 이의 단편을 포함할 수 있고, 자연, 다중클론 또는 단일클론일 수 있고, 그리고 다양한 부류와 아이소타입(isotype), 예를 들면, IgA, IgD, IgE, IgG1, IgG2a, IgG2b and IgG3, IgM 등을 포함할 수 있다. 이의 단편은 Fab, Fv와 F(ab')2, Fab' 등을 포함할 수 있다. 단수 "항체"은 복수 "항체들"을 포함한다.
본 명세서에서 언급된 항체에 대하여, 용어 "활성화된-강화된 형태" 또는 "강화된 형태"는 각각, 항체의 임의의 최초 용액의 동종요법 강화의 산물을 표시하는데 이용된다. "동종요법 강화"는 관련 물질의 최초 용액에 동종요법 효능을 부여하는 동종요법 (homeopathy)의 방법의 이용을 표시한다. 비록 이렇게 한정되지 않지만, "동종요법 강화"은 예로써, 외부 처리, 특히 (기계적) 진탕과 합동된 반복된 연속 희석을 수반할 수 있다. 다시 말하면, 항체의 최초 용액은 동종요법 기술에 따라서 각 획득된 용액의 연속 반복 희석 및 복수 수직 진탕에 종속된다. 용매, 바람직하게는, 물 또는 물-에틸 알코올 혼합물에서 항체의 최초 용액의 바람직한 농도는 약 0.5 내지 약 5.0 mg/ml 범위에서 변한다. 각 성분, 다시 말하면, 항체 용액을 제조하기 위한 바람직한 절차는 백진법 동종요법 희석액 (C12, C30과 C200)에 대등한, 각각 10012, 10030과 100200회 희석된 항체의 일차 매트릭스 용액 (모 팅크 (mother tincture))의 3가지 수성 또는 수성-알코올 희석액의 혼합물의 이용이나, 또는 백진법 동종요법 희석액 (C12, C30과 C50)에 대등한, 각각 10012, 10030과 10050회 희석된 항체의 일차 매트릭스 용액의 3가지 수성 또는 수성-알코올 희석액의 혼합물의 이용이다. 동종요법 강화의 실례는 본 발명에 참고문헌으로서 편입되는 U.S. Patent No. 7,572,441과 7,582,294에서 기술된다. 용어 "활성화된-강화된 형태"은 청구항에서 이용되는 반면, 용어 "초저용량"은 실시예에서 이용된다. 용어 "초저용량"은 물질의 동종요법적으로 희석되고 강화된 형태의 연구와 이용에 의해 산출된 당해 분야의 전문 용어 (a term of art)가 되었다. 용어 "초저용량" 또는 "초저용량들"은 청구항에서 이용된 용어 '활성화된-강화된" 형태를 충실하게 뒷받침하고 상기 용어와 근본적으로 동의어인 것으로 의도된다.
다시 말하면, 항체는 3가지 인자가 존재할 때 "활성화된-강화된" 형태에 있다. 먼저, 항체의 "활성화된-강화된" 형태는 동종요법 분야에서 충분히 인정되는 제조 공정의 산물이다. 둘째, 항체의 "활성화된-강화된" 형태는 최신 약리학에서 충분히 인정되는 방법에 의해 결정된 생물학적 활성을 가져야 한다. 셋째, 항체의 "활성화된-강화된" 형태가 나타내는 생물학적 활성은 동종요법 공정의 최종 산물에서 항체의 분자 형태의 존재에 의해 설명될 수 없다.
가령, 항체의 활성화되고 강화된 형태는 분자 형태에서 최초, 단리된 항체를 외부 충격, 예를 들면, 기계적 진탕과 결합된 연속 복수 희석에 종속시킴으로써 제조될 수 있다. 농도 감소의 과정에서 외부 처리 역시 예로써, 초음파, 전자기, 또는 기타 물리적 요인에 노출에 의해 달성될 수 있다. 본 발명에 전체로서 참고문헌으로 편입되는 V. Schwabe "Homeopathic medicines", M., 1967, U.S. Patent No. 7,229,648과 4,311,897에서는 동종요법 분야에서 동종요법 강화의 충분히 인정되는 방법과 같은 공정을 기술한다. 이러한 절차는 항체의 최초 분자 형태의 분자 농도에서 균일한 감소를 산출한다. 이러한 절차는 원하는 동종요법 효능이 획득될 때까지 반복된다. 개별 항체의 경우에, 필요한 동종요법 효능은 중간 희석액을 원하는 약리학적 모델에서 생물학적 검사에 종속시킴으로써 결정될 수 있다. 비록 이렇게 한정되진 않지만, "동종요법 강화"는 예로써, 외부 처리, 특히 (기계적) 진탕과 합동된 반복된 연속 희석을 수반할 수 있다. 다시 말하면, 항체의 최초 용액은 동종요법 기술에 따라서 각 획득된 용액의 연속 반복 희석 및 복수 수직 진탕에 종속된다. 용매, 바람직하게는, 물 또는 물-에틸 알코올 혼합물에서 항체의 최초 용액의 바람직한 농도는 약 0.5 내지 약 5.0 mg/ml 범위에서 변한다. 각 성분, 다시 말하면, 항체 용액을 제조하기 위한 바람직한 절차는 백진법 동종요법 희석액 C12, C30과 C200에 대등한, 각각 10012, 10030과 100200회 희석된 항체의 일차 매트릭스 용액 (모 팅크 (mother tincture))의 3가지 수성 또는 수성-알코올 희석액의 혼합물, 또는 백진법 동종요법 희석액 C12, C30과 C50에 대등한, 각각 10012, 10030과 10050회 희석된 항체의 일차 매트릭스 용액 (모 팅크 (mother tincture))의 3가지 수성 또는 수성-알코올 희석액의 혼합물의 이용이다. 원하는 효능을 획득하는 방법의 실례 역시 예로써, U.S. Patent No. 7,229,648과 4,311,897에서 제공되는데, 이들은 본 발명에 전체로서 참고문헌으로 편입된다. 본 명세서에서 기술된 항체의 "활성화되고 강화된" 형태에 적용될 수 있는 절차는 하기에 더욱 상세하게 기술된다.
인간 개체의 동종요법 치료와 관련하여 상당한 논란이 존재한다. 본 발명이 항체의 "활성화된-강화된" 형태를 획득하기 위해 인정된 동종요법 공정에 의존하긴 하지만, 본 발명은 활성의 증거를 위해 인간 개체에서 동종요법에만 의존하지 않는다. 놀랍게도, 항체의 출발 분자 형태의 연속 복수 희석으로부터 궁극적으로 획득된 용매는 표적 희석액 내에 상기 항체의 분자 형태의 미량 존재와 무관한 확정적인 활성을 갖는 것으로 본 출원의 발명자에 의해 발견되었고 인정된 약리학적 모델에서 충분히 증명되었다. 본 발명에서 제시된 항체의 "활성화된-강화된" 형태는 적절한 시험관내 시험에서, 또는 적절한 동물 모델에서 생체내에서 활성의 충분히 인정된 약리학적 모델에서 생물학적 활성에 대해 조사된다. 하기에 더욱 제시된 이들 실험은 이런 모델에서 생물학적 활성의 증거를 제공한다. 하기에서 또한 제시된 인간 임상 연구는 그 중에서도, 동물 모델에서 관찰된 활성이 인간 요법에 충실히 재현된다는 증거를 제공한다. 인간 연구는 또한, 의학에서 병리학적 질환으로서 충분히 인정되는 특정한 인간 질환 또는 장애를 치료하기 위한 본 명세서에서 기술된 "활성화되고 강화된" 형태의 유효성의 증거를 제공한다.
또한, 항체의 청구된 "활성화된-강화된" 형태는 단지, 생물학적 활성이 최초, 출발 용액으로부터 남아있는 항체의 분자 형태의 존재에 의해 설명될 수 없는 용액 또는 고형 제조물만을 포함한다. 다시 말하면, 항체의 "활성화된-강화된" 형태가 상기 항체의 최초 분자 형태를 미량 내포할 수도 있는 것으로 고려되긴 하지만, 당업자는 연속 희석후 남아있는 항체의 분자 형태의 극히 낮은 농도로 인하여, 인정된 약리학적 모형에서 관찰된 생물학적 활성이 상기 항체의 남아있는 분자 형태에 기인하는 것으로 타당성 (plausibility) 있게 주장할 수 없다. 본 발명이 임의의 특정 이론에 한정되지 않지만, 본 발명의 항체의 "활성화된-강화된" 형태의 생물학적 활성은 상기 항체의 최초 분자 형태에 기인하지 않는다. 바람직하게는, 항체의 "활성화된-강화된" 형태는 상기 항체의 최초 분자 형태의 농도가 인정된 분석 기술, 예를 들면, 모세관 전기영동 및 고성능 액체 크로마토그래피의 검출 한계 미만인 액상 또는 고형 형태이다. 특히 바람직하게는, 항체의 "활성화된-강화된" 형태는 상기 항체의 최초 분자 형태의 농도가 아보가르도 수 (Avogadro number) 미만인 액상 또는 고형 형태이다. 치료 물질의 분자 형태의 약리학에서, 약리학적 반응의 수준이 개체에 투여되거나 시험관내에서 조사된 활성 약물의 농도에 대해 플롯팅 (plotting)되는 용량 반응 곡선 (dose-response curve)을 작성하는 것이 일반적 관례이다. 임의의 검출가능 반응을 발생시키는 약물의 최소 수준은 역치 용량 (threshold dose)으로 알려져 있다. 바람직하게는, 항체의 "활성화된-강화된" 형태는 만약에 있다면, 소정의 생물학적 모델에서 상기 항체의 분자 형태에 대한 역치 용량보다 낮은 농도에서 분자 항체를 내포하는 것으로 특히 고려된다.
본 발명은 당뇨병 및 기타 대사성 장애들의 질환을 앓고 있는 환자에게 투여하기 위한 제약학적 조성물을 제공하는데, 이 조성물은 a) 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태 또는 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태와 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태를 포함한다. 여기에서 제시한 것과 같이, 이 복합물의 각 개별 성분들은 이들 고유의 개별적인 의학적 용도에 대해 일잔벅으로 공지되어 있다. 그러나, 본 특허 출원의 발명자들은 이 복합물을 투여하면 당뇨병 및 인슐린 저항성을 가진 환자의 치료에 유용하며, 더욱이 혈당 수준을 감소시킨다는 놀라운 사실을 알았다. 출원인은 이 이론에 구속되지 않지만, "촉진제(accelerator)" 가설은 유형 I 진성 당뇨병 (DM) 및 유형 II 진성 당뇨병은 인슐린 저항성을 특징으로 하는 동일한 질환이며, 유형 I DM 및 유형 II DM로의 발달은 환자의 유전자형에 의해 결정된다고 가정한다. 이 가설은 자가면역 과정의 역할을 부정하지 않는다; 그러나, 이의 주요 역할에 의심을 품는다. "촉진제(accelerator)" 가설은 진행 속도에 따라 유형 I 및 유형 II 진성 당뇨병으로 나눈다: 유형 I 당뇨병의 경우, 병인적 변화의 신속한 발달이 임상적 질환 증상의 현시를 더 일찍 개시하도록 결정한다. 이 가설은 2001년 처음 제안되었고, 현재 6가지 별개의 임상 실험 결과에 의해 확인된다(Wilkin, T.J. The accelerator hypothesis: a review of the evidence for insulin resistance as the basis for type [I] as well as type II diabetes. // International Journal for Obesity. 2009: Vol. 33 - p. 716-726 참고). 두 가지 유형의 당뇨병의 발병학에 주요 역할은 인슐린 저항성에 의해 나타나는데, 인슐린 저항성의 감소는 유형 I 당뇨병 및 유형 II 당뇨병의 임상적 과정의 완화를 유도한다 (Cellular mechanisms of insulin resistance. World Congress on Insulin Resistance Syndrome, 2009, Diabetes Care. 2010: Vol. 33, N8, pp. 103-108.). 인슐린 경로에서 인슐린 수용체 베타 소단위의 역할은 공지되어 있다. 인슐린이 수용체와 결합하고, 베타 소단위 활성화 후, 이 경로는 두 가지 상이한 방향으로 진행될 것이다: 포스파티딜이노시톨 3-키나제(PI 3-K) 또는 MAP 키나제 (MAP-K). 제 1 경로는 인슐린의 대사 및 항-아팝토시스 효과의 대부분의 실현에 필수적인 것으로 보이며, 그리고 또다른 경로는 이의 비-대사성, 증식성 그리고 유사분열 효과와 연결된다. 인슐린 저항성에서, P13-K 경로를 따라 베타 소단위 활성화와 연계된 대사 인슐인 저항성만이 진성 당뇨병의 발달을 결정하는데 중요한 역할을 하는 것으로 알려져 있다(Muntoni, S, Muntoni, S. Insulin Resistance: Pathophysiology and Rationale for Treatment, Ann. Nutr. Metab. 2011: Vol. 58, N1, pp. 25-36). 청구된 제약학적 조성물은 대사 인슐린 저항성에 효과를 가진다.
본 발명의 이러한 양상에 따른 제약학적 조성물은 액상 형태 또는 고형 형태일 수 있다. 제약학적 조성물 내에 포함된 항체의 각각의 활성화되고 강화된 형태는 동종요법 분야에서 인정되는 공정을 통해 상기 항체의 최초 분자 형태로부터 제조된다. 출발 항체는 예로써, 본 발명에 참고문헌으로 편입되는 Immunotechniques, G. Frimel, M., "Meditsyna", 1987, p. 9-33; "Hum. Antibodies. Monoclonal and recombinant antibodies, 30 years after" by Laffly E., Sodoyer R. - 2005 - Vol. 14. - N 1-2. P.33-55에서 기술된 바와 같은 공지된 공정에 따라 제조된 단일클론, 또는 다중클론 항체일 수 있다.
단일클론 항체는 예로써, 하이브리도마 기술에 의해 획득될 수 있다. 이러한 공정의 최초 단계는 다중클론 항혈청 제조의 과정에서 이미 개발된 원리에 기초된 면역화를 포함한다. 작업의 추가 단계는 동일한 특이성을 갖는 항체의 클론을 산출하는 하이브리드 세포의 생산을 수반한다. 이들의 개별 단리는 다중클론 항혈청 제조의 경우에서와 동일한 방법을 이용하여 수행된다.
다중클론 항체는 동물의 활성 면역화에 의해 획득될 수 있다. 이러한 목적으로, 예로써 적절한 동물 (가령, 토끼)은 내피 NO-신타아제 및 인간 인슐린 수용체의 베타 소단위의 C-말단 단편 또는 내피 NO-신타아제 및 인간 인슐린 수용체 중에서 어느 한쪽인 적절한 항원의 일련의 주사가 제공된다. 동물의 면역계는 상응하는 항체를 산출하고, 이들은 공지된 방식으로 동물로부터 회수된다. 이러한 절차는 단일특이적 항체-풍부한 혈청의 제조를 가능하게 한다. 원하는 경우에, 항체를 내포하는 혈청은 예로써, 친화성 크로마토그래피, 염 침전에 의한 분별, 또는 이온-교환 크로마토그래피를 이용하여 정제될 수 있다. 결과의 정제된, 항체-농축된 혈청은 항체의 활성화된-강화된 형태의 제조를 위한 출발 물질로서 이용될 수 있다. 용매, 바람직하게는, 물 또는 물-에틸 알코올 혼합물에서 항체의 결과의 최초 용액의 바람직한 농도는 약 0.5 내지 약 5.0 mg/ml 범위에서 변한다.
각 성분을 제조하기 위한 바람직한 절차는 백진법 동종요법 희석액 C12, C30과 C200에 대등한, 각각 10012, 10030과 100200회 희석된 항체의 일차 매트릭스 용액의 3가지 수성-알코올 희석액의 혼합물의 이용이다. 고형 제형을 제조하기 위해, 고형 캐리어는 동종요법 공정에 의해 획득된 원하는 희석액으로 처리된다. 본 발명의 복합의 고형 단위 제형을 획득하기 위해, 캐리어 매스는 각 희석액이 주입 (impregnation)된다. 주입의 양쪽 순서는 원하는 복합 제형을 제조하는데 적절하다.
바람직한 구체예에서, 본 발명의 복합을 포함하는 활성화되고 강화된 형태의 제조를 위한 출발 물질은 상응하는 항원, 다시 말하면, 인간 인슐린 수용체의 베타 소단위의 C-말단 단편 또는 인간 인슐린 수용체 및 내피 NO-신타아제에 대한 다중클론, 동물-발생된 항체이다. 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 다중클론 항체의 활성화된-강화된 형태를 획득하기 위해, 원하는 항원은 면역원으로서 실험실 동물, 바람직하게는, 토끼 내로 주사될 수 있다. 특정 관심 펩티드는 서열의 양 단편중 하나에 최소한 약 3개의 아미노산, 보통 최소한 10개의 아미노산을 포함할 수 있고, 바람직하게는 C-말단 측에 최소한 3개의 아미노산을 가진다. 인간 인슐린 수용체의 다음 서열이 적합한 항원으로 특히 고려된다:
인간 인슐린 수용체의 전체 알파-소단위:
서열 번호: 1
His Leu Tyr
28 30
Pro Gly Glu Val Cys Pro Gly Met Asp Ile Arg Asn Asn Leu Thr
31 35 40 45
Arg Leu His Glu Leu Glu Asn Cys Ser Val Ile Glu Gly His Leu
46 50 55 60
Gln Ile Leu Leu Met Phe Lys Thr Arg Pro Glu Asp Phe Arg Asp
61 65 70 75
Leu Ser Phe Pro Lys Leu Ile Met Ile Thr Asp Tyr Leu Leu Leu
76 80 85 90
Phe Arg Val Tyr Gly Leu Glu Ser Leu Lys Asp Leu Phe Pro Asn
91 95 100 105
Leu Thr Val Ile Arg Gly Ser Arg Leu Phe Phe Asn Tyr Ala Leu
106 110 115 120
Val Ile Phe Glu Met Val His Leu Lys Glu Leu Gly Leu Tyr Asn
121 125 130 135
Leu Met Asn Ile Thr Arg Gly Ser Val Arg Ile Glu Lys Asn Asn
136 140 145 150
Glu Leu Cys Tyr Leu Ala Thr Ile Asp Trp Ser Arg Ile Leu Asp
151 155 160 165
Ser Val Glu Asp Asn Tyr Ile Val Leu Asn Lys Asp Asp Asn Glu
166 170 175 180
Glu Cys Gly Asp Ile Cys Pro Gly Thr Ala Lys Gly Lys Thr Asn
181 185 190 195
Cys Pro Ala Thr Val Ile Asn Gly Gln Phe Val Glu Arg Cys Trp
196 200 205 210
Thr His Ser His Cys Gln Lys Val Cys Pro Thr Ile Cys Lys Ser
211 215 220 225
His Gly Cys Thr Ala Glu Gly Leu Cys Cys His Ser Glu Cys Leu
226 230 235 240
Gly Asn Cys Ser Gln Pro Asp Asp Pro Thr Lys Cys Val Ala Cys
241 245 250 255
Arg Asn Phe Tyr Leu Asp Gly Arg Cys Val Glu Thr Cys Pro Pro
256 260 265 270
Pro Tyr Tyr His Phe Gln Asp Trp Arg Cys Val Asn Phe Ser Phe
271 275 280 285
Cys Gln Asp Leu His His Lys Cys Lys Asn Ser Arg Arg Gln Gly
286 290 295 300
Cys His Gln Tyr Val Ile His Asn Asn Lys Cys Ile Pro Glu Cys
301 305 310 315
Pro Ser Gly Tyr Thr Met Asn Ser Ser Asn Leu Leu Cys Thr Pro
316 320 325 330
Cys Leu Gly Pro Cys Pro Lys Val Cys His Leu Leu Glu Gly Glu
331 335 340 345
Lys Thr Ile Asp Ser Val Thr Ser Ala Gln Glu Leu Arg Gly Cys
346 350 355 360
Thr Val Ile Asn Gly Ser Leu Ile Ile Asn Ile Arg Gly Gly Asn
361 365 370 375
Asn Leu Ala Ala Glu Leu Glu Ala Asn Leu Gly Leu Ile Glu Glu
376 380 385 390
Ile Ser Gly Tyr Leu Lys Ile Arg Arg Ser Tyr Ala Leu Val Ser
391 395 400 405
Leu Ser Phe Phe Arg Lys Leu Arg Leu Ile Arg Gly Glu Thr Leu
406 410 415 420
Glu Ile Gly Asn Tyr Ser Phe Tyr Ala Leu Asp Asn Gln Asn Leu
421 425 430 435
Arg Gln Leu Trp Asp Trp Ser Lys His Asn Leu Thr Ile Thr Gln
436 440 445 450
Gly Lys Leu Phe Phe His Tyr Asn Pro Lys Leu Cys Leu Ser Glu
451 455 460 465
Ile His Lys Met Glu Glu Val Ser Gly Thr Lys Gly Arg Gln Glu
466 470 475 480
Arg Asn Asp Ile Ala Leu Lys Thr Asn Gly Asp Gln Ala Ser Cys
481 485 490 495
Glu Asn Glu Leu Leu Lys Phe Ser Tyr Ile Arg Thr Ser Phe Asp
496 500 505 510
Lys Ile Leu Leu Arg Trp Glu Pro Tyr Trp Pro Pro Asp Phe Arg
511 515 510 525
Asp Leu Leu Gly Phe Met Leu Phe Tyr Lys Glu Ala Pro Tyr Gln
526 530 535 540
Asn Val Thr Glu Phe Asp Gly Gln Asp Ala Cys Gly Ser Asn Ser
541 545 550 555
Trp Thr Val Val Asp Ile Asp Pro Pro Leu Arg Ser Asn Asp Pro
556 560 565 570
Lys Ser Gln Asn His Pro Gly Trp Leu Met Arg Gly Leu Lys Pro
571 575 580 585
Trp Thr Gln Tyr Ala Ile Phe Val Lys Thr Leu Val Thr Phe Ser
586 590 595 600
Asp Glu Arg Arg Thr Tyr Gly Ala Lys Ser Asp Ile Ile Tyr Val
601 605 610 615
Gln Thr Asp Ala Thr Asn Pro Ser Val Pro Leu Asp Pro Ile Ser
616 620 625 630
Val Ser Asn Ser Ser Ser Gln Ile Ile Leu Lys Trp Lys Pro Pro
631 635 640 645
Ser Asp Pro Asn Gly Asn Ile Thr His Tyr Leu Val Phe Trp Glu
646 650 655 660
Arg Gln Ala Glu Asp Ser Glu Leu Phe Glu Leu Asp Tyr Cys Leu
661 665 670 675
Lys Gly Leu Lys Leu Pro Ser Arg Thr Trp Ser Pro Pro Phe Glu
676 680 685 690
Ser Glu Asp Ser Gln Lys His Asn Gln Ser Glu Tyr Glu Asp Ser
691 695 700 705
Ala Gly Glu Cys Cys Ser Cys Pro Lys Thr Asp Ser Gln Ile Leu
706 710 715 720
Lys Glu Leu Glu Glu Ser Ser Phe Arg Lys Thr Phe Glu Asp Tyr
721 725 730 735
Leu His Asn Val Val Phe Val Pro Arg Lys Thr Ser Ser Gly Thr
736 740 745 750
Gly Ala Glu Asp Pro Arg Pro Ser Arg Lys Arg Arg
751 755 760 762
인간 인슐린 수용체의 알파-소단위의 단편들:
서열 번호: 2
Leu Gly Leu Tyr Asn
131 135
Leu Met Asn Ile Thr Arg Gly Ser Val
136 140 144
서열 번호: 3
Lys Gly Lys Thr Asn
191 195
Cys Pro Ala Thr Val Ile Asn Gly
196 200 203
서열 번호: 4
Trp Ser Lys His Asn Leu Thr Ile Thr Gln
441 445 450
Gly Lys Leu
451 453
서열 번호: 5
Asn Val Thr Glu Phe Asp Gly Gln Asp Ala Cys Gly Ser Asn Ser
541 545 550 555
Trp Thr Val Val Asp
556 560
서열 번호: 6
Asp Ile Ile Tyr Val
611 615
Gln Thr Asp Ala Thr
616 620
서열 번호: 7
Tyr Glu Asp Ser
702 705
Ala Gly Glu Cys Cys Ser Cys Pro Lys Thr Asp Ser Gln Ile
706 710 715 719
인간 인슐린 수용체의 전체 베타 소단위:
서열 번호: 8
Ser Leu Gly
763 765
Asp Val Gly Asn Val Thr Val Ala Val Pro Thr Val Ala Ala Phe
766 770 775 780
Pro Asn Thr Ser Ser Thr Ser Val Pro Thr Ser Pro Glu Glu His
781 785 790 795
Arg Pro Phe Glu Lys Val Val Asn Lys Glu Ser Leu Val Ile Ser
796 800 805 810
Gly Leu Arg His Phe Thr Gly Tyr Arg Ile Glu Leu Gln Ala Cys
811 815 820 825
Asn Gln Asp Thr Pro Glu Glu Arg Cys Ser Val Ala Ala Tyr Val
826 830 835 840
Ser Ala Arg Thr Met Pro Glu Ala Lys Ala Asp Asp Ile Val Gly
841 845 850 855
Pro Val Thr His Glu Ile Phe Glu Asn Asn Val Val His Leu Met
856 860 865 870
Trp Gln Glu Pro Lys Glu Pro Asn Gly Leu Ile Val Leu Tyr Glu
871 875 880 885
Val Ser Tyr Arg Arg Tyr Gly Asp Glu Glu Leu His Leu Cys Val
886 890 895 900
Ser Arg Lys His Phe Ala Leu Glu Arg Gly Cys Arg Leu Arg Gly
901 905 910 915
Leu Ser Pro Gly Asn Tyr Ser Val Arg Ile Arg Ala Thr Ser Leu
916 920 925 930
Ala Gly Asn Gly Ser Trp Thr Glu Pro Thr Tyr Phe Tyr Val Thr
931 935 940 945
Asp Tyr Leu Asp Val Pro Ser Asn Ile Ala Lys Ile Ile Ile Gly
946 950 955 960
Pro Leu Ile Phe Val Phe Leu Phe Ser Val Val Ile Gly Ser Ile
961 965 970 975
Tyr Leu Phe Leu Arg Lys Arg Gln Pro Asp Gly Pro Leu Gly Pro
976 980 985 990
Leu Tyr Ala Ser Ser Asn Pro Glu Tyr Leu Ser Ala Ser Asp Val
991 995 1000 1005
Phe Pro Cys Ser Val Tyr Val Pro Asp Glu Trp Glu Val Ser Arg
1006 1010 1015 1020
Glu Lys Ile Thr Leu Leu Arg Glu Leu Gly Gln Gly Ser Phe Gly
1021 1025 1030 1035
Met Val Tyr Glu Gly Asn Ala Arg Asp Ile Ile Lys Gly Glu Ala
1036 1140 1145 1050
Glu Thr Arg Val Ala Val Lys Thr Val Asn Glu Ser Ala Ser Leu
1051 1155 1160 1065
Arg Glu Arg Ile Glu Phe Leu Asn Glu Ala Ser Val Met Lys Gly
1066 1170 1175 1080
Phe Thr Cys His His Val Val Arg Leu Leu Gly Val Val Ser Lys
1081 1185 1190 1095
Gly Gln Pro Thr Leu Val Val Met Glu Leu Met Ala His Gly Asp
1096 1100 1105 1110
Leu Lys Ser Tyr Leu Arg Ser Leu Arg Pro Glu Ala Glu Asn Asn
1111 1115 1120 1125
Pro Gly Arg Pro Pro Pro Thr Leu Gln Glu Met Ile Gln Met Ala
1126 1130 1135 1140
Ala Glu Ile Ala Asp Gly Met Ala Tyr Leu Asn Ala Lys Lys Phe
1141 1145 1150 1155
Val His Arg Asp Leu Ala Ala Arg Asn Cys Met Val Ala His Asp
1156 1160 1165 1170
Phe Thr Val Lys Ile Gly Asp Phe Gly Met Thr Arg Asp Ile Tyr
1171 1175 1180 1185
Glu Thr Asp Tyr Tyr Arg Lys Gly Gly Lys Gly Leu Leu Pro Val
1186 1190 1195 1200
Arg Trp Met Ala Pro Glu Ser Leu Lys Asp Gly Val Phe Thr Thr
1201 1205 1210 1215
Ser Ser Asp Met Trp Ser Phe Gly Val Val Leu Trp Glu Ile Thr
1216 1220 1225 1230
Ser Leu Ala Glu Gln Pro Tyr Gln Gly Leu Ser Asn Glu Gln Val
1231 1235 1240 1245
Leu Lys Phe Val Met Asp Gly Gly Tyr Leu Asp Gln Pro Asp Asn
1246 1250 1255 1260
Cys Pro Glu Arg Val Thr Asp Leu Met Arg Met Cys Trp Gln Phe
1261 1265 1270 1275
Asn Pro Lys Met Arg Pro Thr Phe Leu Glu Ile Val Asn Leu Leu
1276 1280 1285 1290
Lys Asp Asp Leu His Pro Ser Phe Pro Glu Val Ser Phe Phe His
1291 1295 1300 1305
Ser Glu Glu Asn Lys Ala Pro Glu Ser Glu Glu Leu Glu Met Glu
1306 1310 1315 1320
Phe Glu Asp Met Glu Asn Val Pro Leu Asp Arg Ser Ser His Cys
1321 1325 1330 1335
Gln Arg Glu Glu Ala Gly Gly Arg Asp Gly Gly Ser Ser Leu Gly
1336 1340 1345 1350
Phe Lys Arg Ser Tyr Glu Glu His Ile Pro Tyr Thr His Met Asn
1351 1355 1360 1365
Gly Gly Lys Lys Asn Gly Arg Ile Leu Thr Leu Pro Arg Ser Asn
1366 1370 1375 1380
Pro Ser
13811382
인간 인슐린 수용체의 베타 소단위의 C-말단 단편의 단편들:
서열 번호: 9
Lys Lys Asn Gly Arg Ile Leu Thr Leu Pro
1368 1370 1375 1377
서열 번호: 10
Arg Ile Leu Thr Leu Pro Arg Ser Asn
1372 1375 1380
Pro Ser
13811382
서열 번호: 11
Lys Asn Gly Arg Ile Leu Thr
13691370 1375
서열 번호: 12
Gly Gly Lys Lys Asn Gly Arg Ile Leu Thr Leu Pro Arg Ser Asn
1366 1370 1375 1380
Pro Ser
13811382
서열 번호: 13
Asn
1365
Gly Gly Lys Lys Asn Gly Arg Ile Leu Thr Leu Pro Arg Ser Asn
1366 1370 1375 1380
Pro Ser
13811382
항원으로 인간 인슐린 수용체의 이용을 또한 고려한다. 각 항원에 대한 적합한 서열은 다음과 같다:
서열 번호: 14
Met Ala Thr Gly Gly Arg Arg Gly Ala Ala Ala Ala Pro Leu Leu
1 5 10 15
Val Ala Val Ala Ala Leu Leu Leu Gly Ala Ala Gly His Leu Tyr
16 20 25 30
Pro Gly Glu Val Cys Pro Gly Met Asp Ile Arg Asn Asn Leu Thr
31 35 40 45
Arg Leu His Glu Leu Glu Asn Cys Ser Val Ile Glu Gly His Leu
46 50 55 60
Gln Ile Leu Leu Met Phe Lys Thr Arg Pro Glu Asp Phe Arg Asp
61 65 70 75
Leu Ser Phe Pro Lys Leu Ile Met Ile Thr Asp Tyr Leu Leu Leu
76 80 85 90
Phe Arg Val Tyr Gly Leu Glu Ser Leu Lys Asp Leu Phe Pro Asn
91 95 100 105
Leu Thr Val Ile Arg Gly Ser Arg Leu Phe Phe Asn Tyr Ala Leu
106 110 115 120
Val Ile Phe Glu Met Val His Leu Lys Glu Leu Gly Leu Tyr Asn
121 125 130 135
Leu Met Asn Ile Thr Arg Gly Ser Val Arg Ile Glu Lys Asn Asn
136 140 145 150
Glu Leu Cys Tyr Leu Ala Thr Ile Asp Trp Ser Arg Ile Leu Asp
151 155 160 165
Ser Val Glu Asp Asn Tyr Ile Val Leu Asn Lys Asp Asp Asn Glu
166 170 175 180
Glu Cys Gly Asp Ile Cys Pro Gly Thr Ala Lys Gly Lys Thr Asn
181 185 190 195
Cys Pro Ala Thr Val Ile Asn Gly Gln Phe Val Glu Arg Cys Trp
196 200 205 210
Thr His Ser His Cys Gln Lys Val Cys Pro Thr Ile Cys Lys Ser
211 215 220 225
His Gly Cys Thr Ala Glu Gly Leu Cys Cys His Ser Glu Cys Leu
226 230 235 240
Gly Asn Cys Ser Gln Pro Asp Asp Pro Thr Lys Cys Val Ala Cys
241 245 250 255
Arg Asn Phe Tyr Leu Asp Gly Arg Cys Val Glu Thr Cys Pro Pro
256 260 265 270
Pro Tyr Tyr His Phe Gln Asp Trp Arg Cys Val Asn Phe Ser Phe
271 275 280 285
Cys Gln Asp Leu His His Lys Cys Lys Asn Ser Arg Arg Gln Gly
286 290 295 300
Cys His Gln Tyr Val Ile His Asn Asn Lys Cys Ile Pro Glu Cys
301 305 310 315
Pro Ser Gly Tyr Thr Met Asn Ser Ser Asn Leu Leu Cys Thr Pro
316 320 325 330
Cys Leu Gly Pro Cys Pro Lys Val Cys His Leu Leu Glu Gly Glu
331 335 340 345
Lys Thr Ile Asp Ser Val Thr Ser Ala Gln Glu Leu Arg Gly Cys
346 350 355 360
Thr Val Ile Asn Gly Ser Leu Ile Ile Asn Ile Arg Gly Gly Asn
361 365 370 375
Asn Leu Ala Ala Glu Leu Glu Ala Asn Leu Gly Leu Ile Glu Glu
376 380 385 390
Ile Ser Gly Tyr Leu Lys Ile Arg Arg Ser Tyr Ala Leu Val Ser
391 395 400 405
Leu Ser Phe Phe Arg Lys Leu Arg Leu Ile Arg Gly Glu Thr Leu
406 410 415 420
Glu Ile Gly Asn Tyr Ser Phe Tyr Ala Leu Asp Asn Gln Asn Leu
421 425 430 435
Arg Gln Leu Trp Asp Trp Ser Lys His Asn Leu Thr Ile Thr Gln
436 440 445 450
Gly Lys Leu Phe Phe His Tyr Asn Pro Lys Leu Cys Leu Ser Glu
451 455 460 465
Ile His Lys Met Glu Glu Val Ser Gly Thr Lys Gly Arg Gln Glu
466 470 475 480
Arg Asn Asp Ile Ala Leu Lys Thr Asn Gly Asp Gln Ala Ser Cys
481 485 490 495
Glu Asn Glu Leu Leu Lys Phe Ser Tyr Ile Arg Thr Ser Phe Asp
496 500 505 510
Lys Ile Leu Leu Arg Trp Glu Pro Tyr Trp Pro Pro Asp Phe Arg
511 515 510 525
Asp Leu Leu Gly Phe Met Leu Phe Tyr Lys Glu Ala Pro Tyr Gln
526 530 535 540
Asn Val Thr Glu Phe Asp Gly Gln Asp Ala Cys Gly Ser Asn Ser
541 545 550 555
Trp Thr Val Val Asp Ile Asp Pro Pro Leu Arg Ser Asn Asp Pro
556 560 565 570
Lys Ser Gln Asn His Pro Gly Trp Leu Met Arg Gly Leu Lys Pro
571 575 580 585
Trp Thr Gln Tyr Ala Ile Phe Val Lys Thr Leu Val Thr Phe Ser
586 590 595 600
Asp Glu Arg Arg Thr Tyr Gly Ala Lys Ser Asp Ile Ile Tyr Val
601 605 610 615
Gln Thr Asp Ala Thr Asn Pro Ser Val Pro Leu Asp Pro Ile Ser
616 620 625 630
Val Ser Asn Ser Ser Ser Gln Ile Ile Leu Lys Trp Lys Pro Pro
631 635 640 645
Ser Asp Pro Asn Gly Asn Ile Thr His Tyr Leu Val Phe Trp Glu
646 650 655 660
Arg Gln Ala Glu Asp Ser Glu Leu Phe Glu Leu Asp Tyr Cys Leu
661 665 670 675
Lys Gly Leu Lys Leu Pro Ser Arg Thr Trp Ser Pro Pro Phe Glu
676 680 685 690
Ser Glu Asp Ser Gln Lys His Asn Gln Ser Glu Tyr Glu Asp Ser
691 695 700 705
Ala Gly Glu Cys Cys Ser Cys Pro Lys Thr Asp Ser Gln Ile Leu
706 710 715 720
Lys Glu Leu Glu Glu Ser Ser Phe Arg Lys Thr Phe Glu Asp Tyr
721 725 730 735
Leu His Asn Val Val Phe Val Pro Arg Lys Thr Ser Ser Gly Thr
736 740 745 750
Gly Ala Glu Asp Pro Arg Pro Ser Arg Lys Arg Arg Ser Leu Gly
751 755 760 765
Asp Val Gly Asn Val Thr Val Ala Val Pro Thr Val Ala Ala Phe
766 770 775 780
Pro Asn Thr Ser Ser Thr Ser Val Pro Thr Ser Pro Glu Glu His
781 785 790 795
Arg Pro Phe Glu Lys Val Val Asn Lys Glu Ser Leu Val Ile Ser
796 800 805 810
Gly Leu Arg His Phe Thr Gly Tyr Arg Ile Glu Leu Gln Ala Cys
811 815 820 825
Asn Gln Asp Thr Pro Glu Glu Arg Cys Ser Val Ala Ala Tyr Val
826 830 835 840
Ser Ala Arg Thr Met Pro Glu Ala Lys Ala Asp Asp Ile Val Gly
841 845 850 855
Pro Val Thr His Glu Ile Phe Glu Asn Asn Val Val His Leu Met
856 860 865 870
Trp Gln Glu Pro Lys Glu Pro Asn Gly Leu Ile Val Leu Tyr Glu
871 875 880 885
Val Ser Tyr Arg Arg Tyr Gly Asp Glu Glu Leu His Leu Cys Val
886 890 895 900
Ser Arg Lys His Phe Ala Leu Glu Arg Gly Cys Arg Leu Arg Gly
901 905 910 915
Leu Ser Pro Gly Asn Tyr Ser Val Arg Ile Arg Ala Thr Ser Leu
916 920 925 930
Ala Gly Asn Gly Ser Trp Thr Glu Pro Thr Tyr Phe Tyr Val Thr
931 935 940 945
Asp Tyr Leu Asp Val Pro Ser Asn Ile Ala Lys Ile Ile Ile Gly
946 950 955 960
Pro Leu Ile Phe Val Phe Leu Phe Ser Val Val Ile Gly Ser Ile
961 965 970 975
Tyr Leu Phe Leu Arg Lys Arg Gln Pro Asp Gly Pro Leu Gly Pro
976 980 985 990
Leu Tyr Ala Ser Ser Asn Pro Glu Tyr Leu Ser Ala Ser Asp Val
991 995 1000 1005
Phe Pro Cys Ser Val Tyr Val Pro Asp Glu Trp Glu Val Ser Arg
1006 1010 1015 1020
Glu Lys Ile Thr Leu Leu Arg Glu Leu Gly Gln Gly Ser Phe Gly
1021 1025 1030 1035
Met Val Tyr Glu Gly Asn Ala Arg Asp Ile Ile Lys Gly Glu Ala
1036 1140 1145 1050
Glu Thr Arg Val Ala Val Lys Thr Val Asn Glu Ser Ala Ser Leu
1051 1155 1160 1065
Arg Glu Arg Ile Glu Phe Leu Asn Glu Ala Ser Val Met Lys Gly
1066 1170 1175 1080
Phe Thr Cys His His Val Val Arg Leu Leu Gly Val Val Ser Lys
1081 1185 1190 1095
Gly Gln Pro Thr Leu Val Val Met Glu Leu Met Ala His Gly Asp
1096 1100 1105 1110
Leu Lys Ser Tyr Leu Arg Ser Leu Arg Pro Glu Ala Glu Asn Asn
1111 1115 1120 1125
Pro Gly Arg Pro Pro Pro Thr Leu Gln Glu Met Ile Gln Met Ala
1126 1130 1135 1140
Ala Glu Ile Ala Asp Gly Met Ala Tyr Leu Asn Ala Lys Lys Phe
1141 1145 1150 1155
Val His Arg Asp Leu Ala Ala Arg Asn Cys Met Val Ala His Asp
1156 1160 1165 1170
Phe Thr Val Lys Ile Gly Asp Phe Gly Met Thr Arg Asp Ile Tyr
1171 1175 1180 1185
Glu Thr Asp Tyr Tyr Arg Lys Gly Gly Lys Gly Leu Leu Pro Val
1186 1190 1195 1200
Arg Trp Met Ala Pro Glu Ser Leu Lys Asp Gly Val Phe Thr Thr
1201 1205 1210 1215
Ser Ser Asp Met Trp Ser Phe Gly Val Val Leu Trp Glu Ile Thr
1216 1220 1225 1230
Ser Leu Ala Glu Gln Pro Tyr Gln Gly Leu Ser Asn Glu Gln Val
1231 1235 1240 1245
Leu Lys Phe Val Met Asp Gly Gly Tyr Leu Asp Gln Pro Asp Asn
1246 1250 1255 1260
Cys Pro Glu Arg Val Thr Asp Leu Met Arg Met Cys Trp Gln Phe
1261 1265 1270 1275
Asn Pro Lys Met Arg Pro Thr Phe Leu Glu Ile Val Asn Leu Leu
1276 1280 1285 1290
Lys Asp Asp Leu His Pro Ser Phe Pro Glu Val Ser Phe Phe His
1291 1295 1300 1305
Ser Glu Glu Asn Lys Ala Pro Glu Ser Glu Glu Leu Glu Met Glu
1306 1310 1315 1320
Phe Glu Asp Met Glu Asn Val Pro Leu Asp Arg Ser Ser His Cys
1321 1325 1330 1335
Gln Arg Glu Glu Ala Gly Gly Arg Asp Gly Gly Ser Ser Leu Gly
1336 1340 1345 1350
Phe Lys Arg Ser Tyr Glu Glu His Ile Pro Tyr Thr His Met Asn
1351 1355 1360 1365
Gly Gly Lys Lys Asn Gly Arg Ile Leu Thr Leu Pro Arg Ser Asn
1366 1370 1375 1380
Pro Ser
13811382
인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 출발 다중클론 항체의 제조를 위한 예시적인 절차는 하기와 같이 기술될 수 있다. 혈액 샘플링전 7-9일에서, 토끼 혈류에서 다중클론 항체의 수준을 증가시키기 위해 원하는 항원의 1-3회 정맥내 주사가 토끼에 만들어진다. 면역화 시에, 혈액 샘플은 항체 수준을 검사하기 위해 채취된다. 전형적으로, 가용성 항원의 면역 반응의 최대 수준이 상기 항원의 첫 번째 주사후 40 내지 60일 내에 달성된다. 첫 번째 면역화 주기의 완결 시에, 토끼는 30-일 재활 기간을 가지고, 그 이후 다른 1-3회 정맥내 주사로 재-면역화가 수행된다.
원하는 항체를 내포하는 항혈청을 획득하기 위해, 면역화된 토끼의 혈액은 토끼로부터 수집되고 50ml 원심분리 튜브 내에 배치된다. 튜브 측면에 형성된 산물 덩어리는 나무 주걱으로 제거되고, 그리고 막대가 튜브 중심에서 덩어리 내로 배치된다. 혈액은 이후, 약 40℃의 온도에서 하룻밤 동안 냉장고 내에 배치된다. 그 다음날, 주걱 위에 덩어리가 제거되고, 그리고 남아있는 액체는 13,000 회전에서 10분 동안 원심분리된다. 상층액 유체는 표적 항혈청이다. 획득된 항혈청은 전형적으로 황색이다. 20%의 NaN3 (무게 농도)가 0.02%의 최종 농도로 항혈청에 첨가되고, 그리고 이용에 앞서 -20℃의 온도에서 동결 상태에서 또는 -70℃의 온도에서 NaN3 없이 보관된다. 항혈청으로부터 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 표적 항체를 분리하기 위해, 하기 고형 상 흡수 서열이 적절하다:
10 ml의 토끼 항혈청은 0.15 M NaCl로 2배 희석되고, 그 이후 6.26g Na2SO4가 첨가되고, 혼합되고, 4℃에서 12-16시간 동안 배양된다. 침전물은 원심분리에 의해 제거되고, 10ml의 인산염 완충액에 희석되고, 그리고 주변 온도에서 하룻밤 동안 동일한 완충액에 대해 투석된다. 침전물이 제거된 이후, 용액이 인산염 완충액에 의해 균형화된 DEAE-셀룰로오스 칼럼에 적용된다. 항체 분획물은 280 Nm에서 용리액의 광학 밀도(optical density)를 측정함으로써 결정된다.
단리된 가공되지 않은 항체는 크로마토그래피 매체의 불용성 매트릭스에 위치된 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 획득된 항체를 부착함에 의한 친화성 크로마토그래피 방법, 이후 농축된 수성 염 용액에 의한 용리를 이용하여 정제된다.
결과의 완충 용액은 항체의 활성화되고 강화된 형태를 제조하는데 이용되는 동종요법 희석 공정을 위한 최초 용액으로서 이용된다. 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항원-정제된 다중클론 토끼 항체의 최초 매트릭스 용액의 바람직한 농도는 0.5 - 5.0 mg/ml, 바람직하게는, 2.0 - 3.0 mg/ml이다.
내피 NO-신타아제에 대한 다중클론 항체는 어쥬번트를 이용한 유사한 방법에 의해 획득된다. 내피 NO-신타아제에 대한 다중클론 항체를 수득하기 위하여, 하기 설명된 서열의 소 내피 NO-신타아제의 전체 분자를 면역원 (항원)으로서 이용된다:
서열 번호: 15
Met Gly Asn Leu Lys Ser Val Gly Gln Glu Pro Gly Pro Pro Cys
1 5 10 15
Gly Leu Gly Leu Gly Leu Gly Leu Gly Leu Cys Gly Lys Gln Gly
16 20 25 30
Pro Ala Ser Pro Ala Pro Glu Pro Ser Arg Ala Pro Ala Pro Ala
31 35 40 45
Thr Pro His Ala Pro Asp His Ser Pro Ala Pro Asn Ser Pro Thr
46 50 55 60
Leu Thr Arg Pro Pro Glu Gly Pro Lys Phe Pro Arg Val Lys Asn
61 65 70 75
Trp Glu Leu GLys er Ile Thr Tyr Asp Thr Leu Cys Ala Gln Ser
76 80 85 90
Gln Gln Asp Gly Pro Cys Thr Pro Arg Cys Cys Leu GLys er Leu
91 95 100 105
Val Leu Pro Arg Lys Leu Gln Thr Arg Pro Ser Pro Gly Pro Pro
106 110 115 120
Pro Ala Glu Gln Leu Leu Ser Gln Ala Arg Asp Phe Ile Asn Gln
121 125 130 135
Tyr Tyr Ser Ser Ile Lys Arg Ser GLys er Gln Ala His Glu Glu
136 140 145 150
Arg Leu Gln Glu Val Glu Ala Glu Val Ala Ser Thr Gly Thr Tyr
151 155 160 165
His Leu Arg Glu Ser Glu Leu Val Phe Gly Ala Lys Gln Ala Trp
166 170 175 180
Arg Asn Ala Pro Arg Cys Val Gly Arg Ile Gln Trp Gly Lys Leu
181 185 190 195
Gln Val Phe Asp Ala Arg Asp Cys Ser Ser Ala Gln Glu Met Phe
196 200 205 210
Thr Tyr Ile Cys Asn His Ile Lys Tyr Ala Thr Asn Arg Gly Asn
211 215 220 225
Leu Arg Ser Ala Ile Thr Val Phe Pro Gln Arg Ala Pro Gly Arg
226 230 235 240
Gly Asp Phe Arg Ile Trp Asn Ser Gln Leu Val Arg Tyr Ala Gly
241 245 250 255
Tyr Arg Gln Gln Asp GLys er Val Arg Gly Asp Pro Ala Asn Val
256 260 265 270
Glu Ile Thr Glu Leu Cys Ile Gln His Gly Trp Thr Pro Gly Asn
271 275 280 285
Gly Arg Phe Asp Val Leu Pro Leu Leu Leu Gln Ala Pro Asp Glu
286 290 295 300
Ala Pro Glu Leu Phe Val Leu Pro Pro Glu Leu Val Leu Glu Val
301 305 310 315
Pro Leu Glu His Pro Thr Leu Glu Trp Phe Ala Ala Leu Gly Leu
316 320 325 330
Arg Trp Tyr Ala Leu Pro Ala Val Ser Asn Met Leu Leu Glu Ile
331 335 340 345
Gly Gly Leu Glu Phe Ser Ala Ala Pro Phe Ser Gly Trp Tyr Met
346 350 355 360
Ser Thr Glu Ile Gly Thr Arg Asn Leu Cys Asp Pro His Arg Tyr
361 365 370 375
Asn Ile Leu Glu Asp Val Ala Val Cys Met Asp Leu Asp Thr Arg
376 380 385 390
Thr Thr Ser Ser Leu Trp Lys Asp Lys Ala Ala Val Glu Ile Asn
391 395 400 405
Leu Ala Val Leu His Ser Phe Gln Leu Ala Lys Val Thr Ile Val
406 410 415 420
Asp His His Ala Ala Thr Val Ser Phe Met Lys His Leu Asp Asn
421 425 430 435
Glu Gln Lys Ala Arg Gly Gly Cys Pro Ala Asp Trp Ala Trp Ile
436 440 445 450
Val Pro Pro Ile Ser GLys er Leu Thr Pro Val Phe His Gln Glu
451 455 460 465
Met Val Asn Tyr Ile Leu Ser Pro Ala Phe Arg Tyr Gln Pro Asp
466 470 475 480
Pro Trp Lys GLy Ser Ala Thr Lys Gly Ala Gly Ile Thr Arg Lys
481 485 490 495
Lys Thr Phe Lys Glu Val Ala Asn Ala Val Lys Ile Ser Ala Ser
496 500 505 510
Leu Met Gly Thr Leu Met Ala Lys Arg Val Lys Ala Thr Ile Leu
511 515 510 525
Tyr Ala Ser Glu Thr Gly Arg Ala Gln Ser Tyr Ala Gln Gln Leu
526 530 535 540
Gly Arg Leu Phe Arg Lys Ala Phe Asp Pro Arg Val Leu Cys Met
541 545 550 555
Asp Glu Tyr Asp Val Val Ser Leu Glu His Glu Ala Leu Val Leu
556 560 565 570
Val Val Thr Ser Thr Phe Gly Asn Gly Asp Pro Pro Glu Asn Gly
571 575 580 585
Glu Ser Phe Ala Ala Ala Leu Met Glu Met Ser Gly Pro Tyr Asn
586 590 595 600
Ser Ser Pro Arg Pro Glu Gln His Lys Ser Tyr Lys Ile Arg Phe
601 605 610 615
Asn Ser Val Ser Cys Ser Asp Pro Leu Val Ser Ser Trp Arg Arg
616 620 625 630
Lys Arg Lys Glu Ser Ser Asn Thr Asp Ser Ala Gly Ala Leu Gly
631 635 640 645
Thr Leu Arg Phe Cys Val Phe Gly Leu GLy Ser Arg Ala Tyr Pro
646 650 655 660
His Phe Cys Ala Phe Ala Arg Ala Val Asp Thr Arg Leu Glu Glu
661 665 670 675
Leu Gly Gly Glu Arg Leu Leu Gln Leu Gly Gln Gly Asp Glu Leu
676 680 685 690
Cys Gly Gln Glu Glu Ala Phe Arg Gly Trp Ala Lys Ala Ala Phe
691 695 700 705
Gln Ala Ser Cys Glu Thr Phe Cys Val Gly Glu Glu Ala Lys Ala
706 710 715 720
Ala Ala Gln Asp Ile Phe Ser Pro Lys Arg Ser Trp Lys Arg Gln
721 725 730 735
Arg Tyr Arg Leu Ser Thr Gln Ala Glu Gly Leu Gln Leu Leu Pro
736 740 745 750
Gly Leu Ile His Val His Arg Arg Lys Met Phe Gln Ala Thr Val
751 755 760 765
Leu Ser Val Glu Asn Leu Gln Ser Ser Lys Ser Thr Arg Ala Thr
766 770 775 780
Ile Leu Val Arg Leu Asp Thr Ala Gly Gln Glu Gly Leu Gln Tyr
781 785 790 795
Gln Pro Gly Asp His Ile Gly Ile Cys Pro Pro Asn Arg Pro Gly
796 800 805 810
Leu Val Glu Ala Leu Leu Ser Arg Val Glu Asp Pro Pro Pro Pro
811 815 820 825
Thr Glu Ser Val Ala Val Glu Gln Leu Glu Lys GLys er Pro Gly
826 830 835 840
Gly Pro Pro Pro Ser Trp Val Arg Asp Pro Arg Leu Pro Pro Cys
841 845 850 855
Thr Leu Arg Gln Ala Leu Thr Phe Phe Leu Asp Ile Thr Ser Pro
856 860 865 870
Pro Ser Pro Arg Leu Leu Arg Leu Leu Ser Thr Leu Ala Glu Glu
871 875 880 885
Pro Ser Glu Gln Gln Glu Leu Glu Thr Leu Ser Gln Asp Pro Arg
886 890 895 900
Arg Tyr Glu Glu Trp Lys Trp Phe Arg Cys Pro Thr Leu Leu Glu
901 905 910 915
Val Leu Glu Gln Phe Pro Ser Val Ala Leu Pro Ala Pro Leu Leu
916 920 925 930
Leu Thr Gln Leu Pro Leu Leu Gln Pro Arg Tyr Tyr Ser Val Ser
931 935 940 945
Ser Ala Pro Asn Ala His Pro Gly Glu Val His Leu Thr Val Ala
946 950 955 960
Val Leu Ala Tyr Arg Thr Gln Asp Gly Leu Gly Pro Leu His Tyr
961 965 970 975
Gly Val Cys Ser Thr Trp Leu Ser Gln Leu Lys Thr Gly Asp Pro
976 980 985 990
Val Pro Cys Phe Ile Arg Gly Ala Pro Ser Phe Arg Leu Pro Pro
991 995 1000 1005
Asp Pro Tyr Val Pro Cys Ile Leu Val Gly Pro Gly Thr Gly Ile
1006 1010 1015 1020
Ala Pro Phe Arg Gly Phe Trp Gln Glu Arg Leu His Asp Ile Glu
1021 1025 1030 1035
Ser Lys Gly Leu Gln Pro Ala Pro Met Thr Leu Val Phe Gly Cys
1036 1040 1045 1050
Arg Cys Ser Gln Leu Asp His Leu Tyr Arg Asp Glu Val Gln Asp
1051 1055 1060 1065
Ala Gln Glu Arg Gly Val Phe Gly Arg Val Leu Thr Ala Phe Ser
1066 1070 1075 1080
Arg Glu Pro Asp Ser Pro Lys Thr Tyr Val Gln Asp Ile Leu Arg
1081 1085 1090 1095
Thr Glu Leu Ala Ala Glu Val His Arg Val Leu Cys Leu Glu Arg
1096 1100 1105 1110
Gly His Met Phe Val Cys Gly Asp Val Thr Met Ala Thr Ser Val
1111 1115 1120 1125
Leu Gln Thr Val Gln Arg Ile Leu Ala Thr Glu Gly Asp Met Glu
1126 1130 1135 1140
Leu Asp Glu Ala Gly Asp Val Ile Gly Val Leu Arg Asp Gln Gln
1141 1145 1150 1155
Arg Tyr His Glu Asp Ile Phe Gly Leu Thr Leu Arg Thr Gln Glu
1156 1160 1165 1170
Val Thr Ser Arg Ile Arg Thr Gln Ser Phe Ser Leu Gln Glu Arg
1171 1175 1180 1185
His Leu Arg Gly Ala Val Pro Trp Ala Phe Asp Pro Pro Gly Pro
1186 1190 1195 1200
Asp Thr Pro Gly Pro
1201 1205
NO 신타아제에 대한 다중클론 항체는 다음의 서열의 인간 NO 신타아제의 전체 분자를 이용하여 수득할 수 있다:
서열 번호:16
Met Gly Asn Leu Lys Ser Val Ala Gln Glu Pro Gly Pro Pro Cys
1 5 10 15
Gly Leu Gly Leu Gly Leu Gly Leu Gly Leu Cys Gly Lys Gln Gly
16 20 25 30
Pro Ala Thr Pro Ala Pro Glu Pro Ser Arg Ala Pro Ala Ser Leu
31 35 40 45
Leu Pro Pro Ala Pro Glu His Ser Pro Pro Ser Ser Pro Leu Thr
46 50 55 60
Gln Pro Pro Glu Gly Pro Lys Phe Pro Arg Val Lys Asn Trp Glu
61 65 70 75
Val GLys er Ile Thr Tyr Asp Thr Leu Ser Ala Gln Ala Gln Gln
76 80 85 90
Asp Gly Pro Cys Thr Pro Arg Arg Cys Leu GLys er Leu Val Phe
91 95 100 105
Pro Arg Lys Leu Gln Gly Arg Pro Ser Pro Gly Pro Pro Ala Pro
106 110 115 120
Glu Gln Leu Leu Ser Gln Ala Arg Asp Phe Ile Asn Gln Tyr Tyr
121 125 130 135
Ser Ser Ile Lys Arg Ser GLys er Gln Ala His Glu Gln Arg Leu
136 140 145 150
Gln Glu Val Glu Ala Glu Val Ala Ala Thr Gly Thr Tyr Gln Leu
151 155 160 165
Arg Glu Ser Glu Leu Val Phe Gly Ala Lys Gln Ala Trp Arg Asn
166 170 175 180
Ala Pro Arg Cys Val Gly Arg Ile Gln Trp Gly Lys Leu Gln Val
181 185 190 195
Phe Asp Ala Arg Asp Cys Arg Ser Ala Gln Glu Met Phe Thr Tyr
196 200 205 210
Ile Cys Asn His Ile Lys Tyr Ala Thr Asn Arg Gly Asn Leu Arg
211 215 220 225
Ser Ala Ile Thr Val Phe Pro Gln Arg Cys Pro Gly Arg Gly Asp
226 230 235 240
Phe Arg Ile Trp Asn Ser Gln Leu Val Arg Tyr Ala Gly Tyr Arg
241 245 250 255
Gln Gln Asp GLy Ser Val Arg Gly Asp Pro Ala Asn Val Glu Ile
256 260 265 270
Thr Glu Leu Cys Ile Gln His Gly Trp Thr Pro Gly Asn Gly Arg
271 275 280 285
Phe Asp Val Leu Pro Leu Leu Leu Gln Ala Pro Asp Glu Pro Pro
286 290 295 300
Glu Leu Phe Leu Leu Pro Pro Glu Leu Val Leu Glu Val Pro Leu
301 305 310 315
Glu His Pro Thr Leu Glu Trp Phe Ala Ala Leu Gly Leu Arg Trp
316 320 325 330
Tyr Ala Leu Pro Ala Val Ser Asn Met Leu Leu Glu Ile Gly Gly
331 335 340 345
Leu Glu Phe Pro Ala Ala Pro Phe Ser Gly Trp Tyr Met Ser Thr
346 350 355 360
Glu Ile Gly Thr Arg Asn Leu Cys Asp Pro His Arg Tyr Asn Ile
361 365 370 375
Leu Glu Asp Val Ala Val Cys Met Asp Leu Asp Thr Arg Thr Thr
376 380 385 390
Ser Ser Leu Trp Lys Asp Lys Ala Ala Val Glu Ile Asn Val Ala
391 395 400 405
Val Leu His Ser Tyr Gln Leu Ala Lys Val Thr Ile Val Asp His
406 410 415 420
His Ala Ala Thr Ala Ser Phe Met Lys His Leu Glu Asn Glu Gln
421 425 430 435
Lys Ala Arg Gly Gly Cys Pro Ala Asp Trp Ala Trp Ile Val Pro
436 440 445 450
Pro Ile Ser GLys er Leu Thr Pro Val Phe His Gln Glu Met Val
451 455 460 465
Asn Tyr Phe Leu Ser Pro Ala Phe Arg Tyr Gln Pro Asp Pro Trp
466 470 475 480
Lys Gly Ser Ala Ala Lys Gly Thr Gly Ile Thr Arg Lys Lys Thr
481 485 490 495
Phe Lys Glu Val Ala Asn Ala Val Lys Ile Ser Ala Ser Leu Met
496 500 505 510
Gly Thr Val Met Ala Lys Arg Val Lys Ala Thr Ile Leu Tyr Gly
511 515 510 525
Ser Glu Thr Gly Arg Ala Gln Ser Tyr Ala Gln Gln Leu Gly Arg
526 530 535 540
Leu Phe Arg Lys Ala Phe Asp Pro Arg Val Leu Cys Met Asp Glu
541 545 550 555
Tyr Asp Val Val Ser Leu Glu His Glu Thr Leu Val Leu Val Val
556 560 565 570
Thr Ser Thr Phe Gly Asn Gly Asp Pro Pro Glu Asn Gly Glu Ser
571 575 580 585
Phe Ala Ala Ala Leu Met Glu Met Ser Gly Pro Tyr Asn Ser Ser
586 590 595 600
Pro Arg Pro Glu Gln His Lys Ser Tyr Lys Ile Arg Phe Asn Ser
601 605 610 615
Ile Ser Cys Ser Asp Pro Leu Val Ser Ser Trp Arg Arg Lys Arg
616 620 625 630
Lys Glu Ser Ser Asn Thr Asp Ser Ala Gly Ala Leu Gly Thr Leu
631 635 640 645
Arg Phe Cys Val Phe Gly Leu GLys er Arg Ala Tyr Pro His Phe
646 650 655 660
Cys Ala Phe Ala Arg Ala Val Asp Thr Arg Leu Glu Glu Leu Gly
661 665 670 675
Gly Glu Arg Leu Leu Gln Leu Gly Gln Gly Asp Glu Leu Cys Gly
676 680 685 690
Gln Glu Glu Ala Phe Arg Gly Trp Ala Gln Ala Ala Phe Gln Ala
691 695 700 705
Ala Cys Glu Thr Phe Cys Val Gly Glu Asp Ala Lys Ala Ala Ala
706 710 715 720
Arg Asp Ile Phe Ser Pro Lys Arg Ser Trp Lys Arg Gln Arg Tyr
721 725 730 735
Arg Leu Ser Ala Gln Ala Glu Gly Leu Gln Leu Leu Pro Gly Leu
736 740 745 750
Ile His Val His Arg Arg Lys Met Phe Gln Ala Thr Ile Arg Ser
751 755 760 765
Val Glu Asn Leu Gln Ser Ser Lys Ser Thr Arg Ala Thr Ile Leu
766 770 775 780
Val Arg Leu Asp Thr Gly Gly Gln Glu Gly Leu Gln Tyr Gln Pro
781 785 790 795
Gly Asp His Ile Gly Val Cys Pro Pro Asn Arg Pro Gly Leu Val
796 800 805 810
Glu Ala Leu Leu Ser Arg Val Glu Asp Pro Pro Ala Pro Thr Glu
811 815 820 825
Pro Val Ala Val Glu Gln Leu Glu Lys Gly Ser Pro Gly Gly Pro
826 830 835 840
Pro Pro Gly Trp Val Arg Asp Pro Arg Leu Pro Pro Cys Thr Leu
841 845 850 855
Arg Gln Ala Leu Thr Phe Phe Leu Asp Ile Thr Ser Pro Pro Ser
856 860 865 870
Pro Gln Leu Leu Arg Leu Leu Ser Thr Leu Ala Glu Glu Pro Arg
871 875 880 885
Glu Gln Gln Glu Leu Glu Ala Leu Ser Gln Asp Pro Arg Arg Tyr
886 890 895 900
Glu Glu Trp Lys Trp Phe Arg Cys Pro Thr Leu Leu Glu Val Leu
901 905 910 915
Glu Gln Phe Pro Ser Val Ala Leu Pro Ala Pro Leu Leu Leu Thr
916 920 925 930
Gln Leu Pro Leu Leu Gln Pro Arg Tyr Tyr Ser Val Ser Ser Ala
931 935 940 945
Pro Ser Thr His Pro Gly Glu Ile His Leu Thr Val Ala Val Leu
946 950 955 960
Ala Tyr Arg Thr Gln Asp Gly Leu Gly Pro Leu His Tyr Gly Val
961 965 970 975
Cys Ser Thr Trp Leu Ser Gln Leu Lys Pro Gly Asp Pro Val Pro
976 980 985 990
Cys Phe Ile Arg Gly Ala Pro Ser Phe Arg Leu Pro Pro Asp Pro
991 995 1000 1005
Ser Leu Pro Cys Ile Leu Val Gly Pro Gly Thr Gly Ile Ala Pro
1006 1010 1015 1020
Phe Arg Gly Phe Trp Gln Glu Arg Leu His Asp Ile Glu Ser Lys
1021 1025 1030 1035
Gly Leu Gln Pro Thr Pro Met Thr Leu Val Phe Gly Cys Arg Cys
1036 1040 1045 1050
Ser Gln Leu Asp His Leu Tyr Arg Asp Glu Val Gln Asn Ala Gln
1051 1055 1060 1065
Gln Arg Gly Val Phe Gly Arg Val Leu Thr Ala Phe Ser Arg Glu
1066 1070 1075 1080
Pro Asp Asn Pro Lys Thr Tyr Val Gln Asp Ile Leu Arg Thr Glu
1081 1085 1090 1095
Leu Ala Ala Glu Val His Arg Val Leu Cys Leu Glu Arg Gly His
1096 1100 1105 1110
Met Phe Val Cys Gly Asp Val Thr Met Ala Thr Asn Val Leu Gln
1111 1115 1120 1125
Thr Val Gln Arg Ile Leu Ala Thr Glu Gly Asp Met Glu Leu Asp
1126 1130 1135 1140
Glu Ala Gly Asp Val Ile Gly Val Leu Arg Asp Gln Gln Arg Tyr
1141 1145 1150 1155
His Glu Asp Ile Phe Gly Leu Thr Leu Arg Thr Gln Glu Val Thr
1156 1160 1165 1170
Ser Arg Ile Arg Thr Gln Ser Phe Ser Leu Gln Glu Arg Gln Leu
1171 1175 1180 1185
Arg Gly Ala Val Pro Trp Ala Phe Asp Pro Pro Gly Ser Asp Thr
1186 1190 1195 1200
Asn Ser Pro
1201 1203
다음 서열의 내피 NO-신타아제 단편은 적합한 항원으로 특히 고려된다:
서열 번호: 17
Pro Trp Ala Phe
1192 1195
서열 번호: 18
Gly Ala Val Pro
1189 1192
서열 번호: 19
Arg
1185
His Leu Arg Gly Ala Val Pro Trp Ala Phe Asp Pro Pro Gly Pro
1186 1190 1195 1200
Asp Thr Pro Gly Pro
1201 1205
서열 번호: 20
Ala Phe Asp Pro Pro Gly Pro
11941195 1200
Asp Thr Pro Gly Pro
1201 1205
서열 번호: 21
His Leu Arg Gly Ala Val Pro Trp Ala Phe Asp
1186 1190 11951196
서열 번호: 22
His Leu Arg Gly Ala Val Pro Trp Ala Phe Asp Pro Pro Gly Pro
1186 1190 1195 1200
Asp Thr Pro Gly Pro
1201 1205
상기 복합의 각 성분의 활성화되고 강화된 형태는 가급적, 외부 충격 (external impact)과 결합된, 중성 용매의 9 분율 (십진법 희석의 경우), 또는 99 분율 (백진법 희석의 경우), 또는 999 분율 (천진법 희석의 경우)에서 각 이전 용액 (최초 용액으로 시작)의 1 분율의 연속 희석에 의한 비례적 농도 감소의 방법을 이용한 동종요법 강화 (potentization)에 의해 최초 용액으로부터 제조될 수 있다. 바람직하게는, 외부 충격은 각 희석액의 복수 수직 진탕 (dynamization)을 수반한다. 바람직하게는, 필요한 효능 수준, 또는 희석 인자까지 각 차후 희석을 위해 개별 용기가 이용된다. 이러한 방법은 동종요법 분야에서 충분히 인정된다. 예로써, 본 발명에 전체로서 참고문헌으로 편입되는 V. Schwabe "Homeopathic medicines", M., 1967, p. 14-29를 참조한다.
가령, 12-백진법 희석액 (C12로 표시됨)을 제조하기 위해, 예로써 3.0 mg/ml의 농도를 갖는 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 최초 매트릭스 용액의 1 분율이 99 분율의 중성 수성 또는 수성-알코올 용매 (바람직하게는, 15%-에틸 알코올)에서 희석되고, 이후 수회 (10회 또는 그 이상) 수직으로 진탕되어 첫 번째 백진법 희석액 (C1로 표시됨)이 산출된다. 두 번째 백진법 희석액 (C2)은 첫 번째 백진법 희석액 C1로부터 제조된다. 이러한 절차는 열두 번째 백진법 희석액 C12을 제조하기 위해 11회 반복된다. 따라서 열두 번째 백진법 희석액 C12는 상이한 용기에서 중성 용매의 99 분율에서 3.0 mg/ml의 농도를 갖는 인간 인슐린-수용체의 베타 소단위의 C-말단 단편에 대한 항체의 최초 매트릭스 용액의 1 분율의 12 연속 희석에 의해 획득된 용액을 나타내고, 이것은 백진법 동종요법 희석액 C12에 대등하다. 희석액 C30과 C200을 획득하기 위해 관련 희석 인자로 유사한 절차가 수행된다. 이들 중간 희석액은 활성을 조사하기 위한 원하는 생물학적 모델에서 조사될 수 있다. 본 발명의 복합을 포함하는 양쪽 항체에 대한 바람직한 활성화되고 강화된 형태는 C12, C30, 그리고 C200 희석액의 혼합물이다. 활성 물질의 다양한 동종요법 희석액 (주로 백진법)의 혼합물을 생물학적으로 활성 액체 성분을 이용할 때, 조성물의 각 성분 (가령, C12, C30, C200)은 끝에서 두 번째 희석액 (가령, 각각 C11, C29, 그리고 C199)이 획득될 때까지 앞서 기술된 절차에 따라 개별적으로 제조되고, 이후 각 성분의 1 분율이 혼합물 조성에 따라 한 용기에 첨가되고 필요한 양의 상기 용매 (가령, 백진법 희석의 경우 97 분율을 가짐)와 혼합된다.
활성 물질을 다양한 동종요법 희석액, 예를 들면, 십진법 및/또는 백진법 (D20, C30, C100 또는 C12, C30, C50 등)의 혼합물로서 이용하는 것이 가능한데, 이의 효율은 적절한 생물학적 모델, 예를 들면, 본 명세서의 실시예에서 기술된 모델에서 상기 희석액을 조사함으로써 실험적으로 결정된다.
강화 및 농도 감소의 과정에서, 수직 진탕은 동종요법 분야에서 허용된 초음파, 전자기장 또는 임의의 유사한 외부 충격 절차에 대한 외부 노출로 대체될 수 있다.
바람직하게는, 본 발명의 제약학적 조성물은 액상 또는 고형 단위 제형의 형태일 수 있다. 제약학적 조성물의 바람직한 액상 형태 (liquid form)는 가급적, 1:1 비율의 인간 인슐린-수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화되고 강화된 형태 및 내피 NO-신타아제에 대한 항체의 활성화되고 강화된 형태에서 혼합물이다. 바람직한 액상 캐리어는 물 또는 물-에틸 알코올 혼합물이다.
본 발명의 제약학적 조성물의 고형 단위 제형은 고형의 제약학적으로 허용되는 캐리어에, 주로 1:1 비율로 혼합되고 액상 제형에 이용되는 활성 성분의 활성화되고 강화된 형태 수성 또는 수성-알코올 용액의 혼합물의 주입을 이용함으로써 제조될 수 있다. 대안으로, 캐리어는 각 필요 희석액으로 연속적으로 주입될 수 있다. 주입의 양쪽 순서가 허용된다.
바람직하게는, 고형 단위 제형에서 제약학적 조성물은 인간 인슐린-수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화되고 강화된 형태 및 내피 NO-신타아제에 대한 항체의 활성화되고 강화된 형태의 수성 또는 수성-알코올성 희석액으로 미리 포화된 제약학적으로 허용되는 캐리어의 과립으로부터 제조된다. 고형 제형은 정제, 캡슐, 마름모꼴정제 등을 비롯한 제약학적 분야에 공지된 임의의 형태일 수 있다. 비활성 제약학적 성분으로서, 윤활제, 붕해제, 결합제 및 착색제를 비롯하여, 글루코오스, 수크로오스, 말토오스, 전분, 이소말토오스, 이소말트 및 약제의 제조에 이용되는 기타 모노-, 올리고-와 폴리사카라이드뿐만 아니라 앞서 언급된 비활성 제약학적 성분과 기타 제약학적으로 허용되는 부형제, 예를 들면, 이소말트, 크로스포비돈, 나트륨 시클라메이트, 나트륨 사카린, 무수성 구연산 등)의 기술적 혼합물이 이용될 수 있다. 바람직한 캐리어는 락토오스와 이소말트이다. 제약학적 제형은 표준 제약학적 부형제, 예를 들면, 미정질 셀룰로오스, 및 마그네슘 스테아레이트를 더욱 포함할 수 있다.
고형 경구 제형을 제조하기 위해, 100-300 μm 과립의 락토오스가 1 kg의 항체 용액 대(對) 5 또는 10 kg의 락토오스 (1:5 내지 1:10)의 비율로 인간 인슐린-수용체의 베타 소단위에 대한 항체의 C-말단 단편의 활성화된-강화된 형태 및 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태의 수성 또는 수성-알코올성 용액에 주입된다. 주입을 달성하기 위해, 락토오스 과립이 비등층 플랜트 (boiling bed plant) (가령, Huttlin GmbH에 의한 "Huttlin Pilotlab") 내에 유동화 비등층 (fluidized boiling bed)에서 포화 관개 (saturation irrigation)에 노출되고, 이후 40℃ 미만의 온도에서 가열된 기류에 의해 건조된다. 항체의 활성화되고 강화된 형태로 포화된 건조된 과립 (10 내지 34 무게 분율)의 추정된 양이 혼합기 내에 배치되고, 그리고 0.1 내지 1 무게 분율의 마그네슘 스테아레이트, 그리고 3 내지 10 무게 분율의 미정질 셀룰로오스와 함께, 25 내지 45 무게 분율의 "비-포화된" 순수한 락토오스 (치료 효율을 감소시키지 않으면서, 비용 감소 및 기술적 공정의 단순화와 가속화의 목적으로 이용됨)와 혼합된다. 획득된 정제 매스 (tablet mass)는 균일하게 혼합되고, 그리고 직접적인 건조 가압에 의해 정제화 (tableting) (가령, Korsch - XL 400 정제 프레스에서)되어 150 내지 500 mg, 바람직하게는, 300 mg 원형 알약이 형성된다. 정제화 이후, 인간 인슐린-수용체의 베타 소단위에 대한 항체의 C-말단 단편의 활성화된-강화된 형태 및 내피 NO-신타아제에 대한 항체의 활성화되고 강화된 형태의 복합의 수성-알코올 용액으로 포화되는 300 mg 알약 (3.0-6.0 mg/알약)이 획득된다. 캐리어에 주입되는 복합의 각 성분은 백진법 동종요법 희석액, 바람직하게는, C12, C30과 C50의 혼합물 또는 백진급 동종 희석액, C12, C30과 C200의 혼합물 형태이다.
본 발명이 임의의 특정 이론에 한정되지 않지만, 본 명세서에서 기술된 항체의 활성화되고 강화된 형태는 분자 형태에 기인한 생물학적 활성을 가질 만큼 충분한 양으로 항체의 이런 분자 형태를 내포하지 않는 것으로 생각된다. 본 발명의 복합 약물의 생물학적 활성은 첨부된 실시예에서 충분하게 증명된다.
본 발명의 제약학적 조성물은 임의의 유형의 당뇨병 환자에게 투여하는데 이용할 수 있다.
상기 제약학적 조성물은 진성 당뇨병의 치료에 고혈당의 단일요법으로 그리고 복합 요법으로 인슐린 대체 요법에 추가로 이용할 수 있고; 및/또는 경구 저혈당 물질, 이를 테면, 비구아니드(메트포르민); 술포닐우레아(글리벤클라미드, 글리피지드, 글리클라지드, 글릭비돈, 글리메피리드); 티아졸리딘에디온 (로시글리타존); 알파-글루코시다제 억제물질(아크로보스) 등과 함께 이용할 수 있고; 뿐만 아니라 당뇨 합병증들을 예방하기 위하여 진성 당뇨볍의 수반 요법에 추가하여 이용할 수 있다.
첨부된 실시예에서 나타낸 것과 같이, 이러한 환자들에게 본 발명의 복합물을 투여하면 혈당 수준을 개선시킨다.
실시예들
실시예 1.
두 가지 실험 연구는 초기 매트릭스 용액 10012, 10030, 100200 배의 과다-희석액의 수득된, 항원 상에서 친화력 정제된 인슐린 베타-소단위에 대한 C-말단 단편에 대한 초저용량의 항체(ULD 항-IR), 초기 매트릭스 용액 10012, 10030, 100200 배의 과다-희석액의 수득된, 항원 상에서 친화력 정제된 내피 NO-신타아제에 대한 초저용량의 항체(ULD 항-ULD 항-eNOS), 뿐만 아니라 인슐린 수용체 베타-소단위의 C 말단 단편에 대한 초저용량의 항체 및 내피 NO-신타제에 대한 초저용량의 항체(ULD 항-IR + ULD 항-eNOS)의 효과를 연구하였다.
세계 보건 기구(WHO) 기준에 따르면, 진성 당뇨병 (유형 I 및 II)은 혈당수준의 증가 (고혈당증) 및 포도당 내성 장애를 특징으로 한다. 후자의 경우 비정상적인 인슐린 분비 및/또는 말초 조직의 인슐린 감응성 감소가 원인일 수 있다. 포도당을 이용하는 신체 조직의 능력의 역학 평가에 근거한 내당 테스트는 신체 조직 내당 장애를 평가하는 감응성 방법이다.
연구 1.
이 연구에서, 150마리의 수컷 Wistar를 이용하였다(연구 시작시 체중은 250-300 g, 월령 3.5-4개월). 10마리 쥐는 고유한 상태였다. 나머지 쥐에게는 스트렙토조토신을 50 mg/kg 약량으로 정맥 투여하였다(진성 당뇨병의 실험 모델). 스트렙토조토신 주사 후 72시간 후, 혈액 혈장 포도당 수준이 12 mmol/l 보다 적지 않은 쥐를 선택하여 7개 집단 (각 20 마리 쥐)으로 나누고, 21일간에 걸쳐 증류수(5 ml/kg/day, 일일 1회 위내), 인슐린® (8 units/kg/day, 피하), Rosiglitazone® (8 mg/kg/day, 일일 2회 위내), ULD anti-IR (5 ml/kg/day 용적내 2.5 ml/kg/day, 일일 1회, 위내), ULD 항-IR + ULD 항-eNOS (5 ml/kg/day, 일일 1회 위내), 그리고 Rosiglitazone® 및 인슐린® 함께, 또는 ULD 항-IR + ULD 항-eNOS 및 인슐린®을 각 조제물에 대응하는 섭생에 따라(상기에서 설명함) 제공하였다. 고유한 쥐에게는 동일 용적의 증류수를 제공하였다. 쥐들에게 조제물 주사 후 7, 14 및 21일 시점에, "포도당 FKD" 키트(Russia)를 사용하여 효소적 방법(포도당 산화효소 방법)으로 공복시 혈액 혈장 포도당 수준을 측정하였다.
표준 방법에 따라 연구 14일 시점(조제물의 투여 14일)에 경구 내당 테스트(OGTT)를 실시하였다(Du Vigneaud and Karr, 1925). 쥐에게 18시간 동안 물을 제공하지 않았다. 테스트 60분 전, 테스트 물질을 제공하였다. 고유한 쥐는 동일 용적의 증류수를 제공받았다. os 50% w/w 물 포도당 용액으로 포도당을 투여하였다 (쥐 체중 kg 당 1 g). 꼬리 정맥으로부터 취한 혈액 시료의 혈청 포도당은 "포도당 FKD" 키트 ( "Pharamaceutical and clinical diagnostics, Russia, www.fkd.ru)를 이용하여 0, 30, 60, 90, 120 분에 측정하였다. 시간에 따른 혈당 농도의 곡선 아래 평균 면적(AUC)을 계산하였다.
스트렙토조토신의 투여로 고유한 동물과 비교하여 쥐의 혈액 혈장 포도당을 실질적으로 증가시켰다(18 mmol/l 대 3.5 mmol/l, p<0.05). ULD 항-IR 집단에서, 조제물의 주사후 7, 14 및 21일 시점에서, 포도당 수준은 대조군보다 평균 22-28% 낮았다; 그러나, 이 차이는 통계학적으로 유의적인 수준에 도달하지 않았다. ULD 항-IR 및 항-eNOS의 조합물이 더 효과적이었다; 실험 14일 및 21일 시점에서 포도당 수준의 감소는 각각 47% 및 42%이었다(p<0.05 대(對) 대조군). 기준 조제물, Rosiglitazone은 실험 14일 및 21일 시점에 포도당 수준을 또한 낮추었다; 이때 효과는 실험 14일 시점에서만 통계학적으로 유의적인 수준에 도달하였다(36%, p<0.05 對 대조군).
효과 약량의 수준으로 투여된 인슐린(예비 연구에서 선택된)이 모든 관찰 기간에 걸쳐 가장 효과적으로 포도당 수준을 낮추었다(고유 대조군의 수준으로 낮추었다)(도 1). 단기-작용 인슐린이 이 연구에서 이용되었고, 혈액 혈장 포도당은 주사후 1시간 후에 측정되었으며, 이 또한 혈당 수준에서 인슐린 약량의 효과에 영향을 주었다는 것이 고려되어야 한다. 배경에 대비하여, 인슐린 및 Rosiglitazone의 복합 이용 또는 인슐린 및 ULD 항-IR + 항-eNOS 복합체의 효과를 충분히 결정하는 것이 가능하지 않았다.
내당 장애(신체에 포도당 이용의 감소)는 진성 당뇨병의 진단 및 치료에 가장 중요한 지표중에 하나다. 고유한 동물에서, 경구 내당 테스트(조제물의 주사후 14일 시점)에서, 복합 조제물 ULD 항-IR + ULD 항-eNOS 그리고 인슐린은 단독으로 투여하였을 때 가장 효과적으로 내당을 증가시켰다. Rosiglitazone은 시간에 따른 농도아래 면적을 또한 감소시켰다(내당 증가); 그러나, 이 효과는 대조군과 비교하여 통계학적으로 유의적이지 않았다(도 2).
연구 2.
본 연구에서, 36 마리의 수컷 Goto-Kakizaki 쥐를 이용하였다(연구 시작시 체중 250-280 g, 주령 10-12주). 이 계통의 쥐는 비-인슐린-의존성 당뇨병의 자발적 발생을 특징으로 한다. 이 동물을 3개 집단(각 집단에 12마리 쥐)으로 나누고, 증류수(5 ml/kg, 일일 1회, 위내), 또는 ULD 항-IR (2.5 ml/kg 일일 1회, 위내), 또는 ULD 항-IR + ULD 항-eNOS (5 ml/kg, 일일 1회, 위내)를 28일간 제공하였다. 조제물을 제공하기 전, 그리고 조제물을 주사후 4, 8, 12, 16, 20, 24, 28 일 시점에서 포도당 분석기를 이용하여(Beckman, Fullerton, California, USA) 혈액 혈장 포도당 수준을 측정하였다. 28일 시점에서, 내당 테스트를 실시하였다. (포도당 p.o., 1 g/kg).
ULD 항-IR의 주사는 쥐의 혈액 혈장 포도당 수준을 유의적으로(p<0.05) 감소시켰다; 그러나, 복합체 ULD 항-IR + ULD 항-eNOS의 이용이 좀더 효과적이었다 (p<0.001 대 대조군) (도 3).
이 결과들은 조제물의 주사후 28일 시점에 실시한 내당 테스트 데이터에 의해 확인되었다(도 4). ULD 항-IR의 주사는 내당을 증가시켰다(대조군과 비교하여 44% AUC의 통계학적으로 무의미한 감소). 동시에, ULD 항-IR + ULD 항-eNOS 복합물의 주사에 의해 이 매개변수(AUC)의 감소는 62%이었고, 대조군과 비교하여 통계학적으로 유의적이었다(p<0.05).
실시예 2.
인슐린 수용체의 베타 소단위 C-말단 단편에 대한 초저용량 항체 (ULD 항-IR) 및 내피 NO-신타아제에 대한 초저용량 항체 (ULD 항-eNOS)의 복합물의 임상 연구를 인간에서 실시하였는데, 이때 각 항체는 이소말토에 주입된 동종요법 희석액 C12, C30, 및 C200의 물-알코올 혼합물 형태다.
유형 1 진성 당뇨병 (DM) 환자에서 ULD 항-IR + ULD 항-eNOS의 효과 및 안전도에 대한 오픈-라벨 비-비교 연구(noncomparative)는 심각한 마크로 및 마이크로 혈관 병리 징후 없이 가벼운 내지 중간 수준의 심각한 유형 I, DM으로 진단받은 환자를 포함한다. 임상 시험에 참가한다는 환자의 자발적 동의를 얻은 후, 환자가 포함/배제 기준에 준하는지를 정하기 위한 목적으로 초기 조사를 실시하였다. 연구 시작 전 2주간의 "세탁(wash-out) 기간"이 제공되고, 이 기간 동안 환자들을 검사하였다(불평사항, 공복 혈당, 당화된 헤모글로빈, 일일 혈당 프로파일, 그리고 지단백량(lipoproteinogram) 그리고 현재 치료의 효과 및 안전도를 평가하였다). 12주간 연구에서 주요 종료점은 "세탁(wash-out)"기간에 측정하고, 치료 6주 및 12주에 측정하였다. 4명의 환자에서 "세탁(wash-out)"기간 및 연구 종료시, CGMS 시스템의 도움으로 혈당 수준의 지속적인 모니터링을 실시하였다. 지속적 포도당 모니터링 시스템(CGMS)은 3일에 걸쳐 포도당 수준을 조절하는 것이 가능하도록 한다. 테스트 결과에서 인슐린 요법 및 생활 양식에 따라 3일에 결쳐 포도당 수준이 어떻게 변화되는지를 보여준다. 이 데이터는 식사, 약물 복용 또는 신체적인 부하에 따라 높은 또는 낮은 포도당 수준 기간을 구별하는 것을 도와준다. 그래프 형태의 시스템에서 최소 포도당 수준 2.2 mmol/L, 최대 값 22.2 mmol/L, 그리고 일일 평균 혈당수준을 보여준다.
대사기능장애 단계에서 약한 정도에서 중간 정도의 심각성을 가진 DM 유형 1 DM 환자들은 연구 포함 및 연구 기간 전 표준 인슐린 요법을 제공받았다:
1. 장기-작용 인슐린 (Protaphane®, Lantus®), 평균 약량 12 내지 26 U/day.
2. 단기-작용 인슐린 (Apidra®, Novorapid®, Aktropid®) 평균 약량:
·아침 8-10 U/day
·점심 8-12 U/day
·저녁 8-13 U/day.
환자의 참여 능력을 확인한 후, 환자들을 연구에 포함시켰고, 그리고 유형 1의 DM 표준 요법에 추가로 ULD 항-IR + ULD 항-eNOS 조제물을 제공받았다; 투여 방식은 DM 유형 1의 중증도 및 보상에 따라 달라진다. 연구에 포함된 환자들은 상이한 약량의 ULD 항-IR + ULD 항-eNOS 조제물을 제공받았다:
1. 4명의 환자들 일일 8:00 AM, 12:00 PM, 6:00 PM, 10:00 PM 4회 1개 정제.
2. 2명의 환자들 - 일일 8:00 AM, 6:00 PM 2회 1개 정제.
3 및 8 주 시점에, 일일 혈당 프로파일을 또한 관리하였고(8개 지점 측정), 환자는 전화로 접촉하였다(전화 "방문"). 임상 검사는 매주 실시하였다. 전부 합해서, 환자들은 14주간 관찰하였다.
6명의 환자들이 연구에 포함되었는데, 이중 5명이 연구 프로토콜을 마쳤다. 혈당 측정은 기준에서 그리고 치료후 3, 6, 및 12주에 8개 지점 일일 포도당 프로파일에 의해 실행하였다. 당화된 헤모글로빈은 기준 및 요법 12주 후에 결정하였다.
연구에 포함된 모든 유형 1, DM 환자들은 연구 약물을 이용하여 6주 요법 후 떨어지는 경향이 있었다. 8개 점 일일 포도당 프로파일에 따라, DM 유형 1, DM 환자에서 혈당이 평균 20% 감소되었다. 요법 12주 후, 당화된(glycated) 헤모글로빈은 기저 값과 비교하여 평균 10-15% 더 낮았다.
모든 환자들에서 CGMS 시스템으로 연속 포도당 모니터링 결과에 따라, ULD 항-IR + ULD 항-eNOS으로 3개월 요법을 실시한 결과 평균 일일 혈당이 감소되었고, 기저 수준의 15-20%의 최대 및 최소 혈당의 진폭이 감소되었다.
유형 1 DM의 환자 번호 103의 환자의 대사기능장애 단계에서, 일일 혈당의 48%의 급격한 감소가 예기치 않게 관찰되었고(1 주 - 8.0 mmol/L, 12 주 - 4.8 mmol/L), 이는 인슐린 요법의 수정을 요구하였다(단기 작용 인슐린의 일일 략량이 8 U/d로 감소되었다). 평균 혈당수준 및 당화된 헤모글로빈의 역학은 도 5에 나타낸다.
연구 과정에서, 심각한 부작용을 포함하는 부작용 기록이 없었고, 이는 조제물의 안전성을 증명한다.
실시예 3.
인슐린 수용체의 베타 소단위 C-말단 단편에 대한 초저용량의 항체(ULD 항-IR)와 내피 NO-신타아제에 대한 초저용량의 항체(ULD 항-eNOS) 복합물의 임상 연구를 인간에서 실시하였는데, 이들 항체는 각각 이소말토에 주입된 동종 요법 희석액 C12, C30, 및 C200의 물-알코올 혼합물 형태다.
유형 2 진성 당뇨병 (DM) 환자에서 ULD 항-IR + ULD 항-eNOS의 효과 및 안전도에 대한 오픈-라벨 비-비교 연구(noncomparative)는 심각한 마크로 및 마이크로 혈관 병리 징후 없이 가벼운 내지 중간 수준의 심각한 유형 2, DM으로 진단을 환자를 포함하는데, 이들 환자는 평균 Metformin 치료량을 제공받았다. 임상 시험에 참가한다는 환자의 자발적 동의를 얻은 후, 환자가 포함/배제 기준에 준하는지를 정하기 위한 목적의 초기 조사를 실시하였다. 연구에 환자의 참여 가능성을 확인할 때, 이 환자는 유형 2 DM 표준 요법에 추가하여 하루에 4회 Subbetta 정제 1개를 제공받았다. 연구 시작 전 2주간의 "세탁(wash-out) 기간"이 제공되고, 이 기간 동안 환자들을 검사하였다(불평사항, 공복 혈당, 당화된 헤모글로빈, 일일 혈당 프로파일, 그리고 지단백량(lipoproteinogram) 및 인슐린 저항 지수 지표(HOMA-IR)그리고 현재 치료의 효과 및 안전도를 평가하였다). 12주간 연구에서 주요 종료점은 "세탁(wash-out)"기간에 측정하고, 치료 6주 및 12주에 측정하였다. 4명의 환자에서 "세탁(wash-out)"기간 및 연구 종료시, CGMS 시스템의 도움으로 혈당 수준의 지속적인 모니터링을 실시하였다. 3 및 8 주 시점에, 8개 지점 혈당 프로파일을 추가로 관리하였고, 전화 "방문"을 실시하였다. 임상 검사는 매주 실시하였다. 전부 합해서, 환자들은 14주간 관찰하였다.
대사기능이상 단계에서 유형 2 DM을 가진 11명 환자들이 이 연구에 포함되었다. 한명의 환자는 이 연구에서 자발적으로 낙오하였다. 나머지 환자들은 치료를 계속하였다. 유형 2 DM 환자에서, 8개 점 일일 포도당 프로파일에 따라, 6주 시점에 DM 환자에서 혈당이 평균 20% 감소되었다. 요법 12주 후, 당화된(glycated) 헤모글로빈은 기저 값과 비교하여 평균 15-19%의 감소가 기록되었다.
12주 과정의 모든 환자들에서, 혈액 테스트 매개변수들(적혈구, 헤모글로빈, 백혈구, 혈소판, 백혈구 포뮬라, ESR), 지단백량(lipoproteinogram), EKG, 간 기능 분석(ALT, AST, 빌리루빈 및 이의 분획들)은 정상 한계 범위내에 유지되었다. HOMA-IR 테스트에 의해 측정된 인슐린 저항성은 기저 값의 17-19%로 평균 감소되었다.
12주의 연구 과정에서, 심각한 부작용을 포함하는 부작용 기록이 없었고, 이는 조제물의 안전성을 증명한다. 간 기능 활성의 비정상도 또한 나타나지 않았다.
평균 혈당수준 및 당화된 헤모글로빈의 역학은 도 6에 나타낸다.
실시예 4.
당뇨병 유형 II로 진단을 받은 환자 X(남성, 74세)는 하루에 2회 5 mg의 약량으로 Maninil (Glibenclamide, Berlin Chemie)를 제공받고 있다. 이러한 치료에도 불구하고 3년 전 종골(calcaneal)에 깊은 괴사성 발 궤양이 나타났었다. 이 환자는 외과 병동에 2차례 입원하였다; 그러나, 치료 결과는 유의적으로 개선되지 않았다. 물-에탄올 동종요법 희석액 C12, C30, C200 의 혼합물( Ab RI + Ab NOS)로 이소말토에 주입된 인슐린 수용체 베타 소단위의 C-말단에 대한 항체의 활성화된-강화된 형태(초저용량) (Ab RI) 와 내피 NO 신타아제에 대한 항체의 활성화된-강화된 형태 (Ab NOS)를 포함하는 청구된 제약학적 조성물, 250 mg의 정제를 Maninil 요법에 추가하였다. 1개월 치료 결과, Maniil®의 약량을 일일 5 mg 으로 줄였다(잠자기 전 1개 정제). 포도당 혈당 수준은 정상 값으로 떨어졌다(8-10 mmol/L 내지 5-6 mmol/L). 주어진 요법은 발 궤양을 저지하였다. 궤양이 괴사 물질에서 깨끗해지고, 각피화되었다. 검사시 궤양이 사라졌고, 종골에서 피부가 벗겨진 둥근 백색 부위(직경 3.5 cm)가 있었다.
SEQUENCE LISTING
<110> Epshtein, Oleg Iliich
<120> A combination pharmaceutical composition and methods of
treating diabetes and metabolic disorders
<130> 841-026-PCT
<140> PCT/IB2011/002177
<141> 2011-07-15
<150> RU2010130348
<151> 2010-07-21
<150> RU2011127051
<151> 2011-07-01
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/organism="Homo sapiens"
<400> 8
Ser Leu Gly Asp Val Gly Asn Val Thr Val Ala Val Pro Thr Val Ala
1 5 10 15
Ala Phe Pro Asn Thr Ser Ser Thr Ser Val Pro Thr Ser Pro Glu Glu
20 25 30
His Arg Pro Phe Glu Lys Val Val Asn Lys Glu Ser Leu Val Ile Ser
35 40 45
Gly Leu Arg His Phe Thr Gly Tyr Arg Ile Glu Leu Gln Ala Cys Asn
50 55 60
Gln Asp Thr Pro Glu Glu Arg Cys Ser Val Ala Ala Tyr Val Ser Ala
65 70 75 80
Arg Thr Met Pro Glu Ala Lys Ala Asp Asp Ile Val Gly Pro Val Thr
85 90 95
His Glu Ile Phe Glu Asn Asn Val Val His Leu Met Trp Gln Glu Pro
100 105 110
Lys Glu Pro Asn Gly Leu Ile Val Leu Tyr Glu Val Ser Tyr Arg Arg
115 120 125
Tyr Gly Asp Glu Glu Leu His Leu Cys Val Ser Arg Lys His Phe Ala
130 135 140
Leu Glu Arg Gly Cys Arg Leu Arg Gly Leu Ser Pro Gly Asn Tyr Ser
145 150 155 160
Val Arg Ile Arg Ala Thr Ser Leu Ala Gly Asn Gly Ser Trp Thr Glu
165 170 175
Pro Thr Tyr Phe Tyr Val Thr Asp Tyr Leu Asp Val Pro Ser Asn Ile
180 185 190
Ala Lys Ile Ile Ile Gly Pro Leu Ile Phe Val Phe Leu Phe Ser Val
195 200 205
Val Ile Gly Ser Ile Tyr Leu Phe Leu Arg Lys Arg Gln Pro Asp Gly
210 215 220
Pro Leu Gly Pro Leu Tyr Ala Ser Ser Asn Pro Glu Tyr Leu Ser Ala
225 230 235 240
Ser Asp Val Phe Pro Cys Ser Val Tyr Val Pro Asp Glu Trp Glu Val
245 250 255
Ser Arg Glu Lys Ile Thr Leu Leu Arg Glu Leu Gly Gln Gly Ser Phe
260 265 270
Gly Met Val Tyr Glu Gly Asn Ala Arg Asp Ile Ile Lys Gly Glu Ala
275 280 285
Glu Thr Arg Val Ala Val Lys Thr Val Asn Glu Ser Ala Ser Leu Arg
290 295 300
Glu Arg Ile Glu Phe Leu Asn Glu Ala Ser Val Met Lys Gly Phe Thr
305 310 315 320
Cys His His Val Val Arg Leu Leu Gly Val Val Ser Lys Gly Gln Pro
325 330 335
Thr Leu Val Val Met Glu Leu Met Ala His Gly Asp Leu Lys Ser Tyr
340 345 350
Leu Arg Ser Leu Arg Pro Glu Ala Glu Asn Asn Pro Gly Arg Pro Pro
355 360 365
Pro Thr Leu Gln Glu Met Ile Gln Met Ala Ala Glu Ile Ala Asp Gly
370 375 380
Met Ala Tyr Leu Asn Ala Lys Lys Phe Val His Arg Asp Leu Ala Ala
385 390 395 400
Arg Asn Cys Met Val Ala His Asp Phe Thr Val Lys Ile Gly Asp Phe
405 410 415
Gly Met Thr Arg Asp Ile Tyr Glu Thr Asp Tyr Tyr Arg Lys Gly Gly
420 425 430
Lys Gly Leu Leu Pro Val Arg Trp Met Ala Pro Glu Ser Leu Lys Asp
435 440 445
Gly Val Phe Thr Thr Ser Ser Asp Met Trp Ser Phe Gly Val Val Leu
450 455 460
Trp Glu Ile Thr Ser Leu Ala Glu Gln Pro Tyr Gln Gly Leu Ser Asn
465 470 475 480
Glu Gln Val Leu Lys Phe Val Met Asp Gly Gly Tyr Leu Asp Gln Pro
485 490 495
Asp Asn Cys Pro Glu Arg Val Thr Asp Leu Met Arg Met Cys Trp Gln
500 505 510
Phe Asn Pro Lys Met Arg Pro Thr Phe Leu Glu Ile Val Asn Leu Leu
515 520 525
Lys Asp Asp Leu His Pro Ser Phe Pro Glu Val Ser Phe Phe His Ser
530 535 540
Glu Glu Asn Lys Ala Pro Glu Ser Glu Glu Leu Glu Met Glu Phe Glu
545 550 555 560
Asp Met Glu Asn Val Pro Leu Asp Arg Ser Ser His Cys Gln Arg Glu
565 570 575
Glu Ala Gly Gly Arg Asp Gly Gly Ser Ser Leu Gly Phe Lys Arg Ser
580 585 590
Tyr Glu Glu His Ile Pro Tyr Thr His Met Asn Gly Gly Lys Lys Asn
595 600 605
Gly Arg Ile Leu Thr Leu Pro Arg Ser Asn Pro Ser
610 615 620
<210> 9
<211> 10
<212> PRT
<213> Homo sapiens
<220>
<221> SOURCE
<222> 1..10
<223> /mol_type="protein"
/organism="Homo sapiens"
<400> 9
Lys Lys Asn Gly Arg Ile Leu Thr Leu Pro
1 5 10
<210> 10
<211> 11
<212> PRT
<213> Homo sapiens
<220>
<221> SOURCE
<222> 1..11
<223> /mol_type="protein"
/organism="Homo sapiens"
<400> 10
Arg Ile Leu Thr Leu Pro Arg Ser Asn Pro Ser
1 5 10
<210> 11
<211> 7
<212> PRT
<213> Homo sapiens
<220>
<221> SOURCE
<222> 1..7
<223> /mol_type="protein"
/organism="Homo sapiens"
<400> 11
Lys Asn Gly Arg Ile Leu Thr
1 5
<210> 12
<211> 17
<212> PRT
<213> Homo sapiens
<220>
<221> SOURCE
<222> 1..17
<223> /mol_type="protein"
/organism="Homo sapiens"
<400> 12
Gly Gly Lys Lys Asn Gly Arg Ile Leu Thr Leu Pro Arg Ser Asn Pro
1 5 10 15
Ser
<210> 13
<211> 18
<212> PRT
<213> Homo sapiens
<220>
<221> SOURCE
<222> 1..18
<223> /mol_type="protein"
/organism="Homo sapiens"
<400> 13
Asn Gly Gly Lys Lys Asn Gly Arg Ile Leu Thr Leu Pro Arg Ser Asn
1 5 10 15
Pro Ser
<210> 14
<211> 1382
<212> PRT
<213> Homo sapiens
<220>
<221> SOURCE
<222> 1..1382
<223> /mol_type="protein"
/organism="Homo sapiens"
<400> 14
Met Ala Thr Gly Gly Arg Arg Gly Ala Ala Ala Ala Pro Leu Leu Val
1 5 10 15
Ala Val Ala Ala Leu Leu Leu Gly Ala Ala Gly His Leu Tyr Pro Gly
20 25 30
Glu Val Cys Pro Gly Met Asp Ile Arg Asn Asn Leu Thr Arg Leu His
35 40 45
Glu Leu Glu Asn Cys Ser Val Ile Glu Gly His Leu Gln Ile Leu Leu
50 55 60
Met Phe Lys Thr Arg Pro Glu Asp Phe Arg Asp Leu Ser Phe Pro Lys
65 70 75 80
Leu Ile Met Ile Thr Asp Tyr Leu Leu Leu Phe Arg Val Tyr Gly Leu
85 90 95
Glu Ser Leu Lys Asp Leu Phe Pro Asn Leu Thr Val Ile Arg Gly Ser
100 105 110
Arg Leu Phe Phe Asn Tyr Ala Leu Val Ile Phe Glu Met Val His Leu
115 120 125
Lys Glu Leu Gly Leu Tyr Asn Leu Met Asn Ile Thr Arg Gly Ser Val
130 135 140
Arg Ile Glu Lys Asn Asn Glu Leu Cys Tyr Leu Ala Thr Ile Asp Trp
145 150 155 160
Ser Arg Ile Leu Asp Ser Val Glu Asp Asn Tyr Ile Val Leu Asn Lys
165 170 175
Asp Asp Asn Glu Glu Cys Gly Asp Ile Cys Pro Gly Thr Ala Lys Gly
180 185 190
Lys Thr Asn Cys Pro Ala Thr Val Ile Asn Gly Gln Phe Val Glu Arg
195 200 205
Cys Trp Thr His Ser His Cys Gln Lys Val Cys Pro Thr Ile Cys Lys
210 215 220
Ser His Gly Cys Thr Ala Glu Gly Leu Cys Cys His Ser Glu Cys Leu
225 230 235 240
Gly Asn Cys Ser Gln Pro Asp Asp Pro Thr Lys Cys Val Ala Cys Arg
245 250 255
Asn Phe Tyr Leu Asp Gly Arg Cys Val Glu Thr Cys Pro Pro Pro Tyr
260 265 270
Tyr His Phe Gln Asp Trp Arg Cys Val Asn Phe Ser Phe Cys Gln Asp
275 280 285
Leu His His Lys Cys Lys Asn Ser Arg Arg Gln Gly Cys His Gln Tyr
290 295 300
Val Ile His Asn Asn Lys Cys Ile Pro Glu Cys Pro Ser Gly Tyr Thr
305 310 315 320
Met Asn Ser Ser Asn Leu Leu Cys Thr Pro Cys Leu Gly Pro Cys Pro
325 330 335
Lys Val Cys His Leu Leu Glu Gly Glu Lys Thr Ile Asp Ser Val Thr
340 345 350
Ser Ala Gln Glu Leu Arg Gly Cys Thr Val Ile Asn Gly Ser Leu Ile
355 360 365
Ile Asn Ile Arg Gly Gly Asn Asn Leu Ala Ala Glu Leu Glu Ala Asn
370 375 380
Leu Gly Leu Ile Glu Glu Ile Ser Gly Tyr Leu Lys Ile Arg Arg Ser
385 390 395 400
Tyr Ala Leu Val Ser Leu Ser Phe Phe Arg Lys Leu Arg Leu Ile Arg
405 410 415
Gly Glu Thr Leu Glu Ile Gly Asn Tyr Ser Phe Tyr Ala Leu Asp Asn
420 425 430
Gln Asn Leu Arg Gln Leu Trp Asp Trp Ser Lys His Asn Leu Thr Ile
435 440 445
Thr Gln Gly Lys Leu Phe Phe His Tyr Asn Pro Lys Leu Cys Leu Ser
450 455 460
Glu Ile His Lys Met Glu Glu Val Ser Gly Thr Lys Gly Arg Gln Glu
465 470 475 480
Arg Asn Asp Ile Ala Leu Lys Thr Asn Gly Asp Gln Ala Ser Cys Glu
485 490 495
Asn Glu Leu Leu Lys Phe Ser Tyr Ile Arg Thr Ser Phe Asp Lys Ile
500 505 510
Leu Leu Arg Trp Glu Pro Tyr Trp Pro Pro Asp Phe Arg Asp Leu Leu
515 520 525
Gly Phe Met Leu Phe Tyr Lys Glu Ala Pro Tyr Gln Asn Val Thr Glu
530 535 540
Phe Asp Gly Gln Asp Ala Cys Gly Ser Asn Ser Trp Thr Val Val Asp
545 550 555 560
Ile Asp Pro Pro Leu Arg Ser Asn Asp Pro Lys Ser Gln Asn His Pro
565 570 575
Gly Trp Leu Met Arg Gly Leu Lys Pro Trp Thr Gln Tyr Ala Ile Phe
580 585 590
Val Lys Thr Leu Val Thr Phe Ser Asp Glu Arg Arg Thr Tyr Gly Ala
595 600 605
Lys Ser Asp Ile Ile Tyr Val Gln Thr Asp Ala Thr Asn Pro Ser Val
610 615 620
Pro Leu Asp Pro Ile Ser Val Ser Asn Ser Ser Ser Gln Ile Ile Leu
625 630 635 640
Lys Trp Lys Pro Pro Ser Asp Pro Asn Gly Asn Ile Thr His Tyr Leu
645 650 655
Val Phe Trp Glu Arg Gln Ala Glu Asp Ser Glu Leu Phe Glu Leu Asp
660 665 670
Tyr Cys Leu Lys Gly Leu Lys Leu Pro Ser Arg Thr Trp Ser Pro Pro
675 680 685
Phe Glu Ser Glu Asp Ser Gln Lys His Asn Gln Ser Glu Tyr Glu Asp
690 695 700
Ser Ala Gly Glu Cys Cys Ser Cys Pro Lys Thr Asp Ser Gln Ile Leu
705 710 715 720
Lys Glu Leu Glu Glu Ser Ser Phe Arg Lys Thr Phe Glu Asp Tyr Leu
725 730 735
His Asn Val Val Phe Val Pro Arg Lys Thr Ser Ser Gly Thr Gly Ala
740 745 750
Glu Asp Pro Arg Pro Ser Arg Lys Arg Arg Ser Leu Gly Asp Val Gly
755 760 765
Asn Val Thr Val Ala Val Pro Thr Val Ala Ala Phe Pro Asn Thr Ser
770 775 780
Ser Thr Ser Val Pro Thr Ser Pro Glu Glu His Arg Pro Phe Glu Lys
785 790 795 800
Val Val Asn Lys Glu Ser Leu Val Ile Ser Gly Leu Arg His Phe Thr
805 810 815
Gly Tyr Arg Ile Glu Leu Gln Ala Cys Asn Gln Asp Thr Pro Glu Glu
820 825 830
Arg Cys Ser Val Ala Ala Tyr Val Ser Ala Arg Thr Met Pro Glu Ala
835 840 845
Lys Ala Asp Asp Ile Val Gly Pro Val Thr His Glu Ile Phe Glu Asn
850 855 860
Asn Val Val His Leu Met Trp Gln Glu Pro Lys Glu Pro Asn Gly Leu
865 870 875 880
Ile Val Leu Tyr Glu Val Ser Tyr Arg Arg Tyr Gly Asp Glu Glu Leu
885 890 895
His Leu Cys Val Ser Arg Lys His Phe Ala Leu Glu Arg Gly Cys Arg
900 905 910
Leu Arg Gly Leu Ser Pro Gly Asn Tyr Ser Val Arg Ile Arg Ala Thr
915 920 925
Ser Leu Ala Gly Asn Gly Ser Trp Thr Glu Pro Thr Tyr Phe Tyr Val
930 935 940
Thr Asp Tyr Leu Asp Val Pro Ser Asn Ile Ala Lys Ile Ile Ile Gly
945 950 955 960
Pro Leu Ile Phe Val Phe Leu Phe Ser Val Val Ile Gly Ser Ile Tyr
965 970 975
Leu Phe Leu Arg Lys Arg Gln Pro Asp Gly Pro Leu Gly Pro Leu Tyr
980 985 990
Ala Ser Ser Asn Pro Glu Tyr Leu Ser Ala Ser Asp Val Phe Pro Cys
995 1000 1005
Ser Val Tyr Val Pro Asp Glu Trp Glu Val Ser Arg Glu Lys Ile Thr
1010 1015 1020
Leu Leu Arg Glu Leu Gly Gln Gly Ser Phe Gly Met Val Tyr Glu Gly
1025 1030 1035 1040
Asn Ala Arg Asp Ile Ile Lys Gly Glu Ala Glu Thr Arg Val Ala Val
1045 1050 1055
Lys Thr Val Asn Glu Ser Ala Ser Leu Arg Glu Arg Ile Glu Phe Leu
1060 1065 1070
Asn Glu Ala Ser Val Met Lys Gly Phe Thr Cys His His Val Val Arg
1075 1080 1085
Leu Leu Gly Val Val Ser Lys Gly Gln Pro Thr Leu Val Val Met Glu
1090 1095 1100
Leu Met Ala His Gly Asp Leu Lys Ser Tyr Leu Arg Ser Leu Arg Pro
1105 1110 1115 1120
Glu Ala Glu Asn Asn Pro Gly Arg Pro Pro Pro Thr Leu Gln Glu Met
1125 1130 1135
Ile Gln Met Ala Ala Glu Ile Ala Asp Gly Met Ala Tyr Leu Asn Ala
1140 1145 1150
Lys Lys Phe Val His Arg Asp Leu Ala Ala Arg Asn Cys Met Val Ala
1155 1160 1165
His Asp Phe Thr Val Lys Ile Gly Asp Phe Gly Met Thr Arg Asp Ile
1170 1175 1180
Tyr Glu Thr Asp Tyr Tyr Arg Lys Gly Gly Lys Gly Leu Leu Pro Val
1185 1190 1195 1200
Arg Trp Met Ala Pro Glu Ser Leu Lys Asp Gly Val Phe Thr Thr Ser
1205 1210 1215
Ser Asp Met Trp Ser Phe Gly Val Val Leu Trp Glu Ile Thr Ser Leu
1220 1225 1230
Ala Glu Gln Pro Tyr Gln Gly Leu Ser Asn Glu Gln Val Leu Lys Phe
1235 1240 1245
Val Met Asp Gly Gly Tyr Leu Asp Gln Pro Asp Asn Cys Pro Glu Arg
1250 1255 1260
Val Thr Asp Leu Met Arg Met Cys Trp Gln Phe Asn Pro Lys Met Arg
1265 1270 1275 1280
Pro Thr Phe Leu Glu Ile Val Asn Leu Leu Lys Asp Asp Leu His Pro
1285 1290 1295
Ser Phe Pro Glu Val Ser Phe Phe His Ser Glu Glu Asn Lys Ala Pro
1300 1305 1310
Glu Ser Glu Glu Leu Glu Met Glu Phe Glu Asp Met Glu Asn Val Pro
1315 1320 1325
Leu Asp Arg Ser Ser His Cys Gln Arg Glu Glu Ala Gly Gly Arg Asp
1330 1335 1340
Gly Gly Ser Ser Leu Gly Phe Lys Arg Ser Tyr Glu Glu His Ile Pro
1345 1350 1355 1360
Tyr Thr His Met Asn Gly Gly Lys Lys Asn Gly Arg Ile Leu Thr Leu
1365 1370 1375
Pro Arg Ser Asn Pro Ser
1380
<210> 15
<211> 1205
<212> PRT
<213> Bos taurus
<220>
<221> SOURCE
<222> 1..1205
<223> /mol_type="protein"
/organism="Bos taurus"
<400> 15
Met Gly Asn Leu Lys Ser Val Gly Gln Glu Pro Gly Pro Pro Cys Gly
1 5 10 15
Leu Gly Leu Gly Leu Gly Leu Gly Leu Cys Gly Lys Gln Gly Pro Ala
20 25 30
Ser Pro Ala Pro Glu Pro Ser Arg Ala Pro Ala Pro Ala Thr Pro His
35 40 45
Ala Pro Asp His Ser Pro Ala Pro Asn Ser Pro Thr Leu Thr Arg Pro
50 55 60
Pro Glu Gly Pro Lys Phe Pro Arg Val Lys Asn Trp Glu Leu Gly Ser
65 70 75 80
Ile Thr Tyr Asp Thr Leu Cys Ala Gln Ser Gln Gln Asp Gly Pro Cys
85 90 95
Thr Pro Arg Cys Cys Leu Gly Ser Leu Val Leu Pro Arg Lys Leu Gln
100 105 110
Thr Arg Pro Ser Pro Gly Pro Pro Pro Ala Glu Gln Leu Leu Ser Gln
115 120 125
Ala Arg Asp Phe Ile Asn Gln Tyr Tyr Ser Ser Ile Lys Arg Ser Gly
130 135 140
Ser Gln Ala His Glu Glu Arg Leu Gln Glu Val Glu Ala Glu Val Ala
145 150 155 160
Ser Thr Gly Thr Tyr His Leu Arg Glu Ser Glu Leu Val Phe Gly Ala
165 170 175
Lys Gln Ala Trp Arg Asn Ala Pro Arg Cys Val Gly Arg Ile Gln Trp
180 185 190
Gly Lys Leu Gln Val Phe Asp Ala Arg Asp Cys Ser Ser Ala Gln Glu
195 200 205
Met Phe Thr Tyr Ile Cys Asn His Ile Lys Tyr Ala Thr Asn Arg Gly
210 215 220
Asn Leu Arg Ser Ala Ile Thr Val Phe Pro Gln Arg Ala Pro Gly Arg
225 230 235 240
Gly Asp Phe Arg Ile Trp Asn Ser Gln Leu Val Arg Tyr Ala Gly Tyr
245 250 255
Arg Gln Gln Asp Gly Ser Val Arg Gly Asp Pro Ala Asn Val Glu Ile
260 265 270
Thr Glu Leu Cys Ile Gln His Gly Trp Thr Pro Gly Asn Gly Arg Phe
275 280 285
Asp Val Leu Pro Leu Leu Leu Gln Ala Pro Asp Glu Ala Pro Glu Leu
290 295 300
Phe Val Leu Pro Pro Glu Leu Val Leu Glu Val Pro Leu Glu His Pro
305 310 315 320
Thr Leu Glu Trp Phe Ala Ala Leu Gly Leu Arg Trp Tyr Ala Leu Pro
325 330 335
Ala Val Ser Asn Met Leu Leu Glu Ile Gly Gly Leu Glu Phe Ser Ala
340 345 350
Ala Pro Phe Ser Gly Trp Tyr Met Ser Thr Glu Ile Gly Thr Arg Asn
355 360 365
Leu Cys Asp Pro His Arg Tyr Asn Ile Leu Glu Asp Val Ala Val Cys
370 375 380
Met Asp Leu Asp Thr Arg Thr Thr Ser Ser Leu Trp Lys Asp Lys Ala
385 390 395 400
Ala Val Glu Ile Asn Leu Ala Val Leu His Ser Phe Gln Leu Ala Lys
405 410 415
Val Thr Ile Val Asp His His Ala Ala Thr Val Ser Phe Met Lys His
420 425 430
Leu Asp Asn Glu Gln Lys Ala Arg Gly Gly Cys Pro Ala Asp Trp Ala
435 440 445
Trp Ile Val Pro Pro Ile Ser Gly Ser Leu Thr Pro Val Phe His Gln
450 455 460
Glu Met Val Asn Tyr Ile Leu Ser Pro Ala Phe Arg Tyr Gln Pro Asp
465 470 475 480
Pro Trp Lys Gly Ser Ala Thr Lys Gly Ala Gly Ile Thr Arg Lys Lys
485 490 495
Thr Phe Lys Glu Val Ala Asn Ala Val Lys Ile Ser Ala Ser Leu Met
500 505 510
Gly Thr Leu Met Ala Lys Arg Val Lys Ala Thr Ile Leu Tyr Ala Ser
515 520 525
Glu Thr Gly Arg Ala Gln Ser Tyr Ala Gln Gln Leu Gly Arg Leu Phe
530 535 540
Arg Lys Ala Phe Asp Pro Arg Val Leu Cys Met Asp Glu Tyr Asp Val
545 550 555 560
Val Ser Leu Glu His Glu Ala Leu Val Leu Val Val Thr Ser Thr Phe
565 570 575
Gly Asn Gly Asp Pro Pro Glu Asn Gly Glu Ser Phe Ala Ala Ala Leu
580 585 590
Met Glu Met Ser Gly Pro Tyr Asn Ser Ser Pro Arg Pro Glu Gln His
595 600 605
Lys Ser Tyr Lys Ile Arg Phe Asn Ser Val Ser Cys Ser Asp Pro Leu
610 615 620
Val Ser Ser Trp Arg Arg Lys Arg Lys Glu Ser Ser Asn Thr Asp Ser
625 630 635 640
Ala Gly Ala Leu Gly Thr Leu Arg Phe Cys Val Phe Gly Leu Gly Ser
645 650 655
Arg Ala Tyr Pro His Phe Cys Ala Phe Ala Arg Ala Val Asp Thr Arg
660 665 670
Leu Glu Glu Leu Gly Gly Glu Arg Leu Leu Gln Leu Gly Gln Gly Asp
675 680 685
Glu Leu Cys Gly Gln Glu Glu Ala Phe Arg Gly Trp Ala Lys Ala Ala
690 695 700
Phe Gln Ala Ser Cys Glu Thr Phe Cys Val Gly Glu Glu Ala Lys Ala
705 710 715 720
Ala Ala Gln Asp Ile Phe Ser Pro Lys Arg Ser Trp Lys Arg Gln Arg
725 730 735
Tyr Arg Leu Ser Thr Gln Ala Glu Gly Leu Gln Leu Leu Pro Gly Leu
740 745 750
Ile His Val His Arg Arg Lys Met Phe Gln Ala Thr Val Leu Ser Val
755 760 765
Glu Asn Leu Gln Ser Ser Lys Ser Thr Arg Ala Thr Ile Leu Val Arg
770 775 780
Leu Asp Thr Ala Gly Gln Glu Gly Leu Gln Tyr Gln Pro Gly Asp His
785 790 795 800
Ile Gly Ile Cys Pro Pro Asn Arg Pro Gly Leu Val Glu Ala Leu Leu
805 810 815
Ser Arg Val Glu Asp Pro Pro Pro Pro Thr Glu Ser Val Ala Val Glu
820 825 830
Gln Leu Glu Lys Gly Ser Pro Gly Gly Pro Pro Pro Ser Trp Val Arg
835 840 845
Asp Pro Arg Leu Pro Pro Cys Thr Leu Arg Gln Ala Leu Thr Phe Phe
850 855 860
Leu Asp Ile Thr Ser Pro Pro Ser Pro Arg Leu Leu Arg Leu Leu Ser
865 870 875 880
Thr Leu Ala Glu Glu Pro Ser Glu Gln Gln Glu Leu Glu Thr Leu Ser
885 890 895
Gln Asp Pro Arg Arg Tyr Glu Glu Trp Lys Trp Phe Arg Cys Pro Thr
900 905 910
Leu Leu Glu Val Leu Glu Gln Phe Pro Ser Val Ala Leu Pro Ala Pro
915 920 925
Leu Leu Leu Thr Gln Leu Pro Leu Leu Gln Pro Arg Tyr Tyr Ser Val
930 935 940
Ser Ser Ala Pro Asn Ala His Pro Gly Glu Val His Leu Thr Val Ala
945 950 955 960
Val Leu Ala Tyr Arg Thr Gln Asp Gly Leu Gly Pro Leu His Tyr Gly
965 970 975
Val Cys Ser Thr Trp Leu Ser Gln Leu Lys Thr Gly Asp Pro Val Pro
980 985 990
Cys Phe Ile Arg Gly Ala Pro Ser Phe Arg Leu Pro Pro Asp Pro Tyr
995 1000 1005
Val Pro Cys Ile Leu Val Gly Pro Gly Thr Gly Ile Ala Pro Phe Arg
1010 1015 1020
Gly Phe Trp Gln Glu Arg Leu His Asp Ile Glu Ser Lys Gly Leu Gln
1025 1030 1035 1040
Pro Ala Pro Met Thr Leu Val Phe Gly Cys Arg Cys Ser Gln Leu Asp
1045 1050 1055
His Leu Tyr Arg Asp Glu Val Gln Asp Ala Gln Glu Arg Gly Val Phe
1060 1065 1070
Gly Arg Val Leu Thr Ala Phe Ser Arg Glu Pro Asp Ser Pro Lys Thr
1075 1080 1085
Tyr Val Gln Asp Ile Leu Arg Thr Glu Leu Ala Ala Glu Val His Arg
1090 1095 1100
Val Leu Cys Leu Glu Arg Gly His Met Phe Val Cys Gly Asp Val Thr
1105 1110 1115 1120
Met Ala Thr Ser Val Leu Gln Thr Val Gln Arg Ile Leu Ala Thr Glu
1125 1130 1135
Gly Asp Met Glu Leu Asp Glu Ala Gly Asp Val Ile Gly Val Leu Arg
1140 1145 1150
Asp Gln Gln Arg Tyr His Glu Asp Ile Phe Gly Leu Thr Leu Arg Thr
1155 1160 1165
Gln Glu Val Thr Ser Arg Ile Arg Thr Gln Ser Phe Ser Leu Gln Glu
1170 1175 1180
Arg His Leu Arg Gly Ala Val Pro Trp Ala Phe Asp Pro Pro Gly Pro
1185 1190 1195 1200
Asp Thr Pro Gly Pro
1205
<210> 16
<211> 1203
<212> PRT
<213> Homo sapiens
<220>
<221> SOURCE
<222> 1..1203
<223> /mol_type="protein"
/organism="Homo sapiens"
<400> 16
Met Gly Asn Leu Lys Ser Val Ala Gln Glu Pro Gly Pro Pro Cys Gly
1 5 10 15
Leu Gly Leu Gly Leu Gly Leu Gly Leu Cys Gly Lys Gln Gly Pro Ala
20 25 30
Thr Pro Ala Pro Glu Pro Ser Arg Ala Pro Ala Ser Leu Leu Pro Pro
35 40 45
Ala Pro Glu His Ser Pro Pro Ser Ser Pro Leu Thr Gln Pro Pro Glu
50 55 60
Gly Pro Lys Phe Pro Arg Val Lys Asn Trp Glu Val Gly Ser Ile Thr
65 70 75 80
Tyr Asp Thr Leu Ser Ala Gln Ala Gln Gln Asp Gly Pro Cys Thr Pro
85 90 95
Arg Arg Cys Leu Gly Ser Leu Val Phe Pro Arg Lys Leu Gln Gly Arg
100 105 110
Pro Ser Pro Gly Pro Pro Ala Pro Glu Gln Leu Leu Ser Gln Ala Arg
115 120 125
Asp Phe Ile Asn Gln Tyr Tyr Ser Ser Ile Lys Arg Ser Gly Ser Gln
130 135 140
Ala His Glu Gln Arg Leu Gln Glu Val Glu Ala Glu Val Ala Ala Thr
145 150 155 160
Gly Thr Tyr Gln Leu Arg Glu Ser Glu Leu Val Phe Gly Ala Lys Gln
165 170 175
Ala Trp Arg Asn Ala Pro Arg Cys Val Gly Arg Ile Gln Trp Gly Lys
180 185 190
Leu Gln Val Phe Asp Ala Arg Asp Cys Arg Ser Ala Gln Glu Met Phe
195 200 205
Thr Tyr Ile Cys Asn His Ile Lys Tyr Ala Thr Asn Arg Gly Asn Leu
210 215 220
Arg Ser Ala Ile Thr Val Phe Pro Gln Arg Cys Pro Gly Arg Gly Asp
225 230 235 240
Phe Arg Ile Trp Asn Ser Gln Leu Val Arg Tyr Ala Gly Tyr Arg Gln
245 250 255
Gln Asp Gly Ser Val Arg Gly Asp Pro Ala Asn Val Glu Ile Thr Glu
260 265 270
Leu Cys Ile Gln His Gly Trp Thr Pro Gly Asn Gly Arg Phe Asp Val
275 280 285
Leu Pro Leu Leu Leu Gln Ala Pro Asp Glu Pro Pro Glu Leu Phe Leu
290 295 300
Leu Pro Pro Glu Leu Val Leu Glu Val Pro Leu Glu His Pro Thr Leu
305 310 315 320
Glu Trp Phe Ala Ala Leu Gly Leu Arg Trp Tyr Ala Leu Pro Ala Val
325 330 335
Ser Asn Met Leu Leu Glu Ile Gly Gly Leu Glu Phe Pro Ala Ala Pro
340 345 350
Phe Ser Gly Trp Tyr Met Ser Thr Glu Ile Gly Thr Arg Asn Leu Cys
355 360 365
Asp Pro His Arg Tyr Asn Ile Leu Glu Asp Val Ala Val Cys Met Asp
370 375 380
Leu Asp Thr Arg Thr Thr Ser Ser Leu Trp Lys Asp Lys Ala Ala Val
385 390 395 400
Glu Ile Asn Val Ala Val Leu His Ser Tyr Gln Leu Ala Lys Val Thr
405 410 415
Ile Val Asp His His Ala Ala Thr Ala Ser Phe Met Lys His Leu Glu
420 425 430
Asn Glu Gln Lys Ala Arg Gly Gly Cys Pro Ala Asp Trp Ala Trp Ile
435 440 445
Val Pro Pro Ile Ser Gly Ser Leu Thr Pro Val Phe His Gln Glu Met
450 455 460
Val Asn Tyr Phe Leu Ser Pro Ala Phe Arg Tyr Gln Pro Asp Pro Trp
465 470 475 480
Lys Gly Ser Ala Ala Lys Gly Thr Gly Ile Thr Arg Lys Lys Thr Phe
485 490 495
Lys Glu Val Ala Asn Ala Val Lys Ile Ser Ala Ser Leu Met Gly Thr
500 505 510
Val Met Ala Lys Arg Val Lys Ala Thr Ile Leu Tyr Gly Ser Glu Thr
515 520 525
Gly Arg Ala Gln Ser Tyr Ala Gln Gln Leu Gly Arg Leu Phe Arg Lys
530 535 540
Ala Phe Asp Pro Arg Val Leu Cys Met Asp Glu Tyr Asp Val Val Ser
545 550 555 560
Leu Glu His Glu Thr Leu Val Leu Val Val Thr Ser Thr Phe Gly Asn
565 570 575
Gly Asp Pro Pro Glu Asn Gly Glu Ser Phe Ala Ala Ala Leu Met Glu
580 585 590
Met Ser Gly Pro Tyr Asn Ser Ser Pro Arg Pro Glu Gln His Lys Ser
595 600 605
Tyr Lys Ile Arg Phe Asn Ser Ile Ser Cys Ser Asp Pro Leu Val Ser
610 615 620
Ser Trp Arg Arg Lys Arg Lys Glu Ser Ser Asn Thr Asp Ser Ala Gly
625 630 635 640
Ala Leu Gly Thr Leu Arg Phe Cys Val Phe Gly Leu Gly Ser Arg Ala
645 650 655
Tyr Pro His Phe Cys Ala Phe Ala Arg Ala Val Asp Thr Arg Leu Glu
660 665 670
Glu Leu Gly Gly Glu Arg Leu Leu Gln Leu Gly Gln Gly Asp Glu Leu
675 680 685
Cys Gly Gln Glu Glu Ala Phe Arg Gly Trp Ala Gln Ala Ala Phe Gln
690 695 700
Ala Ala Cys Glu Thr Phe Cys Val Gly Glu Asp Ala Lys Ala Ala Ala
705 710 715 720
Arg Asp Ile Phe Ser Pro Lys Arg Ser Trp Lys Arg Gln Arg Tyr Arg
725 730 735
Leu Ser Ala Gln Ala Glu Gly Leu Gln Leu Leu Pro Gly Leu Ile His
740 745 750
Val His Arg Arg Lys Met Phe Gln Ala Thr Ile Arg Ser Val Glu Asn
755 760 765
Leu Gln Ser Ser Lys Ser Thr Arg Ala Thr Ile Leu Val Arg Leu Asp
770 775 780
Thr Gly Gly Gln Glu Gly Leu Gln Tyr Gln Pro Gly Asp His Ile Gly
785 790 795 800
Val Cys Pro Pro Asn Arg Pro Gly Leu Val Glu Ala Leu Leu Ser Arg
805 810 815
Val Glu Asp Pro Pro Ala Pro Thr Glu Pro Val Ala Val Glu Gln Leu
820 825 830
Glu Lys Gly Ser Pro Gly Gly Pro Pro Pro Gly Trp Val Arg Asp Pro
835 840 845
Arg Leu Pro Pro Cys Thr Leu Arg Gln Ala Leu Thr Phe Phe Leu Asp
850 855 860
Ile Thr Ser Pro Pro Ser Pro Gln Leu Leu Arg Leu Leu Ser Thr Leu
865 870 875 880
Ala Glu Glu Pro Arg Glu Gln Gln Glu Leu Glu Ala Leu Ser Gln Asp
885 890 895
Pro Arg Arg Tyr Glu Glu Trp Lys Trp Phe Arg Cys Pro Thr Leu Leu
900 905 910
Glu Val Leu Glu Gln Phe Pro Ser Val Ala Leu Pro Ala Pro Leu Leu
915 920 925
Leu Thr Gln Leu Pro Leu Leu Gln Pro Arg Tyr Tyr Ser Val Ser Ser
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Ala Pro Ser Thr His Pro Gly Glu Ile His Leu Thr Val Ala Val Leu
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Ala Tyr Arg Thr Gln Asp Gly Leu Gly Pro Leu His Tyr Gly Val Cys
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995 1000 1005
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1010 1015 1020
Trp Gln Glu Arg Leu His Asp Ile Glu Ser Lys Gly Leu Gln Pro Thr
1025 1030 1035 1040
Pro Met Thr Leu Val Phe Gly Cys Arg Cys Ser Gln Leu Asp His Leu
1045 1050 1055
Tyr Arg Asp Glu Val Gln Asn Ala Gln Gln Arg Gly Val Phe Gly Arg
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Val Leu Thr Ala Phe Ser Arg Glu Pro Asp Asn Pro Lys Thr Tyr Val
1075 1080 1085
Gln Asp Ile Leu Arg Thr Glu Leu Ala Ala Glu Val His Arg Val Leu
1090 1095 1100
Cys Leu Glu Arg Gly His Met Phe Val Cys Gly Asp Val Thr Met Ala
1105 1110 1115 1120
Thr Asn Val Leu Gln Thr Val Gln Arg Ile Leu Ala Thr Glu Gly Asp
1125 1130 1135
Met Glu Leu Asp Glu Ala Gly Asp Val Ile Gly Val Leu Arg Asp Gln
1140 1145 1150
Gln Arg Tyr His Glu Asp Ile Phe Gly Leu Thr Leu Arg Thr Gln Glu
1155 1160 1165
Val Thr Ser Arg Ile Arg Thr Gln Ser Phe Ser Leu Gln Glu Arg Gln
1170 1175 1180
Leu Arg Gly Ala Val Pro Trp Ala Phe Asp Pro Pro Gly Ser Asp Thr
1185 1190 1195 1200
Asn Ser Pro
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Claims (39)
- a) 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태, 및 b) 내피 NO 신타아제에 대한 항체의 활성화된-강화된 형태를 포함하는 제약학적 조성물.
- a) 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태를 포함하는 제약학적 조성물.
- a) 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태, 그리고 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태를 포함하고, 이때 인슐린 수용체 분자는 하나의 알파 소단위와 하나의 베타 소단위를 포함하는 제약학적 조성물.
- 제약학적으로 수용가능한 고형 운반체, 그리고 a) 상기 고형 운반체에 주입된 C12, C30, 및 C200 동종요법 희석액의 혼합물 형태의 인간 인슐린 수용체의 베타 소단위의 C-말단 단편에 대한 항체의 활성화된-강화된 형태, 그리고 b) 상기 고형 운반체에 주입된 C12, C30, 및 C200 동종요법 희석액의 혼합물 형태의 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태를 포함하는 제약학적 조성물.
- 청구항 1, 2, 3, 또는 4에 있어서, 인간 인슐린 수용체에 대한 상기 항체는 단일클론, 다중클론 또는 천연 항체인, 제약학적 조성물.
- 청구항 5에 있어서, 인간 인슐린 수용체에 대한 상기 항체는 다중클론 항체인, 제약학적 조성물.
- 청구항 6에 있어서, 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태는 연속 백진법 희석과 함께, 매 희석액의 진탕(shaking)에 의해 준비되는, 제약학적 조성물.
- 청구항 1, 2, 3, 또는 4에 있어서, 내피 NO-신타아제에 대한 상기 항체는 단일클론, 다중클론 또는 천연 항체인, 제약학적 조성물.
- 청구항 8에 있어서, 내피 NO-신타아제에 대한 상기 항체는 다중클론 항체인, 제약학적 조성물.
- 청구항 9에 있어서, 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태는 연속 백진법 희석과 함께, 매 희석액의 진탕(shaking)에 의해 준비되는, 제약학적 조성물.
- 청구항 1에 있어서, 상기 인간 인슐린 수용체는 서열 번호: 1, 서열 번호: 2, 서열 번호: 3, 서열 번호: 4, 서열 번호: 5, 서열 번호: 6, 서열 번호: 7, 서열 번호: 8, 서열 번호: 9, 서열 번호: 10, 서열 번호: 11, 서열 번호: 12, 서열 번호: 13, 서열 번호: 14로 구성된 군으로부터 선택된 서열로 구성된, 제약학적 조성물.
- 청구항 1에 있어서, 상기 내피 NO 신타아제는 서열 번호: 15, 서열 번호: 16, 서열 번호: 17, 서열 번호: 18, 서열 번호: 19, 서열 번호: 20, 서열 번호: 21, 서열 번호: 22에서 제시되는 서열로 구성된, 제약학적 조성물.
- 청구항 1, 2, 3 또는 4에 따른 제약학적 조성물을 환자에게 투여하여 인간 환자에서 유형 I 당뇨병을 치료하는 방법.
- 청구항 13에 있어서, 상기 제약학적 조성물은 한번 투여시 한 개의 고형 투약형을 환자에게 투여하는, 방법.
- 청구항 13에 있어서, 상기 투약형은 정제인, 방법.
- 청구항 15에 있어서, 상기 정제는 직접 타정(direct compression)에 의해 수득된, 방법.
- 청구항 15에 있어서, 상기 정제는 일일 1회 내지 4회 투여되는, 방법.
- 청구항 15에 있어서, 상기 정제는 일일 2회 투여되는, 방법.
- 청구항 15에 있어서, 상기 정제는 일일 4회 투여되는, 방법.
- 청구항 1, 2, 3 또는 4에 따른 제약학적 조성물을 환자에게 투여하여 인간 환자에서 유형 II 당뇨병을 치료하는 방법.
- 청구항 20에 있어서, 상기 제약학적 조성물은 한번 투여시 한 개의 고형 투약형을 환자에게 투여하는, 방법.
- 청구항 21에 있어서, 상기 투약형은 정제인, 방법.
- 청구항 22에 있어서, 상기 정제는 직접 타정(direct compression)에 의해 수득된, 방법.
- 청구항 22에 있어서, 상기 정제는 일일 1회 내지 4회 투여되는, 방법.
- 청구항 22에 있어서, 상기 정제는 일일 2회 투여되는, 방법.
- 청구항 1, 2, 3 또는 4에 따른 제약학적 조성물을 포유동물에게 투여하여 포유동물에서 혈당 수준을 감소시키는 방법.
- 청구항 26에 있어서, 상기 포유동물은 인간인 방법.
- 청구항 27에 있어서, 상기 제약학적 조성물은 하나 또는 2개의 단위 약형으로 환자에게 투여되는, 방법.
- 청구항 28에 있어서, 상기 투약형은 1일 1회 내지 4회 투여되는, 방법.
- 청구항 29에 있어서, 상기 투약형은 1일 3회 투여되는, 방법.
- 청구항 1, 2, 3 또는 4에 따른 제약학적 조성물을 포유동물에게 투여하여 포유동물에서 인슐린 저항성을 감소시키는 방법.
- 청구항 31에 있어서, 상기 포유동물은 인간인 방법.
- 청구항 32에 있어서, 상기 제약학적 조성물은 하나 또는 2개의 단위 약형으로 환자에게 투여되는, 방법.
- 청구항 33에 있어서, 상기 투약형은 1일 1회 내지 4회 투여되는, 방법.
- 청구항 34에 있어서, 상기 투약형은 1일 3회 투여되는, 방법.
- 청구항 13에 있어서, 이 방법은 인슐린 또는 유형 I 당뇨병을 치료하는데 적합한 기타 추가 제약학적 물질의 투여를 더 포함하는, 방법.
- 청구항 20에 있어서, 상기 방법은 유형 II 당뇨병을 치료하는데 적합한 기타 추가 제약학적 물질의 투여를 더 포함하는, 방법.
- 당뇨병 또는 기타 대사 장애를 앓는 환자의 치료에 사용하기 위한 제약학적 조성물에 있어서, 상기 조성물은 a) 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태 및 b) 내피 NO-신타아제에 대한 항체의 활성화된-강화된 형태를 제공하고, 이들 각각은 동종요법 기술에 따라 연속 반복 희석 및 이렇게 수득된 용액의 다중 진탕(shaking)하고, 그 다음 이를 혼합함으로써 강화된 용액을 복합시키거나, 또는 대안으로 운반체에 상기 혼합된 용액을 주입시키거나, 또는 별도로 용액을 주입시켜 수득하는 제약학적 조성물.
- 청구항 38에 있어서, 상기 인간 인슐린 수용체에 대한 항체의 활성화된-강화된 형태는 인간 인슐린 수용체의 C-말단 단편에 대한 항체의 활성화된-강화된 형태인, 제약학적 조성물.
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| RU2010130348/15A RU2531048C2 (ru) | 2010-07-21 | 2010-07-21 | Лекарственное средство для уменьшения резистентности к инсулину и лечения сахарного диабета и способ повышения эффективности лечения сахарного диабета инсулином и/или гипогликемическими препаратами |
| RU2010130348 | 2010-07-21 | ||
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| RU2011127051/15A RU2509572C2 (ru) | 2011-07-01 | 2011-07-01 | Лекарственное средство для уменьшения резистентности к инсулину и для лечения сахарного диабета, способ уменьшения резистентности к инсулину, способ лечения сахарного диабета и способ лечения сахарного диабета инсулином и/или гипогликемическими препаратами |
| PCT/IB2011/002177 WO2012010966A2 (en) | 2010-07-21 | 2011-07-15 | A combination pharmaceutical composition and methods of treating diabetes and metabolic disorders |
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| RU2181297C2 (ru) * | 2000-06-20 | 2002-04-20 | Эпштейн Олег Ильич | Способ лечения патологического синдрома и лекарственное средство |
| UA76638C2 (en) | 2002-08-02 | 2006-08-15 | Oleh Illich Epshtein | Homeopathic medication based on anti-interferon antibodies and method for treating a pathological syndrome associated with interferon |
| RU2309732C1 (ru) * | 2006-03-13 | 2007-11-10 | Олег Ильич Эпштейн | Спрессованная твердая оральная форма лекарственного препарата и способ получения твердой оральной формы лекарственного препарата |
| EA200802440A1 (ru) * | 2006-06-06 | 2009-06-30 | Олег Ильич ЭПШТЕЙН | Лекарственное средство для лечения ожирения, сахарного диабета и заболеваний с нарушением толерантности к глюкозе |
| BR112013000841A2 (pt) | 2010-07-15 | 2016-06-07 | Oleg Lliich Epshtein | composições farmacêuticas, métodos de tratamento da obesidade e distúrbios metabólicos relacionados, de redução da massa corpórea de mamífero, do crescimento da massa corpórea de mamífero, do consumo de comida em mamífero, de trtamento de paciente de adicção de substância psicoativa, de adicção de substância psicoativa e uso de forma ativada-potencializada de anticorpo para receptor de canabinoide humano. |
| ES2440393R1 (es) * | 2010-07-15 | 2014-10-10 | Oleg Iliich Epshtein | Un método para aumentar el efecto de una forma activada potenciada de un anticuerpo |
| EP2593474A2 (en) | 2010-07-15 | 2013-05-22 | Oleg Iliich Epshtein | Combination pharmaceutical composition and methods of treating diseases or conditions associated with neurodegenerative diseases |
| MX2013000807A (es) | 2010-07-21 | 2013-10-28 | Oleg Iliich Epshtein | Un metodo para el tratamiento del trastorno de hiperactividad con deficit de atencion. |
| AU2011281247B2 (en) * | 2010-07-21 | 2015-07-30 | Oleg Iliich Epshtein | Combination pharmaceutical composition and methods of treating diseases or conditions associated with respiratory disease or condition |
| DE112011102397T5 (de) * | 2010-07-21 | 2013-05-08 | Oleg Iliich Epshtein | Pharmazeutische Kombinationszusammensetzungen und Verfahren zur Behandlung von Schwindel, Kinetose und vegetativ-vaskulärer Dystonie |
| EA030513B1 (ru) * | 2010-08-06 | 2018-08-31 | Олег Ильич ЭПШТЕЙН | Комбинированная фармацевтическая композиция и способ лечения и профилактики инфекционных заболеваний |
| TWI588153B (zh) * | 2012-05-18 | 2017-06-21 | 中國醫藥大學 | 多胜肽、編碼該多胜肽之核酸分子、以及該多胜肽之應用 |
| RU2013111962A (ru) | 2013-03-18 | 2014-09-27 | Олег Ильич Эпштейн | Способ определения выраженности модифицирующей активности, ассоциированной с носителем |
| RU2013111961A (ru) | 2013-03-18 | 2014-09-27 | Олег Ильич Эпштейн | Способ определения выраженности модифицирующей активности, ассоциированной с носителем |
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| US4311897A (en) | 1979-08-28 | 1982-01-19 | Union Carbide Corporation | Plasma arc torch and nozzle assembly |
| US5811437A (en) * | 1996-05-21 | 1998-09-22 | Eli Lilly And Company | Methods of increasing nitric oxide synthesis |
| US6150500A (en) * | 1996-07-12 | 2000-11-21 | Salerno; John C. | Activators of endothelial nitric oxide synthase |
| WO1999026657A1 (en) * | 1997-11-25 | 1999-06-03 | Musc Foundation For Research Development | Inhibitors of nitric oxide synthase |
| US6933272B1 (en) * | 1998-09-22 | 2005-08-23 | Erik Helmerhorst | Use of non-peptidyl compounds for the treatment of insulin related ailments |
| RU2181297C2 (ru) * | 2000-06-20 | 2002-04-20 | Эпштейн Олег Ильич | Способ лечения патологического синдрома и лекарственное средство |
| UA76638C2 (en) | 2002-08-02 | 2006-08-15 | Oleh Illich Epshtein | Homeopathic medication based on anti-interferon antibodies and method for treating a pathological syndrome associated with interferon |
| UA76641C2 (uk) | 2002-08-02 | 2006-08-15 | Олєг Ільіч Епштєйн | Гомеопатичний лікарський засіб та спосіб лікування захворювань передміхурової залози |
| UA76639C2 (uk) | 2002-08-02 | 2006-08-15 | Олєг Ільіч Епштєйн | Гомеопатичний лікарський засіб та спосіб лікування еректильних дисфункцій |
| EP1534302A4 (en) * | 2002-08-22 | 2009-01-07 | Nutrition 21 Inc | ARGININILICATE / INOSITOL COMPLEX AND ITS USE |
| TWI345470B (en) | 2003-03-14 | 2011-07-21 | Nutrition Res Inc | Homeopathic formulations useful for treating pain and/or inflammation |
| WO2005067928A1 (en) * | 2004-01-20 | 2005-07-28 | Astellas Pharma Inc. | Method for treating erectile dysfunction |
| RU2438707C2 (ru) * | 2006-06-06 | 2012-01-10 | Олег Ильич Эпштейн | Лекарственное средство для перорального лечения сахарного диабета и других заболеваний, сопровождающихся нарушением толерантности к глюкозе, и способ получения твердой лекарственной формы для пероральной терапии сахарного диабета и других заболеваний, сопровождающихся нарушением толерантности к глюкозе |
| EA200802440A1 (ru) * | 2006-06-06 | 2009-06-30 | Олег Ильич ЭПШТЕЙН | Лекарственное средство для лечения ожирения, сахарного диабета и заболеваний с нарушением толерантности к глюкозе |
| GB0812019D0 (en) * | 2008-07-02 | 2008-08-06 | Asterion Ltd | Insulin |
| BR112013000841A2 (pt) * | 2010-07-15 | 2016-06-07 | Oleg Lliich Epshtein | composições farmacêuticas, métodos de tratamento da obesidade e distúrbios metabólicos relacionados, de redução da massa corpórea de mamífero, do crescimento da massa corpórea de mamífero, do consumo de comida em mamífero, de trtamento de paciente de adicção de substância psicoativa, de adicção de substância psicoativa e uso de forma ativada-potencializada de anticorpo para receptor de canabinoide humano. |
| EP2593474A2 (en) * | 2010-07-15 | 2013-05-22 | Oleg Iliich Epshtein | Combination pharmaceutical composition and methods of treating diseases or conditions associated with neurodegenerative diseases |
| ES2440393R1 (es) * | 2010-07-15 | 2014-10-10 | Oleg Iliich Epshtein | Un método para aumentar el efecto de una forma activada potenciada de un anticuerpo |
| AU2011281247B2 (en) * | 2010-07-21 | 2015-07-30 | Oleg Iliich Epshtein | Combination pharmaceutical composition and methods of treating diseases or conditions associated with respiratory disease or condition |
| DE112011102397T5 (de) * | 2010-07-21 | 2013-05-08 | Oleg Iliich Epshtein | Pharmazeutische Kombinationszusammensetzungen und Verfahren zur Behandlung von Schwindel, Kinetose und vegetativ-vaskulärer Dystonie |
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