TR201809046T4 - Bir müsin etki alanlı polipeptide bağlı bir aktif protein içeren füzyon polipeptitleri. - Google Patents
Bir müsin etki alanlı polipeptide bağlı bir aktif protein içeren füzyon polipeptitleri. Download PDFInfo
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- TR201809046T4 TR201809046T4 TR2018/09046T TR201809046T TR201809046T4 TR 201809046 T4 TR201809046 T4 TR 201809046T4 TR 2018/09046 T TR2018/09046 T TR 2018/09046T TR 201809046 T TR201809046 T TR 201809046T TR 201809046 T4 TR201809046 T4 TR 201809046T4
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- protein
- fusion protein
- mucin
- polypeptide
- fusion
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Abstract
Mevcut buluş, dairesel permütasyon ile modifiye edilen ve en az bir polipeptit füzyon partnerine kaynaştırılan polipeptit ligantları içeren füzyon polipeptitleri sağlar, burda, bu tür füzyon polipeptitleri, yeni, iyileştirilmiş ve artırılmış biyolojik fonksiyonlar ve aktivitelere sahiptir. Bu tür aktivitelere, bunlarla sınırlı olmaksızın, yüksek bağlanma afinitesi, yüksek agonist aktivitesi (süper agonist), antagonist aktivitesi, yüksek erişililebilirlik, aktif alanın yüksek esnekliği, yüksek stabilite, daha geniş ve/veya değiştirilmiş substrat özgüllüğü ve bunların kombinasyonları dahildir. ' ATCC CRL-2105 " ATCC TIB-214.
Description
TARIFNAME
BIR MÜsiN ETKI ALANLI POLIPEPTIDE BAGLI BIR AKTIF PROTEIN IÇEREN
FÜZYON POLIPEPTITLERI
BULUSUN ALTYAPISI
Protein terapötiklerinin farmakokinetigi, farmakodagilimi, çözünürlügü, stabilitesi,
efektör islevinin iyilestirmesi ve reseptör baglantilari, glikosile proteinlerin karbonhidrat
kISmI ile büyük ölçüde etkilenebilir. Ek olarak, biyolojik olarak aktif olan birçok peptit ve
protein sinirli çözünürlüge sahiptir veya kompleks çözünürlestirme ve dogallasim
prosedürleri gerektiren rekombinant üretimler sirasinda topaklanmis hale gelir. Ayrica,
60 kilodaltondan (kD) daha düsük moleküler agirliga sahip protein ve peptit
terapötikleri, renal arindirma nedeniyle çogu zaman kisa yari-ömür dezavantajina sahip
Protein terapötiklerinin yar-ömrünün uzatilmasina yönelik kullanilan mevcut stratejiler,
iki genel kategoriye ayrilir: 1) FcRn ortamli geri dönüstürmenin kullanilmasi ve 2)
hidrodinamik hacmin artirilmasi. Açiklanmis olan spesifik yaklasimlara, ilk startejiye
yönelik FcRn'ye baglanan proteinlere veya etki alanlarina konjügasyon, baglanma veya
füzyon dahildir, sonuncu stratejiye yönelik mültimerizasyon, polimerlere veya
karbonhidratlara (PEG, Kolominik asit veya Hidroksietil nisasta gibi) kimyasal
baglanma, N-glikosilasyon etki alanlari ile birlesme dahildir. Ancak, Fc-füzyon üretimi,
ek imalat adimlari ve çogu zaman kompleks pürifikasyon prosedürleri gerektiren zaman
harcayici, verimsiz ve masrafli bir prosestir. Ek olarak, en yaygin olarak kullanilan
PEGilasyon olmak üzere kimyasal baglanti stratejileri, ek konjügasyon ve pürifikasyon
adimlari ve düsük toplam verim nedeniyle üretim masrafinda önemli artislar ile
bir polipeptit dizilimi araciligiyla üretilen diger rekombinant PEG mimetikleri de
açiklanmistir. Bu teknolojinin ek konjügasyon adiminin üstünden gelmesine ragmen,
eklenen peptit dizilimi, endojen olmamasi nedeniyle, immünojenesite potansiyeline
bir XTEN polipeptidi içeren füzyon proteinlerini açiklar; bunun sayesinde XTEN
polipeptitleri, aktif proteinin yari-ömrü gibi farmakokinetik özelliklerini artirir. Müsin
proteinleri ve proteinlerin müsin etki alanlari, müsin etki alanlarina sahip müsin
proteinleri ve diger polipeptitlerin, katilasmis düzensiz sargilar olarak hareket etmesine
yapisal olarak olanak veren yüksek bir glikosilasyon derecesine sahiptir. Büyük oranda
glikosile müsin etki alanlarini yapan hidrofilik olarak dallanmis hidrofilik karbonhidratlar
ile kombinasyon içindeki bu katilasmis düzensiz sargili yapi, aktif proteinin
hidrodinamik çapinin, ifade edilen proteinin moleküler agirligina bagli olarak
beklenecek olana göre daha yüksek bir degere yükseltilmesinde belirli olarak yararlidir.
Ayrica yüksek glikosilasyon seviyesi nedeniyle, bir müsin etki alaninin eklenmesi, aktif
proteinin konsantre solüsyonlarinin yükü, çözünürlügü ve viskoelektrik özellikleri gibi bir
proteinin fizikokimyasal özelliklerini modifiye etme potansiyeline sahiptir.
Mevcut bulusun füzyon proteini bilesimleri ve yöntemleri, bir aktif proteinin biyolojik,
farmakolojik, güvenlik ve/veya farmasötik özelliklerini gelistirir.
BULUSUN KISA AÇIKLAMASI
Mevcut bulus, müsin etki alanli polipeptide bagli olmayan ayni protein ile
karsilastirildiginda daha iyi özelliklere (örnegin, farmakokinetik ve/veya fizikokimyasal
özellikler) sahip olan bir aktif proteine kovalent olarak bagli bir müsin etki alanli
polipeptit içeren füzyon proteinleri ile ve bunun yani sira bulusun füzyon proteinlerinin
yapilmasi ve kullanilmasina yönelik yöntemler ile ilgilidir.
Bir düzenlemede bulus, opsiyonel bir baglayici araciligiyla bir aktif proteine bagli olan
bir müsin etki alanli polipeptit içeren bir füzyon proteini saglar, burada, müsin etki alanli
polipeptit glikosiledir ve SEQ ID NO:20 veya en az %90 amino ait dizilimi benzerligi ile
buna homolog olan herhangi amino asit dizilimi içerir, burada, aktif protein IL-1Ra veya
eksendin-4 veya en az %90 amino ait dizilimi benzerligi ile buna homolog olan
herhangi amino asit dizilimidir ve burada, füzyon proteininin yari ömrü, müsin etki alanli
polipeptide kaynasmis olmayan ilgili aktif proteinin yari ömrüne göre iki kat artirilir.
Bir düzenlemede bulus, bulusun füzyon proteinlerini kodlayan nükleik asit dizilimlerinin
yani sira, bulusun nükleik asitlerinin ifade edilmesine yönelik vektörler ve konak
hücreler de saglar.
Bir düzenlemede bulus, bir terapötik aktif proteinin yari ömrünün uzatilmasina yönelik,
asagidaki adimlari içeren yöntemler saglar:
a) bir terapötik aktif proteinin saglanmasi, burada, aktif protein, lL-1Ra veya
eksendin-4 veya en az %90 benzerlik ile buna benzeyen herhangi bir amino asittir;
b) Bir füzyon proteininin olusturulmasina yönelik SEQ ID NO:20 içeren bir müsin
etki alanli polipeptite terapötik aktif proteinin baglanmasi ve
o) bir denege terapötik olarak etkili nit dozun verilmesi sonrasinda füzyon
proteininin yari ömrünün ölçülmesi ve yari ömrün, kiyaslanabilir bir terapötik dozda
verilmesi durumunda yalnizca ilgili terapötik protein ike karsilastirildiginda artmis
oldugunun belirlenmesidir. Bir düzenlemede bulus, bulusun füzyon proteinlerini
içeren farmasötik bilesimler saglar.
Bir düzenlemede, bulus, tipta kullanima yönelik bulusun farmasötik bilesimlerini saglar.
SEKILLERIN KISA AÇIKLAMASI
SEKIL 1. IL1Ra müsin yapilarina ait Coomassie Mavi-izli SDS/polikrilamit jel (A)
ve IEF jel (B). Oklar, ilgili proteinleri belirtir. IEF jelindeki bantlarin çesitliligi,
çogunlukla N-glikosilasyondaki farkliliklar nedeniyle farkli sekilde yüklenmis
olan türleri belirtir
SEKIL 2. RDBl813'ün jel filtrasyon komatografisi (gri) ve moleküler boyut
standartlari (siyah). Standartlarin moleküler agirliklari ve RD81813'ün belirgin
moleküler agirligi, ayrisan her bir pikin üzerinde Iistelenir.
SEKIL 3. RDB1814'ün jel filtrasyon kromatografisi (gri) ve moleküler boyut
standartlari (siyah). Standartlarin moleküler agirliklari ve RDB1814'ün belirgin
moleküler agirligi, ayrisan her bir pikin üzerinde Iistelenir.
SEKIL 4. RDBiBZB'nin jel filtrasyon kromatografisi (gri) ve moleküler boyut
standartlari (siyah). Standartlarin moleküler agirliklari ve RDB1826'nin belirgin
moleküler agirligi, ayrisan her bir pikin üzerinde Iistelenir.
SEKIL 5. RDB1815'in jel filtrasyon kromatografisi (gri) ve moleküler boyut
standartlari (siyah). Standartlarin moleküler agirliklari ve RDB1815'in belirgin
moleküler agirligi, ayrisan her bir pikin üzerinde Iistelenir.
SEKIL 6. RDBl816'nin jel filtrasyon kromatografisi (gri) ve moleküler boyut
standartlari (siyah). Standartlarin moleküler agirliklari ve RDB1816'nin belirgin
moleküler agirligi, ayrisan her bir pikin üzerinde Iistelenir.
SEKIL 7. HEK-mavi tahlilinde RDB tarafindan
sinyal edilen lLlß inhibisyonu. Inhibisyon yoklugunda konsantrasyonunun bir
fonksiyonu olarak IL1ß ( ~~~~~~ I """" ') aktivitesi. RDB ve
ölçümler iki kez yapilir. Tahmin edilen IC50 degerleri, seklin en üst sag
kösesinde gösterilir.
SEKIL 8. HEK-mavi tahlilinde RDB tarafindan sinyal edilen lL1ß
inhibisyonu. Inhibisyon yoklugunda konsantrasyonunun bir fonksiyonu olarak
inhibisyon, 15pM IL1ß varliginda ölçülür. Tüm ölçümler iki kez yapilir. Tahmin
edilen ICso degerleri, seklin en üst sag kösesinde gösterilir.
SEKIL 9. HEK-mavi tahlilinde RDB tarafindan
sinyal edilen lL1ß inhibisyonu. Inhibisyon yoklugunda konsantrasyonunun bir
fonksiyonu olarak IL1ß( """" i iiiii `) aktivitesi. RDB ve
ölçümler iki kez yapilir. Tahmin edilen IC50 degerleri, seklin en üst sag
kösesinde gösterilir.
SEKIL 10. Hareketsiz fare IL1RI reseptörüne baglanan RDB1813'ün Yüzey
Plazmon Rezonans (SPR) ölçümleri. Sensörgramlar ve uydurulmus egriler,
sirasiyla gri ve siyahtir. RDB1813 ve Anakinra (veri gösterilmemistir) için kinetik
parametreler, inset içerisindedir.
SEKIL 11. Hareketsiz fare IL1RI reseptörüne baglanan RDB1814'ün Yüzey
Plazmon Rezonans (SPR) ölçümleri. Sensörgramlar ve uydurulmus egriler,
sirasiyla gri ve siyahtir. RDB1814 ve Anakinra (veri gösterilmemistir) için kinetik
parametreler, inset içerisindedir.
SEKIL 12. Hareketsiz fare IL1RI reseptörüne baglanan RDB1826'nin Yüzey
Plazmon Rezonans (SPR) ölçümleri. Sensörgramlar ve uydurulmus egriler,
sirasiyla gri ve siyahtir. RDB1826 ve Anakinra (veri gösterilmemistir) için kinetik
parametreler, inset içerisindedir.
SEKIL 13. Hareketsiz fare IL1RI reseptörüne baglanan RDB1815”in Yüzey
Plazmon Rezonans (SPR) ölçümleri. Sensörgramlar ve uydurulmus egriler,
sirasiyla gri ve siyahtir. RDB1815 ve Anakinra (veri gösterilmemistir) için kinetik
parametreler, inset içerisindedir.
SEKIL 14. Hareketsiz fare IL1RI reseptörüne baglanan RDB1816'nin Yüzey
Plazmon Rezonans (SPR) ölçümleri. Sensörgramlar ve uydurulmus egriler,
sirasiyla gri ve siyahtir. RDB1816 ve Anakinra (veri gösterilmemistir) için kinetik
parametreler, inset içerisindedir.
SEKIL 15. Fare CAIA modeli enflamasyonunda RDB1816 degerlendirmesine
yönelik deneysel tasarim.
SEKIL 16. Fare CAIA modeli enflamasyonu içerisine tek bir 20 mg/kg RDB1816
( ) IL1Ra (Anakinra 4?) ve tuz kontrolü (“29) enjeksiyonunun inhibitör etkileri.
Siyah oklar, monoklonal antikor kokteyli (mAb) ile ve tedavi molekülü ile birlikte
enjeksiyon günlerini belirtir. Sekiz farelik bir grup her bir tedavi için kullanilir ve
her bir zaman noktasi, her bir gruptan alinan ortalamayi ifade eder.
SEKIL 17. Farede RDB1815 ve RDB186inin farmakokinetik profili. Plazma
konsantrasyon-zaman profilleri, RD81815 i.v. (-0-, tek bir 2.1 mg/Kg [mpk]
enjeksiyon), SC enjeksiyonuna (-~-, tek bir 5.6 mpk enjeksiyonu) yönelik ve
RDB1816 i.v. (ww, tek bir 2.4 mpk enjeksiyon), SC enjeksiyonuna (m, tek bir
6.4 mpk enjeksiyon) yönelik kaydedilir. Semboller, her kosul için üç farkli
fareden alinan ortalamayi ifade eder. SC gruplarina yönelik farmakokinetik
parametreler tabloda özetlenir.
SEKIL 18. Eksendin-4 müsin yapisi RDBZ203'ün Coomassie Mavi-lekeli
SDS/poliyakrilamit jeli.
SEKIL 19. RD82203 jel filtrasyonu kromatogrami (gri) ve moleküler boyut
standartlari (gri). Standartlarin moleküler agirliklari, her bir ayrisan pik üzerinde
SEKIL 20. RD82203 ve eksendin-4'e yönelik GLP-1 R aktivitesi.
SEKIL 21. RDB2203'ün farmakokinetik profili.
BULUSUN DETAYLI AÇIKLAMASI
Bulusun tercih edilen düzenlemelerinin bir açiklamasi asagidadir.
Tanimlar
Burada kullanildigi üzere, asagidaki terimler, aksi belirtilmedikçe, asagida açiklanan
anlamlara sahiptir.
Spesifikasyonlar ve istemlerde kullanildigi üzere, “bir” tekil formu, kapsam açikça aksini
belirtmedikçe, çogul referanslari içerir. Örnegin, “bir hücre" terimi, bunun karisimlari
dahil, birçok hücreyi içerir.
polimerlerini refere etmek üzere burada birbiri ile degistirilebilir sekilde kullanilir.
Polimer, lineer veya dallanmis olabilir, modifiye edilmis amino asitler içerebilir ve amino
olmayan asitler ile kesintiye ugrayabilir. Terimler ayrica, Örnegin, disülfür bagi olusumu,
glikosilasyon, Iipidasyon, asetilasyon, foforilasyon veya bir etiketleme bileseni ile
konjugasyon gibi herhangi bir diger manipülasyon ile modifiye edilen bir amino asit
polimerini kapsar.
Burada kullanildigi üzere, “amino asit1 terimi, glisin ve hem D veya L optik izomerleri
dahil ancak bunlarla sinirli olmamak üzere dogal ve/veya dogal olmayan veya sentetik
amino asitleri ve amino asit analoglarina ve peptidomimetikleri refere eder. Satndart tek
veya üçlü harf kodlari, amino asitleri belirtmek üzere kullanilir.
Dizilimlere yönelik ve burada kullanildigi üzere “dogal olmayan sekilde ortaya çikan”
terimi, bir memelide bulunan bir yabani tip veya dogal sekilde ortaya çikan bir dizilimin
benzerine sahip olmayan, bunu tamamlamayan veya bununla yüksek bir homologluk
derecesine sahip olmayan polipeptit veya polinükleotit dizilimleri anlamina gelir.
Örnegin, dogal olmayan sekilde ortaya çikan bir polipeptit, uygun sekilde hizalanmasi
gliko-proteinler olusturmak üzere hücreler içerisindeki üretimleri sirasinda proteinlere
post-translasyonel olarak baglandigi prosesi ifade etmek üzere burada birbiri ile
degistirilebilir sekilde kullanilir. Protienlerin glikosilasyonu, bir post-translasyonel olaydir
ve glikanlarin serin ve treonine baglanmasini ve O-bagli glikosilasyon durumunda
hidroksiprolin ve hidroksilisin veya N-bagli glikosilasyon durumunda asparajinin daha
küçük bir kapsamini refere eder.
Bir "fragment", terapötik ve/veya biyolojik aktivitenin en az bir kismini tutan bir natif aktif
proteinin bir trunkat formudur. Bir “varyant”, aktif protein terapötik ve/veya biyolojik
aktivitenin en az bir kismini tutan bir natif aktif protein ile dizilim homolojisine sahip bir
proteindir. Örnegin, bir varyant protein, referans aktif protein ile en az %70, %75, %80,
olabilir. Burada kullanildigi üzere, «aktif protein kismi» terimi, örnegin, bölgesel
yönlendirilmis mutajenez, insersiyon ile kasten veya mutasyonlar araciligiyla kazara
modifiye edilmis proteinler içerir.
Bir “konak hücre", denek vektörlere yönelik bir alici olabilen veya olmus ayri bir hücre
veya hücre kültürü içerir. Konak hücreler, tek bir konak hücrenin döllerini içerir. Döl,
dogal, kaza veya kasti mutasyon nedeniyle orijinal ana hücre ile tamamen özdes
(morfoloji veya toplam DNA takiminin genomigi açisindan) olmayabilir. Bir konak
hücre, bu bulusun bir vektörü ile in vivo sekilde transfekte edilmis hücreler içerir.
Burada açiklanna çesitli polipeptitleri açiklamak üzere kullanilmasi durumunda “izole”,
belirlenen ve dogal çevresinin bir bileseninden ayrilan ve/veya geri kazanilan polipeptit
anlamina gelir. Dogal çevresinin kontaminant bilesenleri, tipik olarak polipeptide yönelik
diagnostik veya terapötik kullanimlara karisan materyallerdir ve enzim, hormon ve diger
proteinli veya proteinli olmayan çözünenler içerebilir. Teknikte uzman kisiler tarafindan
bilindigi üzere, dogal olmayan sekilde ortaya çikan bir polinükleotit, peptit, polipeptit,
protein, antikor veya bunlarin fragmentleri, dogal olarak ortaya çikan benzer kismindan
ayirt edilmesine yönelik “izolasyona” gerek duymaz. Ek olarak, bir "konsantre edilmis",
bunlarin fragmentleri, birim hacimdeki molekül konsantrasyonu veya sayisinin dogal
sekilde ortaya çikan benzer kismindan daha yüksek olmasi açisindan, dogal olarak
ortaya çikan benzer kismindan ayirt edilebilir. Genelde, rekombinant araçlar ile
yapilmis ve bir konak hücrede ifade edilen bir polipeptit, "izole" olarak kabul edilir.
Bir "izole" polinükleotit veya polipeptit-kodlayici nükleik asit veya diger polipeptit-
kodlayici nükleik asit, belirlenen ve normal olarak polipeptit-kodlayici nükleik asidin
dogal kaynagina bagli olan en az bir kontaminant nükleik asit molekülünden ayrilan bir
nükelik asit molekülüdür. izole bir polipeptit-kodlayici nükleik asit molekülü, dogada
bulundugu sekilden veya ayardan farklidir. Bu neden izole polipeptit-kodlayici nükleik
asit molekülleri, dogal hücrelerde var olmasi nedeniyle spesifik polipeptit-kodlayici
nükleik asit moleküllerinden ayirt edilir. Ancak, bir izole polipeptit-kodlayici nükleik asit
molekülü, örnegin, genellikle nükleik asit molekülünün dogal hücreninkinden farkli bir
kromozomal veya ekstra kromozomal Iokasyonda bulundugu polipeptidi ifade eden
hücreler içinde bulunan polipeptit-kodlayici nükleik asit moleküllerini içerir.
terimler, iki veya daha fazla kimyasal element veya bilesenin, kimyasal konjügasyon
veya rekombinant araçlar dahil herhangi bir araçla birlesmesini refere eder. Örnegin,
bir kolaylastirici veya artirici, dizilimin transkripsiyonunu etkilemesi durumunda, bir
kodlama dizilimine uygulanabilir sekilde baglidir. Genel olarak, "uygulanabilir sekilde
bagli", bagli olan DNAlnin komsu oldugu ve okuma fazinda veya çerçeve-içi oldugu
anlamina gelir. Bir "çerçeve-içi füzyon“, iki veya daha fazla okuma çerçevesinin
(ORF'Ier), orijinal ORF'Ierin dogru okuma çerçevesini saglayacagi sekilde, daha uzun
sürekli bir ORF olusturmak üzere birlesmesini refere eder. Dolayisiyla, ortaya çikan
rekombinant füzyon proteini, orijinal ORF'Ier (bu segmentler normalde dogada bu
sekilde brlesik degildir) tarafindan kodlanan polipeptitlere karsilik gelen iki veya daha
fazla segment içeren tek bir proteindir.
Polipeptitler kapsaminda, bir “lineer dizilim" veya bir "dizilim", dizilim içinde birbirinin
yaninda bulunan kalintilarin, polipeptidin birincil yapisi içinde komsu oldugu bir amino
asitten karboksil terminali yönündeki bir polipeptit içindeki bir amino asit sirasidir. Bir
kisminin lineer bir dizilimidir.
antiteden derive edilmis anlamina gelir. Örnegin, kendi natif kodlama dizilimden ayrilan
ve natif dizilimden farkli bir kodlama dizilimine uygulanabilir sekilde bagli olan glisin
açisindan zengin bir dizilim, glisin açisindan zengin bir heterolog dizilimdir. Bir
polinükleotit, bir polipeptit için kullanilan "heterolog'l terimi, polinükleotit veya
polipeptidin, karsilastirildigi antitenin geri kalanina göre genotipik olarak belirgin bir
antiteden derive edildigi ankamina gelir.
yerine kullanilabilir. Deoksiribonükleotitler veya ribonükleotitler veya bunlarin analoglari
gibi, herhangi bir boyuttaki nükleotitlerin polimerik formlarini refere eder.
Polinükleotitler, herhangi bir üç boyutlu yapiya sahip olabilir ve bilinen veya bilinmeyen
herhangi bir fonksiyonu gerçeklestirebilir. Siradakiler, polinükleotitlerin sinirlandirici
olmayan örnekleridir: bir gen veya gen fragmentinin kodlayici veya kodlayici olmayan
bölgeleri, baglanti analizi ile tanimlanan Ioci (Ioküs), eksonlar, intronlar, mesajci RNA
(mRNA), transfer RNA'si, ribozomal RNA, ribozimler, cDNA, rekombinant
polinükleotitler, dallanmis polinükleotitler, plazmitler, vektörler, herhangi bir dizilimin
izole DNA`si, herhangi bir dizilimin izole RNA'si, nükleik asit problari ve primerler. Bir
polinükleotit, metillenmis nükleotitler ve nükleotit analoglari gibi modifiye edilmis
nükleotitler içerebilir. Mecut olmasi durumunda, nükleotit yapisina modifikasyonlar,
polimerin birlesmesi öncesinde veya sonrasinda aktarilabilir. Nükleotitlerin dizilimi,
nükleotit olmayan bir bilesen tarafindan bölünebilir.
Bir polinükleotit için kullanilmak üzere "rekombinant", polinükleotitin, in vitro klonlama,
restriksiyon ve/veya ligasyon adimlari ve potansiyel olarak bir konak hücre içerisinde
ifade edilebilecek olan bir yapi ile sonuçlanan diger prosedürlerin çesitli
kombinasyonlarinin ürünü oldugu anlamina gelir.
çevrildikten sonra belirli bir proteini kodlama yetenegine sahip en az bir açik okuma
çerçevesi içeren bir polinükleotiti refere eder. Bir gen veya gen fragmenti, polinükleotit,
tüm kodlama bölgesini veya bunun bir segmentini kaplayabilecek olan en az bir açik
okuma çerçevesi içerdigi sürece genomik veya cDNA olabilir. Bir "füzyon geni",
birbirine bagli olan en az iki heterolog polinükleotitten meydana gelen bir gendir.
fazla polipeptit dizilimi arasindaki dizilim benzerligini veya birbirinin yerine
kullanilabilirligini refere eder. Iki farkli amino asit dizilimi arasindaki dizilim özdesligi,
benzerligi veya homolojisinin belirlenmesine yönelik BestFit gibi bir programin
kullanilmasi durumunda, öndeger ayarlari kullanilabilir veya özdeslik, benzerlik veya
homoloji skorlarinin optimize edilmesine yönelik blosum45 veya blosum80 gibi uygun
bir skorlama matrisi seçilebilir. Tercihen, homolog olan polinükleotitler, burada
tanimlandigi üzere zorlayici kosullar altinda melezlesenler ve bu dizilimler ile en az
daha tercihen %98 ve daha da tercihen %99 dizilim benzerligine sahip olanlardir.
dizilimine, diger dizilimlere göre saptanabilir sekilde daha yüksek bir dereceye (örnegin,
zemin üzerinde en az 2 kat) melezlesecegi kosullara referans içerir. Genellikle,
melezlesme zorlayiciligi, kismen, yikama adiminin gerçeklestirildigi sicaklik ve tuz
konsantrasyonuna referans ile ifade edilir. Tipik olarak, zorlayici kosullar, tuz
konsantrasyonunun pH 7.0,da yaklasik 1.5 M Na iyonu, tipik olarak yaklasik 0.01 ile 1.0
M Na iyonu konsantrasyonu (veya digertuzlar) oldugu ve sicakligin kisa polinükleotitler
(örnegin, 10 ila 50 nükleotit) en az yaklasik 30°C ve uzun polinükleotitler (örnegin, 50
nükleotitten daha fazla) için en az yaklasik 60°C oldugu kosullardir, örnegin, "zorlayici
O.1>
65°C, 60°C, 55°C veya 42°C kullanilabilir. SSC konsantrasyonu, yaklasik %1'de
mevcut olan SDS ile birlikte, yaklasik 0.1 ila 2XSSC arasinda degisiklik gösterebilir. Bu
tür yikama sicakliklari tipik olarak, belirlenmis bir iyonik güç ve pH degerindeki spesifik
dizilime yönelik termal erime noktasindan daha düsük olmak üzere yaklasik 5°C ila
°C olacak sekilde seçilir. Tm, hedef dizilimin %50'sinin mükemmel sekilde eslenmis
bir proba melezlestigi sicakliktir (belirlenmis iyonik güç ve pH altinda). Tm ve nükleik
asit melezlesmesine yönelik kosullarin hesaplanmasina yönelik bir esitlik yaygin olarak
bilinir ve siradaki kaynakta bulunabilir; Sambrook, J. et al. (1989) Molecular Cloning: A
Laboratory Manual, 2nd ed., Vol. 1-3, Cold Spring Harbor Press, Plainview N.Y.;
spesifik olarak bakiniz, Cilt 2 ve Bölüm 9. Tipik olarak, bloklama belirteçleri, spesifik
olmayan melezlesmenin bloke edilmesine yönelik kullanilir. Bu tür bloklama belirteçleri,
örnegin, yaklasik 100-200 ug/ml keailmis ve denatüre edilmis somon spermi DNA'sini
içerir. Hacimsel olarak yaklasik %35-50 konsantrasyondaki formamit gibi, organik
solvent, ayrica RNA:DNA melezlesmeleri gibi belirli sartlar altinda kullanilabilir. Bu
yikama kosullari üzerindeki yararli varyasyonlar, teknikte uzman kisiler tarafindan kolay
sekilde anlasilaoaktir.
Polinükleotit dizilimleri için kullanildigi üzere "benzerlik yüzdesi" ve "% benzerlik"
terimleri, standardize edilmis bir algoritma kullanilarak hizalandirilan en az iki
polinükleotit dizilimi arasindaki kalinti eslesmelerinin yüzdesini refere eder. Bu tür bir
algoritma, standardize edilmis ve yeniden üretilebilir bir yolla, iki dizilim arasindaki
hizalanmanin optimize edilmesine yönelik karsilastirilan dizilimler arasinda bosluklar
sokabilir ve bu sekilde iki dizilimin daha anlamli bir karsilastirmasini gerçeklestirebilir.
Yüzde benzerlik, örnegin belirli bir SEQ ID numarasi ile belirlenen, belirlenmis bütün bir
polinükleotit dizilimi boyunca ölçülebilir veya örnegin, en az 45, en az 60, en az 90, en
bir polinükleotitten alinan bir fragment boyunca, daha kisa bir uzunlukta ölçülebilir. Bu
tür uzunluklar yalnizca örneklendiricidir ve burada, Tablolarda, Sekillerde veya Dizilim
Listesinde gösterilen dizilimler tarafindan desteklenen herhangi bir fragmentin, yüzde
benzerligin ölçülebilecegi bir uzunlugu açiklamak üzere kullanilabilecegi
anlasilmaktadir.
Burada tanimlanan polipeptit dizilimlerine bagli olarak "yüzde (%) amino asit dizilimi
benzerligi", maksimum yüzde dizilim benzerliginin saglanmasina yönelik, gerekli olmasi
durumunda, dizilimlerin hizalanmasi ve bosluklarin eklenmesi ve herhangi bir koruyucu
degisikligin dizilim benzerliginin bir parçasi olarak kabul edilmemesi sonrasinda, ikinci
bir referans polipeptit dizilimi veya bunun bir kisminin amino asit kalintilari ile benzer
olan bir sorgulama dizilimindeki amino asit kalintisi yüzdesi olarak tanimlanir. Yüzde
amino asit dizilimi benzerliginin belsrlenmesine yönelik hizalama, örnegin, BLAST,
BLAST-Z, ALlGN veya Megalign (DNASTAR) yazilimi gibi halka açik bilgisayar
yazilimlari kullanilarak, teknikte bilinen çesitli yollarla gerçeklestirilebilir. Bu teknikte
uzman kisiler, karsilastirilan dizilimlerin tam boyutu üzerinde maksimal hizalama
gerçeklestirilmesine yönelik gerekli olan herhangi algoritma dahil, hizalamanin
ölçülmesine yönelik uygun parametreler belirleyebilir. Yüzde benzerlik, örnegin belirli
bir SEQ ID numarasi ile tanimlanan, tanimlanmis bir bütün polipeptit dizilimi boyunca
veya en az 150 komsu kalintili bir fragment gibi tanimlanmis, daha genis bir polipeptit
diziliminden alinmis bir fragment boyunca, daha kisa bir uzunlukta ölçülebilir. Bu tür
uzunluklar yalnizca örneklendiricidir ve burada, Tablolarda, Sekillerde veya Dizilim
Listesinde gösterilen dizilimler tarafindan desteklenen herhangi bir fragment
uzunlugunun, yüzde benzerligin ölçülebilecegi bir uzunlugu açiklamak üzere
kullanilabilecegi anlasilmaktadir.
Bir "vektör", eklenen bir nükleik asit molekülünü konak hücreler içine ve/veya arasina
transfer eden, tercihen uygun bir konakta kendi kendini replike eden bir nükleik asit
molekülüdür. Terim, öncelikle bir hücre içerisine DNA veya RNA'nin eklenmesine, DNA
veya RNA'nin replikasyonuna yönelik islev gösteren vektörlerin replikasyonuna ve DNA
veya RNA'nin transkripsiyonu ve/veya translasyonuna yönelik islev gösteren vektörlerin
ifade edilmesine yönelik islev gösteren vektörleri içerir. Ayrica, yukaridaki islevlerin
birden fazlasini saglayan vektörler de dahildir. Bir "ifade vektörü", uygun bir konak
hücre içerisine girmesi durumunda, bir veya daha fazla polipeptite kopyalanabilen veya
çevrilebilen bir polinükleotittir. Bir "ifade sistemi“ çogunlukla, istenen bir ifade ürününü
vermek üzere islev gösterebilen bir ifade vektöründen olusan uygun bir konak hücreyi
ifade eder.
Bir polipeptit için kullanilmak üzere "degradasyon direnci", polipeptitlerin kandaki veya
bunun tipik olarak serum veya plazma içerisinde proteazlar içeren bilesenlerindeki veya
bir proteine yönelik bir depolama veya dagitim araci islevindeki bir formülasyon içindeki
degradasyona karsi koyma yetenegini refere eder. Degradasyon direnci, proteinin,
insan (veya fare, siçan, maymun, hangisi uygun ise) kani, serumu, plazmasi veya bir
edilmesi ile ölçülebilir. Numunelerdeki intakt protein akabinde standart protein miktar
tayini teknikleri kullanilarak ölçülür. Proteinin %50'sinin degrade oldugu zaman
noktasu, proteinin "degradasyon yari ömrüdür".
gerekli olan zamani refere eder. "Yari ömür", "ti/2 , eliminasyon yari ömrü" ve "döner
yari ömür" terimleri burada birbirinin yerine kullanilabilir.
özelliklerinden hesaplanan görünür yariçapidir (nm biriminde Rh). Bir proteinin
makromolekül jelleri içerisindeki göç etme yetenegini etkiler. Bir proteinin hidrodinamik
yariçapi, bunun moleküler agirliginin yani sira sekli ve kompaktligi dahil yapisi ve
hidrasyon durumu tarafindan etkilenir. Hidrodinamik yariçapin belirlenmesine yönelik
DLS kullanimi ve büyüklük dislanimli kromatografi gibi yöntemler, teknikte iyi
bilinmektedir. Proteinlerin birçogu, bir proteinin en küçük hidrodinamik yariçap ile sahip
olabilecegi en kompakt üç boyutlu yapi olan globüler yapiya sahiptir. Bazi proteinler
rastgele ve açik bir yapisal olmayan veya 'lineer' biçime sahiptir ve bunun sonucu
olarak, benzer moleküler agirliga sahip tipik globüler proteinlere kiyasla çok daha genis
hidrodinamik yariçapa sahip olur.
kosullarini taklit eden, bir canli konak hücrenin içindeki birtakim kosullarin yani sira in
vitro kosullari refere eder. In vitro kullanima yönelik fizyolojik olarak ilgili kosullarin bir
konagi gerçeklestirilmistir. Genel olarak, fizyolojik bir tampon, fizyolojik bir tuz
konsantrasyonu içerir ve yaklasik 6.5 ila yaklasik 7.8 arasinda ve tercihen yaklasik 7.0
ile yaklasik 7.5 arasinda degiskenlik gösteren nötr bir pH degerine ayarlanir. Birtakim
fizyolojik tamponlar, Sambrook et al. (1989) içinde Iistelenir. Fizyolojik olarak ilgili
sicakliklar, yaklasik 25°C ila yaklasik 38°C arasinda ve tercihen yaklasik 35°C ila
yaklasik 37°C arasinda degiskenlik gösterir.
ajan", bulusun bir polipeptidinin salim süresini, polipeptidin bir ajanin yoklugunda
verilmesi durumundaki salim süresine bagli olarak uzatma yetenegine sahip bir ajani
refere etmek üzere birbirinin yerine kullanilabilir. Mevcut bulusun farkli düzenlemeleri,
farkli terapötik miktarlar ile sonuçlanan farkli salim hizlarina sahip olabilir.
Burada kullanildigi üzere "antagonist" terimi, burada açiklanan bir natif polipeptidin bir
biyolojik aktivitesini kismen veya tam olarak bloke eden, inhibe eden veya nötralize
eden tüm molekülleri içerir. Bir polipeptidin antagonistlerinin belirlenmesine yönelik
yöntemler, bir natif polipeptidin bir aday antagonist molekül ile temas etmesini ve
normal olarak natif polipeptit ile iliskili bir veya daha fazla biyolojik aktivitedeki
saptanabilir degisikligin ölçülmesini içerebilir. Mevcut bulusun kapsami içerisinde,
antagonistlere, proteinler, nükleik asitler, karbohidratlar, antikorlar veya bir aktif
proteinin etkisini azaltan herhangi bir diger molekül dahil olabilir.
bir biyolojsk aktivitesini taklit eden herhangi bir molkeülü içerir. Uyugn agonist
moleküller spesifik olarak, agonist antikorlar veya antikor fragmentleri, natif
polipeptilerin, prptitlerin, küçük organik moleküllerin, vb. fragmentlerini veya amino asit
dizilimi varyantlarini içerir. Bir natif polipeptidin agonistlerinin belirlenmesine yönelik
yöntemler, bir natif polipeptidin bir aday agonist molekül ile temas ettirilmesini ve
normal olarak natif polipeptit ile iliskili olan bir veya daha fazla biyolojik aktivitedeki
saptanabilirbir degisikligin ölçülmesini içerir.
Buradaki amaçlara yönelik "aktivite", ilgili natif aktif proteininki ile tutarli olan bir füzyon
proteinin bir bileseninin bir aksiyonu veya etkisini refere eder, burada, “biyolojik aktivite"
veya "biyoaktivite", bunlarla sinirli olmaksizin, reseptör baglanmasi, antagonist
akivitesi, agonist aktivitesi veya bir hücresel veya fizyolojik tepki dahil, bir in vitro veya
in vivo biyolojik fonksiyonu veya etkiyi refere eder.
Burada kullanildigi üzere, "tedavi" veya "tedavi etme." veya "hafifletme" veya
olmaksizin bir terapötik yarar ve/veya bir profilaktik yarar dahil, yararli veya istenen bir
sonucun elde edilmesine yönelik bir yaklasimi refere eder. Terapötik yarar deyimiyle,
tedavi edilen temeldeki bozuklugun eradikasyonu veya iyilesmesi ifade edilir. Ayrica,
denekte bir iyilesmenin gözlemlenecegi sekilde, temeldeki bozukluk ile iliskili bir veya
daha fazla fizyolojik semptomun eradikasyonu veya iyilesmesi ile gerçeklestirilir,
bununla birlikte, denek temeldeki bozukluktan hala muzdarip olabilir. Profilaktik yarara
yönelik, bilesimler belirli bir hastaligin ortaya çikmasi riski ile birlikte bir hastaya veya
söz konusu hastaligin bir teshisinin yapilmamis olmasina ragmen, bir hastaligin bir
veya daha fazla fizyolojik semptomunu tasiyan bir denege verilebilir,
Burada kullanildigi üzere bir "terapötik etki", bunlarla sinirli olmaksizin insanlarda veya
diger hayvanlarda ki hastaligin tedavisi, mitigasyonu, iyilestirilmesi veya önlenmesi
dahil bir fizyolojik etkiyi veya aksi durumda, ktif proteinin sahip oldugu bir antijenik
epitopa karsi bir antikor üretimini baslatma yeteneginden farkli olarak bulusun bir
füzyon proteini tarafindan neden olunan, insanlarin veya hayvanlarin mental veya
fiziksel sagligini artirmayi refere eder. Terapötik olarak etkili bir miktarin belirlenmesi,
özellikle burada saglanan detayli açiklamanin isiginda, teknikte uzman kisilerin
yetenekleri arasindadir.
Burada kulanildigi üzere "terapötik olarak etkili miktar" veya "terapötik olarak etkili doz"
terimleri, bir denege tek dozda veya tekrarli dozlarda verilmesi durumunda bir hastalik
durumu veya kosulunun herhangi bir semptomu, açisi, ölçülen parametresi veya
karakteristigi üzerinde herhangi bir saptanabilir, yararli etkiye sahip olma yetenegine
sahip, yalniz basina veya bir füzyon proteini bilesiminin bir parçasi olarak, bir aktif
proteinin bir miktarini refere eder. Bu tür bir etkinin yararli olabilmesine yönelik mutlak
olmasi gerekmez.
Burada kullanildigi üzere "terapötik olarak etkili doz rejimi" terimi, yalniz basina veya
bir füzyon proteini bilesiminin bir parçasi olarak, bir aktif proteinin ardisik olarak verilen
dozlarinin bir programini refere eder, burada, dozlar, bir hastalik durumu veya
kosulunun herhangi bir semptom, açisi, ölçülen parametresi veya karakteristigi
üzerinde sürekli yararli etki ortaya çikarmak üzere terapötik olarak etkili miktarlarda
Füzyon Proteinleri
Bulus, bir aktif proteine bagli bir müsin etki alanli polipeptit içeren füzyon proteinleri ile
ilgilidir. Bu tür proteinler ayrica burada "müsinlenmis" proteinler olarak refere edilir.
Burada kullanildigi üzere bulusun bir "füzyon proteini", bir aktif proteine bagli olan bir
müsin etki alanli polipeptit içerir. Bir açida, müsin etki alanli polipeptit veya aktif protein
normal olarak ayri proteinlerde yer alir ve füzyon proteininde bir araya getirilir veya
normal olarak ayni proteinde yer alabilirler ancak füzyon proteininde yeni bir düzen
içinde yerlestirilir. Bulusun bilesimleri ve yöntemleri, farmakokinetik özelliklerin, belirli
olarak bir müsin etki alanli polipeptit ile kaynasmasi duurmunda bir aktif proteinin yari
ömrünün artirilmasina yönelik belirli olarak yararlidir. Bir açida, burada açiklanan
füzyon proteinleri, müsin etki alanli polipeptide bagli olmayan ilgili aktif proteinin
biyoloijk ve/veya terapötik aktivitesinin tümünü veya bir kismini korur. Bir açida, aktif
proteinin terapötik/biyolojik aktivitesi, bir füzyon proteini olusturmak üzere bir müsin etki
alanli polipeptit ile kaynasmasi durumunda artirilir. Bir açida, bulus ile iliskili füzyon
proteini spesifik olarak, immünoglobülin moleküllerini ve bir FC etki alani veya bunun
herhangi bir fragmentini içeren herhangi bir molkeülü içermez. Bir açida, füzyon
proteini veya bunun herhangi bir kismi, 01,3, galaktosiltransferaz veya [31,6-
asetilglukozaminiltransferaz tarafindan glikosile olmaz. Bir açida, füzyon proteini,
dGaliye özgü bir antikora baglanmaz. Bir açida, bulusun füzyon proteini, bir Gal dt,
SGal'ye özgü antikora baglanmaz.
Müsin proteinleri ve proteinlerin müsin etki alanlari, müsin proteinleri ve müsin etki
alanlarina sahip diger polipeptitlerin katilasmis düzensiz sargi olarak davranmasina
yapisal olarak olanak veren yüksek dereceli bir glikosilasyona sahiptir. Glikosile müsin
etki alanlarini gerçeklestiren hidrofilik dallanmis hidrofilik karbonhidratlar ile
kombinasyon içindeki bu katilasmis düzensiz sargilar, aktif proteinin hidrodinamik
yariçapini, ifade edilen proteinin moleküler agirligina bagli olarak beklenecek olana
göre artirmak üzere belirli olarak yararlidir. Ayrica yüksek seviyedeki glikosilasyon
nedeniyle, bir müsin etki alaninin eklenmesi ayrica, bir proteinin, aktif proteinin
konsantre solüsyonlarinin yük, çözünürlük ve viskoelastik özellikleri gibi fizikokimyasal
özelliklerini modifiye etme potansiyeline sahiptir. Bulusun müsinlenmis füzyon
proteinleri, proteinlerin yari ömrünün uzatilmasina yönelik eski teknik stratejiler
üzerinde birçok avantaja sahiptir. Bulusun füzyon proteinleri, ayri konjügasyon ve
pürifikasyon adimlarina gerek duyulmadan standart ifade etme araçlari araciligiyla
üretilebilir. Müsin etki alanli polipeptitler, aktif proteinin N- veya 0- terminalinin her isiki
araciligiyla aktif proteine baglanabilir. Müsin etki alanli polipeptitler, daha az hacim ve
biyokaktivite üzerinde daha düsük etki riskine sahip monomerik, globüler olmayan
proteinler olmasi açisindan diger füzyon proteinlerine göre yapisal olarak daha az
sinirlandiricidir. Müsin etki alanlarinin kullanilmasi, Fc etkili fonksiyonlar gibi endojen
biyoaktivite riskini düsürür. Insan terapötiklerini hazirlamak üzere kullanilmasi
durumunda, bulusun füzyon proteinleri, immünojenesite riskini azaltmak üzere yüksek
glikosilasyona sahip tam insan dizilimleri içerebilir.
Ortaya çikan fonksiyonel karakteristikler veya biyolojik ve farmakolojik aktivite ve
parametreler dahil, bulusun füzyon proteini bilesimlerinin aktivitesi, istenen
karakteristigin ölçülmesine yönelik teknikte bilinen uygun herhangi bir görüntüleme
tahlili ile belirlenebilir. Füzyon proteinlerinin aktivitesi ve yapisi, bulusun bilesimlerinin
yari ömrü, çözünürlük derecesi, yapisi ve biyolojik aktivite sinirlandirmasini ortaya
çikarmak üzere burada açiklanan tahliller, Örneklerdeki tahliller veya teknikte bilinen
yöntemlerin yani sira, bulusun füzyon proteinleri olmayan aktif proteinler ile
karsilastirilarak ölçüleblir.
Füzyon proteinin refere edilmesi durumunda, "baglanmis" veya "kaynasmis" veya
polipeptitin O-bagli glikosilasyonuna olanak verecek sekilde ve aktif proteinin
aktivitesini saglayacak sekilde, hücrelerde tek bir polipeptit olarak ifade edildigini
belirtmek üzere kullanilir. Bir düzenlemede, müsin etki alanli polipeptit opsiyonel
olarak, bir amino asit baglayicisi araciligiyla aktif proteine baglanmis olabilir. Amino
asit baglayicisi ayrica opsiyonel olarak, bir denege füzyon proteininin verilmesi
sonrasinda aktif proteini salmak üzere tasarlanmis olabilecek olan bir klivaj dizilimi
içerebilir.
Opsiyonel olarak, müsin etki alanli polipeptit ile kaynasmis olan aktif proteini içeren
füzyon proteini, aktiviteyi artirmaya ve füzyon proteinine ek aktivite kazandirmaya
yönelik olan bir veya daha fazla ek kisma kaynastirilabilir. Bir açida, füzyon proteini A-
M-B yapisini içerir, burada, A, bir N-terminali füzyon partneri, M, bir müsin etki alani ve
B, bir C-terminali füzyon partneridir. A ve B, benzer ve benzer olmayan özellikleri
içerebilir. Bu düzenlemenin bir açisinda, A ve B, bunlarla sinirli olmaksizin, agonizm,
antagonizm, enzimatik aktivite, spesifik protein veya hücrelere hedeflenme, kimyasal
reaktivite veya oligomerizasyona sahip olacak sekilde, bagimsiz olarak veya sinerjik
olarak hareket edebilen biyoaktif kisimlardir. Diger bir açida, A ve B'nin ayni olmasi
durumunda, aktivite artirimi, avidite araciligiyla saglanir.
Bulusun bir füzyon proteini, standart rekombinant DNA teknikleri ile üretilebilir. Örnegin,
farkli polipeptit dizilimlerine yönelik kodlayan DNA fragmentleri, örnegin, Iigasyona
yönelik kunt uçlu termini ve yumusak uçlu termini, uygun sekilde kohezif uçlarin
doldurulmasi, istenmeyen baglantilarin önlenmesine yönelik alkalin fosfataz ve
enzimatik Iigasyon uygulanarak, klasik tekniklere göre çerçeve-içi sekilde birlikte ligate
olur. Diger bir açida, füzyon geni, otomatik DNA sentezleyicileri dahil klasik teknikler ile
sentezlenebilir. Alternatif olarak, gen fragmentlerinin gen amplifikasyonu, bir kimerik
gen dizilimi olusturmak üzere akabinde tavlanabilen ve yeniden güçlendirilebilen iki
ardisik gen fragmenti arasinda tamamlayici sarkaçlari ortaya çikaran çapa primerleri
kullanilarak gerçeklestirilebilir (bakiniz, örnegin, Ausubel et al. (eds.) Current Protocols
in Molecular Biology, John Wiley & Sons, 1992). Birçok ifade vektörüne, füzyon
kisimlarina yardimci olmak üzere ticari olarak ulasilabilir ve bunlar asagida daha
detayli sekilde açiklanacaktir.
Müsin etki alanli polipeptit
Bir "müsin etki alanli polipeptit", burada bir "müsin etki alani“ içeren herhangi bir protein
olarak tanimlanir. Bir müsin etki alani, potansiyel glikosilasyon alanlari açisindan
zengindir ve müsin etki alani içerisindeki amino asitlerin %40'indan daha fazlasini ifade
edebilen yüksek bir serin ve/veya treonin ve prolin içerigine sahiptir. Bir müsin alani,
büyük çogunlukla O-bagli glikanlar ile büyük ölçüde glikosile edilmistir. Bir müsin etki
alanli polipeptit, kütlesinin yaklasik en az %60'i, en az %80`i veya en az %90'i
glikandir. Müsin etki alanlari, her bir tandem tekrar birimi basina uzunluk olarak
yaklasik 8 amino asit ila 150 amino asit arasinda degisebilen tandem amino asit tekrar
birimleri (ayrica burada TR olarak da refere edilir) içerebilir. Tandem tekrar birimi
sayisi, bulusun bir müsin etki alanli polipeptitinde 1 ve 25 arasinda degiskenlik
gösterebilir.
Burada açiklanna müsin-etki alanli polipeptitler, bunlarla sinirli olmaksizin, müsin
proteinlerini içerir. “Bunun bir kismi", müsin polipeptit baglayicisinin, bir müsin
proteininin en az bir müsin etki alanini içerdigi anlamina gelir. Müsin proteinleri. bir
MUC geni (yani, MUC1, MUC2, MUCSA, MUC3B, MUC4, MUC5AC, MUCSB, MUC6,
MUCZO, MUCZi) ile kodlanan tüm proteinleri içerir. Bir müsin proteinin müsin etki alani
tipik olarak, tekrarli olmayan amino asit bölgeleri ile her iki tarafta yaslanmis haldedir.
Bir müsin etki alanli polipeptit, bir müsin proteininin (örnegin, MUCZO) tümünü veya
müsin proteininin ekstraselüler kismi, müsin proteininin sinyal dizilimi kismi, müsin
proteinin transmembran etki alani ve/veya müsin proteininin sitoplazmik etki alani dahil,
bir kismini içerebilir. Bir müsin etki alanli polipeptit, çözünebilir bir müsin proteininin
tümünü veya bir kismini içerebilir. Tercihen, müsin etki alanli polipeptit, bir müsin
proteininin ekstraselüler kismini içerir.
Bir müsin etki alanli polipeptit ayrica, bir müsin etki alani içeren ancak bir MUC geni ile
kodlanmis olmayan bir proteinin tümünü vey bir kismini da içerebilir. Bir MUC geni
tarafindan kodlanmamis olan ancak müsin etki alanlari içeren bu tür kendiligindne
olusan proteinlere, bunlarla sinirli olmaksizin, transmembran immünoglobülin ve müsin
etki alanli (TIM) familya proteinleri gibi membran-çapali proteinler, fraktalkin (nörotipin),
P-selektin glikoprotein ligand 1 (PSGL-i, CD162), E-selektin, L-selektin, P-selektin,
MAdCAM, kirmizi kan hücresi glikoproteinleri, glikokalsisin, glikophorin, LDL-R, ZP3,
endosiyalin, bozunma hizlandirici faktör (daf, CD55), podokalksin, endoglikan, alfa-
distroglikan, nörofaskin, EMR1, EMR2, EMRB, EMR4, ETL ve epiglikanin dahildir.
Bir müsin etki alanli polipeptit ayrica, terim olarak burada tanimlandigi üzere bir müsin
etki alanina sahip kendilinden olusan bir polipeptit içerir. Bir açida, müsin etki alanli
polipeptit, bir müsin etki alani içermek üzere de novo tasarlanir. Bir açida, bir müsin
etki alanli polipeptit, Pro, Ser ve Thr açisindan zengin olan tandem amino asit tekrarlari
etki alanlari içerir. Bir açida, bir müsin etki alanli polipepetit içerisindeki tandem tekrar
birimi sayisi 1 ve 25 arasindadir. Tercihen, bir müsin etki alanli polipepetit içerisindeki
tandem tekrar birimi sayisi 2 ve 20 arasindadir. Daha tercihen, bir müsin etki alanli
polipepetit içerisindeki tandem tekrar birimi sayisi en az yaklasik 4'tür. Diger bir açida,
bir müsin etki alanli polipeptit içerisindeki serin ve/veya treonin ve prolin kalintilari
yüzdesi en az %10'dur. Tercihen, bir müsin etki alanli polipeptit içerisindeki serin
ve/veya treonin ve prolin kalintilari yüzdesi en az %20'dir. Daha tercihen, bir müsin etki
alanli polipeptit içerisindeki serin ve/veya treonin ve prolin kalintilari yüzdesi %30”dan
daha yüksektir. Son bir açida, müsin etki alani içerisindeki her bir tandem amino asit
tekrar birimi, en a 8 amino asitten olusur. Tercihen, her bir birim en az 16 amino asitten
olusur. Daha tercihen, her bir birim en az 19 amino asitten olusur ve her bir birim
uzunluk olarak yaklasik 19 amino asit ila 150 amino arasinda degiskenlik gösterir.
Bir açida müsin etki alanli polipeptit, en az %40 Serin. Treonin ve Prolin içeren en az
32 amino asit içerir. Bir açida, bir müsin etki alanli polipeptit, tandem tekrarli birim
basina uzunluk olarak en az 8 amino asite sahip en az 2, 4, 8, 10 veya 12 tandem
amnio asit tekrarli birim içerir. Bir tandem tekrarli birimin tercih edilen amino asit
dizilimleri, bunlarla sinirli olmaksizin, Tablo 1'dekileri içerir. Müsin etki alanli polipeptit
ve/veya müsin etki alanli polipeptidi kodlayan nükleik asitler, teknikte bilinen ve Gen
Bank gibi kaynaklar araciligiyla halka açilan müsin etki alanliprotein kodlayan dizilimler
kullanilarak yapilabilir.
Tablo I
Tandem Tekrarli (TR) Amino Asit Dizilimi (# Erisim
TR/MUC* sayisi Notlar
of aa's) Numarasi+
MUC1'in birçok
P15941 varyanti
mevcuttur
Majör TR;
99 Q02817
mevcuttur
Dejenerat TR
dizilimi; uzun
serin açisindan
lTTTETTSHDTPSFTSS (17) [SEQ ID NO: 20
13] Q02505 zengin ve treonin
açisindan zengin
dizilim de
mevcuttur
Dejenerat TR
ATPLPVTDTSSASTGH (16) [SEQ ID NO: dizilimi, uzun
14] serin açisindan
zengin ve treonin
Tandem Tekrarli (TR) Amino Asit Dizilimi (#
TTSTTSAP (8) [SEQ ID NO:15]
ATGSTATPSSTPGTTHTPPVLTTTATTPT
(29) [SEO lD NO:16]
TTAAPPTPSATTQAPPSSSAPPE
EESTTVHSSPGATGTALFP (19) [SEO ID
SSSPTPAT:(,3TSMPTSTYSEGRTPLTSMPVSTT
LVATSA I STLSTTPVI 'JTSTPVTNSTl-ZA (60)
SESSASSDGPHPVITPSRA (19) [SEO ID
TR/MUC* sayisi
(46,17,34,58)°°
59-60
11-12
Numarasi+
P98088
Q9H084
Q6W4X9
Q8TAX7
Q9H3R2
Q8N387
Q8WXI7
Q685J3
Q725P9
Q8N307
Notlar
açisindan zengin
dizilim de
mevcuttur
Konsensus
dizilim T-T-S-T-
T-S-A-P (SEQ ID
Dejenerat TR
Dejenerat TR
Konsensus
dizilim E-E-S-X-
(SEQ ID NO:25)
Dejenerat TR
P-S-A tekrarlari
(SEQ ID NO:26)
Fraktalkin
Makrosiyalin
Endosiyalin
Podokaliksin
Tandem Tekrarli (TR) Amino Asit Dizilimi (#
TR/MUC* sayisi
ATNSESSTVSSGIST (15) [SEQ ID NO:21] 28
VPTTTT (6) [SEO ID NO: 221
Müsin benzeri bölge (PTS)
Müsin benzeri bölge (PTS)
Pro açisindan zengin bölge
Thr açisindan zengin bölge
QTTQPAATEA (10) [SEQ ID NO: 23]
MUC8 ve MUC9 çikarilmistir; güvenilmez veri
PTS prolin/serin/treonin açisindan zengin dizilim
* yaklasik; TR sayisi çogu durumda bir aralik olarak verilir *Uniprot
oo TR'nin n sayisi spesifik bölgelerde farklidir
NA Bildirilmemistir
Notlar
Numarasi+
Dejenerat TR
Q588G8
E2RYF6
Dejenerat TR
Q96D42 _ _ . _
Q96H15
P78423
P34810
P40200
Q9HCUO
P08174
Q14246
Dejenerat TR
Q14242 _ __ _
Bir açida, bir müsin etki alanli polipeptidin toplam dizilim uzunlugu 32 ila 200
arasindadir. Yükselen yari ömrün yükselen hidrodinamik yariçap ile, daha önemlisi,
renal filtrasyonun önlenmesine olanak veren yaklasik 60 kD'dan daha yüksek bir
moleküler agirlik ile korele olmasi nedeniyle, müsin etki alanli polipeptitin uzunlugu bir
sekilde aktif kismin boyutuna baglidir. Örnegin, 5 kD”den daha düsük bir moleküler
agirliga sahip bir peptit, istenen yari ömür uzatmasini gerçeklestirmek üzere 200 amino
asitlik bir müsin etki alanli polipeptit gerektirebilir. Aksine, 40 kD moleküler agirliga
sahip bir protein, istenen yari ömrü saglamak üzere yalnizca bir müsin etki alanli
polipeptide ihtiyaç duyabilir. Ayrica, müsinlestirme, füzyon proteininin müsin etki alanli
peptitindeki müsin tandem tekrar sayisinin artirilmasi veya azaltilmasiyla yari ömrün
optimize edilmesine olanak verir.
Alternatif olarak, müsin etki alanli polipeptit kismi, yabani tipteki bir proteinin
kendiliginden olusan müsin etki alanli diziliminde bir mutasyona sahip olan bir müsin
etki alanli polipeptit varyanti olarak saglanir. Örnegin, varyant müsin etki alanli
polipeptit, yabani tipteki müsin etki alanli polipeptit ile karsilastirildiginda ek O-bagli
glikosilasyon alanlarina sahiptir. Alternatif olarak, varyant müsin etki alanli polipeptit,
yabani tipteki müsin etki alanli polipeptit ile karsilastirildiginda, daha yüksek bir serin,
treonin veya prolin kalintisi sayisi ile sonuçlanan amino asit dizilimi mutasyonlari içerir.
Alternatif olarak, varyant müsin etki alanli polipeptit dizilimleri, bunlarla sinirli
olmaksizin, aspartik asit, glutamik asit, Iisin, histdin ve arjinin dahil, belirli bir pH
degerinde molekülün pl'sini veya yükünü degistiren, eklenen veya çikarilan yüklenmis
kalintilar içerir.
Aktif Protein ve Terapötik Aktif Protein
Burada açiklanan füzyon proteini içine dahil edilmeye yönelik burada kullanildigi üzere
bir "aktif protein", biyolojik, terapötik, profilaktik veya diyagnostik amaca veya
fonksiyona sahip ve/veya bir biyolojik aktiviteye ortam aglama yetenegine sahip bir
protein anlamina gelir. Burada kullanildigi üzere bir "terapötik aktif protein", bir denege
verilmesi durumunda bir hastaligi, bozuklugu veya kosulu önleme veya iyilestirme
yetenegine sahip bir proteindir.
Bir açida, bulusa göre bir aktif protein veya terapötik aktif protein, immünoglobülin
moleküllerini veya bir Fc etki alani veya bunu bir fragmentini içeren herhangi bir
molekülü spesifik olarak hariç tutar.
Aktif proteinler ve terapötik aktif proteinler, bir farmakokinetik parametrede artis, yüksek
çözünürlük, yüksek stabilite veya bazi diger daha yüksek farmasötik özelligin aranmasi
açisindan veya bu aktif proteinler, yüksek yari ömrün, etkinligi, güvenligi artirmasi veya
dozlama frekansinin azalmasi ve/veya hasta uyumlulugunun artmasi ile sonuçlanmasi
açisindan özellikle önemlidir. Dolayisiyla, füzyon proteinleri, örnegin, bulusun füzyon
proteininin, bir denege verilmesi durumunda, müsin etki alanli polipeptite bagli olmayan
bir aktif protein ile karsilastirildiginda, terapötik pencere içerisinde kaldigi veya in vivo
maruz birakildigi zaman periyodunun artirilmasi gibi, terapötik aktif proteinin terapötik
etkinliginin artirilmasi dahil, çesitli amaçlar ile hazirlanir.
Bir açida, bulusun bir füzyon proteini, bir müsin etki alanli polipeptide bagli olan tek bir
aktif protein içerebilir (asagida daha detayli sekilde anlatilmaktadir). Diger bir açida,
füzyon proteini, bir veya daha fazla müsin etki alanli polipeptit araciligiyla bagli olan iki
aktif protein içeren bir füzyon proteini ile sonuçlanmak üzere, ayni aktif proteinin birinci
bir aktif proteinini ve ikinci bir molekülünü içerebilir. Diger bir açida, füzyon proteini, bir
veya daha fazla müsin etki alanli polipeptit araciligiyla bagli olan farkli aktivitelere sahip
iki aktif protein içeren bir füzyon proteini ile sonuçlanmak üzere, birinci bir aktif protein
ve ikinci bir belirgin aktif protein içerebilir.
Bir açida, bir atf protein, in vivo kullanilmasi durumunda veya bir in vitro tahlilde
degerlendirilmesi durumunda verilen bir hedefe veya diger bir istenen biyolojik
karakteristige yönelik bir baglanma özgüllügüne maruz kalir. Örnegin, aktif protein, bir
agonist, bir reseptör, bir Iigant, bir antagonist, bir enzim veya bir hormon olabilir.
Kullanilan veya bir hastalik veya bozukluga yönelik kullanisli oldugu bilinen aktif
proteinler belirli öneme sahiptir, burada, bunlarin yari ömründeki bir uzama, daha az
sik dozlamaya veya daha iyi bir farmakolojik etkiye olanak verir. Ayrica, minimum etkili
doz veya kan konsantrasyonu (Cmin) ve maksimum tolere edilebilir doz veya kan
konsantrasyonu (Cmaks) arasinda dar bir terapötik pencereye sahip aktif proteinler de
önemlidir. Bu tür durumlarda, aktif proteinin bir müsin etki alanli polipeptit içeren bir
füzyon proteinine baglanmasi, bu özelliklerde bir iyilesme ile sonuçlanabilir, bunlar, bir
müsin etki alanli polipeptite bagli olmayan aktif protein ile karsilastirildiginda terapötik
ve önleyici ajanlar olarak daha kullanisli hale gelir.
Terapötik aktif protein olan aktif proteinler, bunlarla sinirli olmaksizin siradaki çesitli
terapötik veya hastalik kategorisindeki tedavide kullanima sahip olabilir: glükoz ve
insülin bozukluklari, metabolik bozukluklar, kardiyovasküler hastaliklar,
koagülasyon/kanama bozukluklari, büyüme bozukluklari veya kosullari, tümörijenik
kosullar, enflamatuar kosullar, otoimmün kosullar veya diger hastaliklar ve hastalik
kategorileri, burada, bir müsin etki alanli polipeptide bagli olmayan bir terapötik protein
veya peptit, bir alt optimal yari ömre maruz kalir veya burada, bir terapötik protein veya
peptit mevcut olmaz.
Bir aktif protein, bir natif, tam uzunluklu protein olabilir veya natif aktif proteinin terapötik
aktivitesinin en az bir kismini koruyan bir aktif proteinin bir fragmenti veya bir dizilim
varyanti olabilir. Bir düzenlemede, bulusa göre aktif proteinler, dogada bulunan bir
protein ile iliskili bir dizilime sahip bir rekombinant polipeptit olabilir. Diger bir
düzenlemede, aktif proteinler, natif aktif proteinin biyolojik aktivitesinin en az bir kismini
koruyan bir dogal dizilimin dizilim varyantlari, fragmentleri, homologlari ve mimetikleri
olabilir.
Sinirlandirici olmayan örneklerde, aktif protein, natif aktif protein veya bir natif aktif
proteinin bir varyanti ile en az yaklasik %80 dizilim benzerligi veya alternatif olarak
proteinler ve peptitlere, bunlarla sinirli olmaksizin, siradakileri içerir: biyoaktif peptitler
(GLP-1, eksendin-4, oksitosin, opiat peptitler), sitokinler, büyüme faktörleri, kemokinler,
lenfokinler, ligantlar, reseptörler, hormonlar, enzimler, antikorlar ve antikor fragmentleri,
etki alani antikorlari, nano-antikorlar, tek Zincirli antikorlar, DARP'Ier gibi tasarlanan
antikorlarin 'alternatif iskeleleri', sentrinler, adnektinler ve büyüme faktörleri. Reseptör
örneklerine, membran ile iliskili reseptörülerin ekstraselüler etki alani (TNFR2, VEGF
reseptörleri, IL-1R1, lL-1RACP, IL-4 reseptör, hGH reseptör, CTLA-4, PD-1, IL-BRor,
FGF reseptörleri gibi), transmembran etki alanlarindan ayrilmis olan çözünebilir
reseptörler, 'yardimci' veya 'yalanci' reseptörler (IL-1RII, TNFRSF11B, DCR3 gibi) ve
herhangi kimyasal olarak veya genetik olarak modifiye edilmis çözünebilir reseptörler
dahildir. Enzim örneklerine, aktiflestirilmis protein C, faktör VII, kollajenaz; agalsidaz-
beta; domaz-alfa; alteplaz; pegylated-asparajinaz; asparajinaz ve imigluseraz dahildir.
Spesifik polipeptit veya protein örneklerine, bunlarla sinirli olmaksizin, granülosit
makrofaj koloni uyarici faktör (GM-GSF), granülosit koloni uyarici faktör (G-CSF),
makrofaj koloni uyarici faktör (M-CSF), koloni uyarici faktör (CSF), interferon beta (IFN-
ß), interferon gama (IFNy)), interferon gama indükleyici faktör l (IGIF), transforme edici
büyüme faktörü beta (TGF-ß), RANTES (aktivasyon üzerine düzenlenir, normal T-
hücre ifade edilir ve muhtemelen salgilanir), makrofaj inflamatuar proteinler (örnegin,
MIP-1-d ve MIP-1-ß), Laysmanya uzama baslatma faktörü (LElF), trombosit kaynakli
büyüme faktörü (PDGF), tümör nekroz faktörü (TNF), büyüme faktörleri, örnegin,
epidermal büyüme faktörü (EGF), vasküler endotelyal büyüme faktörü (VEGF),
fibroblast büyüme faktörü, (FGF), sinir büyüme faktörü (NGF), beyin kaynakli nörotrofik
faktör (BDNF), nörotrofin-2 (NT-2), nörotrofin -3 (NT-3), nörotrofin-4 (NT-4), nörotrofin-5
(NT-5), glial hücre dizisi kaynakli nörotrofik faktör (GDNF), siliyer nörotrofik faktör
(CNTF), TNF tip II reseptörü, eritropoietin (EPO), insülin ve çözünür glikoproteinler
örnegin, gp120 ve gp160 glikoproteinleri. Gp120 glycoproteini, bir insan immün
yetmezlik virüsü zarf proteinidir ve gp160 glikoproteini, gp120 glikoproteinine yönelik
bilinen bir prekürsördür.
Bir açida, biyolojik olarak aktif protein GLP-1'dir. Diger bir açida, biyolojik olarak aktif
polipeptit, nesiritit, insan B tipi natriüretik peptittir (hBNP). Diger bir açida, biyolojik
olarak aktif polipeptit, 27 amnio asitten olusan kendiliginden olusan domuz sekretini ile
ayni olan bir amino asit diziliminden olusan bir peptit hormonu olan sekretindir. Bir
açida, biyolojik olarak aktif protein, HIV-1”in CD4+ hücreleri ile füzyonunun bir inhibitörü
olan lineer bir 36 amino asitli sentetik polipeptit olan enfuvirtittir. Antihemofilik Faktör
(AHF), aktif polipeptit olarak seçilmis olabilir. HEMOFIL MTM AHF'nin ortalama in vivo
yari ömrünün 14.7±5.1 saat (n=61) oldugu bilinmektedir. Diger bir açida, eritropoietin,
biyolojik olarak aktif polipeptittir. Eritropoietin, rekombinant DNA teknolojisi ile üretilen
bir 165 amino asitli glikoproteindir ve endojen eritropoietin ile ayni biyolojik etkilere
sahiptir. Kronik renal yetmezlige sahip yetiskin ve pediatrik hastalarda, intravenöz
verilis sonrasinda modifiye edilmemil plazma eritropoietin yari ömrü eliminasyonunun,
4 ila 13 saat arasinda degistigi bilinir. Diger bir açida, biyolojik olarak aktif polipeptit
Reteplazdir. Reteplaz, kringle 2 ve insan tPA'sinin proteaz etki alanlarini içeren, doku
plazminojen aktivatörünün (tPA) glikosile olmayan delesyon muteinidir. Trombolitik
aktivitenin ölçümüne bagli olarak, modifiye edilmemis Reteplazin yari ömür
eliminasyonunun yaklasik olarak 15 dakika oldugu bilinmektedir.
Tercih edilen bir düzenlemede, aktif polipeptit, insan interlökün-1 reseptörü
antagonistinin bir rekombinant, glikosile olmayan formu veya memei hücrelerinde ifade
edilen glikosile formu (lL-lRa) olan Anakinradir. Bir durumda, Anakinra, 153 amino
asitten olusur ve 17.3 kilodalton moleküler agirliga sahiptir. Bu, bir E. coli bakteriyel
ifade sistemi kulanilarak rekombinant DNA teknolojisi ile üretilebilir. IL-1Ra'nin glikosile
versiyonu, bir memeli ifade sistemi içinde üretilebilir. Modifiye edilmemis Anakinranin in
vivo yari ömrünün 4 ila 6 saat arasinda degiskenlik gösterdigi bilinmektedir.
Diger bir tercih edilen düzenlemede, aktif polipeptit eksendin-4'tür. Bir durumda,
eksendin-4, 39 amino asitten olusur. Bu, bir E. coli bakteriyel ifade sistemi kulanilarak
rekombinant DNA teknolojisi ile üretilebilir. Modifiye edilmemis eksendin-4”ün in vivo
yari ömrünün 0.5 saat oldugu bilinmektedir iv. [Ai, G., et al.; Pharmacokinetics of
Bekaplermin de aktif polipeptit olarak seçilmis olabilir. Bekaplermin, topikal verilise
yönelik bir rekombinant insan trombosit kaynakli büyüme faktörüdür (rhPDGF-BB).
Bekaplermin, maya susu Saccharomyces cerevisiae içerisine, trombosit kaynakli
büyüme faktörünün (PDGF) B zincirine yönelik genin yerlestirilmesi ile rekombinant
DNA teknolojisi ile üretilebilir. Bekaplerminin bir formu, yaklasik olarak 25 kD moleküler
agirliga sahiptir ve disülfür baglari ile birbirine bagli olan iki özdes polipeptit zincirinden
olusan bir homodimerdir. Aktif polipeptit, rekombinant DNA teknolojisi ile Escher/'chia
coli (E. co/i') içerisinde üretilen interlökin on birin (IL-11) bir rekombinant formu olan
Oprelvekin olabilir. Bir açida, seçilen biyolojik olarak aktif polipeptit, yaklasik olarak
19,000 dalton moleküler kütleye sahiptir ve glikosile degildir. Polipeptit uzunluk olarak
177 amino asittir ve natif lL-11'in 178 amino asit uzuluguna göre, yalnizca amino-
terminal prolin kalintisinin eksik olmasi açisindan farklilik gösterir, bunun, in
vitro veya in vi'vo olarak biyoaktivitede ölçülebilen farkliliklar ile sonuçlanmadigi
bilinmektedir. Modifiye edilmemis Oprelvekinin terminal yari ömrünün yaklasik olarak 7
saat oldugu bilinmektedir. Ancak, diger bir biyolojik olarak aktif polipeptit, kan
glükozunu artiran ve gastrointestinal yoldaki yumusak kaslari gevseten insan
glukagonu ile özdes bir polipeptit hormone olan Glukagon olabilir. Glukagon, glukagona
yönelik genin eklenmesi ile genetik olarak degistirilmis olan özel bir patojenik olmayan
E. co/ibakterisi susu içinde sentezlenebilir. Belirli bir açida, glukagon, 29 amino asit
kalintisi içeren ve 3,483 moleküler agirliga sahip olan tek zincirli bir polipeptittir. In vivo
yari ömrün, 8 ila 18 dakika arasinda degismek üzere kisa oldugu bilinmektedir.
G-CSF de aktif polipeptit olarak seçilebilir. Rekombinant granülosit koloni uyarici
faktörü veya G-CSF, beyaz kan hücrelerinin geri kazaniminin uyarmak üzere çesitli
kemoterapi tedavileri izlenerek kullanilir. Rekombinant G-CSF”nin raporlanan yari ömrü
3.5 saattir.
Bir açida, biyolojik olarak aktif polipeptit, interferon alfa (IFN alfa) olabilir. Kimyasal
olarak PEG-modifiye edilmis interferon-alfa 2a, hepatit C`nin tedavisi için klinik olarak
valide edilmistir. Bu PEG'Iestirilmis protein, haftalik enjeksiyon gerektirir ve daha uzun
yari ömürler ile yavas salimli formülasyonlar istenir.
Ek selüler proteinlere, bunlarla sinirli olmaksizin, siradakiler dahildir: VEGF, VEGF-Ri,
VEGF-R2, VEGF-R3, Her-1, Her-2, Her-3, EGF-1, EGF-2, EGP-3, Alpha3, cMet, ICOS,
R1,K0mplemet Reseptör 1, Osteopontin, Vitronektin, Efrin A1-A5, Efrin B1 -B3, alfa-2-
makroglobülin, CCL1, CCL2, CCL3, CCL4, CCL5, CCLG, CCL7, CXCL8. CXCL9,
EGFR, CD33, CD52, Digoksin, Rho (D), Varisella, Hepatit, CMV, Tetanoz, Vaksinia,
Antivenom, Botulinum, Trail-R1, Trail-R2, cMet, TNF-R familyasi, örnegi LA NGF-R,
BAFF-R/TNFRSF13C, TRAIL R2/TNFRSF108, TRAIL R2/TNFRSF1OB, Fas/TNFRSFS
Ligant/TNFSFS, BCMA/TNFRSF17, CD30/TNFRSF8, LIGHT/TNFSF14, 4-
1BB/TNFRSF9, CD40/TNFRSF5, GlTR/TNFRSF18, Osteoprotejerin/TNFRSF1iB,
RANK/TNFRSF11A, TRAIL R3/TNFRSF10C, TRAIL/TNFSF10, TRANCE/RANK
L/TNFSF11, 4-1BB Ligant/TNFSFQ, TWEAK/TNFSF12, CD4O Ligant/TNTSFS, Fas
Ligant/TNFSFB, RELT/TNFRSF19L, APRlL/TNFSF13, DcR3/TNFRSFSB, TNF
R1/TNFRSF1A, TRAIL R1/TNFRSF1OA, TRAIL R4fI'NFRSF10D, CD30
Ligand/TNFSF8, GITR Ligant/TNFSF18, TNFSF18, TACI/TNFRSF1SB, NGF
R/TNFRSF16, OX4O Ligant/TNFSF4, TRAIL R2/TNFRSF1OB, TRAIL R3/TNFRSF1OC,
TWEAK R/TNFRSF12, BAFF/BLyS/TNFSF13, DRö/TNFRSF21, TNF-alfa/TNFSFlA,
Pro-TNF-alfa/TNFSFlA, Lenfotoksin beta R/TNFRSF3, Lenfotoksin beta R (LTbR)/Fc
Kimera, TNF R1/TNFRSF1A, TNF-beta/TNFSF1B, PGRP-S, TNF R1/TNFRSF1A, TNF
RII/TNFRSF1B, EDA-A2, TNF-alpha/TNFSFlA, EDAR, XEDAR, TNF RI/TNFRSF1A
LRAP/ERAPZ, A33, Aminopeptidaz N/ANPEP, Aag, Aminopeptidaz P2/XPNPEP2,
ABCG2, Aminopeptidaz P1/XPNPEP1, ACE, Aminopeptidaz PlLS/ARTS1, ACE-2,
Amnionless, Aktin, Amfiregulin, beta-Aktin, AMPK alfa 1/2, Aktivin A, AMPK alfa 1,
Aktivin AB, AMPK. alfa 2, Aktivin B, AMPK beta 1. Aktivin C, AMPK beta 2, Aktivin
RIA/ALK-2, Androjen R/NR3C4, Aktivin RIB/ALK-4, Anjiogenin, Aktivin RIIA,
Anjiyopoietin-1, Aktivin RIIB, Anjiyopoietin -2, ADAMS, Anjiyopoietin -3, ADAM9,
Anjiyopoietin -4, ADAM10, Anjiyopoietin -benzeri 1, ADAM12, Anjiyopoietin -benzeri 2,
ADAM15, Anjiyopoietin -benzeri 3, TACE/ADAM17. Anjiyopoietin -benzeri 4, ADAM19,
Anjiyopoietin -benzeri 7/CDT6, ADAM33, Anjiyostatin, ADAMTS4, Anneksin
AI/Anneksin l, ADAMTSS, Anneksin A7, ADAMTS1, Anneksin A10, ADAMTSL-
1/Punktin, Anneksin V, Adiponektin/AcrpSO, ANP, AEBSF, AP alani, Aggrekan, APAF-
1, Agrin, APC, AgRP, APE, AGTR-Z, APT, AIF, APLP-1, Akt, APLP-2, Akt1,
Apolipoprotein AI, Akt2, Apolipoprotein B, Akt3, APP, Serum Albumin,
APRIL/TNFSF13, ALCAM, ARC, ALK-1, Artemin, ALK-7, Arilsülfataz A/ARSA, Alkalin
Fosfataz, ASAH2/N-asilsfingosin Amidohidrolaz-Z, alfa 2u-Globulin, ASC, alfa-1-Asit
Glikoprotein, ASGR1, alfa-Fetoprotein, ASK1, ALS, ATM, Ameloblastin, ATRIP,
AMICA/JAML, Aurora A, AMlGO, Aurora B, AMlGOZ, Aksin-1, AMIGO3, Axl,
Aminoasilaz/ACYl, Azurosidin/CAP37/HBP, Aminopeptidaz A/ENPEP, B4GALT1, BIM,
1/PCP, BACE-2, BMP-2, Bad, BMP-3, BAFF/TNFSF1SB, BMP-3b/GDF-10, BAFF
R/TNFRSF13C, BMP-4, Bag-1, BMP-5, BAK, BMP-6, BAMBI/NMA, BMP-7, BARD1,
lA/ALK-3, Bol-2 ile ilgili protein A1, BMPR-IB/ALK-B, Bc1-w, BMPR-Il, Bc1-x, BNIPSL,
Bc1-xL, BOC, BCMA/TNFRSF17, BOK, BDNF, BPDE, Benzamit, Brachyury, Ortak
Beta Zinciri, B-Raf, beta IG-H3, CXCL14/BRAK, Betaselülin, BRCA1, beta-Defensin 2,
BRCA2, BID, BTLA, Biglikan, Bub-1, Bik-benzeri Katil Protein, 0- haziran, CDQO/Thyt,
C1s, CDZOO R1, Tamamlayici Bilesen C2, CD229/SLAMF3, Komplement Bilesen CSa,
CD23/Fc epsilon Rll, Komplement Bilesen C3d, CD2F-10/SLAMF9, Komplement
Bilesen CSa, CDSL, Kadherin-4/R-Kadherin, CD69, Kadherin -6, CDCZ, Kadherin -8,
CDC25A, Kadherin -11, CDCZSB, Kadherin -12, CDCP1, Kadherin -13, CDO, Kadherin
-17, CDX4, E- Kadherin, CEACAM-1/CD66a, N- Kadherin, CEACAM-G, P- Kadherin,
Serberus 1, VE- Kadherin, CFTR, Kalbindin D, CGMP, Kalsinörin A, Chem R23,
Kalsinörin B, Kemerin, Kalretikulin-2, Kemokin Numune Paketleri, CaM Kinaz II, Kitinaz
3-benzeri 1, CAMP, Kitotriosidaz/CHTT1, Kannabinoid R1, Chk1, Kannabinoid
R2/CBZ/CNR2, Chk2, CAR/NR113, CHL-1/L1CAM-2, Karbonik Anhidraz I, Kolin
Asetiltransferaz/ChAT, Karbonik Anhidraz II, Kondrolektin, Karbonik Anhidraz III,
Korrin, Karbonik Anhidraz IV, Korrin-Benzeri 1, Karbonik Anhidraz Va., K0rdin-2,
Karbonik Anhidraz VB, CINC-1, Karbonik Anhidraz VI, CINC-2, Karbonik Anhidraz VIl,
CINC-3, Karbonik Anhidraz VIII, Klaspin, Karbonik Anhidraz IX, KIodin-6, Karbonik
Anhidraz X, CLC, Karbonik Anhidraz XII, CLEC-1, Karbonik Anhidraz XIII, CLEC-2,
Karbonik Anhidraz XIV, CLECSF13/CLEC4F, Karboksimetil Lizin, CLECSF8,
Karboksipeptidaz A1/CPA1, CLF-1, Karboksipeptidaz A2, CL-P1/COLEC12,
Karboksipeptidaz A4, Klusterin, Karboksipeptidaz B1, Klusterin benzeri 1,
Karboksipeptidaz E/CPE, CMG-2, Karboksipeptidaz X1, CMV UL146, Kardiotr 0phin-1,
CMV UL147, Kamosin Dipeptidaz 1, CNP, Karonte, CNTF, CART, CNTF R alfa,
Kaspaz, Pihtilasma Faktörü II/Trombin, Kaspaz-1, Pihtilasma Faktörü III/Doku Faktörü,
Kaspaz-2, Koagülasyon Faktörü VII, Kaspaz-S, Koagülasyon Faktörü X, Kaspaz-4,
Koagülasyon Faktörü XI, Kaspaz-ö, Koagülasyon Faktörü XIV/Protein C, Kaspaz-7,
COCO, Kaspaz-8, Kohesin, Kaspaz-Q, Kollajen I, Kaspaz-lO, Kollajen II, Kaspaz-12,
Kollajen IV, Kaspaz-13, Ortak gama Zincir/IL-2R gamma, Kaspaz Peptit inhibitörleri,
COMP/Trombospondin-S, Katalaz, Kompleman Bileseni C1rLP, beta-Katenin,
Komplement Bileseni CIqA, Katepsin 1, Komplement Bileseni C1qC, Katepsin 3,
Komplement Faktörü D, Katepsin 6, Komplement Faktörü l, Katepsin A, Komplement
MASPS, Katepsin B, Baglanti 43, Katepsin C/DPPI, Kontaktin-1, Katepsin D, Contactin-
2/TAG1, Katepsin E, Kontaktin-4, Katepsin F, Kontaktin-S, Katepsin H, Korin, Katepsin
L, Kornulin, Katepsin O, COR826/C1qTNF, 3, Katepsin S, Siçan Kortikal Kök
Hücreleri, Katepsin V, Kortizol, Katepsin X/Z/P, COUP-TF I/NR2F1, CBP, COUP-TF
Protein, CCR2, Kreatin Kinaz, Kas/CK MM, CCR3, Kreatinin, CCR4, CREB, CCRS,
+/CD62L +/CD44, Cryptic, CD5, CSB/ERCCG, CDG, CCL27/CTACK, CD8,
CD30/TNFRSF8, CXCRS, CD3O Liganti./TNFSF8, CXCR6, CD31/PECAM-1, Siklofilin
Sistatin C, CD40 Ligandi/TNFSFS, Sistatin D, CD43, Sistatin E/M, CD44, Sistatin F,
CD55/DAF, Sistatin SN, CD58/LFA-3, Sitokrom c, CD59, Apositokrom c, CD68,
CD84/SLAMF5, Sitonin, DG, DISP1, DAN, Dkk-1, DANCE, Dkk-2, DARPP-32, Dkk-3,
DAX1/NROB1, Dkk-4, DCC, DLEC, DCIR/CLEC4A, DLL1, DCAR, DLL4,
DcR3/TNFRSFGB, d-Lüsiferin, DC-SIGN, DNA Ligaz IV, DC-SIGNR/CD299, DNA
Polimeraz beta, DCTRAIL R1/TNFRSF23, DNAM-1, DCTRAIL R2/TNFRSF22, DNA-
PKcs, DDR1, DNER, DDR2, Dopa Dekarboksilaz/DDC, DEC-205, DPCR-1,
Dekapentaplejik, DPPG, Dekorin, DPPA4, Dektin -1/CLEC7A, DPPA5/ESG1, Dektin-
2/CLECBA, DPPII/QPP/DPP?, DEP-1/CD148, DPPlV/CD26, Çöl Kirpisi,
DR3/TNFRSF25, Desmin, DR6/TNFRSF21, Desmoglein-1, DSCAM, Desmoglein-2,
DSCAM-L1, Desmoglein-B, DSPG3, Dishevelled -1, Dtk, Dishevelled -3, Dinamin,
EphB1, Ekotin, EphBZ, EDA, EphBS, EDA-A2, EphB4, EDAR, EphBö, EDG-1, Efrin,
EDG-5, Efrin -A1, EDG-8, Efrin -A2, eEF- 2, Efrin -A3, EGF, Efrin -A4, EGF R, Efrin -
A5, EGR1, Efrin -B, EG-VEGF/PK1, Efrin -B1, elF2 alfa, Efrin -B2, eIF4E, Efrin -Bß,
E1k- 1, Epigen, EMAP-II, Epimorfin/Sintaksin 2, EMMPRIN/CD147, Epiregulin,
CXCL5/ENA, EPR-1/Xa Reseptörü, Endoksan, ErbBZ, Endoglin/CD105, ErbBS,
Endoglikan, ErbB4, Endonücleaz III, ERCC1, Endonücleaz IV, ERCC3, Endonuclease
V, ERK1/ERK2, Endonücleaz VIII, ERK1, Endorepellin/Perlekan, ERK2, Endostatin,
ERK3, Endotelin-1, ERK5/BMK1, Engrailed-2, ERR alfa/NRSB1, EN-RAGE, ERR
beta/NR3BZ, Enteropeptidaz/Enterokinaz, ERR gama/NRSBS, CCL11/Eotaxin,
Eritropoietin, CCL24/E0tksin-2, Eritropoietiri R, CCL26/Eotaksin-3, ESAM,
EpCAM/TROP-i, ER alfa/NR3A1, EPCR, ER beta/NR3A2, Eph, Eksonükleaz III,
EphA1, Eksostosin benzeri 2/EXTL2, EphA2, Eksostosin benzeri 3/EXTL3, EphA3,
R3, FABP?, FGF R4, FABP9. FGF R5, Komplement Faktörü B, Fgr, FADD, FHR5,
FAMSA, Fibronektin, FAM3B, Fikolin-2, FAM3C, Ficolin-3 FAM3D, FITC, Fibroblast
Aktivasyon Protein alfa/FAP, FKBP38, Fas/TNFRSFG, Flep, Fas Liganti/TNFSFB,
FLIP, FATP1, FLRG, FATP4, FLRT1, FATP5, FLRT2, Fc gama R1/CDB4, FLRT3, Fc
gama RIIB/CD32b, Fit-3, Fc gama RIIC/CDI32c, Fit-3 Liganti, Fc gama RIlA/CD32a,
Follistatin, Fc gama RIII/CD16, Follistatin benzeri 1, FcRH1/IRTA5, FosB/GOS3,
FcRH2/IRTA4, F0xD3 FcRH4/IRTA1, FoxJl, FcRH5/IRTA2, FoxP3, FC reseptör benzeri
3/CD16-2, Fpg, FEN-1, FPR1, Fetuin A, FPRL1, Fetuin B, FPRL2, FGF asidik,
CX3CL1/Fraktalkin, FGF bazik, Kivrilmis-1, FGF-3, Kivrilmis-2, FGF-4, Kivrilmis-S,
FGF-23, G9a/EHMT2, GFR alfa-3/GDNF R alfa-3, GABA-AR alfa 1, GFR alfa-4/GDNF
R alfa-4, GABA- AR alfa 2, GITR/TNFRSF18, GABA-AR alfa 4, GITR
Liganti/TNFSF18, GABA-AR alfa 5, GLI-1, GABA-AR alfa 6, GLI-2, GABA-AR beta 1,
GLP/EHMT1, GABA -AR beta 2, GLP-1 R, GABA-AR beta 3, Glukagon, GABA-AR
gama 2, Glukozamin (N-asetil) -G-Sulfataz/GNS, GABA-B-RZ, GIuR1, GAD1/GAD67,
gama, Glut2, Galektin-1, Glut3, Galektin-2, Glut4, Galektin-S, GIutS, Galektin-3 BP,
Glutaredoksin 1, Galektin-4, Glisin R, Galektin-7, Glikoforin A, Galektin-8, Glipikan 2,
Galektin-9, Glipikan 3, GaINAc4S-65T, Glipikan 5, GAP-43, Glipikan 6, GAPDH, GM-
CSF, Gasl, GM-CSF R alfa, Gasö, GMF-beta, GASF-iNVFIKKNRP, gp130, GASP-
2NVFIKKN, Glikojen Fosforilaz BB/GPBB, GATA-1, GPR15, GATA-2, GPR39, GATA-3,
GPVI, GATA-4, GR/NR3C1, GATA-5, Gr-1/Ly-6G, GATA-6, Granülisin, GBL, Granzim
A, GCNF/NR6A1, Granzim B, CXCL6/GCP-2, Granzim D, G-CSF, Granzim G, G-CSF
R, Granzim H, GDF-1, GRASP, GDF-3 GRB2, GDF -5, Gremlin, GDF-6, GRO, GDF-7,
CXCL1/GRO alfa, GDF-8, CXCL2/GRO beta, GDF-9, CXCL3/GRO gama, GDF-11.
Büyüme Hormonu, GDF-15, Büyüme Hormonu R, GDNF, GRPTS/HSPAQB, GFAP,
GSK-3 alfa/beta, GFI-1, GSK-3 alfa, GFR alfa-1/GDNF R alfa-1, GSK-3 beta, GFR
HMGB1, HAI-2A, TCF-2/HNF-1 beta, HAl-ZB. HNF-3 beta/FoxAZ, HAND1, HNF-4
alfa/NR2A1, HAPLN1, HNF-4 gama/NR2A2, Hava yolu Tripsin benzeri Proteaz/HAT,
HO-1/HMOX1/HSP32, HB-EGF, HO-2/HMOX2, CCL14a/HCC-1, HPRG,
HCR/CRAM-A/B, HSD-2, HDGF, HSP10/EPF, Hemoglobin, HSP27, Hepassosin,
HSPGO, HES-1, HSP70, HES-4, HSP90, HGF, HTRA/Proteaz Yap, HGF Aktivatörü,
HTRA1/PRSS11, HGFR, HTRA2/Omi, HIF-1 alfa, HVEM/TNFRSF14, HIF-2 alfa,
alfa 1, Iduronat 2-Sulfataz/IDS, IL-13 R alfa 2, IFN, IL-15, IFN-alfa, IL-15 R alfa, IFN-
18 BPa, IFN-alfa WA, lL-18 BPc, IFN-alfa/beta RI, IL-18 BPd, lFN-alfa/beta R2, IL-
lLT4/CD85d, IgY, lLT5/CD85a, IkB-beta, ILT6/CD85e, IKK alfa, Hint Kirpisi, IKK
epsilon, INSRR, IKK gama, Insülin, IL-1 alfa/IL-1F1, Insülin R/CD220, IL-1 beta/IL-1 F2,
Proinsülin, IL-1ra/IL-1F3, Insülinin/IDE, IL-1F5/FIL1 delta, lntegrin alfa 2/CD49b, IL-
alfa M/CD11b, IL-2, Integrin alfa M beta 2, IL-2 R alfa, Integrin alfa V/CD51, IL-2 R
beta, Integrin alfa V beta 5, IL -3, lntegrin alfa V beta 3, IL-3 R alfa, Integrin alfa V beta
6, IL-3 R beta, Integrin alfa X/CD11c, IL-4, Integrin beta 1/CD29, IL-4R, Integrin beta
Jagged 1, JAM-4/IGSFS, Jagged 2, JNK, JAM-A, JNK1/JNK2, JAM-BNE-JAM, JNK1,
JAM-C, JNK2, Kininojen, Kallikrein 3/PSA, Kininostatin, Kallikrein 4, KIR/CD158,
Kallikrein 8/Nör0psin, KIR2DS4, Kallikrein 9, KIR3DL1, Plazma Kallikrein-KLKB1,
KLFö, Kallikrein 14, Klotho, Kallikrein 15, Kloto beta, KC, KOR, Keapl, Kremen-1, Kell,
Kremen-2, KGF/FGF-7, LAG-3, LINGO-2, LAIR1, Lipin 2, LAIR2, Lipokalin- 1, Laminin
alfa 4, Lipokalin-2/NGAL, Laminin gama 1,5-Lipoksijenaz, Laminin I, LXR alfa/NR1H3,
Laminin S, LXR beta/NR1H2, Laminin-1, Livin, Laminin-5, LIX, LAMBA,
LMIRS/CDBOOLB, Layilin, LMIR6/CD300LE, LBP, LM02, LDL R, LOX-1/SR-E1,
LECT2, LRH-1/NR5A2, LEDGF, LRIG1, Lefty, LRIG3, Lefty-1, LRP-1, Lefty-A, LRP-ö,
Legumain, LSECtin/CLEC4G, Leptin, Lumikan, Leptin R, CXCL15/Lungkine, Leukotrie
B4, XCL1/Lenf0ptiniin, Lökotrien B4R1, Lenfotoksin, LIF, Lenfotoksin beta/TNFSFS,
LIF R alfa, Lenfotoksin beta R/TNFRSFS, LIGHT/TNFSF14, Lin, Limitin, Lip,
LIMPII/SR-BZ, Lisil Oksidaz Homolog 2 LIN-28, LYVE-1, LINGO-1, alfa 2-
Makroglobulin, CXCL9/MIG, MAD2L1, Mimekan, MAdCAM-1, Mindin, MafB,
Mineralokortikoit R/NR3C2, MafF, CCL3L1/MIP-1 alfa Izoform LD78 beta, MafG,
CCL3/MIP-1 alfa, MafK, CCL4L1/LAG-1, MAG/SigIeC-4-a, CCL4/MIP-1 beta, MANF,
CCL15/MIP-1 delta, MAP2, CCL9/10/MIP- 1 gama, MAPK, MIP-2, Marapsin/Pankreas,
CCL19/MIP-3 beta, MARCKS, CCL20/MlP-3 alfa, MARCO, MlP-l, Mash1, MIP-H,
Matrilin-2, MlP-III, Matrilin -3, MIS/AMH, Matrilin-4, MIS R11, Matriptaz/ST14, MIXL1,
3, CCL12/MCP-5, MMP- 7, M-CSF, MMF-8, M-CSF R, MMP-9, MCV-tip II, MMF-10,
MEK1, MMP-25/MT6- MMP, MEK2, MMP-26, Melusin, MMR, MEPE, MOG, Meprin
alfa, CCL23/MPIF-1, Meprin beta, M-Ras/R-Rasß, Mer, Mrell, Mezotelin, MRP1
Meteorin, MSK1/MSK2, Metionin Aminopeptidaz 1, MSK1, Metionin Aminopeptidaz,
MSK2, Metionin Aminopeptidaz 2, MSP, MFG-E8, MSP R/Ron, MFRP, Mug,
MgcRacGAP, MULT-1, MGL2, Musasi-1, MGMT, Musasi-2, MIA, MuSK MICA, MutY
DNA Glikosilaz, MIKB, MyD88, MIKL/CLEC12A, Miyeloperoksidaz, beta 2
Mikroglobulin, Miyokardin, Midrin, Miyokin, MIF, Miyoglobin, NAlP NGFl-B
gama/NR4A3, Nanog, NgR2/NgRH1, CXCL7/NAP-2, NgR3/NgRH2, Nbsl, Nidojeri-
1/Entaktin, NCAM-1/CD56, Nidojen-2, NCAM-L1, Nitrik Oksit, Pektin-1, Nitrotirozin,
Nektin-2/CD112, NKGZA, Nektin-3, NKGZC, Nektin-4, NKG2D, Neojen, NKp30,
NKp80/KLRF1, NETOZ, NKX2.5, Netrin-1, NMDA R, NR1 Alt birimi, Netrin-Z, NMDA R,
NR2A Alt birimi, Netrin-4, NMDAR, NRZB Alt birimi, NetrIn-Gla, NMDAR, NR2C Alt-
birimi, Netrin-G2a, N-Me-6,7-diOH-TIQ, Nöregulin-1/NRG1, Nodal, Nöregulin -3/NRG3,
Noggin, Nöritin, Nogo Reseptörü, NöroD1, Nogo-A, Nörofasin, NOMO, Nörojenin-1,
Nope, Nörojenin-2, Norrin, Nörojenin -3, eNOS, Nörolisin, iNOS, Nörofizin II, nNOS,
Nörturin NOV/CCNS, NFAM1, NRAGE, NF-H, NrCAM, NFkB1, NRL, NFkB2, NT-3, NF-
L, NT-4, NF-M, NTB-A/SLAMFB, NGZ/MCSP, NTH1, NGF R/TNFRSF16, Nükleostem,
beta-NGF, Nurr-1/NR4A2, NGFI-B alfa/NR4A1, OASZ, Oreksin B, OBCAM, OSCAR,
OCAM, OSF-2/Periostin, OCIL/CLECZd, Onkostatin M/OSM, OCILRP2/CLEC21, OSM
R beta, Oct-3/4, Osteoaktivin/GPNMB, OGG1, Osteoadherin, Olig 1, 2, 3, Osteokalsin,
OIigI, Osteokrin, OIigZ, Osteopontin, Olig3, Osteoprotejerin/TNFRSF11B,
Oligodendrosit Isaretleyici 01, Otx2, Oligodendrosit Isaretleyici 04, OV-6, OMgp,
OX40/TNFRSF4, Optisin, OX4O Ligant/TNFSF4, Oreksin A, OASZ, Oreksin B,
OBCAM, OSCAR, OCAM, OSF-2/Periostin, OCIL/CLECZd, Onkostatin M/OSM,
OCILRP2/CLECZ1, OSM R beta, Oct-3/4, Osteoaktivin/GPNMB, OGG1, Osteoadherin,
Olig 1, 2, 3, Osteokalsin, Oligl, Osteokrin, OIigZ, Osteopontin, OIigS, Osteoprotejeri
n/NFRSF11B, Oligodendrosit Isaretleyici 01, Otx2, Oligodendrosit Isaretleyici 04, OV-6,
OMgp, OX40/TNFRSF4, Optisin, OX4O Ligant/TNFSF4, Oreksin A, RACK1, Ret, Rad1,
A, Rae-1 alfa, RGM-B, Rae-1 beta, RGM-C, Rae-1 delta, Rheb, Rae-1 epsilon,
Ribozomal Protein 86, Rae-1 gamma, RIP1, Raf-1, ROBO1, RAGE, ROBOZ,
Ra1A/Ra1B, R, RANK/TNFRSF11A,
ROR alfa/NR1F1, CCL5/RANTES, ROR gama/NR1 F3, Rap1A/B, RTK benzeri Yeyim
Reseptör 1/ROR1, RAR alfa/NR1Bi, RTK benzeri Orphan Reseptörü 2/ROR2, RAR
beta/NR1BZ, RP, RBP4, RSK1/RSK2,
RECK, RSK1, Reg 2/PAP, RSK2, Reg I, RSKB, Reg II, RSK4, Reg III, R-Spondin 1,
Reg Ma, R-Spondin 2, Reg IV, R-Spondin 3, Relksin-1, RUNX1/CBFA2, Relaksin-2,
RUNX2/CBFA1, Relaksin-S RUNX3/CBFA3, RELM alfa, RXR alfa/NRZB1, RELM beta,
RXR beta/NRZB2, RELT/TNFRSF19L, RXR gama/NRZBS, Resistin, S100A10,
SALL1, Smad3, delta-Sarcoglycan, Smad4, Sca-1/Ly6, SmadS, SCD-1, Smad?, SCF,
Smad8, SCF R/c-kit, SMC1, SCGF, alfa-Düz Kas Aktin, SCL/Uzun, SMUG1,
SCPS/SYCP3, Salyangoz, CXCL12/SDF-1, Sodyum Kalsiyum Degistirici 1,
SDNSF/MCFDZ, Soggy-1, alfa-Sekretaz, Sonkc Kirpi, gama- Sekretaz, 8 veya CS1,
beta- Sekretaz, 8 veya CSS, E-Selektin, Sortilin, L-Selektin, SOST, P-Selektin, SOX1,
Semaforin 3A, SOX2, Semaforin 3C, SOX3, Semaforin 3E, SOX7, Semaforin 3F,
Semaforin 6D, SPARC, Semaforin 7A, SPARC benzeri 1, Separaz, SP-D,
Serin/Treonin Fosfataz Substrat I, Spinesin, Serpin A1, F-Spo ndin, Serpin A3, SR-
AI/MSR, Serpin A4/Kallistatin, Src, Serpin A5/Pr0tein C Inhibitörü, SREC-I/SR-F1,
Serpin A8/Anjiyotensin0jen, SREC-II, Serpin BS, SSEA-1, Serpin C1/Antitrombin-III,
SSEA-3, Serpin D1/Heparin Kofaktör II, SSEA-4, Serpin E1/PAI-1, ST7/LRP12, Serpin
E2, Stabilin-1, Serpin F1, Stabilin-2, Serpin F2, Stanniocalcin 1, Serpin G1/C1
Inhibitörü, Stanniokalsin 2, Serpin 12, STAT1, Serum Amiloit AI, START2, SF-
1/NR5A1, STAT3, SGK, STAT4, SHBG, STAT5a/b, GEMI, STAT5a, SHP/NROBZ,
STAT5b, SHP-1, STAT6, SHP-2, VE-Statin, SlGIRR, Stella/Dppa3, Siglec-2/CD22,
STRO-1, Siglec-S/CD33, Madde P, SigIeC-5, Sülfamidaz/SGSH, Siglec-ö, Sülfataz
Modifiye Faktörü 1/SUMF1, Siglec-Y, Sülfotaz Degistirici Faktör 2/SUMF2, Siglec-Q,
SUMO1, Siglec-10, SUM02/3/4, Siglec-11, SUMOS, Siglec-F, Süperoksit Dismutaz,
SIGNR1/CD209, Süperoksit Dismutaz-1/Cu-Zn SOD, SIGNR4, Süperoksit Dismutaz-
2/Mn-SOD, SIRP beta 1, Süperoksit Dismutaz-ß/EC-SOD, SKI, Survivin,
SLAM/CD150, Synapsin l, Uyuyan Güzel Transposazi, Sindekan-1/CD138, Slit3,
Sindekan -2, SLITRK1, Sindekan -3, SLITRK2, Sindekan -4, SLITRK4,
alfa/TNFSF1A, CCL17/TARC, TNF-beta/TNFSF1B, Tau, TNF R1/TNFRSF1A, T021/R-
RasZ, TNF R11/TNFRSF1B, TCAM-1, TOR, TCCR/WSX-1, TP-1, TC-PTP,
TRADD, Testikan 2/SPOCK2, TRAF-1, Testikan 3/SPOCK3, TRAF-2, TFPI, TRAF-3,
TFPI-2, TRAF-4, TGF-alfa, TRAF-6, TGF-beta, TRAIL/TNFSF10, TGF-beta 1, TRAIL
R1/TNFRSF10A, LAP (TGF-beta 1), TRAIL R2/TNFRSF1OB, Latent TGF-beta 1,
TRAIL R3/TNFRSF1OC, TGF-beta 1.2, TRAIL R4/TNFRSF1OD, TGF- beta2,
TRANCE/TNFSF11, TGF-beta 3, TfR (Transferin R), TGF-beta 5, Apo-Transferin,
Latent TGF-beta bp1, Holo-Transferrn, Latent TGF-beta bp2, Trappin-2/Elafin, Latent
TGF-beta bp4, TREM-1, TGF-beta RI/ALK-5, TREM-2, TGF-beta RII, TREM-3, TGF-
beta Rllb, TREML1/TLT-1, TGF-beta RIII, TRF-1, Thermolisin, TRF-2, Tioredoksin-1,
TRH-indirgeyici Ektoenzim/TRHDE, Tioredoksin-2, TRIMS, Tioredoksin-80, Tripeptidil-
Peptidaz I, Tioredoksin benzeri 5/TRP14, TrkA, THOP1, TrkB, Trombomodulin/CD141,
TrkC, Trombopoietin, TROP-2, Trombopoietin R, Troponin l Peptit 3, Trombospondin-
1, Troponin T, Trombospondin-Z, TROY/TNFRSF19, Trombospondin-4, Tripsin 1,
Timopoietin, Tripsin 2/PR882, Timus Kemokin-l, Tripsin 3/PRSS3, Tie-1, Triptaz-
/Prs32, Tie -2, Triptaz alfa/TPS1, TIM-1/KIM-1/HAVCR, Triptaz beta-1/MCPT-7, TIM-
2, Triptaz beta-2/TPSB2, TIM-3, Tryptase epsilon/BSSP-4, TIM -4, Triptaz Gama-
TlMP-3, TSK, TIMP-4, TSLP, TL1A/TNFSF15, TSLP R, TLR1, TSP50, TLR2, beta-III
Tubulin, TLR3, TWEAK/TNFSF12, TLR4, TWEAK R/TNFRSF12, TLRS, Tyk2, TLR6,
Fosfo-Tirozin, TLR9, Tirozin Hidroksilaz, TLX/NR2E1, Tirozin Fosfataz Substrati l,
Ubikuitin, UNC5H3, Ugi, UNCSH4, UGRP1, UNG, ULBP-1, uPA, ULBP-2, uPAR,
ULBP-3, URB, UNCSH1, UVDE, UNC5H2, Vanilloid R1, VEGF R, VASA, VEGF R1/Flt-
1, Vasohibin, VEGF R2/KDR/FIk-1, Vasorin, VEGF R3/FIt-4, Vasostatin, Versican, Vav-
1, VGSQ, VCAM-1, VHR, VDR/NR111, Vimentin, VEGF, Vitronektin VEGF-B, VLDLR,
VEGF-C, vWF-A2, VEGF-D, Sinüklein- alfa, Ku70, WASP, Wnt-7b, WlF-1, Wnt-8a
Wnt-10b. Wnt-Sa, Wnt-11, Wnt-5D, wnvNSS, Wnt7a, XCR1, XPE/DDBl, XEDAR,
XPE/DDB2, Xg, XPF, XIAP, XPG, XPA, XPV, XPD, XRCCl, Yes, YY1, EphA4.
Diger aktif polipeptitlere siradakiler dahildir: BOTOX, Miyoblok, Nöroblok, Disport (veya
botulinum nörotoksinlerin diger serotipleri), algluosidaz alfa, daptomisin, YH-16,
koriogonadotropin alfa, filgrastim, setrorelik, interlökin-2, aldeslökin, tekelökin, denilösin
diftitoks, interferon alfa-n3 (enjeksiyon) interferon alfa-nl, DL-8234, interferon, Suntory
(gama-1 a), interferon gama, timosin alfa 1, tasonermin, DigiFab, ViperaTAb, EchiTAb,
CroFab, nesiritid, abatacept, alefasept, Rebif, eptoteminalfa, teriparatid (osteoporoz),
kalsitonin enjektabl (kemik hastaligi), kalsitonin (nazal, osteoporoz), etanersept,
hemoglobin glutamer 250 (sigir), drotrekojin alfa, kolajenaz, karperitid, rekombinant
insan epidermal büyüme faktörü (topikal jel, yara iyilesmesi), DWP-401, darbepoetin
alfa, epoetin omega, epoetin beta, epoetin alfa, desirudin, lepirudin, bivalirudin,
nonacog alfa, Mononin, eptacog alfa (aktive), rekombinant Faktör VIII + VWF,
rekombinat, rekombinant Faktör VIII, Faktör VIII (rekombinant), Alfanat, oktocog al fa,
Faktör VIII, palifermin, Indikinaz, tenepplaz, alteplaz, pamiteplaz, reteplaz, nateplaz,
monteplaz, follitropin alfa, rFSH, hpFSH, mikafungin, pegfilgrastim, tenograstim,
nartograstim, sermorelin, glukagon, ekenatit, pramlintid, imiglurazraz, galsulfaz,
Lökotropin, molgramostim, triptorelin asetat, histrelin (subkütanöz implant, Hidron),
deslorelin, histrelin, nafarelin, Ieuprolide sürekli salim deposu (ATRIGEL), Ieuprolide
implant (DUROS), goserelin, somatropin, Ötropin, KP-102 programi, somatropin,
somatropin, mekasermin (büyüme basarisizligi), enfuvirtid, Org-33408, insülin glargin,
insülin glulisine, insülin (inhale edilen), insülin Iispro, insülin detemir, insülin (bukal,
RapidMist), mekasermin rinfabat, anakinra, selmolökin, 99 mTc-apitit enjeksiyonu,
miyelopid, Betaseron, glatiramer asetat, Gepon, sargramostim, oprelvekin insan Iökosit
türevli alfa interferonlar, Biliv, insülin (rekombinant), rekombinant insan insülini, insülin
aspart, mekasermin, Roferon-A, interferon-alfa 2, Alfaferon, interferon alfakon-t,
interferon alfa, Avoneks 'rekombinant insan Iuteinize edici hormon, dornaz alfa,
trafermin, zikonotid, taltirelin, diboterminalfa, atosiban, bekaplermin, eptifibatid,
Zemaira, CTC-, Nov-002 oktreotid,
(topikal jel), rasburikaz, ranibizumab, Aktimmün, PEG-Intron, Trikomin, rekombinant ev
tozu akari alerjisi duyarsizlastirma enjeksiyonu, rekombinant insan paratiroit hormonu
(PTH) , epoetin delta, transjenik antitrombin III, Granditropin,
Vitrase, rekombinant insülin, interferon-alfa (oral pastil), GEM-218, vapreotide,
idursülfaz, omapatrilat, rekombinant serum albümini, sertolizumab pegol, glukarpidaz,
insan rekombinant CI esteraz inhibitörü (anjiyoödem), Ianoteplaz, rekombinant insan
büyüme hormonu, enfuviitid (igne içermeyen enjeksiyon, Biojector 2000), VGV-1,
interferon (alfa), Iukinaktant, aviptadil (inhale, pulmoner hastalik), ikatibant, ekallantid,
omiganan, Aurograb, peksiganan asetat, ADI-PEG-ZO, LDI-200, degareliks, cintredekin
besudotoks, Favld, MDX-, tifakogin,
desmoteplaz, amidiplaz, corifollitropin alfa, TH-9507, teduglutid, Diamid, DWP-412,
büyüme hormonu (sürekli salim enjeksiyon), rekombinant G-CSF, insülin (inhalasyon,
HAVA), insülin (inhalasyon, Technosfer), insülin (inhale, AERX), RGN-303, DiaPep277,
interferon beta (hepatit C viral enfeksiyon (HCV)), interferon alfa-n3 (oral), belatasept,
transdermal insülin yamalari, AMG-531, MBP-8298, Xerecept, opebakan, AIDSVAX,
GV-1001, Lymphoscan, ranpirnaz, Lipoksisan, Iusupultid, MP52 (beta-triksitofosfat
tasiyici, kemik rejenerasyonu), melanoma asisi, sipuleökel- T, CTP-37, Insegia,
gearpen, insan trombin (donmus, cerrahi kanama), trombin, TranleD, alfimepraz,
Puricase, terlipressin (intravenöz, hepatorenal sendrom), EUR-1008M, rekombinant
duramisin (inhale edilen, kistik fibrozis), SCV-07, OPI-45, Endostatin, Anjiostatin, ABT-
510, Bowman Birk Inhibitör Konsantresi, XMP-629, 99 mTc-Hynic-Anneksin V,
kahalalid F, CTCE-9908, tevereliks (genisletilmis salim), ozareliks, romidepsin, BAY-
ATN-161, cilengitid, Albuferon, Biphasix, lRX-2, omega interferon, PCK-3145, CAP-
Oncovax-CL, OncoVax-P, BLP-25, CerVax-16, multi-epitop peptit melanoma asisi
(MART-1, gp, CGRP
(inhale, astim), pegsunersept, timozin beta-4, plitidepsin, GTP-200, ramoplanin,
GRASPA, OBI-1, AC-100, somon kalsitonin (oral, eligen), kalsitonin (oral, oste0poroz),
depelestat, hematid, Krizalin (topikal), rNAPcZ, rekombinant Faktör Vlll (PFGile
lipozomal), bFGF, PEG'Ienmis rekombinant stafilokinazlar e-varyant, V-10153,
SonoLysis Prolyse, NeuroVax, CZEN-OOZ, islet hücresi neogenez tedavisi, rGLP-1,
avorelin AOD-, hizli etkili
insülin (enjektabl, Viadel), intranazal insülin, insülin (inhale edilen), insülin (oral, eligen),
rekombinant metionil insan leptin, pitrakinra deri alti enjeksiyonu, egzama), pitrakinra
rEV-131 (oftalmik), rEV-131 (solunum yolu hastaligi), oral rekombinant insan insülini
interferon alfa-n13 (topikal), lRX-3, RDP-58, Tauferon, safra tuzu uyarilmis Iipaz,
Merispaz, alkalin fosfataz, EP-2104R, Melanotan-Il, bremelanotid, ATL-104,
PeviPRO), ALTU-135, parvovirus B 19 asisi, influenza asisi (rekombinant
nöraminidaz), sitma/HBV asisi, sarbon asisi, Vacc-5q, Vacc-4 X, HIV asisi (oral), HPV
asisi, Tat Toxoid, YSPSL, CHS-,
Ostabolin-C, PTH analogu (topikal, psoriazis), MBR1-93.02, MTB72F asisi
asisi, AG-702, OXSODro1, rBetVl, Der-p1/Der-p2/Der-p7 alerjen hedefleyici asi (toz
akari alerjisi), PR1 peptit antijeni (lösemi), mutant ras asisi, HPV-16 E7 Iipopeptid asisi,
diyabetik ayak ülseri), rupintrivir, retikuloz, rGRF, PIA, alfa-galaktosidaz A, ACE-011,
reseptör baglanma peptitleri, 111In-hEGF, AE-37, trastuzumab-DMi, Antagonist G, IL-
12 (rekombinant), PM-, L-19
asisi (kanser), VX-OO1, AVE-, NA17.A2
peptidleri, melanoma asisi (darbeli antijen terapötik), prostat kanseri asisi, GBP-501,
edilebilir), ACP-HIP, SUN-11031, peptid YY [3-36] (obezite, burun içi), FGLL, atacikept,
CCR1, AT- Iipozomal krem
(Novazome), duramisin (oftalmik), kuru göz), CAB-2, CTCE-0214, GlikoPEGile edilmis
eritropoietin, EPO-FC, CNTO-528, AMG-114, JR-013, Faktör XIII, aminokandin, PN-
rhTPO, trombopoietin reseptörü agonisti (trombositopenik bozukluklar), AL-108, AL-
(Therapore), EP-1043, S. pneumoniae pediatrik asisi, sitma asisi, Nei'sseria
men/'ngi'tidisGrup B asisi, neonatal grup B streptokok asisi, sarbon asisi, HCV asisi
(gpE1 + gpE2 + MF-59), otitis media tedavisi, HCV asisi (çekirdek antijen +
aviscumine, BIM-23190, tüberküloz asisi, çoklu epitop tirosinaz peptidi, kanser asisi,
tümörler), desmopresin (bukal kontrollü salim), onersept, TP-9201.
Çok sayida aktif proteinin nükleik asit ve amino asit dizilimleri teknikte iyi bilinmektedir
ve açiklama ve dizilimler, Kimyasal Adlar Servis Veritabani (örnegin, CAS Kaydi),
GenBank, GenPept, Entrez Nükleotit, Entrez Protein, Üniversel Protein Kaynagi
(UniProt) gibi halka açik veritabanlari ve GenSeq (örnegin, Dervvent) gibi abonelik ile
saglanan veri tabanlarinda mevcuttur. Polinükleotit dizilimleri, verilen bir aktif proteini
(örnegin, tam uzunluk veya matür) kodlayan yabani tipteki bir polinükleotit dizilimi
olabilir veya bazi durumlarda, dizilim, yabani tipteki dizilimin (örnegin, yabani tipteki
aktif proteini kodlayan bir polinükleotit) bir varyanti olabilir, burada, polinükleotitin DNA
dizilimi, örnegin, belirli bir türde veya bir bölgesel yönlendirilmis mutant veya allelik
varyant gibi bir yabani tipteki proteini kodlayan bir polinüleotitte ifade edilmeye yönelik,
optimize edilir. Teknikte bilinen ve/veya burada saglananyöntemler kullanilarak ve
Örneklerde daha detayli sekilde açiklanan kilavuz ve yöntemler ile iliskili olarak, füzyon
proteini yapilari olusturmak üzere, bir aktif proteinin bir yabani tip veya konsensus
cDNA dizilimi veya bir kodon optimize edilmis varyantinin kullanilmasi, teknikte uzman
kisinin yetenekleri içerisindedir.
Füzyon Proteinlerinin Farmakokinetik Özellikleri
Bulus, bir müsin polipeptit etki alanina bagli olmayan terapötik aktif protein ile
karsilastirildiginda daha fazla farmakokinetige sahip terapötik aktif proteinlerin füzyon
proteinlerini saglar, bunlar, burada açilanan yöntemler ile bilesime yönelik belirlenen
optimal dozda kullanilmasi durumunda, bulusa göre bir müsin etki alanli polipeptit ile
bagli olmayan terapötik aktif proteinin kiyaslanabilir bir dozu ile karsilastirildiginda
daha fazla farmokinetik gerçeklestirebilir. Burada kullanildigi üzere, bir "kiyaslanabilir
doz, kiyaslanabilir bir sekilde bir denege verilen terapötik aktif proteine yönelik
esdeger bir mol/kg degerine sahip bir doz anlamina gelir. Füzyon proteinin bir
füzyon proteini dozu içerisindeki terapötik aktif protein ile esas olarak ayni mol-
esdegerine sahip olacagi ve/veya terapötik aktif proteine göre yaklasik ayni molar
konsantrasyona sahip olacagi anlasilacaktir.
Bir terapötik aktif proteinin, terapötik aktif proteine bir müsin polipeptit etki alaninin
baglanmasi ile artirilabilecek olan farmakokinetik (PC) özelliklerine, yari ömür, egri
altindaki alan (AUC), Cmaks, Tmaks, inis-çikis konsantrasyon orani ve dagilim hacmi
dahildir. PK özelliklerindeki artis, artan maruz birakilma nedeniyle etkinlikte artis,
dozdaki azalma ve Cmaks'taki bir sönümleme nedeniyle yan etkilerde azalma ve
dozlama frekansinda bir azalmaya yol açabilir. Örneklerde daha detayli açiklandigi
üzere, bulus, füzyon proteinine bagli olmayan ilgili terapötik aktif protein ile
karsilastirildiginda, verilen füzyon proteinine yönelik yari ömrü, en az yaklasik iki kat
daha uzun veya en az yaklasik üç kat veya en az yaklasik dört kat veya en az yaklasik
bes kat veya en az yaklasik alt kat veya en az yaklasik yesi kat veya en az yaklasik
sekiz kat veya en az yaklasik dokuz kat veya en az yaklasik on kat veya en az yaklasik
kat veya en az yaklasik 20 kat uzatan veya füzyon proteinine bagli olmayan
terapötik aktif protein ile karsilastirildiginda yari ömrü daha fazla uzatan, bir terapötik
aktif proteine bagli bir müsin etki alanli polipeptit içeren füzyon proteinleri saglar.
Benzer sekilde, füzyon proteinleri, füzyon proteinine bagli olmayan ilgili terapötik aktif
protein ile karsilastirildiginda AUC'de en az yaklasik %50 veya en az yaklasik %60
veya en az yaklasik %70 veya en az yaklasik %80 veya en az yaklasik %90 veya en
az yaklasik %100 veya en az yaklasik %150 veya en az yaklasik %200 veya en az
yaklasik %300 artisa sahip olabilir. Bir füzyon proteininin yari ömür ve AUC
farmakokinetik parametreleri, ELISA, HPLC, radyotahlil veya teknikte bilinen veya
burada açiklanan diger yöntemleri kullanilarak dozlama, zaman araliklarinda kan
örneklerinin alinmasi ve proteinin tahlil edilmesini, akabinde, yari ömür ve diger PK
parametrelerin derive edilmesine yönelik standar veri hesaplamalarini içeren standart
yöntemler ile belirlenebilir.
Yari ömürdeki artislar, inis-çikis konsantrasyon oraninda azalma ile sonuçlanir, bu
sekilde birden fazla dozun verilmesi durumunda konsantrasyona karsilik zaman profili
yumusar. Daha devam maruz kalma, daha iyi etkinligin yani sira siklikla yüksek bir
Cmaks (supraterapötik konsantrasyonlar) ile yol açilan yan etkilerde azalma ile
sonuçlanir. Ayri dozlarin uzatilmis süresi, ayrica doz sikligini azaltir, bunun
sonucunda, verilis ile alakali tüm yan etkilerde (enjeksiyon alani reaksiyonlari gibi)
azalma, daha iyi uyumluluk ve hastaya yönelik kolaylik ortaya çikar.
Fizikokimyasal ve Farmasötik Özellikler
Bir terapötigin PK özelliklerinin artirilmasina ek olarak, bir müsin etki alanli polipeptit ile
füzyon, terapötik aktif peptit veya proteinin farmasötik veya fizikokimyasal özelliklerinin
(aköz çözünürlük derecesi gibi) iyilestirilmesine yönelik kullanisli olabilir. Çözünürlük
iyilestirmeleri, müsin üzerine yüksek derecede hidrofilik karbohidratlarin eklenmesinin
yani sira, ek olarak aspartik asit, glutamik asit, histidin, lisin ve arjinin gibi iyonlasabilir
kalintilari da içerebilen, uygun müsin-polipeptit diziliminin seçilmesi araciligiyla
gerçeklestirilebilir. Iyaonlasabilir kalintilar, füzyon proteininin pl'sinin modülasyonu ve
bu sekilde, proteinin belirli bir formülasyondaki toplam yükü ile sonuçlanir.
Füzyon proteinleri, füzyon proteinlerinin fizikokimyasal özelliklerinin istenen özellik ile
sonuçlandiginin dogrulanmasina yönelik, burada açiklanan yöntemler kullanilarak,
yapilandirilabilir ve tahlil edilebilir. Bir açida, müsin etki alanli polipeptit. füzyon
proteinine bagli olmayan terapötik aktif protein ile karsilastirildigindai füzyon proteininin
en az yaklasik %25 veya en az yaklasik %30 veya en az yaklasik %40 veya en az
yaklasik %50 veya en az yaklasik %75 veya en az yaklasik %100 veya en az yaklasik
daha yüksek veya füzyon proteinine bagli olmayan ilgili terapötik aktif proteine göre en
az yaklasik %1000 daha yüksek aköz çözünürlüge sahip olacagi sekilde seçilir. Tercih
edilen müsin etki alanli polipeptit dizilimleri, en az %80 dizilim benzerligine veya
yaklasik %99 ila, Tablo 1'den seçilen müsin etki alanli polipeptit ile yaklasik %100
dizilim benzerligi sahip olabilir.
Füzyon Proteinlerinin Kullanimi
Diger bir açida, spesifikasyon, terapötik aktif proteinin yol açtigi bir hastalik, bozukluk
veya kosulda yararli bir etkinin gerçeklestirilmesine yönelik bir yöntem açiklar. Mevcut
spesifikasyon, nispeten kisa terminal yari ömre ve/veya minimum etkili doz ve
maksimum tolere edilebilir doz arasinda daha dar bir terapötik pencereye sahip
terapötik aktif proteinlerin dezavantajlar ve/veya sinirlandirmalara yöneliktir.
Bir açida, spesifikasyon, bir denekte yararli bir etkinin gerçeklestirilmesine yönelik,
denege terapötik olarak veya profilaktik olarak etkili miktarda füzyon proteininin
verilmesi adimini içeren bir yöntemi açiklar. Etkili miktar, bir hastalik veya bozuklugun
tedavi edilmesine yardimci olmada yararli bir etki üretebilir. Bazi durumlarda, yarali bir
etkinin gerçeklestirilmesine yönelik yöntem, bir müsin etki alanli polipeptide bagli
olmayan bir terapötik protein veya peptitin bir alt optimal yari ömre sahip oldugu
hastaliklar ve hastalik kategorilerine yönelik bir denegin tedavi edilmesine yönelik bir
füzyon proteini bilesiminin terapötik olarak etkili bir miktarinin verilmesini içerebilir.
Diger durumlarda, yararli bir etkinin gerçeklestirilmesine yönelik yöntem, bir terapötik
protein veya peptitin mevcut olmadigi hastaliklar ve hastalik kategorilerine yönelik bir
denegin tedavi edilmesine yönelik bir füzyon proteini bilesiminin terapötik olarak etkili
bir miktarinin verilmesini içerebilir. Ayrica diger durumlarda, yararli bir etkinin
gerçeklestirilmesine yönelik yöntem, bir terapötik protein veya peptitin sirasiyla bir
agonist veya antagonist olarak bir alt optimal uyarici veya alt optimal inhibe edici etki
gösterdigi hastaliklar ve hastalik kategorilerine yönelik bir denegin tedavi edilmesine
yönelik bir füzyon proteini bilesiminin terapötik olarak etkili bir miktarinin verilmesini
içerebilir.
Burada açiklanan bilesimlerin verilmesi ile tedavi tabi tutulan hastaliklara, kisitlama
olmaksizin, enflamatuar hastaliklar, artrit, osteoporoz, özellikle hepatit enfeksiyonlari,
bakteriyel enfeksiyonlar, viral enfeksiyonlar, genetik hastaliklar, pulmoner hastaliklar,
tip 1 diyabet, tip 2 diyabet, hormonla iliskili hastalik, Alzheimer hastaligi, kalp
hastaliklari, miyokardiyal enfarktüs, derin ven trombozu, dolasim sistemi hastaliklari,
hipertansiyon, hipotansiyon, alerji, agri kesici, cücelik ve diger büyüme bozukluklari,
zehirlenmeler, leke pihtilasma hastaliklari, dogustan gelen bagisiklik sistemi
hastaliklari, emboli, yara iyilesmesi, yaniklarin iyilesmesi, Crohn hastaligi, astim, ülser,
sepsis, glokom, serebrovasküler iskemi, solunum sikintisi sendromu, korneal ülserler,
böbrek hastaligi, diyabetik ayak ülseri, anemi, faktör IX eksikligi, faktör VIII eksikligi,
faktör VII eksikligi, mukozit, disfaji, trombosit bozuklugu, akciger embolisi, infertilite,
hipogonadizm, Iökopeni, nötropeni, endometriozis, Gaucher hastaligi, obezite, Iizozom
depolama hastaligi, AIDS, premenstrüel sendrom, Turners sendromu, kaseksi, kas
distrofisi, Huntington hastaligi, kolit, SARS, Kaposi sarkomu, karaciger tümörü, meme
tümörü, glioma, Non-Hodgkin Ienfoma, Kronik miyelositik lösemi; Killi hücre lösemi;
Renal hücreli karsinom; Karaciger tümörü; Ienfoma; Melanom, multipl skleroz, Kaposis
sarkomu, papilloma virüsü, amfizem, bronsit, periodontal hastalik, demans, dogum,
küçük hücreli olmayan akciger kanseri, pankreas tümörü, prostat tümörü, akromegali,
sedef hastaligi, yumurtalik tümörü, Fabry hastaligi, Iizozom depo hastaligi dahildir.
Bir açida, yöntem, bir müsin etki alanli polipeptite bagli bir terapötik aktif protein ve en
az bir farmasötik olarak kabul edilebilir tasiyici içeren bir füzyon proteini içeren bir
farmasötik bilesimin terapötik olarak etkili bir miktarinin, ihtiyaç içindeki bir denege
verilmesini içerir, bu sekilde, kiyaslanabilir bir dozda verilen bir müsin etk alanli
polipeptide bagli olmayan bir terapötik aktif protein içeren bir farmasötik bilesimin
verilmesi ile ortaya çikan etki ile karsilastirildiginda, füzyon proteininin terapötik aktif
proteininin yol açtigi en az bir parametre, fizyolojik kosul veya klinik çiktida daha büyük
bir iyilesme ortaya çikar. Bir açida, farmasötik bilesim, terapötik olarak etkili bir dozda
verilir. Diger bir açida, farmasötik bilesim, dozlama periyodunun uzunluguna yönelik
terapötik oalrak etkili bir doz rejimi (burada açiklandigi üzere) kullanilarak birden fazla
es zamanli veya asamali doz kullanilarak verilir.
Uzatilmis yari ömür gibi burada açiklandigi üzere, füzyon proteininin iyilestirilmil
farmakokinetik parametrelerinin bir sonucu olarak, bir müsin-etki alanli polipeptite bagli
terapötik aktif protein, bir müsin etki alanli polipeptide bagli olmayan ilgili terapötik aktif
protein ile karsilastirildiginda, hastalik, bozukluk veya kosulun semptomlari veya klinik
abnormalitelerinin önlenmesi, tedavi edilmesi, hafifletilmesi, tersine döndürülmesi veya
iyilestirilmesine veya tedavi edilmekte olan denegin hayatta yasaminin uzatilmasina
yönelik, dozlar arasinda daha uzun araliklar kullanilarak verilebilir.
Bir füzyon proteininin terapötik olarak etkili bir miktari, hastaligin asamasi, yas, cinsiyet
ve kisinin agirligi ve antikor veya antikor kisminin kiside istene bir tepkiyi ortaya
çikarma yetenegi gibi faktörlere göre degiskenlik gösterebilir. Terapötik olarak etkili bir
miktar ayrica, füzyon proteininin tüm toksik veya zarar verici etkilerinin terapötik olarak
yararli etkiler tarafindan bastirildigi miktardir. Profilaktik olarak etkili bir miktar, istenen
profilaktik sonucu gerçeklestirmek üzere gerekli zaman periyoduna yönelik gerekli olan
füzyon proteini miktarini refere eder.
Bir açida, bir tedavi yöntemi, bir füzyon proteini içeren bir farmasötik bilesimin terapötik
olarak etkili bir dozunun ihtiyaç içinde olan bir denege verilmesini içerir, bu, bir füzyon
polipeptidine bagli olmayan terapötik aktif proteinin kiyaslanabilir bir dozu ile
karsilastirildiginda terapötik aktif proteinin yari ömründe bir artis ile sonuçlanir. Diger
bir açida, spesifikasyon, posr-ekspresyon kimyasal baglanma gerektiren imalat ile ilgili
yari ömür uzatma teknolojilerinin kolayliginin gelistirilmesi ve natif terapötik aktif
proteinler ile karsilastirildiginda, yüksek stabilite, yüksek su çözünürlügü ve/veya
formülasyon kolayligi ile sonuçlanmasina yönelik füzyon proteinlerinin yapilmasina
yönelik yöntemleri açiklar. Bir açida, spesifikasyon, bir müsin etki alanli polipeptide
bagli olmayan terapötik aktif protein ile karsilastirildiginda, fizyolojik kosullar altinda
veya terapötik olarak kabul edilebilir formülasyon içinde, ortaya çikan füzyonun
çözünebilir formunda daha yüksek konsantrasyon gerçeklestirilebilecegi sekilde seçilen
bir müsin etki alanli polipeptite terapötik aktif proteinin baglanmasi adimini içeren, bir
terapötik aktif proteinin aköz çözünürlügün artirilmasina yönelik bir yöntemi açiklar.
Müsin etki alanli polipeptitin özelliklerine, bir füzyon proteini ile birlestirilmesi
durumunda daha yüksek suda çözünürlük kazandiran faktörlere, yüksek glikosilasyon
yüzdesi, glikan tipleri ve müsin etki alanli polipeptitin amino asitleri üzerindeki yük
dahildir. Bazi düzenlemelerde, yöntemler, suda çözünürlügün, natif terapötik aktif
protein ile karsilastirildiginda, fizyolojik kosullar altinda veya terapötik olarak kabul
edilebilir bir formülasyon içinde, en az yaklasik %50 veya en az yaklasik %60 daha
yüksek en az yaklasik %70 daha yüksek veya en az yaklasik %80 daha yüksek veya
en az yaklasik %90 daha yüksek veya en az yaklasik %100 daha yüksek veya en az
yaklasik %150 daha yüksek veya en az yaklasik %200 daha yüksek veya en az
yaklasik %400 daha yüksek veya en az yaklasik %600 daha yüksek veya en az
yaklasik %800 daha yüksek veya en az yaklasik %1000 daha yüksek veya en az
yaklasik %2000 daha yüksek veya en az yaklasik %4000 daha yüksek veya en az
yaklasik %6000 daha yüksek oldugu birfüzyon proteini ile sonuçlanir.
Nükleik Asit Dizilimleri
Mevcut bulus, bulusun füzyon proteinlerini kodlayan polinükleik asit moleküllerini
tamamlayici olan füzyon proteinleri ve dizilimlerini kodlayan izole polinükleik asitler
saglar. Diger bir açida, bulus, bulusun füzyon proteinlerini kodlayan polinükleik asitler
ve homolog varyantlar dahil, bulusun füzyon proteinlerini tamamlayici dizilimler
üretmek üzere yöntemleri kapsar. Genelde, bulus, bir füzyon proteinine yönelik
kodlayan bir polinükleotit dizilimi üretmek ve ortaya çikan gen ürününün ifade edilmesi,
müsin etki alanli polipeptitler ve aktif proteinlerin her birini kodlayan nükleotitleri
toplamak, bilesenleri çerçeveye baglamak, ifade vektörü ile uygun bir konak hücreyi
dönüstürmek ve füzyon proteininin dönüstürülen konak hücre üzerinde ifade edilmesine
denek olmak, bu sekilde bulusun füzyon proteinini üretmek üzere yöntemser saglar.
Moleküler biyolojideki standart rekombinant teknikleler, mevcut bulusun polinükleotitleri
ve ifade vektörlerinin yapilmasina yönelik kullanilabilir. Bulusa göre, bir füzyon
proteinini kodlayan nükleik asit dizilimleri, uygun konak hücrelerdeki füzyon
proteinlerinin ifadesini yönlendiren rekombinant DNA moleküllerinin olusturulmasina
yönelik kullanilabilir. Birkaç klonlama stratejisi, mevcut bulusun gerçeklestirilmesine
yönelik uygun oldugu öngörülmüstür, bunlarin birçogu, bir füzyon proteini veya bunun
komplementine yönelij bir gen kodlamasi içere bir yapinin olusturulmasina yönelik
kullanilabilir. Bir düzenlemede, klonlama stratejisi, bir aktif protein ve bir müsin etki
alanli polieptit içeren bir monomerik füzyon proteinini kodlayan bir genin
olusturulmasina yönelik kullanilabilir. Bu paragrafta asagida açiklanan siradaki
düzenlemelerde, gen, ayrica klevaj dizilimi veya dizilimlerini de kodlayabilen, aralayici
dizilimleri kodlayan nükleotitler de içerebilir.
Bir yaklasimda, bir yapi ilk olarak, bir füzyon proteinine karsilik gelen DNA dizilimini
içerecek sekilde hazirlanir. Bir aktif protein ve/veya bir müsin polipeptit etki alani
kodlayan DNA, bir aktif proteinin mRNA'sini tasidigina ve bunu saptanabilir bir
seviyede ifade ettigine inanilan doku veya izole hücrelerden standart yöntemler
kullanilarak hazirlanan bir cDNA kitaligindan elde edilebilir. Gerekli olmasi durumunda,
kodlama dizilimi, cDNA'ya ters-kopyalanmis olmayabilen mRNA prekürsörleri ve islem
ara maddelerinin saptanmasina yönelik, Sambrook, et al., supra içerisinde açiklanan
klasik primer uzatma prosedürleri kullanilarak elde edilebilir. Bu sekilde, DNA, bu tür
kaynaklardan hazirlanan bir cDNA kitapligindan klasik sekilde elde edilebilir. Kodlayici
gen veya genler ayrica, bir genomik kitapliktan elde edilebilir veya halka açik
veritabanlari, patentler veya literatür referanslarindan elde edilen DNA dizilimleri
kullanilarak teknikte bilinen standart sentetik prosedürler (örnegin, otomatik nükleik asit
sentezi) ile olusturulabilir. Bu tür prosedürler teknikte iyi bilinmektedir ve bilimsel ve
patent literatüründe iyi sekilde açiklanmistir. Örnegin, dizilimler, aktif proteinin veya
aktif proteinin bir fragmenti veya varyantinin veya bir müsin etki alanli polipeptidin bir
amino asit dizilimini içeren, CAS Kayitlari veya GenBank veritabanindaki girdilere
karsilik gelen, ncbi.nlm.nih.gov dünya çapinda ag üzerinden ulasilabilen Ulusal
Biyoteknoloji Bilgi Merkezi (NCBI) web sayfasi araciligiyla elde edilebilen Kimyasal
Adlar Servisi (CAS) Kayit Numaralari (Amerikan Kimya Dernegi tarafindan
yayinlanmistir) ve/veya GenBank Erisim Numaralarindan elde edilebilir.
Aktif proteini kodlayan bir gen veya polinükleotit akabinde, örnegin, bir biyolojik
sistemde yüksek seviyedeki protein ifadesine yönelik uygun transkripsiyon ve
translasyon dizilimlerinin kontrolü altindaki bir plazmit veya diger bir vektör olabilen bir
yapiya klonlanabilir. Sonraki bir adimda, müsin etki alanli polipeptide yönelik kodlayan
ikinci bir gen veya polinükleotit, örnegin, aktif protein genini, aktif proteine yönelik
kodlayan gen veya genler ile bitisik ve çerçeve içinde olan yapi içerisine klonlayarak,
aktif protein geninin N- ve/veya C-terminalini kodlayan nükleotitlere genetik olarak
kaynastirilir.
Füzyon polipeptitlerini kodlayan ortaya çikan polinükleotitler akabinde, bir ifade vektörü
içerisine ayri ayri klonlanabilir. Nükleik asit dizilimi, çesitli prosedürler ile vektör
içerisine yerlestirilebilir. Genelde, DNA, teknikte bilinen teknikler kullanilarak uygun bir
sinirlandirma endonükleaz alani veya alanlari içerisine yerlestirilir. Vektör bilesenleri
genel olarak, bunlarla sinirli olmaksizin. bir veya daha fazla dizilim, bir replikasyon
orijini, bir veya daha fazla isaretleyici gen, bir artirici element, bir yardimci ve bir
transkripsiyon terminasyonu dizilimi içerir. Bu bilesenlerin biri veya daha fazlasini
içeren uygun vektörlerin yapilmasi, teknikte uzman kisi tarafindan bilinen standart
patent Iiteratüründe iyi sekilde açiklanmaktadir.
Uygun vektörler, konaklar ve ifade sistemleri, rekombinant ifade tekniginde uzman
kisiler tarafindan iyi bilinir. Çesitli vektörler halka açiktir. Vektör, örnegin, bir plazmit,
kozmit, viral partikül veya faj formunda olabilir. Her iki ifade ve klonlama vektörü,
vektörün bir veya daha fazla seçilmis konak hücrede tekrarlanmasina olanak veren ve
ayrica, konak hücre içerisinde rekombinant proteinin ifadesi ve post-translasyonel
modifikasyonuna olanak veren bir nükleik asit dizilimi içerir.
Mevcut bulus ayrica, bulusun monomerik füzyon proteini bilesimlerinin ifade edilmesine
yönelik bir konak hücre saglar. Örnek uygun ökaryotik konak hücrelere, bunlarla sinirli
olmaksizin, Saccharomyces cerevisiae, Pichi'a pastoris ve Hansenu/a po/ymorpha gibi
maya konaklari; Sgodogtera frugigerda Sf9, Spodoptera frugi'perda Sf21 gibi böcek
konaklari ve High Five hücreleri ve fare fibroblast hücreleri, (C , Çin hamster
yumurtalik hücreleri (CHO-DHFR, CHO-NEOSPLA, CHO-G8)ve fare miyelom hücreleri
(NSO-GS) gibi memeli konaklar dahildir.
Ifade edilen füzyon proteinleri, teknikte bilinen yöntemler veya burada açiklanan
yöntemler araciligiyla saflastirilabilir. Jel filtrasyonu, tuz fraksiyonasyonu, iyon degisimi
kromatografisi, büyüklük dislanimli kromatografi, hidroksiapatit adsorpsiyon
kromatografisi, hidrofobik etkilesim kromatografisi ve jel elektroforezi gibi prosedürler
kullanilabilir; bunlarin her biri, ilgili konak hücre tarafindan üretilen füzyon proteinini geri
kazanmak ve saflastirmak üzere uygun hale getirilir. Saflastirma yöntemleri, Robert K.
Scopes, Protein Purification: Principles and Practice, Charles R. Castor (ed.), Springer-
Verlag 1994 ve Sambrook, et al., supra içerisinde açiklanir. Çok adimli saflastirma
Farmasötik Bilesimler
Mevcut bulus, bulusun füzyon proteinlerini içeren farmasötik bilesimler saglar. Bir
düzenlemede, farmasötik bilesim, füzyon proteinini ve en az bir farmasötik olarak kabul
edilebilir tasiyici içerir. Mevcut bulusun füzyon proteinleri,farmasötik olarak kulanisli
bilesimlerin hazirlanmasina yönelik bilinen yöntemlere göre formüle edilebilir, bu
sekilde, polipeptit, aköz solüsyonlar veya taponlar, farmasötik olarak kabul edilebilir
süspansiyonlar ve emülsiyonlar gibi farmasötik olarak kabul edilebilir bir tasiyici araç ile
kombine edilir. Aköz olmayan solvent örneklerine, propil etilen glikol, polietilen glikol ve
bitkisel yaglar dahildir. Terapötik formülasyonlar, istenen saflik derecesine sahip aktif
malzemenin, Iiyofilize formülasyonlar veya aköz solüsyonlar seklindeki, Remington's
Pharmaceutical Sciences 16th edition, Osol, A. Ed. (1980) içerisinde açiklandigi üzere,
opsiyonel fizyolojik olarak kabul edilebilir tasiyicilar, eksipiyanlar veya stabilize ediciler
ile karistirilmasiyla depolanmak üzere hazirlanir.
Farmasötik bilesimler, oral olarak, burun içi yoluyla, prenteral olarak veya inhalasyon
terapisi ile verilebilir ve tablet, pastil, granül, kapsül, hap, ampul, supozituar veya
aerosol formunda olabilir. Ayrica, aköz veya aköz olmayan seyreltici, surup, granülat
veya toz içindeki aktif malzemenin süspansiyonu, solüsyonu ve emülsiyonu seklinde
olabilir. Ek olarak, farmasötik bilesimler ayrica, diger farmasötik olarak aktif bilesikleri
veya bulusun birtakim bilesiklerini de içerebilir.
Daha belirli olarak, mevcut farmasötik bilesimler, oral, rektal, nazal, topikal
(transdermal, aerosol, bukal ve dil alti dahil), vajinal, parenteral (subkütanöz,
subkütanöz veya infüzyon pompasi ile intratekal olarak, intramüsküler, intravenöz ve
intradermal dahil), intravitreal ve pulmoner olarak dahil herhangi bir uygun yolla
terapiye yönelik verilebilir. Tercih edilen yolun, terapötik ajan, alicinin kosulu ve yasi ve
tedavi edilen hastaliga bagli olarak degisecegi bilinir.
Tercih edilen bir açida, bilesim, insanlara intravenöz verilise yönelik adapte edilmil bir
farmasötik bilesim olarak rutin prosedürlere göre formüle edilir. Tipi olarak, intravenöz
verilise yönelik bilesimler, steril izotonik aköz tampon içindeki solüsyonlardir. Bilesimin
infüzyon ile verildigi durumda, steril farmasötik kalitedeki su veya salin içeren bir
infüzyon sisesi ile dagitilabilir. Bilesimin enjeksiyon ile verilmesi durumunda,
enjeksiyona yönelik bir steril su ampulü veya salin, verilis öncesinde malzemelerin
karisabilmesine yönelik saglanabilir.
Tercih edilen diger bir açida, farmasötik bilesim, subkütanöz olarak verilir. Bu
düzenlemede, bilesim, verilis öncesinde yeniden yapilandirilmak üzere bir Iiyofilize toz
olarak tedarik edilebilir. Bilesim ayrica, bir hastaya direkt olarak verilebilecek olan sivi
bir formda da tedarik edilebilir. Bir düzenlemede, bilesim, bir hastanin bilesimi kolay
sekilde kendi kendine verebilecegi sekilde, önceden doldurulmis bir siringa içinde bir
sivi olarak tedarik edilir.
Diger bir açida, mevcut bulusun bilesimleri, Iipozomlar içerisinde enkapsüle edilir, bu,
yararli aktif ajanlarin uzatilmis zaman periyotlari boyunca kontrollü bir sekilde
dagitilmasinda kullanim göstermistir. Lipozomlar, hapsedilmis bir aköz hacim içeren
kapali çift katmanli membranlardir. Lipozomlar, her biri digerinden bir aköz katman ile
ayrilan, tek bir membran çift katmani içeren tek lamelli kesecikler veya birden fazla
membran çift katmani içeren çok lamelli kesecikler de olabilir. Ortaya çikan membran
çift katmaninin yapisi, Iipidin hidrofobik (polar olmayan) kuyruklari çift katmanin
merkezine dogru yönlenmisken hidrofilik (polar) basliklarin aköz faza dogru yönlenmis
olacagi sekildedir. Bir düzenlemede, Iipozom, mononükleer fagosit sistem organlari,
öncelikli olarak karaciger ve dalak tarafindan alimi önleyen esnek bir suda çözünebilir
polimer ile kaplanmis olabilir. Lipozomlari çevrelemek üzere uygun hidrofilik
polimerlere, kisitlama olmadan, U.S. Pat. No.
polivinilpirolidon, polivinilmetileter, polimetiloksazolin, polietiloksazolin,
polihidroksipropiloksazolin, polihidroksipropilmetakrilamid, polimetakrilamid,
polidimetilasilamid, polihidroksipropilmetakrilat, polihidroksietilakrilat,
hidroksimetilselüloz hidroksietilselüloz, polietilenglikol, poliaspartamid ve hidrofilik peptit
dizilimleri dahildir.
Lipozomlar, teknikte bilinen herhangi bir Iipit veya Iipit kombinasyonundan olusabilir.
Örnegin, kesecik olusturan Iipitler, fosfatidilkolin, fosfatidiletanolamin, fosfatidik asit,
fosfatidilserin, fosfatidilgliserol, fosfatidilinositolgibi fosfolipitler ve U.S. Pat. No.
veya sentetik lipitler olabilir. Kesecik olusturan lipitler ayrica, glikolipitler, serebrositler
propil] -N, N-dimetiI-N-hidroksietilamonyum bromür (DMRIE); N- [1- (2,3-dioleyoksi)
propil] -N, N-dimetiI-N-hidroksi etilamonyum bromür (DORIE); N- [1- (2,3-dioleyoksi)
propil] -N, N, N-trimetilamonyum klorür (DOTMA); 3 [N- (N '. N'-dimetilaminoetan)
karbamoly] kolesterol (DC-Chol) gibi katyonik Iipitler veya U.S. Pat. No. 6,056,973ite
açilandigi üzere dimetildioktadesilamonyum (DDAB) da olabilir. Ayrica kolesterol de,
kazandirmak üzere uygun aralik içerisinde yer alabilir.
Sivi formülasyonlara yönelik, istenen bir özellik, formülasyonun, intravenöz,
igne içinden geçecek bir formda tedarik edilmesidir.
Diger açilarda bilesim, aktif ajanlarin koku alma ile ilgili geçitlerdeb CNS içerisine
transferine olanak vermek ve sistemik verilisi azaltmak üzere intranazal, bukal veya dil
alti yollari araciligiyla verilebilir. Bu verilis yoluna yönelik yaygin sekilde kullanilan
cihazlar U.S. Pat. No. 6,715,485 içerisinde yer alir. Bu yol araciligiyla verilen bilesimler,
belirli ilaçlar ile iliskili sistemik toksisite risklerini azaltarak, yüksek CNS dozlama veya
düsük toplam vücut yüküne olanak verebilir. Bir farmasötik bilesimin, deri altina
implante edilebilir bir cihaz içerisinde dagitima yönelik hazirlanmasi, örnegin U.S. Pat.
kullanilarak gerçeklestirilebilir.
ÖRNEKLER
Asagidaki örnekler, örneklendirme amaciyla verilmektedir ve istemlerde belirtilen
bulusu herhangi bir sekilde sinirlandirici sekilde yorumlanmamalidir.
Örnek 1. Müsin Etki Alanli Füzvon Yapilarinin Tasarimi, Hazirlanmasi, ifadesi ve
Saflastirilmasi
1. Müsinlestirilmis IL-1Ra füzyon proteinlerinin tasarimi
etki alaninin uzunlugu, müsin tandem tekrar sayisnin degistirilmesiyle sistematik olarak
artirilir. Füzyon proteinlerinin müsinlestirilmis etki alanlari, insan MUC20 proteininden
tandem tekrarina (TR) baglidir. lL-1Ra'nin füzyon proteinleri, 2TR, 4TR, GTR, 8TR ve
12TR ile tasarlanir, sirasiyla, RDB],
RDBi], RDB1826 [SEO ID NO: 5
(protein); SEO ID NO: 6 (DNA)], RDB; SEO ID NO: 8
(DNA)] ve RDB] olarak tasarlanir.
4 glisinden olusan bir baglayici (GGGG (SEO ID NO: 27)), IL-1Ra diziliminin C-
terminali ve birinci müsin TR'si arasinda ve her bir 2 müsin RT seti arasina yerlestirilir.
bir FLAG etiketi, saflastirma kolayligina yönelik RDB1826'nin C-terminaline eklenir.
2. Müsinlestirilmis eksendin-4 füzyon proteini RDBZZO3 tasarimi
Insan MUC2O proteininden 8TR ile birlikte eksendin-4 füzyon proteini tasarlanir:
eksendin-4 diziliminin C-terminali ve birinci müsin TR'si arasina ve her bir 2 müsin RT
seti arasina yerlestirilir. Saflstirma kolayligina yönelik, nihai TR ve His-etiketi arasinda
bir aralayici (GGGGS (SEO lD NO: 28)) ile birlikte, C-terminaline bir His-etiketi eklenir.
3. Gen sentezi
Tasarlanan yapilarin ifadesine yönelik genlerin sentezi, standart yöntemler kullanilarak
gerçeklesti rilir.
4. Sentez/enen genin bir memeli ifade vektörüne alt klonlanmasi
A) pcDNAT'VI (lnvitrogen) ifade vektörünün hazirlanmasi
ug pcDNA, 37°C'de iki saat boyunca BamHl ve Hindlll ile sindirilir. Dijest, 5' fosfatin
uzaklastirilmasi dolayisiyla vektörün kendi üzerinde tekrar ligate olmasinin
engellenmesine yönelik kalf alkalin fosfataza tabi tutulur. Tampon, kalf alkalin fosfataz
reaksiyonundan tuzlarin uzaklastirilmasina yönelik degistirilir. Oiagen'in PCR
temizleme kiti, üreticinin önerdigi protokol izlenerek kullanilir. DNA, 30 pl H20 içerisinde
ayristirilir.
B) Ilgili genin hazirlanmasi
Ilgili gen, 37°C'de iki saat boyunca BamHl ve Hindlll ile sindirilir. Sindirim reaksiyonu,
gerçeklestirilir. Ilgili gene karsilik gelen fragment, jel üzerindeki ikinci sira
çukurcuklardan izole edilir.
C) Genin pcDNA'ya Iigasyon reaksiyonu.
Hazirlanan pcDNA (adim A), T4 Iigaz varliginda adim B'deki DNA ile karistirilir ve 30
dakika boyunca oda sicakliginda inkübe edilir. Ligasyon sonrasinda, ürünler, TOP1O
hücrelerine (lnvitrogen; E. coli'nin kimyasal olarak yetkin susu) dönüstürülür ve dogru
klon tutulur ve -80 "C'de bir gliserol stogu olarak depolanir.
. Müsinlestirilmis IL-IRa ve eksendin-4 füzyon proteinlerinin ifadesi
Tüm proteinler, üreticinin önerdigi protokol izlenerek FreeStyleTM MAX Belirteci
(Invitrogen) kullanilarak CHO hücrelerinde ifade edilir. Kisaca, transfeksiyondan bir gün
önce, hücreler 0.5x106 hücreler/mL'de ekilir ve transfeksiyon gününde, üretici
tarafindan tavsiye edildigi üzere, 1x106 hücreler/mL'ye ayarlanir. 1 litre transfeksiyona
yönelik, iki tüp (A ve B) ortam (OptiPROT'V', lnvitrogen) hazirlanir, her biri yaklasik 10 ml
içerir. Tüp A'ya img DNA eklenir ve tüp B`ye 1 ml FreeStyleTM MAX Belirteci eklenir.
Hemen sonrasinda, her iki tüpün içerigi karistirilir ve 15 dakika boyunca oda
sicakliginda inkübe edilir. Inkübasyon periyodu sonrasinda, karisim, 1 litre CHO
hücresine yavasça eklenir. Transfeksiyon sonrasinda, hücreler, 6 ila 7 gün birakilir ve
6. Müsinlestirilmis IL-IRa ve eksendin-4 füzyon proteinlerinin saflastirilmasi
His-etiketli ifade edilmis proteinlerin saflastirilmasi, bir nikel kolonda gerçeklestirilir.
proteinin baglanmasi sonrasinda, kolon, en faz 5 kolon hacmindeki tampon A (50mM
Tris pH8 ve 500mM NaCI) ile yikanir. Baglanan protein, yüksek bir imidazol
konsantrasyonu (20 ile 500mM) ile ayristirilir. Saflastirilan protein, PBS,ye karsilik bir
gece boyunca diyaliz edilir.
RDBiB26, bir anti-FLAG kolonda saflastirilir. Proteinin baglanmasi sonrasinda, kolon,
en fazla 5 kolon hacmindeki PBS ile yikanir. Protein, pH3'te ayristirilir ve Tris tampon
pH7 ile direkt olarak nötralize edilir. Saflastirilan protein, PBS'ye karsilik bir gece
boyunca diyaliz edilir.
Örnek 2. Müsin- IL-1Ra Yapilarinin Moleküler Agirlik ve gs'leri
lL-1Ra-müsin füzyon proteinleri RDB,
RDB, SDS/PAGE kullanilarak karakterize
edilir (Sekil 1A). Tüm yapilarin görünen moleküler agirligi, beklenen yksek seviye
glikosilasyon ile tutarli olarak, polipeptit diziliminin hesaplanan moleküler agirligindan
polipeptitlerin hesaplanan molkeüler agirliklari sirasiyla 22kD, 26.2kD, 34.8kD ve
43.3kD”dir ve jel üzerindeki hareketliliklerine bagli olarak ilgili görünür moleküler
agirliklari 35kD, 45kD, 65kD ve 80kD'dir (Sekil 1A; oklar).
RDB ve RDB yapilarinin izoelektrik noktalari, izoelektrik odaklama kullanilarak ölçülür
(Sekil 18). Tüm yapilar, proteinin Pl'si etrafinda birden fazla bant ile birlikte yüke göre
heterojendir. Proteinin Pl'lari, O-glikanlarin büyük ölçüde siyaliklesmedigi varsayilarak,
polipeptit dizilimine bagli olarak hesaplanan Pl'lari ile büyük ölçüde hizalidir. Bantlarin
çoklugu, büyük ölçüde N-glikosilasyondaki farkliliklar nedeniyledir.
Tüm yapilar, bir Superdex 200 kolonu (Sekiller 2-6) üzerinde analitik jel filtrasyonu ile
karakterize edilir. Jel filtrasyonu, natif kosullar altinda hidrodinamik hacimlerine bagli
olarak proteinleri ayirir (yani, SDS/PAGE gibi degildir, denatüre edici degildir). Ayrisma
zamanlari, bilinmeyen bir globüler proteine yönelik görünür moleküler agirligin
hesaplanabilecegi sekilde, globüler protein standartlari ile kalibre edilebilir. Ayrisma
zamaninin, gerçek moleküler agirliktan ziyade daha direkt olarak hidrodinamik
yariçapa bagli olmasi ile, hesaplanan molkeüler agirliklarina göre büyük ölçüde daha
yüksek olan görünür moleküler agirliklar, globüler olmayan (yani, uzatilmis veya kablo
benzeri) yapilar, yüksek glikosilasyon seviyeleri ve/veya yüksek hidrasyon seviyeleri
öne sürer.
230kDidir (Sekiller 2-6). Tüm üsin yapilarinin görünür moleküler agirliklari, hem
hesaplanmis moleküler agirliklarindan (yalnizca amino asit dizilimine bagli olarak) hem
de SDS/PAGE üzerindeki hareketliliklerinden daha yüksektir. Bu gözlemler. yüksek
glikosilasyon seviyesi ve müsin yapilarinin beklenen kablo benzeri yapilarinin her ikisi
ile de tutarlidir.
Örnek 3. Müsin-lL-1Ra Yawrinin Antagonist A_ktiviteleri
HEK-BIueT'V' IL-1ß hücreleri (Invivogen), NF-KB/AP-1 salgilayan bir embriyonik alkalin
fosfataz (SEAP) raporlayici genin lL-1ß-kaynakli ifadesi ile in vitro biyoaktif IL-1ß
saptamak üzere spesifik olarak tasarlanmis insan embriyonik böbrek hücreleridir.
SEAP, SEAP saptama ortami QUANTI-BlueTM (Invivogen) kullanilmasi durumunda
kolay sekilde izlenebilir. IL-1Ra, IL-1RAcP baglanmasini ve dolayisiyla tam sinyal
kompleksinin toplanmasini önleyen IL-1RI baglayarak bu IL-1ß-kaynakli sinyali inhibe
eder. Müsin-IL1Ra yapilari RDB, RDB, IL-1ß-kaynakli
SEAP'yi inhibe etme yetenegi degerlendirilir. Kaynasmis bir müsin etki alani eksik olan
HEK-BlueTM IL-1ß hücreleri içeren 100 uL ortam, 50,000 hücre/çukurcuk nihai
konsantrasyonunda 96-çukurcuklu mikrotitre plakasina yerlestirilir. Müsin-IL1Ra
yapilari RDB,
(RDB baslangiç
konsantrasyonlarinda hazirlanir ve akabinde seri olarak seyreltilir ve ikili test
numunelerinde HEK-BlueTM IL-1ß hücrelerine eklenir. 0.015nM'deki IL-1ß, yalnizca
SEAP. 0.117 nM IL-1ß'yi uyarmak üzere tüm test numunelerinde kullanilir ve 11.76 nM
boyunca 37°C'de inhibe edilir ve QUANTI-BIueT'V'tahIili kullanilarak degerlendirilir.
Müsin-ILIRa yapilari RDB, RDB1826 (IL1Ra
6TR), RDB, kontrol (modifiye edilmemis
inhibitör aktivitesi, modifiye edilmemis IL1Ra (müsinlestirilmemis) protein kontrolünün
birkaç kati içerisindedir.
Örnek 4. Müsin-ll_.-1Ra'nin ll=-1Rl've B_aglanma_Afinitesi
bir BiacoreT'V' Sensor Chip üzerinde hareketsiz hale getirilir. Modifiye edilmemis IL-1Ra
(pozitif baglanma kontolü), RDB, RDB, çip üzerinde 5
spesifik yapinin 0.24nM konsantrasyonu, çipin yüzeyi üzerindeki bagli Iigant üzerinden
180 saniye boyunca akitilit, akabinde, analitin ayrilmasina olanak verilmesine yönelik
yüzey üzerinden bir bos solüsyon geçirilir. Ayni prosedür, her bir yapi için 0.74 ila 20nM
arasinda yükselen bir konsantrasyon kullanilarak ek olarak dört kez tekrarlanir. Ortaya
çikan sensörgramlar, yapilarin baglanma afinitelerinin hesaplanmasina yönelik natif
enstrüman yazili ile analiz edilir (Sekiller 10-14).
Hücre temelli tahlilden alinan aktivite verileri ile tutarli olarak, tüm yapilar, IL-1Rl'ye
yönelik potent baglanma afinitesi gösterir. RDB, RDB1814 (IL1Ra
4TR), RDB
ve QOOpM'dir. Dolayisiyla, müsinlestirilmis yapilarin baglanma afiniteleri, KD degerinin
52pM oldugu belirlenen modifiye edilmemis IL-1Ra'dan , 1.2-kat
(RDB daha
yüksektir. IL-1Rl'ye en zayif afinite gösteren yapinin (yani, RDB1816), seriler içinde en
yüksek müsin tandem tekrar sayisina (12TR) sahip olduguna dikkat edilmesi önemlidir.
RDB1816'nin afinitesindeki kayip, bu nedenle tamamen, modifiye edilmemis IL-1Ra
nedeniyle, belki de, RDB1816'nin (Kd= 1.4 x 104) ayrilma hizinin (Kd) modifiye
edilmemis IL-1Ra (Kd: 1.5 X 104) ile ayni olmasi nedeniyle, daha düsük bir
yuvarlanma hizi nedeniyledir (Sekil 14).
Örnek 5. RDB1816”nin in Vivo Etkinligi
RDB1816'in (IL1Ra 12TR) etkinligi ve aksiyon süresi, fare kolajen-antikor-kaynakli-
artrit (CAIA) modelinde degerlendirilir. Modifiye edilmemis lL-1Ra, 6 mg/kg/saat hizda
sürekli olarak infüze edilmesi durumunda bu model içinde aktiftir, ancak, çok düsük yari
ömrg nedeniyle tek bir 20 mg/kg dozda herhangi bir etkiye sahip degildir.
Fare CAIA modeline yönelik deneysel tasarim, n'in grup basina 8 fare oldugu Sekil
,te açiklanir. Kisaca, artrit, farelerde, bir anti-kolajen antikor kokteylini intavenöz (IV)
olarak enjeksiyonu ile baslatilir. 3 gün sonrasinda, enflamatuar tepki, bir intraperitoneal
(IP) lipopolisakkarit (LPS) enjeksiyonu ile yükseltilir, ayni zamanda, test bilesikler
RDB1816 (20mg/kg) ve anakinra (modifiye edilmemis lL-1Ra, 20 mg/kg) ve bir salin
kontrolü subkütanöz olarak (SC) verilir. Pati hacmi, enflamasyon derecesinin
belirlenmesine yönelik birden fazla gün boyunca ölçülür.
Fare CAIA deneyinin sonuçlari Sekil 16'da gösterilir. Anakinraya tabi tutulmus grup,
salin kontrole bagli olarak enflamasyonda azalma göstermez. Bu, bu modelde sürekli
anakinra infüzyonunun etkili olmasi nedeniyle, düsük maruz kalma ile sonuçlanan kisa
yari ömür nedeniyledir. Isaretli kontrastlarda, saline maruz tutulmus ve anakinraya
maruz tutulmus gruplarin her ikisine göre, RDB1816lya maruz tutulan farelerde pati
hacminde belirgin bir azalma gözlenir. Dolayisiyla, müsinilasyon, bir farmakodinamik
etki ortaya çikarmak üzere IL-1Ra molekülünün maruz kalmasini yeterince artirmistir.
Örnek 6. RDB1815 ve R_D_B1816,nin Farmakokinetikleri (PK)
Siradaki iki IL-1Ra-müsin füzyon polipeptit yapisinin yari ömrünün belirlenmesine
yönelik siçanlarda bir farmakokinetik çalisma yürütülür: RDB1815 ve RDB1816. Dozaj
grubu basina n=3 siçan olmak üzere, tek bir RDB1815 dozu, subkütanöz olarak
(5.6mg/Kg) veya intravenöz olarak (2.1mg/Kg) verilir ve tek bir RDB1816 dozu,
subkütanöz olarak (6.4mg/Kg) veya intravenöz olarak (2.4mg/Kg) verilir. 6 gün boyunca
çesitli zaman noktalarinda kan alinir ve ELISA ile IL-1Ra'ya yönelik analiz edilir.
yönelik, 17.9 saat ve 13.9 saat yari ömürleri ve SC durumunda sirasiyla 11.0 saat ve
8.0 saat yari ömürleri hesaplanir. Bu, modifiye edilmemis lL-1Ra kontrolüne (Anakinra)
yönelik raporlanan degerler üzerinde 10-kat ve 14-kat arasinda yari ömür uzamasini
ifade eder. Dolayisiyla, RDB1815 ve RDB1816”nin her ikisinin maruz kalmasi, fare
CAIA modelinde gözlemlenen etkinlik ile tutarli olarak, büyük ölçüde artar.
Örnek 7. Müsin-Eksendin-4 Yapisi RDB2203'ün Moleküler Agirligi
RDBZ203, bir Superdex 200 kolonu üzerinde SDS/PAGE ve analitik jel filtrasyonu
kullanilara karakterize edilir. SDS/PAGE ile, RDB2203'ün görünür moleküler agirligi
yaklasik 45kD, hesaplanan polipeptit moleküler agirligi olan 22.8kD'un yaklasik iki
katidir, bu, yüksek bir glikosilasyon seviyesi ile tutarlidir (Sekil 18: soldaki moleküler
isaretleyiciler). Analitik jel filtrasyonu ile, RDB2203`ün görünür moleküler agirligi,
yüksek derecede glikosile müsin etki alaninin yol açtigi genis hidrodinamik yariçap
Örnek 8. RDB2203'ün Biyoaktivitesi
RD82203'ün GLP-1 reseptörünü agonize etme yetenegi, DiscoveRX PathHunter
eXpress GLP-1 reseptörü CAMP tahlili kullanilarak ölçülür. Tahlil, üreticinin talimatlarina
göre gerçeklestirilir. Sonuç, RDB2203'ün, modifiye edilmemis eksendin-4'e (0.07nM
E050) göre yaklasik 21-kat daha az potent olan, 1.5nM degerindeki bir ECso göstererek,
GLP-l reseptörünün bir potent agonisti oldugunu belirtir (Sekil 20).
Örnek 9. RDB2203'ün Farmakokinetjk Profili
RDBZ203, farelerde intravenöz olarak 0.65mg/kglde ve subkütanöz olarak 0.65mg/kg
ve 7.0mg/kg'de dozlanir. Müsinlestirilmemis eksendin-41'e göre, RD82203, toplam
maruz kalmada bir atis ile sonuçlanmak üzere, yari ömürde bir artis (2.0 saate karsilik
0.5 saat, iv) ve berraklikta azalma (74 mI/saat/kg'ye karsili gösterir
RD82203 ayrica, modifiye edilmemis eksendin-4'e yönelik %65'e göre iyilesmis bir
biyoelverislilik >%95 gösterir (Sekil 21 ).
Burada refere edilen patent ve bilimsel literatür, teknikte uzman kisilerin bilgisini
olusturur.
Bu bulus, tercih edilen düzenlemelere referansla belirli olarak gösterilirken ve
açiklanirken, teknikte uzman kisiler tarafindan, ekli istemlerde belirtilen bulusun
kapsami disina çikilmadan sekil ve detaylarda çesitli degisikliklerin yapilabilecegi
anlasilacaktir. Burada açiklanan düzenlemelerin karsilikli olarak münhasir olmadigi ve
çesitli düzenlemelerin özelliklerinin, bulusa bagli kalinarak bütün veya kismi olarak
kombine edilebilecegi anlasilmalidir.
Claims (1)
- ISTEMLER . Bir füzyon proteini olup. özelligi opsiyonel bir baglayici araciligiyla en az bir aktif proteine bagli olan bir müsin etki alanli polipeptit içermesidir, burada müsin etki alanli polipeptit glikosiledir ve SEO ID NO:20 veya en az %90 amino asit benzerligi ile homolog olan herhangi bir amino asit dizilimi içerir, burada aktif protein lL-1Ra veya eksendin-4 veya en az %90 amino asit benzerligi ile homolog olan herhangi bir amino asit dizilimidir; ve burada füzyon proteininin yari ömrü, müsin etki alanli polipeptit ile kaynasmamis olan ilgili aktif proteinin yari ömrü ile karsilastirildiginda iki-kat daha yüksektir. . Istem 1'deki füzyon proteini olup, özelligi müsin etki alanli polipeptidin, SEQ ID NO: 20'nin en az iki tandem tekrarini içermesidir. . Istem 1'deki füzyon proteini olup, özelligi füzyon proteininin görünür moleküler agirliginin, füzyon proteininin hesaplanan moleküler agirligindan daha yüksek olmasidir. . Istem 1'deki füzyon proteini olup, özelligi füzyon proteininin, SEQ ID NO: 1'in 4- 200 amino asitlerini içermesidir. . Istem 1'deki füzyon proteini olup, özelligi füzyon proteininin, SEQ ID NO: 3'ün 4- 245 amino asitlerini içermesidir. . Istem 1ideki füzyon proteini olup, özelligi füzyon proteininin, SEQ ID NO: 5'in 4- 283 amino asitlerini içermesidir. . Istem iideki füzyon proteini olup, özelligi füzyon proteininin, SEQ ID NO: 7'nin 4-335 amino asitlerini içermesidir. . Istem 1'deki füzyon proteini olup, özelligi füzyon proteininin, SEQ ID NO: 9'un 4- 425 amino asitlerini içermesidir. Istem 1'deki füzyon proteini olup, özelligi SEQ ID NO: 24'ün 1-224 amino asitlerini içermesidir. Istemler 1-9'dan herhangi birindeki füzyon proteinini kodlayan bir polinükleotit dizilimi içeren bir izole nükleik asittir. Istem 10'daki polinükleotit dizilimini içeren bir ifade vektörü olup, özelligi tercihen ayrica, polinükleotit dizilimine uygulanabilir bir sekilde bagli olan bir rek0mbinant düzenleyici dizilim içermesidir. istem 11”deki ifade vektörünü içeren bir konak hücredir. Bir terapötik aktif proteinin serum yari ömrünün artirilmasina yönelik bir yöntem olup, özelligi asagidaki adimlari içermesidir: a) bir terapötik aktif proteinin saglanmasi, burada aktif protein, lL-1Ra veya eksendin-4 veya en az %90 dizilim benzerligi ile buna benzeyen herhangi bir amino asittir; b) bir füzyon proteininin olusturulmasina yönelik SEQ ID NO:20 içeren bir müsin etki alanli polipeptite terapötik aktif proteinin baglanmasi; ve o) bir denege terapötik olarak etkili bir dozun verilmesi sonrasinda füzyon proteininin yari ömrünün ölçülmesi ve yari ömrün, kiyaslanabilir bir terapötik dozda verilmesi durumunda yalnizca ilgili terapötik protein ile karsilastirildiginda iki-kat artmis oldugunun belirlenmesidir. istem 13'deki yöntem olup, özelligi müsin etki alanli polipeptidin, SEQ ID NO: 20'nin en az iki tandem tekrarini içermesidir. Istem 13'deki yöntem olup, özelligi baglama adiminin, aktif proteinin bir amino asit baglayicisi araciligiyla bir müsin etki alanli polipeptide baglanmasini içermesidir. Istemler 1-9'dan herhangi birindeli füzyon proteinini ve en az bir farmasötik olarak kabul edilebilir tasiyici içeren birfarmasötik bilesimdir. 17. Tipta kullanima yönelik istem 16'ya göre birfarmasötik bilesimdir. 18.8iradakiler arasindan seçilen bir hastalik veya bozuklugun tedavi edilmesine yönelik bir yöntemde kullanilmak üzere Istem 17'nin kullanimina yönelik bir farmasötik bilesimdir: tip 2 diyabet, hemofili, nötropeni, anemi, trombositopeni, romatoid artrit, Crohn hastaligi, sedef hastaligi, psoriatik artrit, ankilozan spondilit, osteoartrit.
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TR2018/09046T TR201809046T4 (tr) | 2012-06-08 | 2013-06-06 | Bir müsin etki alanlı polipeptide bağlı bir aktif protein içeren füzyon polipeptitleri. |
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