US20130323222A1 - Human tissue kallikrein 1 glycosylation isoforms - Google Patents

Human tissue kallikrein 1 glycosylation isoforms Download PDF

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US20130323222A1
US20130323222A1 US13/909,220 US201313909220A US2013323222A1 US 20130323222 A1 US20130323222 A1 US 20130323222A1 US 201313909220 A US201313909220 A US 201313909220A US 2013323222 A1 US2013323222 A1 US 2013323222A1
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klk1
composition
polypeptide
seq
amino acid
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Matthew Charles
Tadeusz Kolodka
Mark Williams
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Diamedica Therapeutics Inc
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Assigned to DIAMEDICA, INC. reassignment DIAMEDICA, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: KOLODKA, TADEUSZ, WILLIAMS, MARK, CHARLES, MATTHEW
Publication of US20130323222A1 publication Critical patent/US20130323222A1/en
Priority to US14/677,122 priority patent/US9364521B2/en
Priority to US15/153,126 priority patent/US9839678B2/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/43—Enzymes; Proenzymes; Derivatives thereof
    • A61K38/46—Hydrolases (3)
    • A61K38/48—Hydrolases (3) acting on peptide bonds (3.4)
    • A61K38/482—Serine endopeptidases (3.4.21)
    • A61K38/4853—Kallikrein (3.4.21.34 or 3.4.21.35)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
    • A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N9/00—Enzymes; Proenzymes; Compositions thereof; Processes for preparing, activating, inhibiting, separating or purifying enzymes
    • C12N9/14—Hydrolases (3)
    • C12N9/48—Hydrolases (3) acting on peptide bonds (3.4)
    • C12N9/50—Proteinases, e.g. Endopeptidases (3.4.21-3.4.25)
    • C12N9/64—Proteinases, e.g. Endopeptidases (3.4.21-3.4.25) derived from animal tissue
    • C12N9/6421—Proteinases, e.g. Endopeptidases (3.4.21-3.4.25) derived from animal tissue from mammals
    • C12N9/6424—Serine endopeptidases (3.4.21)
    • C12N9/6445—Kallikreins (3.4.21.34; 3.4.21.35)
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N9/00—Enzymes; Proenzymes; Compositions thereof; Processes for preparing, activating, inhibiting, separating or purifying enzymes
    • C12N9/96—Stabilising an enzyme by forming an adduct or a composition; Forming enzyme conjugates
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12Y—ENZYMES
    • C12Y304/00—Hydrolases acting on peptide bonds, i.e. peptidases (3.4)
    • C12Y304/21—Serine endopeptidases (3.4.21)
    • C12Y304/21035—Tissue kallikrein (3.4.21.35)

Definitions

  • Diabetes mellitus or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.
  • diabetes mellitus can cause many complications. Acute complications include diabetic ketoacidosis and nonketotic hyperosmolar coma. Serious long-term complications include cardiovascular disease, chronic renal failure, diabetic retinopathy, and diabetic neuropathy. The adequate treatment of diabetes is thus important and there is a need for improved therapies for the treatment of diabetes.
  • the present invention includes a composition, comprising a first tissue kallikrein-1 (KLK1) polypeptide and a second tissue kallikrein-1 (KLK1) polypeptide:
  • first KLK1 polypeptide has three glycans attached at three different positions per polypeptide and the second KLK1 polypeptide has two glycans attached at two different positions per polypeptide;
  • first KLK1 polypeptide and the second KLK1 polypeptides are present in the composition in a ratio ranging from about 45:55 to about 55:45.
  • one or more of said glycans are N-linked glycans. In some aspects, one or more of the glycans are attached at amino acid residues 78, 84, or 141 of KLK1 as defined by SEQ ID NO:1. In some aspects, the three glycans of the first KLK1 polypeptide are N-linked glycans at residues 78, 84, and 141. In some aspects, the two glycans of the second KLK1 polypeptide are N-linked glycans at residues 78 and 84 but not 141. In some aspects, the ratio of first KLK1 polypeptide and the second KLK1 polypeptide in the composition is about 50:50.
  • the present invention includes a composition including a triple glycosylated isoform of a tissue kallikrein-1 (KLK1) polypeptide and a double glycosylated isoform of a tissue kallikrein-1 (KLK1) polypeptide, wherein the triple glycosylated isoform of the KLK1 polypeptide and the double glycosylated isoform of the KLK1 polypeptide are present in the composition in a ratio ranging from about 45:55 to about 55:45.
  • the triple glycosylated isoform includes N-linked glycans at amino acid residues 78, 84, and 141 of KLK1, as defined by SEQ ID NO:l.
  • the double glycosylated isoform includes N-linked glycans at amino acid residues 78 and 84, but not at amino acid residue 141 of KLK1, as defined by SEQ ID NO:1.
  • the triple glycosylated isoform and the double glycosylated isoform of KLK1 are present in the composition in a ratio of about 50:50.
  • one or more KLK1 polypeptide(s) is a human tissue kallikrein-1 (hKLK1) polypeptide.
  • one or more KLK1 polypeptide(s) includes amino acid residues 78-141 of SEQ ID NO:1 or amino acids residues 78-141 SEQ ID NO:2.
  • one or more KLK1 polypeptide(s) includes amino acid residues 25-262 of SEQ ID NO:1 or amino acid residues 25-262 of SEQ ID NO:2.
  • one or more KLK1 polypeptide(s) includes an amino acid sequence having at least about 95% sequence identity to SEQ ID NO:1 or SEQ ID NO:2.
  • one or more KLK1 polypeptide(s) includes an amino acid sequence having at least about 95% sequence identity to amino acid residues 25-262 of SEQ ID NO:1 or SEQ ID NO:2.
  • one or more KLK1 polypeptide(s) includes an amino acid sequence having at least about 95% sequence identity to amino acid residues 25-262 of SEQ ID NO:2, and wherein said KLK1 polypeptide(s) comprises E145 and/or A188.
  • one or more KLK1 polypeptide(s) includes an amino acid sequence having at least about 95% sequence identity to amino acid residues 25-262 of SEQ ID NO:2, and said KLK1 polypeptide(s) comprises Q145 and/or V188.
  • the KLK1 polypeptide(s) has SEQ ID NO:1 or SEQ ID NO:2.
  • the KLK1 polypeptide(s) has residues 25-262 of SEQ ID NO:1 or SEQ ID NO:2.
  • composition further includes a pharmaceutically acceptable diluent, adjuvant, or carrier.
  • composition is substantially free of other glycosylated isoforms (glycoforms) of KLK1.
  • the composition has endotoxin levels of less than about 1 EU/mg protein, host cell protein of less than about 100 ng/mg total protein, host cell DNA of less than about 10 pg/mg total protein, and/or is substantially free of aggregates (greater than about 95% appearing as a single peak by SEC HPLC).
  • the present invention also includes a device including a composition as described herein, wherein the device is suitable for delivering the composition subcutaneously.
  • the device is a syringe.
  • the syringe further includes a hypodermic needle assembly attached to the syringe.
  • the syringe further includes a protective cover around the needle assembly.
  • the syringe has a needle that is about 1 ⁇ 2 inch to about 5 ⁇ 8 of an inch in length and has a gauge of about 25 to about 31.
  • the present invention includes methods of treating a subject in need thereof, including administering to the subject a composition as described herein.
  • administration is subcutaneous administration.
  • the subject has established type 1 diabetes (T1D) or type 2 diabetes (T2D).
  • T1D type 1 diabetes
  • T2D type 2 diabetes
  • insulin resistance pre-diabetes
  • diabetes impaired glucose tolerance
  • impaired glucose metabolism hyperglycemia
  • hyperinsulinaemia hyperinsulinaemia
  • syndrome X syndrome X
  • the subject has latent autoimmune diabetes of adults (LADA).
  • the subject is also treated with a diabetes drug.
  • the diabetes drug is insulin or an incretin mimetic.
  • an element means one element or more than one element.
  • FIG. 1 is an SDS-PAGE gel stained with Coomassie Blue stain of various amounts of recombinant human KLK1 purified from CHO or 293 cell lines following transient transfection.
  • Lane 1 is a pre-stained protein ladder, the molecular weights of the standards are written on the side (in kDa).
  • Lanes 2-5 have KLK1 purified from CHO cells (lane 2-14 ⁇ g protein; lane 3-7 ⁇ g protein; lane 4-3.5 ⁇ g protein; lane 5-1.35 ⁇ g protein).
  • Lane 6 has 14 ⁇ l of KLK1 protein purified from transient transfection of 293 cells.
  • FIG. 2 is a Western blot stained with mouse anti-human KLK1 polyclonal antibodies of various amounts of recombinant human KLK1 purified from CHO or 293 cell lines following transient transfection.
  • Lanes 1 and 6 are loaded with a pre-stained protein ladder, the molecular weights of the standards are written on the side (in kDa).
  • Lanes 2-5 have KLK1 purified from CHO cells (lane 2-5 ⁇ l protein; lane 3-2.5 ⁇ l protein; lane 4-1.25 ⁇ l protein).
  • Lane 5 has 2.5 ⁇ l of KLK1 protein purified from transient transfection of 293 cells.
  • FIG. 3 is chromatogram results.
  • FIG. 3A is a chromatogram depicting the A280 absorbance of various elution fractions from the Octyl Sepharose hydrophobic interaction resin used to separate the low and high molecular weight recombinant human KLK1 glycoforms.
  • FIG. 3B is an enlargement of the peak shown in FIG. 3A .
  • ⁇ represents protein concentration (measured at A280);
  • ⁇ represents % elution buffer;
  • ⁇ represents % loading buffer/wash buffer; and
  • ⁇ represents pH of solution leaving column.
  • FIG. 4 is an SDS-PAGE of samples from the elution fractions from the Octyl Sepharose hydrophobic interaction resin used to separate the low and high molecular weight recombinant human KLK1 isomers.
  • FIG. 5 is chromatogram results.
  • FIG. 5A is a chromatogram of RP-HPLC analysis of human KLK1 isolated from CHO cells depicting the mixture of low- and high molecular weight glycoforms (approximate ratio 45:55) of hKLK1.
  • FIG. 5B is a chromatogram of RP-HPLC analysis of Fraction B11 (High molecular weight human KLK1 glycoform).
  • FIG. 5C is a chromatogram of RP-HPLC analysis of Fraction B5 (Low molecular weight human KLK1 glycoform).
  • FIG. 6 is a chromatogram of RP-HPLC analysis of human KLK1 isolated from CHO cells depicting an approximate 50:50 mixture of low- and high molecular weight glycoforms of hKLK1.
  • FIG. 7 is a graph of the glucose infusion rate in Sprague-Dawley rat during a hyperinsulinemic-euglycemic clamp, following administration of HU KLK1, rhKLK1, low molecular weight or high molecular weight KLK1 glycoforms.
  • FIG. 8 is a graph of the area under the curve (AUC) of the glucose infusion rate in FIG. 7 .
  • the present invention provides compositions of tissue kallikrein-1 (KLK1) polypeptide glycoforms of defined ratios of double and triple glycosylated KLK1 polypeptides for use in the treatment of diabetes. Surprisingly, these compositions are more effective in the treatment and control of diabetes than naturally occurring compositions of KLK1.
  • KLK1 tissue kallikrein-1
  • Tissue kallikreins are members of a gene super family of serine proteases comprising at least 15 separate and distinct proteins (named tissue kallikrein 1 through 15) (Yousef et al., 2001, Endocrine Rev; 22:184-204). Tissue kallikrein-1 is produced predominantly in the pancreas, hence the origin of the name from the Greek term ‘kallikrein.’ It is also produced in the salivary glands and kidneys and is found in the urogenital tract and in skeletal muscle.
  • Tissue kallikrein-1 is also known as KLK1, pancreatic/renal kallikrein, glandular kallikrein 1, kallikrein serine protease 1, kallikrein 1, renal kallikrein, renal/pancreas/salivary kallikrein, kidney/pancreas/salivary gland kallikrein.
  • tissue kallikrein-1 and “KLK1” are synonymous.
  • Tissue kallikrein-1 is a trypsin-like serine protease.
  • tissue kallikrein-1 cleaves kininogen into lysyl-bradykinin (also known as kallidin), a decapeptide kinin having physiologic effects similar to those of bradykinin.
  • Bradykinin is a peptide that causes blood vessels to dilate and therefore causes blood pressure to lower.
  • Kallidin is identical to bradykinin with an additional lysine residue added at the N-terminal end and signals through the bradykinin receptor.
  • the KLK1 gene encodes a single pre-pro-enzyme that is 262 amino acid residues in length and that includes the “pre-” sequence (residues 1-18) and the “pro-” sequence (residues 19-24), which is activated by trypsin-like enzymes.
  • the mature and active form human KLK1 is a glycoprotein of 238 amino acid residues (residues 25-262) with a molecular weight of 26 kDa and a theoretical pl of 4.6.
  • KLK1 has five disulphide bonds in its tertiary structure that are believed to be responsible for the protein's high stability, both against trypsin digestion and heat inactivation.
  • tissue kallikrein-1 is available for a wide variety of species, including, but not limited to, human (SEQ ID NO:1 and SWQ ID NO:2), mouse (see, for example, GenBank: AAA39349.1, Feb. 1, 1994); domestic cat (see, for example, NCBI Reference Sequence: XP — 003997527.1, Nov. 6, 2012); gorilla (see, for example, NCBI Reference Sequence: XP — 004061305.1, Dec. 3, 2012); cattle (see, for example, GenBank: AAI51559.1, Aug. 2, 2007); dog (see, for example, CBI Reference Sequence: NP — 001003262.1, Feb.
  • KLK1 is functionally conserved across species in its capacity to release the vasoactive peptide, Lys-bradykinin, from low molecular weight kininogen.
  • a tissue kallikrein-1 polypeptide of the present invention may have any of the known amino acid sequences for KLK1, or a fragment or variant thereof.
  • tissue kallikrein-1 polypeptide is a human tissue kallikrein-1 (hKLK1), including, but not limited to, a hKLK1 polypeptide represented by SEQ ID NO:1 or SEQ ID NO:2.
  • hKLK1 may be represented by the amino acid sequence of GenBank Ref. NP — 002248.1, having the complete KLK1 preproprotein amino acid sequence shown below:
  • the preproprotien includes a presumptive 17-amino acid signal peptide, a 7-amino acid proenzyme fragment and a 238-amino
  • a second amino acid sequence for human KLK1 is represented by SEQ ID NO:2, shown below:
  • the preproprotien includes a presumptive 17-amino acid signal peptide, a 7-amino acid proenzyme fragment and a 238-a
  • SEQ ID NO:1 A comparison between SEQ ID NO:1 and SEQ ID NO:2 shows two amino acid differences between the two hKLK1 amino acid sequences.
  • Single-nucleotide polymorphism (SNP's) between the two individuals within a species account for an E to Q substitution at amino acid residue 145 of 262 and an A to V substitution at position 188 of 262.
  • SEQ ID NO:1 has an E (glutamic acid) at position 145 and an A (alanine) at position 188
  • SEQ ID NO:2 has a Q (glutamine) at position 145 and a V (valine) at position 188.
  • a KLK1 polypeptide of the present invention may have an E at position 145; may have a Q at position 145; may have an A at position 188; may have an A at position 188; may have an E at position 145 and an A at position 188; may have a Q at position 145 and a V at position 188; may have an Q at position 145 and an A at position 188; or may have an E at position 145 and a V at position 188.
  • a tissue kallikrein-1 polypeptide may include residues 1-262, residues 19-262, or residues 25-262 of a kallikrein preproprotein sequence, including, but not limited to human KLK1 having SEQ ID NO:1 or SEQ ID NO:2, and fragments and variants thereof. Fragments and variants of a KLK1 polypeptide retain the enzymatic capacity to release the vasoactive peptide, Lys-bradykinin, from low molecular weight kininogen.
  • an active variant or fragment retains serine protease activity of a KLK1 polypeptide that releases kallidin from a higher molecular weight precursor such as kininogen, or that cleaves a substrate similar to kininogen such as D-val-leu-arg-7 amido-4-trifluoromethylcoumarin to release a colorimetric or fluorometric fragment.
  • a “variant” of a starting or reference polypeptide is a polypeptide that has an amino acid sequence different from that of the starting or reference polypeptide. Such variants include, for example, deletions from, insertions into, and/or substitutions of residues within the amino acid sequence of the polypeptide of interest.
  • a variant amino acid in this context, refers to an amino acid different from the amino acid at the corresponding position in a starting or reference polypeptide sequence. Any combination of deletion, insertion, and substitution may be made to arrive at the final variant or mutant construct, provided that the final construct possesses the desired functional characteristics.
  • the amino acid changes also may alter post-translational processes of the polypeptide, such as changing the number or position of glycosylation sites.
  • a polypeptide variant may have at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 98.5%, at least about 99%, or at least about 99.5% amino acid identity with a reference sequence, such as, for example, an amino acid sequence described herein.
  • a KLK1 polypeptide has at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 98.5%, at least about 99%, or at least about 99.5% amino acid identity to SEQ ID NO:1, or to a fragment of SEQ ID NO:1, such as for example, residues 25-262 or residues 78-141 of SEQ ID NO:l.
  • Such a KLK1 polypeptide may have an E or a Q at amino acid residue 145, and/or an A or a V at position 188.
  • a KLK1 polypeptide has at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 98.5%, at least about 99%, or at least about 99.5% amino acid identity to SEQ ID NO:2, or to a fragment of SEQ ID NO:2, such as for example, residues 25-262 or residues 78-141 of SEQ ID NO:2.
  • Such a KLK1 polypeptide may have an E or a Q at amino acid residue 145, and/or an A or a V at position 188.
  • Percent (%) amino acid sequence identity with respect to a polypeptide is defined as the percentage of amino acid residues in a candidate sequence that are identical with the amino acid residues in the reference sequence, after aligning the sequences and introducing gaps, if necessary, to achieve the maximum percent sequence identity, and not considering any conservative substitutions as part of the sequence identity. Alignment for purposes of determining percent amino acid sequence identity can be achieved in various ways that are within the skill in the art, for instance, using publicly available computer software such as BLAST, BLAST-2, ALIGN, or Megalign (DNASTAR) software. Those skilled in the art can determine appropriate parameters for measuring alignment, including any algorithms needed to achieve maximal alignment over the full length of the sequences being compared. The ALIGN-2 program is publicly available through Genentech, Inc., South San Francisco, Calif.
  • % amino acid sequence identity of a given amino acid sequence A to, with, or against a given amino acid sequence B can be calculated as follows:
  • Variants may also include sequences added to the reference polypeptide to facilitate purification, to improve metabolic half-life or to make the polypeptide easier to identify, for example, an Fc region, a His-tag, and/or a PEGylation sequence.
  • fragment includes smaller portions of a KLK1 polypeptide that retain the activity of a KLK1 polypeptide. Fragments includes, for example, a KLK1 polypeptide fragment that ranges in size from about 20 to about 50, about 20 to about 100, about 20 to about 150, about 20 to about 200, or about 20 to about 250 amino acids in length. In other embodiments, a KLK1 polypeptide fragment ranges in size from about 50 to about 100, about 50 to about 150, about 50 to about 200, or about 50 to about 250 amino acids in length.
  • a KLK1 polypeptide fragment ranges in size from about 100 to about 150, about 100 to about 200, about 100 to about 250, about 150 to about 175, about 150 to about 200, or about 150 to about 250 amino acids in length. In other illustrative embodiments, a KLK1 polypeptide fragment ranges in size from about 200 to about 250 amino acids in length. Certain embodiments comprise a polypeptide fragment of a full-length KLK1 of about, up to about, or at least about 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160, 170, 180, 190, 200, 210, 220, 230, 240, 250 or more (e.g., contiguous) amino acid residues. In some embodiments, a fragment may have residues 25-262 or residues 78-141 of a preproprotein sequence. In some embodiments, a fragment may be any such fragment size, as described above, of SEQ D NO:1 or SEQ ID NO:2.
  • a “wild type” or “reference” sequence or the sequence of a “wild type” or “reference” protein/polypeptide may be the reference sequence from which variant polypeptides are derived through the introduction of changes.
  • the “wild type” amino acid sequence for a given protein is the sequence that is most common in nature.
  • a “wild type” gene sequence is the polynucleotide sequence for that gene which is most commonly found in nature. Mutations may be introduced into a “wild type” gene (and thus the protein it encodes) either through natural processes or through human induced means.
  • KLK1 polypeptides and mixtures described herein may be prepared by any suitable procedure known to those of skill in the art, including recombinant techniques.
  • KLK1 may be prepared by a procedure including one or more of the steps of: preparing a construct comprising a polynucleotide sequence that encodes a rhKLK1 and that is operably linked to a regulatory element; introducing the construct into a host cell; culturing the host cell to express the rhKLK1; and isolating the rhKLK1 from the host cell.
  • the construct and expression system may be such that the mature or active rhKLK1 is expressed from the host cell.
  • the rhKLK1 may be expressed in an inactive form, such as a propeptide, and the rhKLK1 serine protease activity may be activated (for example, by removing the “pro” sequence) after the rhKLK1 is isolated form the host cell.
  • an inactive form such as a propeptide
  • the rhKLK1 serine protease activity may be activated (for example, by removing the “pro” sequence) after the rhKLK1 is isolated form the host cell.
  • a nucleotide sequence encoding the polypeptide, or a functional equivalent may be inserted into appropriate expression vector, i.e., a vector which contains the necessary elements for the transcription and translation of the inserted coding sequence.
  • appropriate expression vector i.e., a vector which contains the necessary elements for the transcription and translation of the inserted coding sequence.
  • a variety of expression vector/host systems are known and may be utilized to contain and express polynucleotide sequences. These include, but are not limited to, microorganisms such as bacteria transformed with recombinant bacteriophage, plasmid, or cosmid DNA expression vectors; yeast transformed with yeast expression vectors; insect cell systems infected with virus expression vectors (e.g., baculovirus); plant cell systems transformed with virus expression vectors (e.g., cauliflower mosaic virus, CaMV; tobacco mosaic virus, TMV) or with bacterial expression vectors (e.g., Ti or pBR322 plasmids); or animal cell systems, including mammalian cell systems.
  • microorganisms such as bacteria transformed with recombinant bacteriophage, plasmid, or cosmid DNA expression vectors
  • yeast transformed with yeast expression vectors insect cell systems infected with virus expression vectors (e.g., baculovirus)
  • plant cell systems transformed with virus expression vectors e.g
  • a non-mammalian cell expression system such as bacteria
  • a process would need to be used to add glycan groups to the rhKLK1, such as genetically engineered cells that express the enzymes required for mammalian style glycosylation.
  • a number of viral-based expression systems are generally available.
  • sequences encoding a polypeptide of interest may be ligated into an adenovirus transcription/translation complex consisting of the late promoter and tripartite leader sequence. Insertion in a non-essential E1 or E3 region of the viral genome may be used to obtain a viable virus which is capable of expressing the polypeptide in infected host cells (Logan and Shenk, 1984, PNAS USA; 81:3655-3659).
  • transcription enhancers such as the Rous sarcoma virus (RSV) enhancer, may be used to increase expression in mammalian host cells.
  • RSV Rous sarcoma virus
  • Examples of useful mammalian host cell lines include monkey kidney CV1 line transformed by SV40 (COS-7, ATCC CRL 1651); human embryonic kidney line (293 or 293 cells sub-cloned for growth in suspension culture, Graham et al., 1977, J Gen Virol; 36:59); baby hamster kidney cells (BHK, ATCC CCL 10); mouse sertoli cells (TM4, Mather, 1980, Biol Reprod; 23:243-251); monkey kidney cells (CV1 ATCC CCL 70); African green monkey kidney cells (VERO-76, ATCC CRL-1587); human cervical carcinoma cells (HELA, ATCC CCL 2); canine kidney cells (MDCK, ATCC CCL 34); buffalo rat liver cells (BRL 3A, ATCC CRL 1442); human lung cells (W138, ATCC CCL 75); human liver cells (Hep G2, HB 8065); mouse mammary tumor (MMT 060562, ATCC CCL51); TR1 cells (Mather et al., 1982, Annals NY Ac
  • CHO Chinese hamster ovary
  • DHFR-CHO cells Urlaub et al., 1980, PNAS USA; 77:4216
  • myeloma cell lines such as NSO and Sp2/0.
  • KLK1 polypeptide products of cell culture expression in vertebrate (e.g., mammalian and avian) cells may be further characterized by freedom from association with human proteins or other contaminants, which may be associated with KLK1 in its natural mammalian cellular environment or in extracellular fluids such as plasma or urine.
  • Polypeptides of the invention may also include an initial methionine amino acid residue (at position-1).
  • Certain embodiments therefore include host cells (e.g., eukaryotic host cells such as CHO cells, 293 cells) that comprise a recombinant or introduced polynucleotide that encodes a KLK1 polypeptide described herein, such as the polypeptide of SEQ ID NO:1 or SEQ ID NO:2. Also included are host cells that comprise a polynucleotide that encodes recombinant (e.g., non-naturally occurring) KLK-1 polypeptide described herein, such as the polypeptide of SEQ ID NO:1 or SEQ ID NO:2.
  • host cells e.g., eukaryotic host cells such as CHO cells, 293 cells
  • host cells that comprise a polynucleotide that encodes recombinant (e.g., non-naturally occurring) KLK-1 polypeptide described herein, such as the polypeptide of SEQ ID NO:1 or SEQ ID NO:2.
  • the cell culture expressed KLK1 polypeptides of the present invention may be isolated and purified by using, e.g., chromatographic separations or immunological separations involving monoclonal and/or polyclonal antibody preparations, or using inhibitors or substrates of serine proteases for affinity chromatography.
  • the amino acid sequences of SEQ ID NO:1 and SEQ ID NO:2 list the sequence for pre-pro KLK1. If the gene coding for either of these sequences is expressed in mammalian cells, the 17-amino acid signal peptide (residues 1-18) should result in the KLK1 polypeptide to be secreted by the cell, and the signal peptide removed by the cell.
  • a gene encoding KLK1 may be generated in which the signal sequence is omitted or replaced with another sequence.
  • the 7 amino acid pro-sequence (residues 19-24) will inhibit the serine protease activity of the KLK1 and may be removed to allow activity of the mature KLK1 polypeptide.
  • the pro-sequence may be removed after the KLK1 polypeptide is isolated, for example by exposing the pro-KLK1 to trypsin under conditions that will allow cleavage of the pro-sequence, or by generating a gene encoding KLK1 in which the pro-sequence omitted or replaced with another sequence.
  • KLK1 polypeptides described herein may be “labeled” by covalent association with a detectable marker substance (such as, for example, radiolabels such as I 125 or P 32 and nonisotopic labels such as biotin) to provide reagents useful in detection and quantification of KLK1 in solid tissue and fluid samples such as blood or urine.
  • a detectable marker substance such as, for example, radiolabels such as I 125 or P 32 and nonisotopic labels such as biotin
  • rhKLK1 polypeptides may be produced by direct peptide synthesis using solid-phase techniques (see, for example, Merrifield, 1963, J Am Chem Soc; 85:2149-2154). Protein synthesis may be performed using manual techniques or by automation. Automated synthesis may be achieved, for example, using Applied Biosystems 431A
  • RNA polymerase RNA polymerase
  • ribosomes tRNA and ribonucleotides
  • these reagents may be produced by extraction from cells or from a cell-based expression system.
  • a process may also be employed to add mammalian style, N-linked glycan groups at position 78 and 84 to generate the (double glycosylated) and at position 78, 84 and 141 to generate the high-(triple glycosylated) molecular weight glycoforms of the rhKLK1 polypeptide.
  • the present invention relates to compositions of various tissue kallikrein-1 (KLK1) polypeptide glycoforms, including compositions that comprise defined ratios of double and triple glycosylated KLK1 polypeptides and related methods of use.
  • KLK1 tissue kallikrein-1
  • tissue kallikrein-1 indicates that there are three potential Asn-linked (N-linked) glycosylation sites on the polypeptide, at amino acid positions 78, 84, and 141 (relative to the intact preproprotein amino acid sequence shown, for example, in SEQ ID NO:1), as well as putative O-linked glycosylation sites.
  • KLK1 is present in circulation only in small quantities, found in the serum at 3.5+/ ⁇ 0.4 ng/mL (Chao and Chao, 1996, Hypertension; 27:491-494).
  • a major route of elimination of KLK1 from the human body is through the kidneys.
  • Tissue kallikrein-1 isolated from human urine appears on a SDS PAGE gel as two bands, a low-molecular weight glycoform and a high-molecular weight glycoform.
  • Human urinary kallikrein (HU KLK) contains approximately 30% carbohydrate content based on the molecular weight estimated by sodium dodecyl sulphate (SDS) polyacrylamide gel electrophoresis.
  • Human kallikrein has three potential Asn-linked (N-linked) glycosylation sites at position 78, 84, and 141. On closer analysis, it has been determined that human urinary KLK1 is completely glycosylated at positions 78 and 84, but is only partially glycosylated at position 144, with only 60% glycosylation at position 141 (see WO/1989/000192). O-linked glycosylation is not detected in naturally occurring KLK1.
  • rhKLK1 recombinant human KLK1 expressed from CHO cells, detects a similar glycosylation pattern as in urine sourced human KLK1, that is, 40% of the polypeptides demonstrated N-linked glycosylation at only two positions, positions 78 and 84, and 60% of the polypeptides demonstrated N-linked glycosylation at all three positions, positions 78, 84, and 141 (Lu et al., 1996, Protein Expression and Purification; 8:227-237).
  • the only known ratio for the low-molecular weight glycoform KLK1 to high-molecular weight glycoforms of rhKLK1 is 40:60 (low:high).
  • glycoform refers to various isoforms of KLK1 that differ with respect to the number or type of attached glycan groups (i.e., carbohydrates, polysaccharides, oligosaccharides, or glycosylation groups).
  • KLK1 polypeptides glycosylated at only two of three available positions are detected as a low molecular weight band and are referred to herein as the low-molecular weight, double glycosylated glycoform of KLK1 (or as “low” or “double” KLK1).
  • KLK1 polypeptides glycosylated at all three positions are detected as the high molecular weight band and are referred to herein as the high-molecular weight, triple glycosylated glycoform of KLK1 (or “high” or “triple” KLK1).
  • the present invention includes compositions of a first tissue kallikrein-1 polypeptide and a second tissue kallikrein-1 polypeptide, wherein the first tissue kallikrein-1 polypeptide has three glycans attached at the three different positions available for glycosylation in the polypeptide and the second tissue kallikrein-1 polypeptide has two glycans attached at only two of the three different positions available for glycosylation in the polypeptide, and wherein the first and second rhKLK1 polypeptides are present in a ratio ranging from about 45:55 to about 55:45 (high:low).
  • a ratio of high molecular weight glycoforms to low molecular weight glycoforms is about 50:50.
  • the ratio is not about 60:40 (high:low).
  • the ratio is not about 40:60 (high:low).
  • the ratios of the double and triple glycosylated isoforms of KLK1 may be detected and quantitated by a variety of methods, including high performance liquid chromatography (HPLC), which may include reversed phase (RP-HPLC), lectin affinity chromatography and lectin affinity electrophoresis.
  • HPLC high performance liquid chromatography
  • RP-HPLC reversed phase
  • lectin affinity chromatography lectin affinity electrophoresis
  • the ratio of low- (double glycosylated) and high-(triple glycosylated) molecular weight glycoforms of KLK1 is about 50:50 (low:high). In other embodiments, the ratio is between about 45:55 and about 55:45 including, for example, about 46:54, about 47:53, about 48:52, about 49:51, about 51:49, about 52:48, about 53:47, and about 54:46, including all integers and decimal points in between.
  • Embodiments of the present invention include compositions that comprise a recombinant KLK1 (rKLK1) polypeptide, and those that comprise a nucleic acid encoding a rKLK1 polypeptide, and mixtures of such rKLK1 polypeptide glycoforms.
  • the KLK1 polypeptide is a recombinant human polypeptide.
  • Recombinant human KLK1 (rhKLK1) can provide certain advantages over other sources of KLK1, such as urinary KLK1 (e.g., human KLK1 isolated from human urine), including a homogenous preparation of rhKLK1, simpler regulatory path to licensure, and options to alter the amino acid sequence or glycosylation pattern based on cell culture conditions.
  • recombinant human KLK1 is may be expressed as a pro-KLK1 wherein the KLK1 is attached to the pro-peptide.
  • the pro-peptide may be removed prior to separation of the low- and high- molecular weight glycoforms, or the low- and high- molecular weight glycoforms of pro-KLK1 may be separated, and then digested to release the pro-peptide and thus generate the active KLK1.
  • Pro-KLK1 may be activated by trypsin digestion, or other enzymes.
  • a variant of KLK1 may be expressed that does not encode the pro-sequence, or encodes a pro-sequence that is cleaved by enzymes in the cell, thus generating an active KLK1.
  • a vector encoding KLK1 may be introduced into a cell line, and a variety of clones expressing recombinant KLK1 may be screened to determine the ratio of low- and high- molecular weight glycoforms of KLK1 that are expressed.
  • a cell line that expresses the desired ratio of low- and high- molecular weight glycoforms of KLK1 may then be chosen.
  • a cell line may not express the desired ratio of low and high molecular weight glycoforms of KLK1, but the cell culture conditions may be manipulated until the cell line expresses low- and high- molecular weight glycoforms of KLK1 at desired ratio.
  • Several techniques are known in the art to manipulate cell culture conditions such that the glycosylation of proteins is altered, such as the addition of certain sugars or other nutrients, levels of dissolved oxygen, etc.
  • One exemplary article for manipulating cell culture conditions to affect changes in glycosylation is described by Devasahayam, 2007, Indian J Med Res; 126:22-27.
  • purified kallikrein or prokallikrein preparation may be separated into two different glycoforms by benzamidine—Sepharose chromatography.
  • the benzamidine-coupled affinity column exhibits differential binding affinity to the two glycoforms.
  • High-molecular-weight kallikrein is loosely bound to the affinity column and can be eluted with an isocratic elution using 50 mM NaCl in the elution buffer, while low-molecular- weight kallikrein binds more tightly to the benzamidine column and may be eluted by 2 M GdnHCl in 10 mM Tris-HCl buffer at pH 7.6.
  • benzamidine—Sepharose separation of high- and low-molecular-weight kallikreins may be performed using partially purified kallikrein preparation.
  • the steps described above for purification of recombinant kallikrein may be followed to isolate a specific ratio of KLK1 glycoforms.
  • the column wash conditions may be altered such that some of the high molecular weight KLK1 is eluted and not retained prior to elution of the remaining KLK1, resulting in a 50:50 mixture of glycoforms following column purification.
  • the elution conditions may be manipulated such that a fraction of the high molecular weight KLK1 is retained on the column, resulting in a 50:50 mixture of glycoforms following column purification.
  • Hydrophobic interaction chromatography using an octyl Sepharose column may also be used to isolate high- and low-molecular-weight prokallikreins.
  • octyl Sepharose can selectively bind prokallikrein obtained from a partially purified prokallikrein preparation. Under such conditions, the unbound, residual kallikrein in the preparation elutes in the column flow-through fraction.
  • High-molecular-weight prokallikrein in the preparation displays a weaker binding to the hydrophobic interaction column and is eluted by an isocratic elution using 1 M ammonium sulfate.
  • Low-molecular- weight prokallikrein which exhibits a stronger binding to the column may be subsequently eluted by a reverse linear gradient from 1.0 to 0 M ammonium sulfate.
  • the column wash conditions may be altered such that some of the high molecular weight KLK1 is eluted and not retained prior to elution of the remaining KLK1, resulting in a 45:55 to 55:45 mixture of glycoforms following column purification.
  • the elution conditions may be manipulated such that a fraction of the high molecular weight KLK1 is retained on the column, resulting in a 45:55 to 55:45 mixture of glycoforms following column purification.
  • the glycoforms may be isolated by reverse phase HPLC.
  • the glycoforms may be isolated by size exclusion chromatography may be employed, and preferably this separation may be employed on solutions wherein the KLK1 is either partially or substantially purified from the cell medium.
  • the glycoforms are separated under non-reducing or non-denaturing conditions to allow the KLK1 to maintain the internal disulfide bonds.
  • Another technique that could be employed is separation based on charge or hydrophobicity.
  • the third glycosylated group that distinguished the low- and high molecular weight glycoforms of KLK1 would result in the higher molecular weight glycoform being more hydrophilic.
  • the two glycoforms would differ in isoelectric point due to additional sialic acid on the carbohydrate moiety.
  • the glycoforms can be recombined to generate the desired ratio.
  • either the low- or high-molecular weight glycoform of KLK1 may be added to a pre-existing mixture of KLK1 glycoforms until the desired ratio is achieved.
  • an amount of low molecular weight KLK1 glycoform may be added until the mixture reaches 55:45.
  • additional high molecular weight KLK1 may be added to achieve a 45:55 ratio.
  • compositions of the present invention may include, but are not limited to, determination so endotoxin, host cell protein, host cell DNA, and/or percentage single peak purity by SEC HPLC.
  • HCPs host cell proteins
  • the host cells used for recombinant expression may range from bacteria and yeast to cell lines derived from mammalian or insect species.
  • the cells contain hundreds to thousands of host cell proteins (HCPs) and other biomolecules that could contaminate the final product.
  • the HCP may be secreted along with the protein of interest, or released by accidental lysing of the cells, and may contaminate the protein of interest.
  • Two types of immunological methods may be applied to HCP analysis: Western blotting (WB) and immunoassay (IA), which includes techniques such as ELISA and sandwich immunoassay or similar methods using radioactive, luminescent, or fluorescent reporting labels.
  • Compositions of the present invention may include host cell protein of less than about 500, less than about 400, less than about 300, less than about 200, less than about 100 or less than about 50 ng/mg total protein.
  • compositions of the present invention may include host cell deoxyribonucleic acid (DNA) of less than about 100, less than about 90, less than about 80, less than about 70, less than about 60, less than about 50, less than about 40, less than about 30, less than about 20, or less than about 10 pg/mg total protein.
  • DNA host cell deoxyribonucleic acid
  • Endotoxin testing Endotoxin is extremely potent, is heat stable, passes sterilizing membrane filters and is present everywhere bacteria are or have been present.
  • An Endotoxin Unit (EU) is a unit of biological activity of the USP Reference Endotoxin Standard.
  • the bacterial endotoxins test is a test to detect or quantify endotoxins from Gram-negative bacteria using amoebocyte lysate (white blood cells) from the horseshoe crab ( Limulus polyphemus or Tachypleus tridentatus ). Limulus amebocyte lysate (LAL) reagent, FDA approved, is used for all USP endotoxin tests.
  • Method A the gel-clot technique, which is based on gel formation
  • Method B the turbidimetric technique, based on the development of turbidity after cleavage of an endogenous substrate
  • Method C the chromogenic technique, based on the development of color after cleavage of a synthetic peptide-chromogen complex.
  • Photometric tests require a spectrophotometer, endotoxin-specific software and printout capability.
  • the simplest photometric system is a handheld unit employing a single-use LAL cartridge that contains dried, pre-calibrated reagents; there is no need for liquid reagents or standards.
  • the FDA-approved unit is marketed under the name of Endosafe®-PTSTM. The device requires about 15 minutes to analyze small amounts of sample, a 25 ⁇ L aliquot from CSP diluted in a sterile tube, and to print out results.
  • gel-clot methods require a dry-heat block, calibrated pipettes and thermometer, vortex mixer, freeze-dried LAL reagents, LAL Reagent Water (LRW) for hydrating reagents and depyrogenated glassware.
  • diluted sample and liquid reagents require about an hour for sample and positive- control preparation and an hour's incubation in a heat block; results are recorded manually.
  • LRW LAL Reagent Water
  • SEC Size-exclusion chromatography
  • the “purity” of a KLK1 polypeptide in a composition may be specifically defined.
  • certain compositions may include a hKLK1 polypeptide that is at least about 80, at least about 85, at least about 90, at least about 91, at least about 92, at least about 93, at least about 94, at least about 95, at least about 96, at least about 97, at least about 98, at least about 99, or 100% pure, including all decimals in between, as measured, for example and by no means limiting, by high pressure liquid chromatography (HPLC), a well-known form of column chromatography used frequently in biochemistry and analytical chemistry to separate, identify, and quantify compounds.
  • HPLC high pressure liquid chromatography
  • compositions are also substantially free of aggregates (greater than about 95% appearing as a single peak by SEC HPLC). Certain embodiments are free of aggregates with greater than about 96%, about 97%, about 98%, or about 99%, appearing as a single peak by SEC HPLC.
  • the rhKLK1 low- or high- molecular weight glycoform, or mixture of glycoforms may have one or more of the following determinations of purity: less than about 1 EU endotoxin/mg protein, less that about 100 ng host cell protein/mg protein, less than about 10 pg host cell DNA/mg protein, and/or greater than about 95% single peak purity by SEC HPLC.
  • KLK1 is a serine protease which cleaves low-molecular-weight kininogen resulting in the release of kallidin (lys-bradykinin)
  • This protease activity of isolated KLK1 glycoforms may be measured in an enzyme activity assay by measuring either the cleavage of low-molecular-weight kininogen, or the generation of lys-bradykinin.
  • an enzyme activity assay In one assay format, a labeled substrate is reacted with the KLK1 glycoform, and the release of a labeled fragment is detected.
  • D-val- leu-arg-7 amido-4-trifluoromethylcoumarin D-VLR-AFC, FW 597.6 (Sigma, Cat #V2888 or Ana Spec Inc Cat #24137).
  • D-VLR-AFC D-val- leu-arg-7 amido-4-trifluoromethylcoumarin
  • fluorometric detection excitation 400 nm, emission 505 nm
  • Other methods and substrates may also be used to measure KLK1 glycoform proteolytic activity.
  • KLK1 activity measured in Units or Units/ml, may be determined by comparing the relative activity of a KLK1 sample to the porcine kininogenase standard acquired from the National Institute for Biological Standards and Control (NIBSC Product No. 78/543).
  • the assigned potency is 22.5 international units (IU) per 20 ⁇ g ampoule of porcine pancreatic kininogenase.
  • serial dilutions are made of the standard, and the activity in an unknown sample of KLK1 is compared to the standard.
  • the rhKLK1 glycoforms or mixtures had specific activities of approximately 200 to 450 IU/mg, though specific activities of certain lots may be outside this range.
  • the specific activity of rhKLK1 may vary from lot to lot, and thus would need to be checked to determine the dosage in mg/kg or total mg of rhKLK1 to administer to an animal or patient.
  • Animal based assays may also be used to determine the activity of hKLK1 glycoforms, including stimulating the uptake of glucose from the circulation in an animal.
  • the KLK1 glycoform may be administered to an animal that is responsive to KLK1, such as Sprague-Dawley rat, and glucose uptake by the tissues determined by an hyperinsulinemic-euglycemic clamp. Results of such animal based assays may be difficult to quantitate. As such, results from animal testing may be used in a qualitative manner such as comparing glycoforms to determine if certain glycoforms or mixtures have more or less activity compared to other glycoforms/mixtures.
  • the present invention also includes pharmaceutical compositions including a therapeutically effective amount of mixture of KLK1 glycosylated isoforms described herein, and a pharmaceutically acceptable diluent, adjuvant or carrier.
  • Such pharmaceutical compositions may be formulated with pharmaceutically acceptable carriers or excipients, for instance, to optimize stability and achieve isotonicity.
  • a composition (e.g., pharmaceutical composition) comprises a KLK1 polypeptide in combination with a physiologically acceptable carrier.
  • Such carriers include pharmaceutically acceptable carriers, excipients, or stabilizers which are nontoxic to the cell or mammal being exposed thereto at the dosages and concentrations employed. Methods of formulation are well known in the art and are disclosed, for example, in Remington: The Science and Practice of Pharmacy, Mack Publishing Company, Easton, Pa., Edition 21 (2005).
  • physiologically-acceptable or “pharmaceutically-acceptable” refers to molecular entities and compositions that do not produce a significant allergic or similar untoward reaction when administered to a human.
  • compositions are prepared as injectables, either as liquid solutions or suspensions; solid forms suitable for solution in, or suspension in, liquid prior to injection can also be prepared.
  • the preparations can also be emulsified.
  • carrier includes any and all solvents, dispersion media, vehicles, coatings, diluents, isotonic and absorption delaying agents, buffers, carrier solutions, suspensions, colloids, and the like. Except insofar as any conventional media or agent is incompatible with the active ingredient, its use in the therapeutic compositions is contemplated.
  • the KLK1 compositions described herein may be formulated for administered by a variety of techniques, including, for example, subcutaneous, intravenous, oral, rectal, transmucosal, transdermal, intestinal, parenteral, intramuscular, intramedullary, intrathecal, direct intraventricular, intraperitoneal, intranasal, and intraocular administration, among others.
  • Some embodiments include administration by subcutaneous infection.
  • a subcutaneous injection (abbreviated as SC, SQ, sub-cu, sub-Q or subcut with SQ being the preferred abbreviation) can be administered as a bolus into the subcutis, the layer of skin directly below the dermis and epidermis, collectively referred to as the cutis.
  • SC subcutaneous injection
  • Exemplary places on the body where people can inject SC most easily include, without limitation, the outer area of the upper arm, just above and below the waist, excepting in certain aspects the area right around the navel (a ⁇ 2-inch circle), the upper area of the buttock, just behind the hip bone, and the front of the thigh, midway to the outer side, about 4 inches below the top of the thigh to about 4 inches above the knee. These areas can vary with the size of the person. Also, changing the injection site can prevent lumps or small dents called lipodystrophies from forming in the skin.
  • Subcutaneous injections usually go into the fatty tissue below the skin and in certain instances can utilize a smaller, shorter needle.
  • a needle that is about 1 ⁇ 2 inch to about 5 ⁇ 8 of an inch in length with a gauge of about 25 to about 31 is sufficient to subcutaneously administer the medication.
  • SC injections may be administered with needles of other sizes.
  • SC administration is performed by pinching-up on the tissue to prevent injection into the muscle, and/or insertion of the needle at a ⁇ 45° angle to the skin.
  • Intramuscular injection is injection into the substance of a muscle, usually the muscle of the upper arm, thigh, or buttock. Intramuscular injections are given when the substance is to be absorbed quickly. They should be given with extreme care, especially in the buttock, because the sciatic nerve may be injured or a large blood vessel may be entered if the injection is not made correctly into the upper, outer quadrant of the buttock.
  • the deltoid muscle at the shoulder is also used, but less commonly than the gluteus muscle of the buttock; care must be taken to insert the needle in the center, 2 cm below the acromion. Injections into the anterolateral aspect of the thigh are considered the safest because there is less danger of damage to a major blood vessel or nerve.
  • the needle should be long enough to insure that the medication is injected deep into the muscle tissue. As a general rule, not more than 5 ml is given in an intramuscular injection for an adult. The needle is inserted at a 90-degree angle
  • Intraperitoneal injections are not commonly performed in human patients due to discomfort, and are administered to obtain systemic blood levels of the agent; faster than subcutaneous or intramuscular injection and used when veins not accessible.
  • the needle is introduced into the upper flank and the syringe plunger withdrawn to ensure that intestine has not been penetrated.
  • the injected solution should run freely.
  • Intravitreal (intraocular) injections are injections into the eye and a small volume of injection is essential for these types of injections to avoid hypertension in the eye.
  • the site of injection is usually inferotemporal for ease of access.
  • Some retina specialists will do the injection in the superotemporal quadrant, as they feel that should a complication such as a retinal detachment form, it can be easier treated with a pneumatic retinopexy.
  • Intracerebral injection is an injection into the cerebellum or brain. Such injections would require a small injection volume to avoid localized hypertension that may result in damage to neuronal tissue.
  • Intraspinal (intrathecal) injection is the injection of a substance through the theca of the spinal cord into the subarachnoid space.
  • KLK1 glycoform mixtures will depend on various factors, including the disease to be treated, other medications that the patient is taking, etc. Dosing of KLK1 is also dependent on the specific activity of the KLK1 protein. Dosages of KLK1 are administered based on the number of units, which are converted into mg of protein. KLK1 is a serine protease which cleaves low-molecular- weight kininogen resulting in the release of kallidin (lys-bradykinin) This activity of KLK1 may be measured in an enzyme activity assay described above, or other methods and substrates may also be used to measure KLK1 proteolytic activity.
  • a KLK1 mixture of glycoforms is subcutaneously administered at a dose of at least about 200 ⁇ g/kg (0.20 mg/kg), or in range of about 20 ⁇ g/kg to about 5000 ⁇ g/kg (0.02 to 5.0 mg/kg).
  • rhKLK1 is administered at a dose of about 200 ⁇ g/kg into a 90 kg patient, then a total of about 18.0 mg of KLK1 would be required. If the KLK1 is formulated at 5 mg/mL, then a total of about 3.6 mL would be injected, which is a large volume and could cause discomfort if injected subcutaneously. However, if the KLK1 is formulated at 25 mg/mL, the total injection volume is 0.72 mL, which is within the recommended injection volume for subcutaneous delivery of 1.0 to 1.5 mL.
  • KLK1 is formulated at 25 mg/mL, the injection volume is about 1.8 mL, which is above the recommended volume for subcutaneous injection. If the KLK1 is formulated at 50 mg/mL, the injection volume is about 0.9 mL or within the tolerable limit for subcutaneous injection into a human.
  • a composition of the present invention may include one or more additional therapeutic modalities.
  • the administration of a composition of the present disclosure may allow for the effectiveness of a lower dosage of other therapeutic modalities when compared to the administration of the other therapeutic modalities alone, providing relief from the toxicity observed with the administration of higher doses of the other modalities.
  • One or more additional therapeutic agents may be administered before, after, and/or coincident to the administration of agents of the present disclosure.
  • Agents of the present disclosure and additional therapeutic agents may be administered separately or as part of a mixture of cocktail.
  • an additional therapeutic agent may include, for example, an agent whose use for the treatment of diabetes is known to the skilled artisan.
  • a KLK1 compositions as described herein may also be administered in combination with other drugs.
  • a KLK1 composition described herein may be used to treat a patient with diabetes such as type 1 diabetes or type 2 diabetes and the subject many be administered a KLK composition and a known diabetes drug, known in the art to be useful in the treatment or prevention of insulin resistance and diabetes.
  • diabetes drugs include, for example, an antioxidant (such as vitamin E, vitamin C, an isoflavone, zinc, selenium, ebselen, or a carotenoid); an insulin or insulin analogue (such as regular insulin, lente insulin, semilente insulin, ultralente insulin, detemir, glargine, degludec, NPH or Humalog); an ⁇ -adrenergic receptor antagonist (such as prazosin, doxazocin, phenoxybenzamine, terazosin, phentolamine, rauwolscine, yohimbine, tolazoline, tamsulosin, or terazosin); a ⁇ -adrenergic receptor antagonist (such as acebutolol, atenolol, betaxolol, bisoprolol, carteolol, esmolol, metoprolol, nadolol, penbutolol, pin
  • the present invention includes methods of treating a subject in need thereof, comprising administering to the subject an effective amount of a composition as described herein.
  • the subject has established type 1 diabetes (T1D) or type 2 diabetes (T2D).
  • T1D type 1 diabetes
  • T2D type 2 diabetes
  • the subject is in the honeymoon phase, with the recent onset or diagnosis of type 1 diabetes T1D.
  • the honeymoon, or remission phase refers to the period following initial diagnosis when the remaining insulin producing beta cells are functioning well. During this honeymoon, it is easier to control blood sugars, with fewer swings, less risk for hypoglycemia, and lower overall average blood-sugar levels.
  • the honeymoon period in type I diabetic patients is characterized by the preserved B cell function.
  • the subject in the honeymoon phase or recent onset of T1D has about 10-20% of their pancreatic beta cells relative to a healthy control and produces insulin.
  • the subject does not have type 1 diabetes (T1D) but is at risk for developing T1D.
  • the subject has latent autoimmune diabetes of adults (LADA).
  • Type 2 diabetes (T2D) as used herein is a disease characterized by above normal levels of blood glucose. T2D may be caused by insufficient production of insulin in the subject or the subject being resistant to the action of insulin (insulin resistant). Administration of the compositions described herein to a subject with T2D may aid in moderating blood glucose levels.
  • a therapeutically effective amount of a KLK1 composition includes an amount that lowers fasting glucose, increases glucose tolerance, or other indicator in a subject with diabetes.
  • a therapeutically effective dose is the amount of KLK1 glycoform composition that treats or delay the onset of type I diabetes without adverse side effects on blood pressure and heart rate.
  • the subject has an ischemic condition.
  • ischemic condition Non-limiting examples include cardiac ischemia (myocardial ischemia), ischemic colitis, brain ischemia (ischemic stroke), limb ischemia, and cutaneous ischemia. These and related medical conditions can be diagnosed according to routine techniques in the art.
  • compositions of the present disclosure can be administered by any suitable means including, but not limited to, for example, oral, rectal, nasal, topical (including, for example, transdermal, aerosol, buccal and sublingual), vaginal, parenteral (including, for example, subcutaneous, intramuscular, intravenous, intradermal, intravesical, intraperitoneal, intravitreal, intraocular, or intracerebral, intraspinal).
  • parenteral including, for example, subcutaneous, intramuscular, intravenous, intradermal, intravesical, intraperitoneal, intravitreal, intraocular, or intracerebral, intraspinal.
  • the present invention also includes devices that contain a composition described herein, including devices suitable for subcutaneous delivery.
  • the device is a syringe.
  • the syringe is attached to a hypodermic needle assembly, optionally comprising a protective cover around the needle assembly.
  • the needle may be about 1 ⁇ 2 inch to about 5 ⁇ 8 of an inch in length and has a gauge of about 25 to about 31. Certain embodiments thus include devices that attached or attachable to a needle assembly that is suitable for subcutaneous administration, comprising a KLK1 glycoform mixture-based composition described herein.
  • certain devices include a vial or syringe, optionally where the vial or syringe is attachable to or is attached to a hypodermic needle assembly. Also included are vials having a rubber cap, where a needle/syringe can be inserted into the vial via the rubber cap to withdraw the KLK1-based composition for subcutaneous administration.
  • the device is a syringe that is attachable or attached to a hypodermic needle, and is packaged with one or more removable and/or permanent protective covers around the needle or needle assembly.
  • a first removable protective cover (which is removed during administration) can protect a user or other person from the needle prior to administration, and a second protective cover can be put (i.e., snapped) into place for safe disposal of the device after administration.
  • a device optionally a disposable device, comprises an individual dose of a KLK1 of at least about 25 mg, or in the range of about 2 to about 500 mg. In some embodiments, the device comprises a dose of at least about 0.02 to about 5.0 mg/kg, at least about 0.02 to about 10 mg/kg.
  • the device comprises a dose of at least about 0.02, about 0.03, about 0.04, about 0.05, about 0.06, about 0.07, about 0.08, about 0.09, about 0.1, about 0.2, about 0.3, about 0.4, about 0.5, about 0.6, about 0.7, about 0.8, about 0.9, about 1.0, about 1.1, about 1.2, about 1.3, about 1.4, about 1.5, about 1.6, about 1.7, about 1.8, about 1.9, about 2.0, about 2.1,about 2.2, about 2.3, about 2.4,about 2.5, about 2.6, about 2.7, about 2.8, about 2.9, about 3.0, about 3.1, about 3.2, about 3.3, about 3.4, about 3.5, about 3.6,about 3.7, about 3.8, about 3.9, about 4.0, about 4.1, about 4.2, about 4.3, about 4.4, about 4.5, about 4.6, about 4.7, about 4.8, about 4.9, or about 5.0 mg/kg.
  • the KLK1 composition may be packaged to allow administration by the patient or to the patient in a home setting on a daily basis, several times a week, weekly basis, or less frequently.
  • a KLK1 composition may be formulated in a multi-dose vial or a multi-dose/multiuse syringe, similar to formulations of insulin or human growth hormone.
  • an amount sufficient for at least 2 administrations may be in a vial (for example, 50 mg, or in the range of about 5 to 1000 mg), and a needle and syringe are used to draw the required amount of KLK1 from the vial and inject into a patient.
  • a multi-dose or multiuse syringe contains an amount of KLK1 sufficient for at least 2 administrations (for example, 50 mg, or in the range of about 5 to 1000 mg), and the volume that may be injected may be determined by the patient.
  • the multi-dose syringe may also have a replaceable cartridge that may be loaded into the syringe that contains additional amounts of KLK1 composition.
  • KLK1 glycoform mixture of a defined ratio is effective in treating a patient, either in terms of the amount (number of units administered to a patient) of KLK1 glycoform administered or the frequency of administration.
  • markers are described as examples in treating patients with T1D, and are not intended to be an exhaustive list.
  • An effective dose of KLK1 glycoform may increase the numbers of T-regulatory cells in the spleen, specifically CD4+/CD25+/FoxP3+ cells in the spleen of subject with T1D.
  • Another endpoint to determine the effective dose is an improvement in a hyperinsulinemic-euglycemic clamp test, as observed and described herein below.
  • Another endpoint to determine the effective dose is a decreases in insulitis, which measured by pancreatic biopsies, or other non-invasive procedures in humans.
  • insulitis which measured by pancreatic biopsies, or other non-invasive procedures in humans.
  • other markers may be measured to determine if a dose of KLK1 glycoform or mixture thereof is effective in treating the disease.
  • the KLK1 glycoforms mixture composition is administered to the subject parameters are measured such as a decrease in glycated hemoglobin (HbAlc) decrease in fasting blood glucose levels. Other parameters may also be measured to determine if the dose of rhKLK1 glycoform mixtures is effective in treating T2D.
  • HbAlc glycated hemoglobin
  • the dosage amount of KLK1 glycoform or mixtures can be increased or decreased, merely by way of example, by about 1.1 ⁇ , 1.2 ⁇ , 1.3 ⁇ , 1.4 ⁇ , 1.5 ⁇ , 1.6 ⁇ , 1.7 ⁇ , 1.8 ⁇ , 1.9 ⁇ , 2 ⁇ , 2.5 ⁇ , 3 ⁇ , 3.5 ⁇ , 4 ⁇ , 4.5 ⁇ , 5 ⁇ , 6 ⁇ , 7 ⁇ , 8 ⁇ , 9 ⁇ , 10 ⁇ , 15 ⁇ , 20 ⁇ or more, relative to the previous dosage.
  • the dosage frequency can be increased or decreased, merely by way of illustration, by about 1, 2, 3, 4, 5 or more dosages per day, and/or 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more dosages per week, relative to the previous dosing schedule.
  • the dosage amount can be increased or decreased separately or in combination with the dosage frequency, and vice versa, optionally until a desired level or range of one or more biomarkers or other treatment indicators is achieved.
  • a composition of the present invention may be endotoxin free or substantially endotoxin free.
  • endotoxin free or “substantially endotoxin free” relates generally to compositions, solvents, devices, and/or vessels that contain at most trace amounts (e.g., amounts having no clinically adverse physiological effects to a subject) of endotoxin, and preferably undetectable amounts of endotoxin.
  • Endotoxins are toxins associated with certain bacteria, typically gram-negative bacteria, although endotoxins may be found in gram-positive bacteria, such as Listeria monocytogenes.
  • LPS lipopolysaccharides
  • LOS lipo-oligo-saccharides
  • a depyrogenation oven may be used for this purpose, as temperatures in excess of 300° C. are typically required to break down most endotoxins.
  • a glass temperature of 250° C. and a holding time of 30 minutes is often sufficient to achieve a 3 log reduction in endotoxin levels.
  • Other methods of removing endotoxins are contemplated, including, for example, chromatography and filtration methods, as described herein and known in the art.
  • KLK1 polypeptides in and isolating them from eukaryotic cells such as mammalian cells to reduce, if not eliminate, the risk of endotoxins being present in a composition of the invention.
  • methods of producing KLK1 polypeptides in and isolating them from recombinant cells grown in chemically defined, serum free media are also included.
  • Endotoxins can be detected using routine techniques known in the art.
  • the Limulus Ameobocyte Lysate assay which utilizes blood from the horseshoe crab, is a very sensitive assay for detecting presence of endotoxin.
  • very low levels of LPS can cause detectable coagulation of the limulus lysate due a powerful enzymatic cascade that amplifies this reaction.
  • Endotoxins can also be quantitated by enzyme-linked immunosorbent assay (ELISA).
  • endotoxin levels may be less than about 0.001, 0.005, 0.01, 0.02, 0.03, 0.04, 0.05, 0.06, 0.08, 0.09, 0.1, 0.5, 1.0, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, or 10 EU/ml, or EU/mg protein.
  • 1 ng lipopolysaccharide (LPS) corresponds to about 1-10 EU.
  • modulating and “altering” include “increasing,” “enhancing” or “stimulating,” as well as “decreasing” or “reducing,” typically in a statistically significant or a physiologically significant amount or degree relative to a control.
  • An “increased,” “stimulated” or “enhanced” amount is typically a “statistically significant” amount, and may include an increase that is 1.1, 1.2, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 30 or more times (e.g., 500, 1000 times) (including all integers and decimal points in between and above 1, e.g., 1.5, 1.6, 1.7. 1.8, etc.) the amount or level produced by a control composition, sample or test subject.
  • a “decreased” or “reduced” amount is typically a “statistically significant” amount, and may include a 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or 100% decrease in the amount or level produced a control composition, sample or test subject.
  • the comparison can be between the amount or level of a pharmacokinetic parameter or biological/therapeutic response produced by administration of one mixture of triple:double glycosylated isoforms (or glycoforms) of KLK1 (for example, about 55:45, about 50:50, or about 45:55) relative to administration of a different mixture of such glycoforms (for example, about 60:40, about 40:60, ⁇ 90:10, ⁇ 10:90, ⁇ 95:5, or ⁇ 5:95).
  • the comparison can be between amount or level of a pharmacokinetic parameter or biological/therapeutic response produced by administration of a substantially pure composition of a triple glycosylated isoform (or glycoform) of rhKLK1 (for example, about 90%, about 95% triple glycosylated) relative to administration of a different glycoform (for example, about 90%, about 95% double glycosylated) or a mixture of glycoforms (for example, about 60:40 or about, 40:60).
  • a substantially pure composition of a triple glycosylated isoform (or glycoform) of rhKLK1 for example, about 90%, about 95% triple glycosylated
  • a different glycoform for example, about 90%, about 95% double glycosylated
  • a mixture of glycoforms for example, about 60:40 or about, 40:60.
  • a result is typically referred to as “statistically significant” if it is unlikely to have occurred by chance.
  • the significance level of a test or result relates traditionally to the amount of evidence required to accept that an event is unlikely to have arisen by chance.
  • statistical significance may be defined as the probability of making a decision to reject the null hypothesis when the null hypothesis is actually true (a decision known as a Type I error, or “false positive determination”). This decision is often made using the p-value: if the p-value is less than the significance level, then the null hypothesis is rejected. The smaller the p-value, the more significant the result. Bayes factors may also be utilized to determine statistical significance (see Goodman, Ann Intern Med. 130:1005-13, 1999).
  • solubility refers to the property of a rhKLK1 polypeptide provided herein to dissolve in a liquid solvent and form a homogeneous solution. Solubility is typically expressed as a concentration, either by mass of solute per unit volume of solvent (g of solute per kg of solvent, g per dL (100 mL), mg/ml, etc.), molarity, molality, mole fraction or other similar descriptions of concentration.
  • the maximum equilibrium amount of solute that can dissolve per amount of solvent is the solubility of that solute in that solvent under the specified conditions, including temperature, pressure, pH, and the nature of the solvent.
  • solubility is measured at physiological pH, or other pH, for example, at pH 6.0, pH 7.0, pH 7.4, pH 8.0 or pH 9.0. In certain embodiments, solubility is measured in water or a physiological buffer such as PBS or NaCl (with or without NaP). In specific embodiments, solubility is measured at relatively lower pH (for example, pH 6.0) and relatively higher salt (for example, 500 mM NaCl and 10 mM NaP). In certain embodiments, solubility is measured in a biological fluid (solvent) such as blood or serum. In certain embodiments, the temperature can be about room temperature (for example, about 20, about 21, about 22, about 23, about 24, or about 25° C.) or about body temperature (37° C.).
  • a KLK1 polypeptide has a solubility of at least about 1, at least about 2, at least about 3, at least about 4, at least about 5, at least about 6, at least about 7, at least about 8, at least about 9, at least about 10, at least about 11, at least about 12, at least about 13, at least about 14, at least about 15, at least about 16, at least about 17, at least about 18, at least about 19, at least about 20, at least about 25, at least about 30, at least about 35, at least about 40, at least about 45, at least about 50, or at least about 60 mg/ml at room temperature or at 37° C.
  • substantially or “essentially” means nearly totally or completely, for instance, 95%, 96%, 97%, 98%, 99% or greater of some given quantity.
  • Treatment includes any desirable effect on the symptoms or pathology of a disease or condition, and may include even minimal changes or improvements in one or more measurable markers of the disease or condition being treated. “Treatment” or “treating” does not necessarily indicate complete eradication or cure of the disease or condition, or associated symptoms thereof. The subject receiving this treatment is any subject in need thereof. Exemplary markers of clinical improvement will be apparent to persons skilled in the art.
  • a “subject,” as used herein, includes any animal that exhibits a symptom, or is at risk for exhibiting a symptom, which can be treated with a KLK1 polypeptide or composition of the present invention.
  • Suitable subjects include laboratory animals (such as mouse, rat, rabbit, or guinea pig), farm animals, and domestic animals or pets (such as a cat or dog).
  • Non-human primates and, preferably, human patients, are included.
  • isolated is meant material that is substantially or essentially free from components that normally accompany it in its native state.
  • an “isolated peptide” or an “isolated polypeptide” and the like, as used herein, includes the in vitro isolation and/or purification of a peptide or polypeptide molecule from its natural cellular environment, and from association with other components of the cell; i.e., it is not significantly associated with in vivo substances such as host cell proteins or nucleic acids.
  • the KLK1 cDNA (Catalogue No. SC122623) is a human cDNA open reading frame clone, cloned into the multi-cloning site of OriGene's pCMV6-XL5 vector, between a cytomegalovirus (CMV) promoter to control transcription of cDNA coding for pre-pro-human KLK1 and a polyadenylation signal.
  • CMV cytomegalovirus
  • SEQ ID NO:1 This sequence differed at 2 amino acid residues from the human KLK1 sequence in GenBank as Ref No. NP — 002248.1 (SEQ ID NO:1). As depicted in SEQ ID NO:2, single nucleotide polymorphisms (SNP's) resulted in an E to Q change at amino acid residue 145 of 262, and an A to V change at amino acid position 188 of 262. All subsequent experiments were performed with KLK1 having the amino acid sequence in SEQ ID NO:2.
  • the human KLK1 cDNA in the pCMV6-XL5 was transfected into a CHO cell line using the FreeStyleTM MAX CHO Expression System (Invitrogen, Carlsbad, Calif. Catalog no. K9000-20).
  • the kit allowed for transient transfection of vectors into Chinese Hamster Ovary (CHO) cells, growth of the transfected CHO cells in 10 liter culture, and protein expression in defined, serum-free medium.
  • the CHO cells are grown in suspension and transient transfection of the KLK1 vector was performed with the liposome reagent supplied in the kit as per instructions.
  • activity assay of cell culture supernatant KLK1 involves an activation step with trypsin digestion. Activation is done with trypsin at 10 nM final concentration for 2 hours at room temperature, and the trypsin inactivated with Soybean Trypsin Inhibitor.
  • the purified recombinant human KLK1 contained approximately 30% carbohydrate content based on the molecular weight estimated by sodium dodecyl sulphate (SDS) polyacrylamide gel electrophoresis (see FIG. 1 ).
  • KLK1 from CHO cells appears as a band having an apparent molecular weight of ⁇ 40 to 49 kDa; such a broad band may result from different glycosylated isoforms of KLK1 secreted by CHO cells.
  • SDS sodium dodecyl sulphate
  • the identity of the bands as human KLK1 was confirmed by Western blot analysis using mouse polyclonal antibody raised against a full-length human KLK1 protein (Catalog #: H00003816-B01P, KLK1 purified MaxPab mouse polyclonal antibody (B01P), Abnova Corporation, Walnut, Calif., USA) (see FIG. 2 ).
  • the Western blot confirms the results of the SDS-PAGE gel, in that recombinant human KLK1 from CHO cells appears as a band having an apparent molecular weight of ⁇ 40 to 49 kDa, and KLK1 expressed in 293 cells resolves as two bands at approximately 40 kDa and 45 kDa.
  • KLK1 The purity of KLK1 from CHO was visually estimated from the SDS-PAGE gel to be >90% with a final concentration of 1.19 mg KLK1 protein/ml. From the SDS-PAGE gel, it appears CHO produced KLK1 also contains higher molecular weight impurities ( ⁇ 70-95 kDa) that are not visible in the 293 preparation.
  • An enzyme activity assay was used to test for activity of recombinant human KLK1 in cell culture supernatants, chromatography fractions during purification and in the final purified product.
  • One fluorogenic substrate suitable for tissue kallikrein measurement of activity is D-val-leu-arg-7 amido-4-trifluoromethylcoumarin (D-VLR-AFC, FW 597.6) (Sigma, Cat # V2888 or Ana Spec Inc Cat #24137).
  • D-VLR-AFC D-val-leu-arg-7 amido-4-trifluoromethylcoumarin
  • the measurement of recombinant human KLK1 activity (Units/ml) produced in the CHO cells was determined by comparing the relative activity of recombinant KLK1 to the kininogenase porcine standard acquired from the National Institute for Biological Standards and Control (NIBSC Product No. 78/543). For this standard, the assigned potency is 22.5 international units (IU) per 20 ⁇ g ampoule of porcine pancreatic kininogenase.
  • the chromatogram in FIG. 3A (magnified in FIG. 3B ) and the SDS-PAGE analysis in FIG. 4 illustrate that the low molecular weight KLK1 glycoform was isolated from the high molecular glycoform using the Octyl Sepharose column. All fractions were sterile filtered and stored at 2-8° C. pending analysis.
  • RP-HPLC absorbance, activity and reverse phase—high performance liquid chromatography
  • FIG. 5A depicts a mixture of purified rhKLK1 with the low and high molecular weight KLK1 glycoforms at an approximate ratio of 55:45, respectively, and specifically 52% and 47.5% for the high- and low-molecular weight KLK1 glycoforms, respectively, and 0.5% as aggregates.
  • rhKLK1 was also purified from another recombinant CHO cell line that was expressing rhKLK1 glycoforms at approximately a 50:50 ratio (see FIG. 6 ).
  • KLK1 specific activity of KLK1.
  • One fluorogenic substrate suitable for tissue kallikrein-1 measurement of activity is D-val-leu-arg-7 amido-4-trifluoromethylcoumarin (D-VLR-AFC, FW 597.6) (Sigma, Cat # V2888 or Ana Spec Inc Cat #24137).
  • the measurement of the specific activity (Units/mg) for the KLK1 glycoforms and mixtures was determined by comparing the relative activity of KLK1 to the kininogenase porcine standard acquired from the National Institute for Biological Standards and Control (NIBSC Product No. 78/543). For this standard, the assigned potency is 22.5 international units (IU) per 20 ⁇ g ampoule of porcine pancreatic kininogenase. All dosing of rats was based on units of KLK1.
  • HU KLK1 Human urinary (HU) KLK1 purchased from Lee BioSciences (Catalog #: 314-15: CAS: 9001-01-8: Lot #: L23165).
  • HU KLK1 is known to comprise a 60:40 glycoform ratio (high to low molecular weight). According to the product specification from the manufacturer, the HU KLK1 is >99% pure and has a specific activity of 9.9 U/mg. However, this determination of specific activity was with a different assay and under different conditions than the D-VLR-AFC assay described above. Therefore, HU KLK1 was tested in the D-VLR-AFC assay along with the low- and high molecular weight rhKLK1 glycoforms and 50:50 rhKLK1 mixture. The results of the specific activity calculations and the protein concentrations as determined by RP-HPLC or A280 nm are summarized in Table 2 below.
  • rhKLK1 The purity of rhKLK1 (50:50 mixture, B5 and B11 fraction) was relatively low endotoxin to total protein ( ⁇ 1 EU/mg protein), low host cell protein to total protein ( ⁇ 100 ng/mg protein), low host cell DNA to total protein ( ⁇ 10 pg/mg protein), and mostly appeared as a monomer (>95% single peak by SEC HPLC). For HU KLK1 the endotoxin and degree of aggregation were not quantitated.
  • HU KLK1 had endotoxin levels of >1 EU/mg protein, higher than for the rkKLK1 50:50 mixture, B5 and B11 fraction, and a greater degree of aggregation (>5%) than rhKLK1 (50:50 mixture, B5 and B11 fraction), the latter having aggregation levels of ⁇ 5%.
  • Hyperinsulinemic-euglycemic clamp The in vivo activity, and specifically the ability to stimulate glucose uptake by tissues, of the two isolated glycoforms of rhKLK1, the 50:50 mixture of glycoforms and HU KLK1, were determined by a hyperinsulinemic-euglycemic clamp study.
  • the hyperinsulinemic-euglycemic clamp is the gold standard for investigating glucose utilization, including quantifying insulin resistance because it measures the amount of glucose necessary to compensate for an increased insulin level without causing hypoglycemia. Increased glucose infusion rate detected in the clamp may also indicate increased insulin sensitivity, or increased uptake of glucose by muscles, adipocytes, or other tissues in the body.
  • a 120 minute hyperinsulinemic-euglycemic clamp assay was performed on 6 hours fasted Sprague Dawley rats with continuous infusion of human insulin (Humulin, Lilly) at a constant rate of 4 mU/kg/minute. At the same time 20% glucose solution at variable rate was infused and the rate adjusted every 10 minutes to maintain target blood glucose level. Both insulin and glucose were infused through catheterized right jugular vein and blood glucose levels were monitored from the catheterized left carotid artery.
  • FIG. 7 is a graph of the glucose infusion rate (GIR) for rats treated with 1U/rat of rhKLK1 (50:50 mixture), HU KLK1, or the low- or high molecular weight glycoform of rhKLK1.
  • This graph is typical of the GIR graphs in that the GIR increases from time zero and peaks at about 40 to 60 minutes, and then there is a slight decrease in GIR. Further analysis was performed on the glucose infusion rate (GIR) to calculate the area under the curve (AUC), a measure of total glucose infused (mg/kg/min ⁇ min) during the clamp study.
  • GIR glucose infusion rate
  • the rate of glucose infusion required to maintain equal blood glucose level was significantly higher with the groups treated with rhKLK1 (50:50 mixed glycoforms) at 1U/rat than in animals treated with Fraction 11, Fraction 5, or HU KLK1. This difference is evident when the data is calculated a total AUC for the glucose infusion rate (see FIG. 8 and Table 4).
  • the AUC is 3996+/ ⁇ 98 mg/kg/min ⁇ min (Mean+/ ⁇ SEM) and for fraction B5, the AUC is 3551+/ ⁇ 113 mg/kg/min ⁇ min. It was expected that the 50:50 mixture of rhKLK1 would have an intermediate AUC between the low and high molecular weight glycoform.
  • the AUC was 4547+/ ⁇ 69 mg/kg/min ⁇ min.
  • This surprisingly high AUC indicates that the combination of the high and low molecular weight KLK1 has an unexpectedly additive or greater effect on stimulating glucose uptake.
  • the human urinary KLK1 since an equal amount of rhKLK1 and HU KLK1 was administered to the rats based on in vitro activity (Units calculated in the D-VLR-AFC assay), it was expected that the effect on GIR would be the same.
  • the GIR AUC for human urinary KLK1 was 3444+/ ⁇ 227 mg/kg/min ⁇ min, which was significantly less than the 4547+/ ⁇ 69 mg/kg/min ⁇ min calculated for rhKLK1.
  • the 50:50 mixture of rhKLK1 consistently stimulated increased glucose uptake in rats compared to HU KLK1 as measured by an increased AUC GIR.
  • the rhKLK1 50:50 mixture AUC was 4127+/ ⁇ 78 mg/kg/min ⁇ min while HU KLK1 was 2969+/ ⁇ 144 mg/kg/min ⁇ min, and at 0.1 U, rhKLK1 was 3612+/ ⁇ 135 mg/kg/min ⁇ min while HU KLK1 was 2503+/ ⁇ 266 mg/kg/min ⁇ min.
  • KLK1 double glycosylated isoform, triple glycosylated isoform, 50:50 mixture, or HU KLK1
  • a single dose of KLK1 was administered subcutaneously 30 minutes prior to clamp.
  • the protein should be absorbed slowly into circulation relative to IV administration.
  • the animals were tested within 30 minutes of administration of the KLK1 polypeptides. As such, any differences in pK or half-life between the KLK1 polypeptides in circulation should be minimized and any effect on GIR should result from the activity of the administered KLK1.
  • the additional glycosylation may enable the higher molecular weight KLK1 glycoform to bind certain receptors in the animal, which could result in changes in glucose utilization.
  • the high molecular weight glycoform may be more efficient than the low molecular weight glycoform at stimulating a receptor directly, or bind another protein (eg serpin) more efficiently and the complex affects glucose utilization.
  • the high molecular weight glycoform may also bind a receptor more efficiently that the low molecular weight glycoform, and sequester the KLK1 glycoform into a microenvironment where its enzyme activity acts to influence glucose utilization.
  • the additional glycosylation may also allow the high molecular weight KLK1 glycoform to be more active in a physiological environment such as an animal, which is not reflected in the in vitro assays.
  • the 50:50 mixture of glycoforms of rhKLK1 resulted in a greater AUC GIR compared to the high molecular weight glycoform.
  • the expected result is the 50:50 mixed glycoforms would have an activity (as measured by AUC GIR) that is intermediate to the low- and high molecular weight glycoforms.
  • This synergistic effect in the 50:50 mixture is unexpected. Indeed, the AUC GIR was significantly higher with the rats treated with rhKLK1 (50:50 mixture) compared to HU KLK1 (60:40 mixture) at all doses tested (see Table 5).
  • synergy of the 50:50 glycoform mixture in the rats is that the high- and low- molecular weight glycoforms act in slightly different ways (slightly different enzyme activities, or slightly different binding to receptors) in a physiological setting. These slight differences in activities are complementary and thus synergistic when the glycoforms are in a 50:50 mixture.
  • KLK1 may act through several difference mechanisms to influence glucose utilization, such as receptor binding and enzyme activity.
  • the high- and low-molecular weight glycoforms may act in a complementary manner wherein one glycoform has higher enzyme activity in a physiological setting, while the other glycoform has higher binding affinity. Together, such differences result in a synergistic effect in an animal. This synergy or complementarity was not detected at the 60:40 ratio of high- to low-molecular weight KLK1.
  • mice were separated into four groups of ten mice per group, and following an overnight (8 hour) fast, the mice were administered either buffer alone (negative control) or 2 Units, 0.8 Units or 0.04 Units per mouse of rhKLK1 mixture. 90 minutes after administration of rhKLK1, the blood glucose levels in the mice was tested. In negative control animals, the blood glucose levels remained high 220+/ ⁇ 16 mg/dl. Animals receiving 2 Units rhKLK1 had a significant decrease in blood glucose levels to 141+/ ⁇ 9 mg/dl (p ⁇ 0.05) compared to control. Animals receiving 0.8 Units per mouse had a less dramatic but still significant decrease in blood glucose levels to 149+/ ⁇ 14 mg/dl (p ⁇ 0.05) compared to control.
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