US20220378931A1 - Insulin analogs and methods of using the same - Google Patents

Insulin analogs and methods of using the same Download PDF

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US20220378931A1
US20220378931A1 US17/632,173 US202017632173A US2022378931A1 US 20220378931 A1 US20220378931 A1 US 20220378931A1 US 202017632173 A US202017632173 A US 202017632173A US 2022378931 A1 US2022378931 A1 US 2022378931A1
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seq
ins
analog
mutation
amino acid
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Petra Verdino
Stacey Lynn Lee
Michael James Berna, Sr.
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Eli Lilly and Co
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Eli Lilly and Co
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    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
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Definitions

  • the disclosure relates generally to biology and medicine, and more particularly it relates to insulin (INS) analogs, especially long-acting, single-chain INS (SCI) analogs that can bind to an INS receptor (IR), thereby functioning as IR agonists.
  • INS insulin
  • SCI single-chain INS
  • IR INS receptor
  • compositions including the same and their use in treating metabolic conditions, diseases or disorders such as diabetes and obesity.
  • INS is a peptide hormone secreted by pancreatic beta (p) cells that physiologically acts to maintain normal blood glucose levels by facilitating cellular glucose uptake and by concomitantly suppressing hepatic gluconeogenesis, thereby regulating carbohydrate, lipid and protein metabolism. Additionally, INS promotes cell division and growth in a fed state.
  • INS is a heterodimer of two peptide chains of twenty-one and thirty amino acids (A chain and B chain, respectively) linked by two interchain disulfide bonds with the A chain further having one intrachain disulfide bond.
  • INS is produced from its prohormone, proinsulin, by cleaving a C peptide therefrom. See, e.g., De Meyts (2004) Bioessays 26:1351-1362; and Wilcox (2005) Clin. Biochem. Rev. 26:19-39.
  • INS there are six main types of INS including, (1) rapid-acting INS, (2) short-acting (prandial) INS, (3) intermediate-acting INS, (4) long-acting (basal) INS, (5) combination/pre-mixed INS and (6) inhaled INS.
  • Effective INS therapy for individuals having diabetes typically is a combination of two types of exogenous INS formulations—a short-acting (prandial) INS administered at mealtime and a long-acting (basal) INS administered once or twice daily to control blood glucose levels between meals.
  • INS analogs exist having an extended t1 ⁇ 2 when compared to native INS so that they can be administered as long-acting (basal) INS.
  • INS analogs that include INS and variants thereof linked to fatty acid moieties (i.e., acylated) to improve t1 ⁇ 2.
  • U.S. Pat. No. 5,656,722 describes INS analogs that include an Asp21Gly mutation of the A-chain and a carboxy-terminal extension of B-chain by two Arg residues.
  • WO 2005/012347 describes INS analogs that are hexamers resulting from adding hexadecanedioic acid to a Lys at 29 position of the B chain.
  • Duttaroy et al. describes analogs that include human INS linked to human serum albumin to improve t2 (see, Duttaroy et al. (2005) Diabetes 54:251-258).
  • Patent Application Publication No. WO 2016/178905 describe INS analogs that are fusions of the A chain and/or B chain that further include a Fc moiety to improve t1 ⁇ 2.
  • SCI analogs having activity at an IR, which thereby can act as IR agonists.
  • SCI analogs include a basic structure from an amino-terminus (N-terminus) to a carboxy-terminus (C-terminus) of:
  • VHH-L 1 -A-L 2 -B VHH-L 1 -A-L 2 -B
  • VHH-L 1 -B-L 2 -A VHH-L 1 -B-L 2 -A
  • VHH is a moiety acting as a pharmacokinetic enhancer
  • A is an INS A chain
  • B is an INS B chain
  • L 1 is a first linker
  • L 2 is a second linker
  • the VHH moiety can have an amino acid sequence of SEQ ID NO:7, 8 or 9.
  • the VHH moiety can be a variant having one or more additions, deletions, insertions or substitutions such that the VHH moiety has an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NOS:7, 8 or 9.
  • the A chain can have an amino acid sequence of SEQ ID NO:3.
  • the A chain can be a variant having one or more additions, deletions, insertions or substitutions such that the A chain has an amino acid sequence having at least about 90% to about 99% sequence similarity to any one of SEQ ID NO:3.
  • the A chain can include a E4Q mutation, T8H mutation, a Y14E mutation or a N21G mutation of SEQ ID NO:3.
  • the B chain can have an amino acid sequence of SEQ ID NO:4.
  • the B chain can be a variant having one or more additions, deletions, insertions or substitutions such that the B chain has an amino acid sequence having at least about 90% to about 99% sequence similarity to any one of SEQ ID NO:4.
  • the B chain can include a N3D mutation, a N3K mutation, a N3S mutation, a S9A mutation, a Y16E mutation, a Y16F mutation, a Y16H mutation, a Y16R mutation, a Y16W mutation, a E21Q mutation or a F25H mutation of SEQ ID NO:4.
  • L 1 can have an amino acid sequence of (GGGGQ) n (SEQ ID NO:10), (GGGQ) n (SEQ ID NO:11), (GGGGS) n (SEQ ID NO:12), (PGPQ) n (SEQ ID NO:13), (PGPA) n (SEQ ID NO:14), (GGE) n GG (SEQ ID NO:15), (GGGGE) n GGGG (SEQ ID NO:16), (GGGGK) n GGGG (SEQ ID NO:17), GGGG(AP) n GGGG (SEQ ID NO:18), GGGG(EP) n GGGG (SEQ ID NO:19), GGGG(KP) n GGGG (SEQ ID NO:20), (PGPE) n PGPQ (SEQ ID NO:21), (PGPK) n PGPQ (SEQ ID NO:22), where n can be from 1 to 10.
  • L 1 can have an amino acid sequence of any one of SEQ ID NOS:23 to 33.
  • L 1 can be a variant having one or more additions, deletions, insertions or substitutions such that L 1 has an amino acid sequence having at least about 90% to about 99% sequence similarity to any one of SEQ ID NOS:23 to 33.
  • L 2 can have an amino acid sequence of any one of SEQ ID NOS:34 to 36. In other instances, L 2 can be a variant having one or more additions, deletions, insertions or substitutions such that L 2 has an amino acid sequence having at least about 90% to about 99% sequence similarity to any one of SEQ ID NOS:34 to 36.
  • the INS analogs can have an amino acid sequence that includes a VHH of SEQ ID NO:7 or 8; an A chain of SEQ ID NO:3 or a variant thereof, a B chain of SEQ ID NO:4 or a variant thereof, a L 1 of any one of SEQ ID NO:23 to 33 and a L 2 of any one of SEQ ID NO:34 to 36.
  • the INS analogs can have an amino acid sequence having at least about 90% to about 99% sequence similarity to an amino acid sequence that includes a VHH of SEQ ID NO:7 or 8; an A chain of SEQ ID NO:3 or a variant thereof, a B chain of SEQ ID NO:4 of a variant thereof, a L 1 of any one of SEQ ID NOS:23 to 33; and a L 2 of any one of SEQ ID NOS:34 to 36.
  • the INS analogs can have an amino acid sequence of any one of SEQ ID NOS:37 to 81.
  • the INS analogs can have an amino acid sequence having at least about 90% to about 99% sequence similarity to an amino acid sequence of any one of SEQ ID NOS:37 to 81.
  • the VHH moiety can bind serum albumin, especially human serum albumin, and can include a complementarity-determining region 1 (CDR1), a complementarity-determining region 2 (CDR2) and a complementarity-determining region 3 (CDR3), where CDR1 can have an amino acid sequence of SEQ ID NOS:84, 85 or 86, where CDR2 can have an amino acid sequence of SEQ ID NOS:87, 88 or 89, and CDR3 can have an amino acid sequence of SEQ ID NOS:90, 91 or 92.
  • CDR1 can have an amino acid sequence of SEQ ID NOS:84, 85 or 86
  • CDR2 can have an amino acid sequence of SEQ ID NOS:87, 88 or 89
  • CDR3 can have an amino acid sequence of SEQ ID NOS:90, 91 or 92.
  • the VHH moiety can include a CDR1 of SEQ ID NO:84, a CDR2 of SEQ ID NO:87 and a CDR3 of SEQ ID NO:90; a CDR1 of SEQ ID NO:84, a CDR2 of SEQ ID NO:88 and a CDR3 of SEQ ID NO:90; a CDR1 of SEQ ID NO:85, a CDR2 of SEQ ID NO:89 and a CDR3 of SEQ ID NO:91; or a CDR1 of SEQ ID NO:86, a CDR2 of SEQ ID NO:89 and a CDR3 of SEQ ID NO: 92.
  • the INS analogs have a binding affinity at an IR that is comparable to the binding affinity of native, human INS (SEQ ID NOS:3 and 4). In other instances, the INS analogs have a binding affinity at an IR that is greater than that of native, human INS (SEQ ID NOS:3 and 4). In other instances, the INS analogs have a binding affinity at an IR that is weaker than that of native, human INS (SEQ ID NOS:3 and 4).
  • the INS analogs have a t1 ⁇ 2 that is longer than that of native, human INS (SEQ ID NOS:3 and 4), including up to about 20 days to about 30 days longer when administered to a human.
  • compositions above alternatively can be nucleic acid sequences encoding the amino acid sequences herein, as well as vectors and host cells including the same for expressing the VHH moieties or the INS analogs herein.
  • compositions that include an INS analog herein or a pharmaceutically acceptable salt thereof (e.g., trifluroacetate salts, acetate salts or hydrochloride salts) and a pharmaceutically acceptable carrier.
  • the pharmaceutically acceptable carrier is a buffer such as, for example, physiological saline, phosphate-buffered saline, citrate-buffered saline or histidine-buffered saline.
  • the buffer is histidine, a histidine buffer or a histidine-buffered saline.
  • the pharmaceutical compositions further can include carriers, diluents and/or excipients.
  • the pharmaceutical compositions can include at least one additional therapeutic agent such as, for example, an agent used as a standard of care in a metabolic condition, disease or disorder.
  • the at least one additional therapeutic agent can be a dipeptidyl peptidase 4 (DPP-IV) inhibitor, a native amylin or analog thereof, a short-acting (prandial) INS analog, a native incretin or analog thereof, a native insulin-like growth factor (IGF) or analog thereof, metformin, a sodium-glucose co-transporter-2 (SGLT2) inhibitor, a statin, a sulfonylurea (SU), a thiazolidinedione (TZD), and/or other anti-glycemic agent or other anti-obesity agent.
  • DPP-IV dipeptidyl peptidase 4
  • IGF insulin-like growth factor
  • SGLT2 sodium-glucose co-transporter-2
  • statin a statin
  • SU sul
  • the methods include at least a step of administering to an individual in need thereof an effective amount of an INS analog or a pharmaceutically acceptable salt thereof.
  • the INS analog can be administered via any standard route of administration such as, for example, intramuscularly, intravenously, parenterally, subcutaneously or transdermally.
  • the INS analog is administered subcutaneously (SQ), intramuscularly (IM) or intravenously (IV).
  • the INS analog can be administered SQ or IV to the individual.
  • the INS analog can be administered daily, every other day, three times a week, two times a week, one time a week (i.e., weekly), biweekly (i.e., every other week), one time a month (i.e., monthly), bimonthly (i.e., every other month), or even every three months.
  • the INS analog can be administered SQ every other day, SQ three times a week, SQ two times a week, SQ one time a week, SQ every other week, or SQ once a month.
  • the INS analog is administered SQ one time a week (QW).
  • the INS analog can be IV administered to the individual.
  • the INS analog can be administered daily, every other day, three times a week, two times a week, one time a week (i.e., weekly), biweekly (i.e., every other week), or monthly.
  • the INS analog can be administered IV every other day, IV three times a week, IV two times a week, IV one time a week, IV every other week, or IV once a month.
  • the INS analog is administered IV one time a week.
  • the methods also can include a step of administering the INS analog in combination with an effective amount of at least one additional therapeutic agent.
  • the standard of care for many of the conditions/diseases/disorders herein includes a DPP-IV inhibitor, a native amylin or analog thereof, a short-acting (prandial) INS analog, a native incretin or analog thereof, a native IGF or analog thereof, metformin, a SGLT2 inhibitor, a statin, a SU, a TZD, and/or other anti-glycemic agent or other anti-obesity, as well as other therapeutic agents to control comorbidities, including, but not limited to, high cholesterol and high blood pressure.
  • the additional therapeutic agent can be administered simultaneously, separately or sequentially with the INS analog.
  • the additional therapeutic agent can be administered with a frequency the same as the INS analog (i.e., every other day, twice a week, weekly or even monthly). In other instances, the additional therapeutic agent can be administered with a frequency distinct from the INS analog. In other instances, the additional therapeutic agent can be administered SQ or IV. In still other instances, the INS analog is administered SQ, and the additional therapeutic agent can be administered orally or IV. Alternatively, the INS analog is administered IV, and the additional therapeutic agent is administered SQ.
  • the individual is a diabetic and/or obese.
  • the methods also may include steps such as measuring or obtaining blood glucose, HbAlc, cholesterol, triglycerides and/or body weight and comparing such measured/obtained value(s) to one or more baseline values or previously measured/obtained values to assess the effectiveness of treatment/therapy.
  • the methods also may be combined with diet and exercise and/or may be combined with additional therapeutic agents other than those discussed above.
  • the INS analog can be provided for use in therapy, especially in treating metabolic conditions, diseases or disorders, especially diabetes and/or obesity.
  • the INS analog optionally can be administered simultaneously, separately or sequentially (i.e., in combination) with at least one additional therapeutic agent.
  • the INS analog can be provided for use in manufacturing a medicament for treating metabolic conditions, diseases or disorders, where the medicament optionally may further include one or more additional therapeutic agents as noted above.
  • a compound that includes an amino acid sequence of: FVNQHLCGSHLVEALYLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRTVSSTAVAWFRQAPGKEREFVAGIGGSVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAVRPGRPLITSRDANLYDYWGQGTLVTVSS (SEQ ID NO:37).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:37.
  • a compound that includes an amino acid sequence of: FVDQHLCGSHLVEALYLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRTVSSTAVAWFRQAPGKEREFVAGIGGSVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAVRPGRPLITSRDANLYDYWGQGTLVTVSS (SEQ ID NO:38).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:38.
  • a compound that includes an amino acid sequence of: FVNQHLCGAHLVEALYLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLEN YCGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRL SCAASGRTVSSTAVAWFRQAPGKEREFVAGIGGSVDITYYADSVKGRFTISRDNS KNTLYLQMNSLRPEDTAVYYCAVRPGRPLITSRDANLYDYWGQGTLVTVSS (SEQ ID NO:39).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:39.
  • a compound that includes an amino acid sequence of: FVNQHLCGSHLVEALELVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRTVSSTAVAWFRQAPGKEREFVAGIGGSVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAVRPGRPLITSRDANLYDYWGQGTLVTVSS (SEQ ID NO:40).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:40.
  • a compound that includes an amino acid sequence of: FVNQHLCGSHLVEALHLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRTVSSTAVAWFRQAPGKEREFVAGIGGSVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAVRPGRPLITSRDANLYDYWGQGTLVTVSS (SEQ ID NO:41).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:41.
  • a compound that includes an amino acid sequence of: FVNQHLCGSHLVEALYLVCGERGFHYTPKTGGGGGGGIVEQCCTSICSLYQLEN YCGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRL SCAASGRTVSSTAVAWFRQAPGKEREFVAGIGGSVDITYYADSVKGRFTISRDNS KNTLYLQMNSLRPEDTAVYYCAVRPGRPLITSRDANLYDYWGQGTLVTVSS (SEQ ID NO:42).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:42.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALYLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:43).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:43.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALYLVCGERGFHYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:44).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:44.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALYLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:45).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:45.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALHLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:46).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:46.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALHLVCGERGFFYTPKTGGGGGGGIVEQCCHSICSLEQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:47).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:47.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALHLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:48).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:48.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALHLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLEQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:49).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:49.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:50).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:50.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALFLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:51).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:51.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALWLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:52).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:52.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFFYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:53).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:53.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGPGPAPGPAPGPAPGPAPGPAPGPAPGPAPGPAEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:54).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:54.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALYLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGGGGGQGGGGQGGGGQGGQEVQLLESGGGLVQPGGSLRLSCAAS GRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTLY LQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:55).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:55.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALYLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPQPGPQPGPQPGPQPGPQPGPQPGPQEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:56).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:56.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALHLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAAS GRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTLY LQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:57).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:57.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALHLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGPGPQPGPQPGPQPGPQPGPQPGPQPGPQEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:58).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:58.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALHLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLEQLENY CGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAAS GRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTLY LQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:59).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:59.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALHLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLEQLENY CGPGPQPGPQPGPQPGPQPGPQPGPQPGPQEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:60).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:60.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGGGGGQGGGGQGGGGQGGQEVQLLESGGGLVQPGGSLRLSCAAS GRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTLY LQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:61).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:61.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFFYTPKTGGGGGGGIVEQCCTSICSLYQLENY CGPGPQPGPQPGPQPGPQPGPQPGPQPGPQEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:62).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:62.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFFYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAAS GRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTLY LQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:63).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:63.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFFYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGPGPQPGPQPGPQPGPQPGPQPGPQPGPQEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:64).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:64.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAAS GRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTLY LQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:65).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:65.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGPGPQPGPQPGPQPGPQPGPQPGPQPGPQEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:66).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:66.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGGGEGGEGGEGGEGGEGGEGGEGGEVQLLESGGGLVQPGGSLRLSCAASGRYI DETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTLYLQM NSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:67).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:67.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGGGGGEGGGGEGGGGEGGGGEGGGGEVQLLESGGGLVQPGGSLRLSCAASGR YIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTLYLQ MNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:68).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:68.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGGGGGKGGGGKGGGGKGGGGKGGGGEVQLLESGGGLVQPGGSLRLSCAASG RYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTLYL QMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:69).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:69.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGGGGGAPAPAPAPAPAPAPAPGGGGEVQLLESGGGLVQPGGSLRLSCAA SGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTL YLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:70).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:70.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGGGGGEPEPEPEPEPEPEPEPEPEPGGGGEVQLLESGGGLVQPGGSLRLSCAASG RYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTLYL QMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:71).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:71.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGGGGGKPKPKPKPKPKPKPKPKPKPKPKPKPKPKPKPKPGGGGEVQLLESGGGLVQPGGSLRLSCAA SGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTL YLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:72).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:72.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGPGPEPGPEPGPEPGPEPGPEPGPQEVQLLESGGGLVQPGGSLRLSCA ASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNT LYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:73).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:73.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGPGPKPGPKPGPKPGPKPGPKPGPKPGPKPGPQEVQLLESGGGLVQPGGSLRLS CAASGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSK NTLYLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:74).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:74.
  • a compound that includes an amino acid sequence of: FVKQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLEN YCGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAA SGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTL YLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:75).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:75.
  • a compound that includes an amino acid sequence of: FVKQHLCGSHLVEALRLVCGQRGFHYTPKTGGGGGGGIVEQCCHSICSLYQLEN YCGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAA SGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTL YLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:76).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:76.
  • a compound that includes an amino acid sequence of: FVKQHLCGSHLVEALRLVCGQRGFHYTPKTGGGGGGGIVQQCCHSICSLYQLEN YCGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAA SGRYIDETAVAWFRQAPGKEREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTL YLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:77).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:77.
  • a compound that includes an amino acid sequence of: FVSQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLENY CGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAAS GRYIDETAVAWFRQAPGKGREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTL YLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:78).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:78.
  • a compound that includes an amino acid sequence of: FVKQHLCGSHLVEALRLVCGERGFHYTPKTGGGGGGGIVEQCCHSICSLYQLEN YCGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAA SGRYIDETAVAWFRQAPGKGREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTL YLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:79).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:79.
  • a compound that includes an amino acid sequence of: FVKQHLCGSHLVEALRLVCGQRGFHYTPKTGGGGGGGIVEQCCHSICSLYQLEN YCGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAA SGRYIDETAVAWFRQAPGKGREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTL YLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:80).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:80.
  • a compound that includes an amino acid sequence of: FVKQHLCGSHLVEALRLVCGQRGFHYTPKTGGGGGGGIVQQCCHSICSLYQLEN YCGGGGGQGGGGQGGGGQGGGGQEVQLLESGGGLVQPGGSLRLSCAA SGRYIDETAVAWFRQAPGKGREFVAGIGGGVDITYYADSVKGRFTISRDNSKNTL YLQMNSLRPEDTAVYYCAARPGRPLITSKVADLYPYWGQGTLVTVSSPP (SEQ ID NO:81).
  • the compound can have an amino acid sequence having at least about 90% to about 99% sequence similarity to SEQ ID NO:81.
  • INS analogs herein can be chemically or recombinantly synthesized as a single-chain polypeptide (i.e., monomeric) and thus do not require endoproteolytic processing for biological activity. It is contemplated, however, that in some instances, the VHH moiety can be conjugated not only to single-chain INS but also to two-chain INS (e.g., native) as well. On the VHH moiety, one could conjugate not only to the N- and C-terminus but also to any surface-exposed amino acid of the VHH (with the proviso that such conjugation does not entirely abrogate albumin binding by the VHH moiety or IR signaling by the INS moiety).
  • VHH moieties can be used not only with native A chain and B chain sequences but also with modified sequences thereof. Moreover, the VHH moieties may be further modified to have enhanced or additional functionality via other peptide/protein fusions or small molecules being attached to the VHH moieties.
  • VHH moieties provide an extended duration of action in mammals such as humans and can have a t1 ⁇ 2 of about 20 days to about 30 days, thereby allowing for at least weekly or biweekly administration when compared to native, human INS, especially native, human INS (SEQ ID NOS:3 and 4), which can improve compliance.
  • INS analogs herein have similar or better selectivity, affinity and/or potency for an IR when compared to native, human INS (SEQ ID NOS:3 and 4).
  • INS analogs herein have tunable pharmacokinetics achieved by changing albumin affinity of the VHH moieties.
  • INS analogs herein have improved stability in formulation, especially in a preserved formulation, when compared to native, human INS (SEQ ID NOS:3 and 4) or INS analogs not fused with one of the VHH moieties herein.
  • VHH moieties herein have similar binding not only to human serum albumin but also to dog, monkey, mouse, pig and rat serum albumin, which allows for pharmacodynamic, pharmacokinetic and toxicologic studies to more readily translate from these species to humans or among the other species listed above.
  • VHH moieties herein are not only can be used to improve the t1 ⁇ 2 of the INS analogs herein when compared to native, human INS (SEQ ID NOS:3 and 4) but also can be used to improve the t1 ⁇ 2 of other biologically active peptides and proteins such as, for example, growth differentiation factor 15 (GDF-15), glucose-dependent insulinotropic peptide 1 (GLP-1) or relaxin (RLN).
  • GDF-15 growth differentiation factor 15
  • GLP-1 glucose-dependent insulinotropic peptide 1
  • RNN relaxin
  • indefinite article “a” or “an” does not exclude the possibility that more than one element is present, unless the context clearly requires that there be one and only one element.
  • the indefinite article “a” or “an” thus usually means “at least one.”
  • “about” means within a statistically meaningful range of a value or values such as, for example, a stated concentration, length, molecular weight, pH, sequence similarity, time frame, temperature, volume, etc. Such a value or range can be within an order of magnitude typically within 20%, more typically within 10%, and even more typically within 5% of a given value or range. The allowable variation encompassed by “about” will depend upon the particular system under study, and can be readily appreciated by one of skill in the art.
  • activity means a capacity of a compound, such as an INS analog herein, to bind to and induce a response at the receptor(s), as measured using assays known in the art, such as the in vtro assays described below.
  • amino acid means a molecule that, from a chemical standpoint, is characterized by a presence of one or more amine groups and one or more carboxylic acid groups, and may contain other functional groups.
  • amino acids there is a set of twenty amino acids that are designated as standard amino acids and that can be used as building blocks for peptides/proteins produced by any living being.
  • the amino acid sequences in the disclosure contain the standard single letter or three letter codes for the twenty naturally occurring amino acids.
  • analog means a compound, such as a synthetic peptide, polypeptide or protein, that activates a target receptor and that elicits at least one in vivo or in vitro effect elicited by a native agonist for that receptor.
  • agonist means a ligand for a receptor that binds to the receptor and activates the receptor.
  • conservative substitution means a variant of a reference peptide, polypeptide or protein that is identical to the reference molecule, except for having one or more conservative amino acid substitutions in its amino acid sequence.
  • a conservatively modified variant includes an amino acid sequence that is at least about 70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99% identical to a reference amino acid sequence.
  • a conservative substitution refers to substitution of an amino acid with an amino acid having similar characteristics (e.g., charge, side-chain size, hydrophobicity/hydrophilicity, backbone conformation and rigidity, etc.) and having minimal impact on the biological activity of the resulting substituted peptide, polypeptide or protein.
  • Conservative substitutions of functionally similar amino acids are well known in the art and thus need not be exhaustively described herein.
  • an effective amount means an amount or dose of one or more of the INS analogs herein, or a pharmaceutically acceptable salt thereof that, upon single or multiple dose administration to an individual in need thereof, provides a desired effect in such an individual under diagnosis or treatment (i.e., may produce a clinically measurable difference in a condition of the individual such as, for example, reduced blood glucose, reduced HbAlc, reduced cholesterol, reduced triglyceride or reduce body weight).
  • An effective amount can be readily determined by one of skill in the art by using known techniques and by observing results obtained under analogous circumstances.
  • a number of factors are considered, including, but not limited to, the species of mammal, its size, age and general health, the specific disease or disorder involved, the degree of or involvement or the severity of the disease or disorder, the response of the individual, the particular INS analog administered, the mode of administration, the bioavailability characteristics of the preparation administered, the dose regimen selected, the use of concomitant medication, and other relevant circumstances.
  • extended duration of action means that binding and activity for an INS analog herein continues for a period of time greater than a native INS, especially native, human INS (SEQ ID NOS:3 and 4), allowing for dosing at least as infrequently as once daily or even thrice-weekly, twice-weekly or once-weekly.
  • the time action profile of the INS analog may be measured using known pharmacokinetic test methods such as those utilized in the Examples below.
  • half-life means a time it takes for one-half of a quantity of a compound, such as native INS or an INS analog herein, to be removed from a fluid or other physiological space such as serum or plasma of an individual by biological processes.
  • t1 ⁇ 2 also can mean a time it takes for a quantity of such a compound to lose one-half of its pharmacological, physiological or radiological activity.
  • half-maximal effective concentration or “EC 50 ” means a concentration of compound that results in 50% activation/stimulation of an assay endpoint, such as a dose-response curve (e.g., IRS-PI3K-Akt and IRS-Raf/Ras/MEK/MAPK signaling pathways).
  • a dose-response curve e.g., IRS-PI3K-Akt and IRS-Raf/Ras/MEK/MAPK signaling pathways.
  • INS analogs herein either simultaneously, sequentially or in a single combined formulation with one or more additional therapeutic agents.
  • insulin or “INS” means an insulin obtained or derived from any species, such as a mammalian species, especially a human, where the native form is a heterodimeric peptide having two peptide chains (e.g., an A chain and a B chain) connected via two disulfide bonds, and with the A chain further having a single intramolecular disulfide bond.
  • INS processing begins with preproinsulin (SEQ ID NO:1; see also, UniProt/SwissProt Database Accession No.
  • proinsulin includes A chain, B chain and C peptide; native INS has a structure of B-C-A
  • native INS has a structure of B-C-A
  • the sequence of native, human proinsulin is set forth in SEQ ID NO:2.
  • Proinsulin undergoes further processing in which the C peptide is cleaved to arrive at INS.
  • the sequence for the A chain of native, human INS is set forth in SEQ ID NO:3.
  • sequence for the B chain of native, human INS is set forth in SEQ ID NO:4.
  • INS signaling occurs through the IR, which is a homodimer of two ⁇ chains and two ⁇ ( ⁇ ) 2 chains that possess tyrosine kinase activity.
  • the IR has been found, for example, in adipose tissue, brain, erythrocytes, fibroblasts, granulocytes, heart, kidney, monocytes, pulmonary alveoli, pancreatic acini, placenta, vascular endothelium and skeletal muscle.
  • IR-A SEQ ID NO:5; see also, UniProt/SwissProt Database Accession No.
  • IR-B SEQ ID NO:6; see also, UniProt/SwissProt Database Accession No. P06213).
  • tissue expression e.g., Belfiore et al. (2009) Endocr. Rev. 30:586-6923; Benyoucef (2007) Biochem. J. 403:603-613; Frasca (1999) Mol. Cell. Biol. 19:3278-3288; Seino et al. (1989) Proc. Natl. Acad. Sci. USA 86:114-118; and Yamaguchi et al. (1993) Endocrinology 132:1132-1138. Stimulating the IR activates signal transduction networks involving tyrosine kinase, PI3K or Ras.
  • insulin analog or “INS analog” and the like means a compound, such as a peptide or polypeptide, that elicits one or more effects of native INS at an IR but varies in some manner with respect to the amino acid sequence when compared native INS due to one or more additions, deletions, insertions and/or substitutions.
  • INS analog also can include variants of these compounds, which are functionally equivalent to native INS but have sequences that are fragments or are the complete sequence but themselves having further additions, deletions, insertions and/or substitutions.
  • INS analogs herein can bind to the IR with higher or lower affinity but demonstrate a longer t1 ⁇ 2 in vivo or in vitro when compared to native INS, especially a native, human INS (SEQ ID NOS:3 and 4). In this manner, the INS analogs herein are synthetic compounds that act as IR agonists.
  • insulin resistance means a physiological condition where a normal or elevated INS level produces an attenuated biological response in an individual.
  • “individual in need thereof” means a mammal, such as a human, with a condition, disease, disorder or symptom requiring treatment or therapy, including for example, those listed herein.
  • the preferred individual to be treated is a human.
  • long-acting means that binding affinity and activity of an INS analog herein continues for a period of time greater than native, human INS (SEQ ID NOS:3 and 4), allowing for dosing at least as infrequently as once daily or even thrice-weekly, twice-weekly, once-weekly or monthly.
  • the time action profile of the INS analogs herein may be measured using known pharmacokinetic test methods such as those described in the Examples below.
  • non-standard amino acid means an amino acid that may occur naturally in cells but does not participate in peptide synthesis.
  • Non-standard amino acids can be constituents of a peptide and often times are generated by modifying standard amino acids in the peptide, polypeptide or protein (i.e., via post-translational modification).
  • Non-standard amino acids can include D-amino acids, which have an opposite absolute chirality of the standard amino acids above.
  • pharmaceutically acceptable buffer means any of the standard pharmaceutical buffers known to one of skill in the art.
  • sequence similarity means a quantitative property of two or more nucleic acid sequences or amino acid sequences of biological compounds such as, for example, a correspondence over an entire length or a comparison window of the two or more sequences. Sequence similarity can be measured by (1) percent identity or (2) percent similarity. Percent identity measures a percentage of residues identical between two biological compounds divided by the length of the shortest sequence; whereas percent similarity measures identities and, in addition, includes sequence gaps and residue similarity in the evaluation. Methods of and algorithms for determining sequence similarity are well known in the art and thus need not be exhaustively described herein.
  • a specified percentage of identical nucleotide or amino acid positions is at least about 75%, 80%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or higher.
  • single-chain insulin As used herein, “single-chain insulin,” “scINS,” “SCI” and the like means an INS polypeptide where the A and B chains are connected to one another by a non-native linker (i.e., L 2 ) as in A-L 2 -B or B-L 2 -A.
  • SCI can include at least one of the native interchain and/or intrachain disulfide bonds to maintain correct structural folding.
  • two-chain insulin means an INS polypeptide where the A and B chains are connected to one another by one or more interchain and/or intrachain disulfide bonds, but not by any linkers, to maintain correct structural folding, such as a native INS.
  • treating means managing and caring for an individual having a condition, disease, disorder or symptom for which INS analog administration is indicated for the purpose of attenuating, restraining, reversing, slowing or stopping progression or severity of the condition, disease, disorder or symptom.
  • Treating includes administering an INS analog herein or composition containing an INS analog herein to the individual to prevent the onset of symptoms or complications, alleviating the symptoms or complications, or eliminating the condition, disease, disorder or symptom.
  • Treating includes administering an INS analog or composition containing an INS analog herein to the individual to result in such as, for example, reduced blood glucose, reduced HbAlc, reduced cholesterol, reduced triglyceride or reduced body weight.
  • the individual to be treated is a mammal, especially a human.
  • patient As used herein, “patient,” “subject” and “individual,” are used interchangeably herein, and mean a mammal, especially a human. In certain instances, the individual is further characterized with a condition, disease, disorder or symptom that would benefit from administering an INS analog herein.
  • VHH or “VHH moiety” means a form of single-domain antibody, especially an antibody fragment of a single, monomeric variable region of a heavy chain only antibody (HcAb), which has a very small size of about 15 kDa. It has been found herein that VHH moieties can be used as a pharmacokinetic enhancer to extend the duration of action of and/or to improve the t1 ⁇ 2 of the INS analogs herein.
  • the VHH moieties herein bind serum albumin, especially human serum albumin; however, the VHH moieties alternatively can be used to bind IgG (including Fc domain), neonatal Fc receptor (FcRn) or other long-lasting serum proteins.
  • VHH moieties herein are used to improve the t1 ⁇ 2 of INS, they likewise can be used to improve the t1 ⁇ 2 of other biologically active peptides/proteins such as, for example, GDF-15, GLP-1 or RLN.
  • VHH moieties are a single-domain, heavy chain antibody, they have three CDRs, which include residues that form specific interactions with an antigen such as, for example, human serum albumin. Assigning the residues to the various CDRs may be done by algorithms such as, for example, Chothia, IMBT, Kabat or North.
  • the North CDR definition is based on affinity propagation clustering with a large number of crystal structures (North et al. (2011) J. Mol. Bio. 406:228-256).
  • the CDRs are best defined by the sequences listed in the Sequence Listing, which are based upon a combination of multiple definitions including North and Kabat.
  • the VHH moiety at least can include a complementarity-determining region (CDR) 1 (CDR1), a CDR2 and a CDR3, where CDR1 can be one of SEQ ID NOS:84, 85 and 86, where CDR2 can be one of SEQ ID NOS:87, 88 and 89, and CDR3 can be one of SEQ ID NOS:90, 91 and 92.
  • CDR1 can be one of SEQ ID NOS:84, 85 and 86
  • CDR2 can be one of SEQ ID NOS:87, 88 and 89
  • CDR3 can be one of SEQ ID NOS:90, 91 and 92.
  • ACR refers to urine albumin/urine creatinine ratio
  • amu refers to atomic mass unit
  • AUC refers to area under the curve
  • BHI refers to biosynthetic human insulin
  • Boc refers to tert-butoxycarbonyl
  • cAMP refers to cyclic adenosine monophosphate
  • CMV refers to cytomegalovirus
  • DNA refers to deoxyribonucleic acid
  • DMF refers to dimethylformamide
  • DMSO refers to dimethyl sulfoxide
  • EDC refers to 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride
  • EDTA refers to ethylenediaminetetraacetic acid
  • EIA/RIA refers to enzyme immunoassay/radioimmunoassay
  • ETA refers to ethanolamine
  • the INS analogs herein have structural similarities to, but many structural differences, from native, human INS (SEQ ID NOS:3 and 4).
  • the INS analogs herein when compared to native, human INS (SEQ ID NOS:3 and 4), include at least one variation when compared to the amino acids present in native, human INS, include a peptide linker between the A chain and the B chain, and include a pharmacokinetic enhancer such as an albumin-binding VHH moiety.
  • the INS analogs herein result in sufficient activity at an IR and therefore have beneficial attributes relevant to their developability as therapeutic treatments, including improved solubility in aqueous solutions, improved chemical and physical formulation stability, extended pharmacokinetic profile (which can be tuned based upon VHH affinity to serum albumin), and minimized potential for immunogenicity.
  • the INS analogs herein include an amino acid sequence from the amino-terminus to the carboxy-terminus having one of the following structures:
  • VHH-L 1 -A-L 2 -B VHH-L 1 -A-L 2 -B
  • VHH-L 1 -B-L 2 -A VHH-L 1 -B-L 2 -A
  • VHH is a moiety acting as a pharmacokinetic enhancer
  • A is an INS A chain
  • B is an INS B chain
  • L 1 is a first peptide linker
  • L 2 is a second peptide linker, where L 1 and L 2 are distinct from one another (i.e., each have an amino acid sequence that is not the same).
  • the INS analogs have an amino acid sequence from the amino-terminus to the carboxy-terminus of B-L 2 -A-L 1 -VHH.
  • the A chain can be a native INS A chain, such as a native, human INS A chain (SEQ ID NO:3).
  • the A chain can be a variant thereof.
  • the A chain variant can have an amino acid sequence that includes a E4Q mutation, a T8H mutation, a Y14E mutation, a N21G mutation or a combination thereof (e.g., T8H and N21G; or T8H, Y14E and N21G) when compared to SEQ ID NO:3.
  • the A chain can be a truncation thereof.
  • the A chain may be an INS A chain lacking residues 1 to 3 (desA1-3) or lacking residue 21 (desA21) of SEQ ID NO:3.
  • the B chain can be a native INS chain, such as a native, human INS B chain (SEQ ID NO:4).
  • the B chain can be a variant thereof.
  • the B chain variant can have an amino acid sequence that includes a N3D mutation, a N3K mutation, a N3S mutation, a S9A mutation, a Y16E mutation, a Y16F mutation, a Y16H mutation, a Y16R mutation, a Y16W mutation, a E21Q mutation, a F25H mutation or a combination thereof (e.g., N3S and Y16F; N3S and Y16H; N3S and Y16R; N3S and Y16W; N3S and F25H; N3S and Y16R; N3S, Y16H and F25H; or N3S, Y16R and F25H) of SEQ ID NO:4.
  • the B chain can be
  • the A chain can be a native, human INS A chain (SEQ ID NO:3) and the B chain can be a native, human INS B chain (SEQ ID NO:4).
  • the A chain can be a variant of SEQ ID NO:3 and the B chain can be SEQ ID NO:4.
  • the A chain can be SEQ ID NO:3 and the B chain can be a variant of SEQ ID NO:4.
  • the A chain can be a variant of SEQ ID NO:3 and the B chain can be a variant of SEQ ID NO:4.
  • the A chain can be a truncation of SEQ ID NO:3 and the B chain can be SEQ ID NO:4.
  • the A chain can be a truncation of SEQ ID NO:3 and the B chain can be a variant of SEQ ID NO:4 or a truncation of SEQ ID NO:4.
  • the A chain can be SEQ ID NO:3 and the B chain can be a truncation of SEQ ID NO:4.
  • the A chain can be a variant of SEQ ID NO:3 or a truncation of SEQ ID NO:3 and the B chain can be a truncation of SEQ ID NO:4.
  • L 1 it can be a peptide of about 1 to about 50 amino acids.
  • L 1 can be from about 1, about 5, about 10, about 15, about 20, about 25, about 30, about 35, about 40, about 45 or about 50 amino acids.
  • L 1 can be from about 5 to about 10 amino acids, from about 10 to about 15 amino acids, from about 15 to about 20 amino acids, from about 20 to about 25 amino acids, from about 25 to about 30 amino acids, from about 30 to about 35 amino acids, from about 35 to about 40 amino acids, from about 40 to about 45 amino acids, or from about 45 to about 50 amino acids.
  • L 1 may be omitted such that the A chain or B chain is directly conjugated to the VHH moiety.
  • L 1 can include a repeating sequence of (GGGGQ) n (SEQ ID NO:10), where n can be from about 1 to about 10, especially 5 (i.e., (GGGGQ) 5 ; SEQ ID NO:23).
  • L 1 can include a repeating sequence of (PGPQ) n (SEQ ID NO:13), where n can be from about 1 to about 10, especially 8 (i.e., (PGPQ) 8 ; SEQ ID NO:24).
  • L 1 can include a repeating sequence of (PGPA) n (SEQ ID NO:14), where n can be from about 1 to about 10, especially 8 (i.e., (PGPA) 8 ; SEQ ID NO:25).
  • L 1 can include a repeating sequence of (GGE) n GG (SEQ ID NO:15), where n can be from about 1 to about 10, especially 7 (i.e., (GGE) 7 GG; SEQ ID NO:26).
  • L 1 can include a repeating sequence of (GGGGE) n GGGG (SEQ ID NO:16), where n can be from about 1 to about 10, especially 4 (i.e., (GGGGE) 4 GGGG; SEQ ID NO:27).
  • L 1 can include a repeating sequence of (GGGGK) n GGGG (SEQ ID NO:17), where n can be from about 1 to about 10, especially 4 (i.e., (GGGGK) 4 GGGG; SEQ ID NO:28).
  • L 1 can include a repeating sequence of GGGG(AP) n GGGG (SEQ ID NO:18), where n can be from about 1 to about 10, especially 10 (i.e., GGGG(AP) 10 GGGG; SEQ ID NO:29).
  • L 1 can include a repeating sequence of GGGG(EP) n GGGG (SEQ ID NO:19), wherein n can be from about 1 to about 10, especially 10 (i.e., GGGG(EP) 10 GGGG; SEQ ID NO:30).
  • L 1 can include a repeating sequence of GGGG(KP) n GGGG (SEQ ID NO:20), where n can be from about 1 to about 10, especially 10 (i.e., GGGG(KP) 10 GGGG; SEQ ID NO:31).
  • L 1 can include a repeating sequence of (PGPE) n PGPQ (SEQ ID NO:21), where n can be from about 1 to about 10, especially 7 (i.e., (PGPE) 7 PGPQ; SEQ ID NO:32).
  • L 1 can include a repeating sequence of (PGPK) n PGPQ (SEQ ID NO:22), where n can be from about 1 to about 10, especially 7 (i.e., (PGPK) 7 PGPQ; SEQ ID NO:33).
  • linkers that could be used in the INS analogs as L 1 include, but are not limited to, (GGGQ) n (SEQ ID NO:11) or (GGGGS) n (SEQ ID NO:12).
  • L 2 it can be a peptide of about 1 to about 15 amino acids.
  • L 2 can be about 1, about 2, about 3, about 4, about 5, about 6, about 7, about 8, about 9, about 10, about 11, about 12, about 13, about 14, or about 15 amino acids.
  • L 2 can be about 1 to about 5 amino acids, about 5 to about 10 amino acids, about 10 to about 15 amino acids, especially 10 to 15 amino acids.
  • L 2 can include a mix of Ala/A, Gln/Q, Gly/G, Pro/P and Ser/S residues.
  • L 2 can be SEQ ID NO:34, 35 or 36.
  • VHH can be a polypeptide of about 50 to about 200 amino acids, especially about 125 of about 150 amino acids that can bind serum albumin or another serum protein having a long t1 ⁇ 2.
  • VHH can be any one of SEQ ID NOS:7, 8 or 9.
  • the structural features of these VHH moieties result in INS analogs having a longer t1 ⁇ 2 when compared to native INS, especially native, human INS (SEQ ID NOS:3 and 4).
  • the t1 ⁇ 2 of the INS analogs herein therefore can be expected to be similar to that of serum albumin of the species to which the INS analog is administered (taking into account any target-mediated drug disposition).
  • exemplary INS analogs are as follows:
  • INS Analog 1 which includes from N-terminus to C-terminus a B chain of INS, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 2 which includes from N-terminus to C-terminus a B chain of INS having a N3D mutation, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 3 which includes from N-terminus to C-terminus a B chain of INS having a S9A mutation, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 4 which includes from N-terminus to C-terminus a B chain of INS having a Y16E mutation, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 5 which includes from N-terminus to C-terminus a B chain of INS having a Y16H mutation, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 6 which includes from N-terminus to C-terminus a B chain of INS having a F25H mutation, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 7 which includes from N-terminus to C-terminus a B chain of INS having a N3S mutation, a L 2 of six residues (bolded), an A chain of INS having a N21G, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acids sequence:
  • INS Analog 8 which includes from N-terminus to C-terminus a B chain of INS having N3S and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 9 which includes from N-terminus to C-terminus a B chain of INS having N3S and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 10 which includes from N-terminus to C-terminus a B chain of INS having N3S and Y16H mutations, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 11 which includes from N-terminus to C-terminus a B chain of INS having N3S and Y16H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H, Y14E and N21G mutations, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 12 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16H and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 13 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16H and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H, Y14E and N21G mutations, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 14 which includes from N-terminus to C-terminus a B chain of INS having N3S and Y16R mutations, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 15 which includes from N-terminus to C-terminus a B chain of INS having N3S and Y16F mutations, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 16 which includes from N-terminus to C-terminus a B chain of INS having N3S and Y16W mutations, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 17 which includes from N-terminus to C-terminus a B chain of INS having N3S and Y16R mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 18 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (PGPA) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 19 which includes from N-terminus to C-terminus a B chain of INS having a N3S mutation, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 20 which includes from N-terminus to C-terminus a B chain of INS having a N3S mutation, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPQ) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 21 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16H and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G4Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 22 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16H and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (PGPQ) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 23 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16H and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having Y14E and N21G mutations, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 24 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16H and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having Y14E and N21G mutations, a (PGPQ) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 25 which includes from N-terminus to C-terminus a B chain of INS having N3S and Y16R mutations, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 26 which includes from N-terminus to C-terminus a B chain of INS having N3S and Y16R mutations, a L 2 of six residues (bolded), an A chain of INS having a N21G mutation, a (PGPQ) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 27 which includes from N-terminus to C-terminus a B chain having N3S and Y16R mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 28 which includes from N-terminus to C-terminus a B chain of INS having N3S and Y16R mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (PGPQ) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 29 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 30 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (PGPQ) 8 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 31 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 2 E) 7 G 2 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 32 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 4 E) 4 G 4 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 33 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 4 K) 4 G 4 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 34 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a G 4 (AP) 10 G 4 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 35 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a G 4 (EP) 10 G 4 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 36 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a G 4 (KP) 10 G 4 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 37 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (PGPE) 7 PGPQ L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 38 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (PGPK) 7 PGPQ L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 39 which includes from N-terminus to C-terminus a B chain of INS having N3K, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 40 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R, E21Q and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 41 which includes from N-terminus to C-terminus a B chain of INS having N3K, Y16R, E21Q and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 42 which includes from N-terminus to C-terminus a B chain of INS having N3S, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 43 which includes from N-terminus to C-terminus a B chain of INS having N3K, Y16R and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 44 which includes from N-terminus to C-terminus a B chain of INS having N3K, Y16R, E21Q and F25H mutations, a L 2 of six residues (bolded), an A chain of INS having T8H and N21G mutations, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • INS Analog 45 which includes from N-terminus to C-terminus a B chain of INS having N3K, Y16R and F25Q mutations, a L 2 of six residues (bolded), an A chain of INS having E4Q, T8H and N21G mutations, a (G 4 Q) 5 L 1 (italicized) and a VHH moiety (underlined), has the following amino acid sequence:
  • Half-life of the INS analogs herein may be measured using methods known in the art including, for example, those described in the Examples below.
  • affinity of the INS analogs herein for albumins of different species may be measured using methods known in the art for measuring binding affinities, for example, those described in the Examples below, and is commonly expressed as the equilibrium dissociation constant (K D ) value.
  • activity of the INS analogs herein at an IR or an insulin-like growth factor 1 receptor (IGF-1R) may be measured using methods known in the art, including, for example, the in vitro activity assays described below, and is commonly expressed as an EC 50 value.
  • the INS analogs herein have a t2 that is longer than that of a native INS, especially native, human INS (SEQ ID NOS:3 and 4) when administered to a mammal, especially a human.
  • the VHH moieties herein target serum album; therefore, the t1 ⁇ 2 of the INS analogs herein can be expected to be similar to that of serum albumin of the species to which the INS analog is administered.
  • the INS analogs can have a t1 ⁇ 2 of about 1 day to about 31 days, of about 5 days to about 25 days, of about 10 days to about 20 days, or even of about 15 days.
  • the INS analogs can have a t1 ⁇ 2 of about 1 to about 5 days, of about 6 to about 10 days, of about 11 to about 15 days, of about 16 to about 20 days, of about 21 to about 25 days, or even of about 26 to about 31 days when administered to a human.
  • the INS analogs can have a t1 ⁇ 2 of about 1 day, about 2 days, about 3 days, about 4 days, about 5 days, about 6 days, about 7 days, about 8 days, about 9 days, about 10 days, about 11 days, about 12 days, about 13 days, about 14 days, about 15 days, about 16 days, about 17 days, about 18 days, about 19 days, about 20 days, about 21 days, about 22 days, about 23 days, about 24 days, about 25 days, about 26 days, about 27 days, about 28 days, about 29 days, about 30 days, or even about 31 days or more.
  • the INS analogs can have a t1 ⁇ 2 of about 20 days when administered to a human.
  • the INS analogs herein have a potency at an IR (such as native, human IR-A or human IR-B; SEQ ID NOS:5 and 6, respectively) that is within about 10-fold to about 1000-fold of, for example, native, human INS (SEQ ID NOS:3 and 4) when administered to a human.
  • an IR such as native, human IR-A or human IR-B; SEQ ID NOS:5 and 6, respectively
  • native, human INS SEQ ID NOS:3 and 4
  • the INS analogs herein have a potency at an IR (such as native, human IR-A or human IR-B; SEQ ID NOS:5 and 6, respectively) that is within about 25-fold to about 975-fold, about 50-fold to about 950-fold, about 75-fold to about 925-fold, about 100-fold to about 900-fold, about 125-fold to about 875-fold, 150-fold to about 850-fold, about 175-fold to about 825-fold, about 200-fold to about 800-fold, about 225-fold to about 775-fold, about 250-fold to about 750-fold, about 275-fold to about 725-fold, about 300-fold to about 700-fold, about 325-fold to about 675-fold, about 350-fold to about 650-fold, about 375-fold to about 625-fold, about 375-fold to about 600-fold, about 400-fold to about 575-fold, about 425-fold to about 550-fold, about 450
  • the INS analogs herein have a potency at an IR (such as native, human IR-A or human IR-B; SEQ ID NOS:5 and 6, respectively) that is about 10-fold, about 25-fold, about 50-fold, about 75-fold, about 100-fold, about 125-fold, about 150-fold, about 175-fold, about 200-fold, about 225-fold, about 250-fold, about 275-fold, about 300-fold, about 325-fold, about 350-fold, about 375-fold, about 400-fold, about 425-fold, about 450-fold, about 475-fold, about 500-fold, about 525-fold, about 550-fold, about 575-fold, about 600-fold, about 625-fold, about 650-fold, about 675-fold, about 700-fold, about 725-fold, about 750-fold, about 775-fold, about 800-fold, about 825-fold, about 850-fold, about 875-fold, about 900-fold,
  • the INS analogs herein can be formulated as pharmaceutical compositions, which can be administered by parenteral routes (e.g., intravenous, intraperitoneal, intramuscular, subcutaneous or transdermal). Such pharmaceutical compositions and techniques for preparing the same are well known in the art. See, e.g., Remington, “The Science and Practice of Pharmacy” (D. B. Troy ed., 21 st Ed., Lippincott, Williams & Wilkins, 2006). In particular instances, the INS analogs are administered SQ or IV. Alternatively, however, the INS analogs can be formulated in forms for other pharmaceutically acceptable routes such as, for example, tablets or other solids for oral administration, time release capsules, and any other form currently used, including creams, lotions, inhalants and the like.
  • parenteral routes e.g., intravenous, intraperitoneal, intramuscular, subcutaneous or transdermal.
  • Such pharmaceutical compositions and techniques for preparing the same are well known in the art. See, e.
  • the INS analogs herein may be reacted with any of a number of inorganic and organic acids/bases to form pharmaceutically acceptable acid/base addition salts.
  • Pharmaceutically acceptable salts and common techniques for preparing them are well known in the art (see, e.g., Stahl et al., “Handbook of Pharmaceutical Salts: Properties, Selection and Use” (2 nd Revised Ed. Wiley-VCH, 2011)).
  • Pharmaceutically acceptable salts for use herein include sodium, trifluoroacetate, hydrochloride and acetate salts.
  • the INS analogs herein may be administered by a physician or self-administered using an injection. It is understood the gauge size and amount of injection volume can be readily determined by one of skill in the art. However, the amount of injection volume can be ⁇ about 2 ml or even ⁇ about 1 ml, and the needle gauge can be ⁇ about 27 G or even ⁇ about 29 G. Alternatively, the INS analogs herein may be administered via a pump system.
  • the disclosure also provides and therefore encompasses novel intermediates and methods useful for synthesizing the INS analogs herein, or a pharmaceutically acceptable salt thereof.
  • the intermediates and INS analogs can be prepared by a variety of techniques that are well known in the art. For example, a method using recombinant synthesis is illustrated in the Examples below. The specific steps for each of the techniques described may be combined in different ways to prepare the INS analogs herein. The reagents and starting materials are readily available to one of skill in the art.
  • INS analogs herein are generally effective over a wide dosage range.
  • exemplary doses of the INS analogs or of pharmaceutical compositions including the same can be milligram (mg) or microgram ( ⁇ g), nanogram (ng), or picogram (pg) amounts per kilogram (kg) of an individual.
  • a daily dose can be from about 1 ⁇ g to about 100 mg.
  • the effective amount of the INS analog in a pharmaceutical composition can be a dose of about 0.25 mg to about 5.0 mg.
  • the effective amount i.e., dose/dosage
  • the effective amount may be below the lower limit of the aforesaid range and be more than adequate, while in other cases the effective amount may be a larger dose and may be employed with acceptable side effects.
  • the pharmaceutical composition also can include at least one additional therapeutic agent, especially a therapeutic agent typically used as the standard of care in metabolic conditions, diseases and disorders.
  • a pharmaceutical composition can include an effective amount of at least one INS analog of SEQ ID NOS:37-81, a pharmaceutically acceptable carrier and optionally at least one additional therapeutic agent.
  • the pharmaceutical composition can include an effective amount of an INS analog of SEQ ID NO:37 and a pharmaceutically acceptable carrier, an effective amount of an INS analog of SEQ ID NO:38 and a pharmaceutically acceptable carrier, an effective amount of an INS analog of SEQ ID NO:39 and a pharmaceutically acceptable carrier, an effective amount of an INS analog of SEQ ID NO:40 and a pharmaceutically acceptable carrier, an effective amount of an INS analog of SEQ ID NO:41 and a pharmaceutically acceptable carrier, an effective amount of an INS analog of SEQ ID NO:42 and a pharmaceutically acceptable carrier, an effective amount of an INS analog of SEQ ID NO:43 and a pharmaceutically acceptable carrier, an effective amount of an INS analog of SEQ ID NO:44 and a pharmaceutically acceptable carrier, an effective amount of an INS analog of SEQ ID NO:45 and
  • the INS analogs herein can be provided as part of a kit.
  • the kit includes a device for administering at least one INS analog or a composition including the same (and optionally at least one additional therapeutic agent) to an individual.
  • the kit includes a syringe and needle for administering an INS analog or a composition including the same (and optionally at least one additional therapeutic agent).
  • the INS analog or composition including the same (and optionally at least one additional therapeutic agent) is pre-formulated in aqueous solution within the syringe.
  • the INS analogs herein can be made via any number of standard recombinant DNA methods or standard chemical peptide synthesis methods known in the art.
  • recombinant DNA methods one can use standard recombinant techniques to construct a polynucleotide having a nucleic acid sequence that encodes an amino acid sequence for an INS analog herein, incorporate that polynucleotide into recombinant expression vectors, and introduce the vectors into host cells, such as bacteria, yeast and mammalian cells, to produce the INS analog herein. See, e.g., Green & Sambrook, “Molecular Cloning: A Laboratory Manual” (Cold Spring Harbor Laboratory Press, 4 th ed. 2012).
  • the compounds herein can be prepared by producing a protein or precursor protein molecule using recombinant DNA techniques.
  • DNA including cDNA and synthetic DNA
  • the coding sequences therein encoding a compound herein may vary as a result of the redundancy or degeneracy of the genetic code.
  • the DNA sequences encoding the compounds herein are introduced into a host cell to produce the compound or precursor thereof.
  • the host cells can be bacterial cells such as K12 or B strains of Escherichia coli , fungal cells such as yeast cells, or mammalian cells such as Chinese hamster ovary (CHO) cells.
  • An appropriate host cell is transiently or stably transfected or transformed with an expression system, such as expression vectors, for producing a compound herein or a precursor thereof.
  • Expression vectors typically are replicable in the host organisms either as episomes or as an integral part of the host chromosomal DNA. Commonly, expression vectors will contain selection markers such as, for example, tetracycline, neomycin, G418 and dihydrofolate reductase, to permit selection of those cells transformed with the desired DNA sequences.
  • One use of the INS analogs herein is for treating metabolic conditions, diseases and/or disorders.
  • exemplary conditions, diseases and disorders include, but are not limited to, metabolic syndrome, diabetes and obesity.
  • INS analogs herein is for treating heart and/or kidney conditions, diseases and/or disorders.
  • exemplary heart and/or kidney conditions, diseases and disorders include, but are not limited to, dyslipidemia, stroke, nephropathy, and retinopathy.
  • the methods can include the steps described herein, and these maybe be, but not necessarily, carried out in the sequence as described. Other sequences, however, also are conceivable. Moreover, individual or multiple steps may be carried out either in parallel and/or overlapping in time and/or individually or in multiply repeated steps. Furthermore, the methods may include additional, unspecified steps.
  • Such methods therefore can include selecting an individual having a metabolic condition, disease or disorder or who is predisposed to the same.
  • the methods can include selecting an individual having diabetes or who is predisposed to the same.
  • the methods can include selecting an individual who is obese or who is predisposed to the same.
  • the methods can include selecting an individual who is diabetic and obese or who is predisposed to the same.
  • the methods also can include administering to the individual an effective amount of at least one INS analog herein, which may be in the form of a pharmaceutical composition as also described herein.
  • the INS analog/pharmaceutical composition can include an additional therapeutic agents such a DPP-IV inhibitor, a native amylin or analog thereof, a short-acting (prandial) INS analog, a native incretin or analog thereof, a native IGF or analog thereof, metformin, a SGLT2 inhibitor, a statin, a SU, a TZD, and/or other anti-glycemic agent or other anti-obesity, as well as other therapeutic agents to control comorbidities, including, but not limited to, high cholesterol, high triglyceride, high blood pressure, atrial fibrillation and diabetes.
  • concentration/dose/dosage of the INS analog and optional additional therapeutic agent are discussed elsewhere herein.
  • the INS analog or pharmaceutical composition including the same can be administered in accord with known methods such as, for example, orally; by injection (i.e., intra-arterially, intravenously, intraperitoneally, intracerebrally, intracerebroventricularly, intramuscularly, intraocularly, intraportally or intralesionally); by sustained release systems, or by implantation devices.
  • the INS analog or pharmaceutical composition including the same can be administered SQ by bolus injection or continuously.
  • the INS analog or pharmaceutical composition including the same can be administered daily, every other day, three times a week, two times a week, one time a week (i.e., weekly), biweekly (i.e., every other week), or monthly.
  • the INS analog or pharmaceutical composition including the same is administered SQ every other day, SQ three times a week, SQ two times a week, SQ one time a week, SQ every other week or SQ monthly.
  • the INS analog or pharmaceutical composition including the same is administered SQ one time a week (QW).
  • the INS analog or pharmaceutical composition including the same is administered in combination with an effective amount of at least one additional therapeutic agent.
  • the additional therapeutic agent can be administered simultaneously, separately or sequentially with the INS analog or pharmaceutical composition including the same.
  • the additional therapeutic agent can be administered with a frequency the same as the INS analog or pharmaceutical composition including the same (i.e., every other day, twice a week, or even weekly).
  • the additional therapeutic agent can be administered with a frequency distinct from the INS analog or pharmaceutical composition including the same.
  • the additional therapeutic agent can be administered SQ.
  • the additional therapeutic agent can be administered IV.
  • the additional therapeutic agent can be administered orally.
  • the methods may be combined with diet and exercise and/or may be combined with additional therapeutic agents other than those discussed above.
  • Example 1 is an INS analog having an amino acid sequence of:
  • the INS analog of SEQ ID NO:37 is generated in a mammalian cell expression system using CHOK1 cell derivatives.
  • a cDNA sequence encoding SEQ ID NO:37 is sub-cloned into GS-containing expression plasmid backbone (pEE12.4-based plasmids).
  • the cDNA sequence is fused in frame with the coding sequence of a signal peptide sequence, METDTLLLWVLLLWVPGSTG (SEQ ID NO:82) to enhance secretion of the INS analog into the tissue culture medium.
  • the expression is driven by the viral CMV promoter.
  • CHOK1 cells are transfected with the recombinant expression plasmid using a PEI-based method. Briefly, the appropriate volume of CHOK1 suspension cells at a density of 4 ⁇ 10 6 cells/ml is transferred in shake flasks, and both PEI and recombinant plasmid DNA are added to the cells. Cells are incubated in a suspension culture at 32° C. for 6 days. At the end of the incubation period, cells are removed by low speed centrifugation, and the INS analog is purified from the conditioned medium.
  • CHOK1 cells are stably transfected using electroporation and the appropriate amount of recombinant expression plasmid, and the transfected cells are maintained in suspension culture at an adequate cell density. Selection of the transfected cells is accomplished by growth in 25 ⁇ M MSX-containing serum-free medium and incubated at 35° C.-37° C. and 5%-7% CO 2 .
  • the INS analog secreted into the media from the CHO cells is purified by Protein A affinity chromatography followed by ion exchange, hydrophobic interaction, or size-exclusion chromatography. Specifically, the INS analog from harvested media is captured onto Mab Select Protein A resin (GE). The resin then is briefly washed with a running buffer, such as a phosphate-buffered saline (PBS; pH 7.4) or a running buffer containing Tris, to remove non-specifically bound material. The protein is eluted from the resin with a low pH solution, such as 10 mM citric acid, 150 mM NaCl pH 3. Fractions containing the INS analog are pooled then diluted 1:1 with 20 mM NaOAc pH 5.
  • a running buffer such as a phosphate-buffered saline (PBS; pH 7.4) or a running buffer containing Tris
  • the final pH is adjusted to pH 5 using 1 M NaOH and the solution may be held at a low pH to inactivate potential viruses.
  • the pH may be neutralized by adding a base such as 0.1 M Tris pH 8.0 for subsequent size-exclusion chromatography.
  • the INS analog may be further purified by ion exchange chromatography using resins such as POROS 50 HS (ThermoFisher). The INS analog is eluted from the column using a 0 mM to 500 mM NaCl gradient in 20 mM NaOAc, pH 5.0 over 15 column volumes.
  • the INS analog may be further purified by hydrophobic interaction chromatography by using a Capto Phenyl ImpRes HIC Column (GE Healthcare). The purification is performed by adjusting the column charge solution to around 0.5 M Na 2 SO 4 and eluting using a 10 column volume (CV) gradient going from 0.5 M to 0 M Na 2 SO 4 in a 20 mM Tris pH 8 solution. After HIC, the INS analog may be even further purified by SEC by loading the concentrated Capto Phenyl ImpRes pool on a Superdex200 (GE Healthcare) with isocratic elution in PBS pH 7.4 or in 20 mM histidine, 50 mM NaCl pH 6.0.
  • GE Healthcare Capto Phenyl ImpRes HIC Column
  • Purified INS analog may be passed through a viral retention filter such as Planova 20N (Asahi Kasei Medical) followed by concentration/diafiltration into 20 mM histidine, 20 mM NaCl pH 6 using tangential flow ultrafiltration on a regenerated cellulose membrane (Millipore).
  • a viral retention filter such as Planova 20N (Asahi Kasei Medical) followed by concentration/diafiltration into 20 mM histidine, 20 mM NaCl pH 6 using tangential flow ultrafiltration on a regenerated cellulose membrane (Millipore).
  • the INS analog therefore is prepared in this manner or in a similar manner that would be readily determined by one of skill in the art.
  • Example 2 is an INS analog having an amino acid sequence of:
  • Example 2 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:38 is used in the expression plasmid.
  • Example 3 is an INS analog having an amino acid sequence of:
  • Example 3 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:39 is used in the expression plasmid.
  • Example 4 is an INS analog having an amino acid sequence of:
  • Example 4 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:40 is used in the expression plasmid.
  • Example 5 is an INS analog having an amino acid sequence of:
  • Example 5 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:41 is used in the expression plasmid.
  • Example 6 is an INS analog having an amino acid sequence of:
  • Example 6 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:42 is used in the expression plasmid.
  • Example 7 is an INS analog having an amino acid sequence of:
  • Example 7 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:43 is used in the expression plasmid.
  • Example 8 is an INS analog having an amino acid sequence of:
  • Example 8 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:44 is used in the expression plasmid.
  • Example 9 is an INS analog having an amino acid sequence of:
  • Example 9 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:45 is used in the expression plasmid.
  • Example 10 is an INS analog having an amino acid sequence of:
  • Example 10 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:46 is used in the expression plasmid.
  • Example 11 is an INS analog having an amino acid sequence of:
  • Example 11 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:47 is used in the expression plasmid.
  • Example 12 is an INS analog having an amino acid sequence of:
  • Example 12 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:48 is used in the expression plasmid.
  • Example 13 is an INS analog having an amino acid sequence of:
  • Example 13 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:49 is used in the expression plasmid.
  • Example 14 is an INS analog having an amino acid sequence of:
  • Example 14 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:50 is used in the expression plasmid.
  • Example 15 is an INS analog having an amino sequence of:
  • Example 15 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:51 is used in the expression plasmid.
  • Example 16 is an INS analog having an amino sequence of:
  • Example 16 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:52 is used in the expression plasmid.
  • Example 17 is an INS analog having an amino sequence of:
  • Example 17 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:53 is used in the expression plasmid.
  • Example 18 is an INS analog having an amino sequence of:
  • Example 18 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:54 is used in the expression plasmid.
  • Example 19 is an INS analog having an amino sequence of:
  • Example 19 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:55 is used in the expression plasmid.
  • Example 20 is an INS analog having an amino sequence of:
  • Example 20 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:56 is used in the expression plasmid.
  • Example 21 is an INS analog having an amino sequence of:
  • Example 21 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:57 is used in the expression plasmid.
  • Example 22 is an INS analog having an amino sequence of:
  • Example 22 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:58 is used in the expression plasmid.
  • Example 23 is an INS analog having an amino sequence of:
  • Example 23 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:59 is used in the expression plasmid.
  • Example 24 is an INS analog having an amino sequence of:
  • Example 24 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:60 is used in the expression plasmid.
  • Example 25 is an INS analog having an amino sequence of:
  • Example 25 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:61 is used in the expression plasmid.
  • Example 26 is an INS analog having an amino sequence of:
  • Example 26 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:62 is used in the expression plasmid.
  • Example 27 is an INS analog having an amino sequence of:
  • Example 27 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:63 is used in the expression plasmid.
  • Example 28 is an INS analog having an amino sequence of:
  • Example 28 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:64 is used in the expression plasmid.
  • Example 29 is an INS analog having an amino sequence of:
  • Example 29 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:65 is used in the expression plasmid.
  • Example 30 is an INS analog having an amino sequence of:
  • Example 30 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:66 is used in the expression plasmid.
  • Example 31 is an INS analog having an amino acid sequence of:
  • Example 31 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:67 is used in the expression plasmid.
  • Example 32 is an INS analog having an amino acid sequence of:
  • Example 32 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:68 is used in the expression plasmid.
  • Example 33 is an INS analog having an amino acid sequence of:
  • Example 33 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:69 is used in the expression plasmid.
  • Example 34 is an INS analog having an amino acid sequence of:
  • Example 34 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:70 is used in the expression plasmid.
  • Example 35 is an INS analog having an amino acid sequence of:
  • Example 35 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:71 is used in the expression plasmid.
  • Example 36 is an INS analog having an amino acid sequence of:
  • Example 36 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:72 is used in the expression plasmid.
  • Example 37 is an INS analog having an amino acid sequence of:
  • Example 37 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:73 is used in the expression plasmid.
  • Example 38 is an INS analog having an amino acid sequence of:
  • Example 38 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:74 is used in the expression plasmid.
  • Example 39 is an INS analog having an amino acid sequence of:
  • Example 39 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:75 is used in the expression plasmid.
  • Example 40 is an INS analog having an amino acid sequence of:
  • Example 40 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:76 is used in the expression plasmid.
  • Example 41 is an INS analog having an amino acid sequence of:
  • Example 41 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:77 is used in the expression plasmid.
  • Example 42 is an INS analog having an amino acid sequence of:
  • Example 42 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:78 is used in the expression plasmid.
  • Example 43 is an INS analog having an amino acid sequence of:
  • Example 43 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:79 is used in the expression plasmid.
  • Example 44 is an INS analog having an amino acid sequence of:
  • Example 44 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:80 is used in the expression plasmid.
  • Example 45 is an INS analog having an amino acid sequence of:
  • Example 45 is generated essentially as described for Example 1 except that a cDNA sequence encoding SEQ ID NO:81 is used in the expression plasmid.
  • Example 46 INS Analog Albumin-Binding Studies Via SPR
  • Binding of the INS analogs of Examples 23 to 30 to various serum albumins is carried out on Biacore 8K instrument. Immobilization of serum albumin to a Series S Sensor Chip CM5 surface is performed according to the manufacturer's instructions (Amine Coupling Kit BR-1000-50). Briefly, carboxyl groups on the sensor chip surfaces (flow cell 1 and 2) are activated by injecting 70 ⁇ L of a mixture containing 75 mg/ml EDC and 11.5 mg/ml NHS at 10 ⁇ L/min.
  • Human, cynomolgus monkey, mouse, rat, pig, dog, cow and rabbit serum albumin are diluted in 10 mM NaOAc pH 4.0 (BR-1003-49) at 1, 1, 3, 1, 1, 1, 1, 1 and 1 ⁇ g/mL and then injected over the activated chip surfaces (flow cell 2, channel 1 to 7) at 10 ⁇ L/min for 90 sec (human, mouse, rat, pig and cow serum albumin are obtained from Sigma Aldrich (St. Louis, Mo.); cynomolgus monkey serum albumin is obtained from Holzel Diagnostika (Cologne, Germany); dog serum albumin is obtained from Molecular Innovations (Novi, Mich.); and rabbit serum albumin is obtained from Fitzgerald Industries International (Acton, Mass.)).
  • the various serum albumins are covalently immobilized through free amines onto a carboxymethyl dextran-coated sensor chip CM5 targeting a surface density average of about 77 (58-98) RU. Excess reactive groups on the surfaces (flow cell 1 and 2) are deactivated by injecting 70 ⁇ L of 1 M ETA HCl—NaOH pH 8.5 at 10 ⁇ L/min.
  • Examples 23 to 30 are diluted in HBS-EP+ buffer (10 mM HEPES pH 7.6, 150 mM NaCl, 3 mM EDTA, 0.05% Polysorbate 20) at concentrations of 1000, 333.33, 111.11, 37.04, 12.35, 4.12, 1.37, 0.457, 0.152, 0.051 and 0.017 nM.
  • 150 ⁇ L of sample is individually injecting sequentially across the immobilized serum albumins surface and then dissociates for 600 sec at 50 ⁇ L/min flow rate at 25° C.
  • the surface is regenerated by injecting 10 mM glycine-HCl pH 1.5 (BR-1003-54) at 50 ⁇ L/min for 100 sec.
  • the resulting sensorgrams are analyzed using Biacore 8K Insight Evaluation Software (version 2.0.15.12933) 1:1 binding kinetics or steady-state affinity model fitting to calculate the binding kinetic parameter association rate (ka), dissociation rate (kd), and equilibrium dissociation constant (K D )
  • K D is determined as 0.73, 6.8, 76, 53, 130, 23 and 590 nM for human, cynomolgus monkey, mouse, rat, pig, dog and cow serum albumin binding with Example 23, respectively.
  • K D is determined as 0.91, 5.5, 49, 40, 100, 16 and 430 nM for human, cynomolgus monkey, mouse, rat, pig, dog and cow serum albumin binding with Example 24, respectively.
  • K D is determined as 0.32, 3.5, 42, 34, 90, 16 and 390 nM for human, cynomolgus monkey, mouse, rat, pig, dog and cow serum albumin binding with Example 25, respectively.
  • K D is determined as 0.49, 3.9, 35, 32, 87, 13 and 400 nM for human, cynomolgus monkey, mouse, rat, pig, dog and cow serum albumin binding with Example 26, respectively.
  • K D is determined as 0.75, 4.7, 45, 32, 90, 17 and 390 nM for human, cynomolgus monkey, mouse, rat, pig, dog and cow serum albumin binding with Example 27, respectively.
  • K D is determined as 0.73, 4.1, 37, 26, 75, 12 and 400 nM for human, cynomolgus monkey, mouse, rat, pig, dog and cow serum albumin binding with Example 28, respectively.
  • K D is determined as 0.74, 4.4, 48, 32, 86, 16, 380 nM for human, cynomolgus monkey, mouse, rat, pig, dog, and cow serum albumin binding with Example 29, respectively.
  • K D is determined as 0.73, 4.3, 39, 30, 80, 13 and 370 nM for human, cynomolgus monkey, mouse, rat, pig, dog and cow serum albumin binding with Example 30, respectively.
  • Example 47 INS Analog In Vitro Potency at IR-A and IR-B
  • Cellular membranes are prepared from HEK293 cells stably transfected with human IR-A (hIR-A; SEQ ID NO:5) and human IR-B (hIR-B; SEQ ID NO:6) containing a C-terminal C9 tag (TETSQVAPA; SEQ ID NO:83).
  • IR-A human IR-A
  • hIR-B human IR-B
  • TETSQVAPA C-terminal C9 tag
  • cell pellets are from cell passages 6 to 12, depending on the receptor. Frozen cell pellets are thawed in ice-cold homogenization/resuspension buffer (50 mM Tris-HCl, pH 7.5) containing one Complete® protease inhibitor tablet with EDTA (Roche Diagnostics) per 50 mL of buffer.
  • the cells are homogenized with an overhead motor driven Teflon®-glass Potter-Elvehjem homogenizer using 15 to 20 strokes, followed by centrifugation at 1100 ⁇ g for 10 min at 4° C.
  • the supernatant is saved on ice and the pellets are re-homogenized as before and centrifuged at 1100 ⁇ g for 10 min at 4° C. All supernatants are combined and subsequently centrifuged at 35,000 ⁇ g for 60 min at 4° C.
  • the pellet is resuspended in buffer (4 to 5 ml/g of starting cell paste) containing protease inhibitors and quick frozen in liquid nitrogen prior to storage at ⁇ 80° C. Protein concentration is determined using a BCA kit (ThermoScientific) with bovine serum albumin (BSA) as standard.
  • BSA bovine serum albumin
  • Receptor binding affinities are determined from a competitive radioligand binding assay with either human recombinant (3-[ 125 I]-iodotyrosyl-A14)-insulin (2200 Ci/mmol) or human recombinant [ 125 I]-insulin-like growth factor-1 (1680 to 2800 Ci/mmol), both obtained from Perkin Elmer (Waltham, Mass.).
  • the assays are performed with a SPA method using polyvinyltoluene (PVT) wheat germ agglutinin-coupled SPA beads (Perkin Elmer).
  • Assay buffer contains 50 mM Tris-HCl, pH 7.5, 150 mM NaCl and either A) 0.1% w/v fatty-acid free BSA; B) 0.1% w/v fatty-acid free human serum albumin (HSA); C) 0.1% w/v rat serum albumin (RSA); or D) 0.001% Nonidet P-40 Substitute (NP-40, Roche Diagnostics).
  • Ten-point concentration response curves using three-fold serial dilutions of test samples or controls are prepared in Assay Buffer using a Freedom/Evo robot (Tecan).
  • radioactivity is determined using a MicrobetaTM Trilux scintillation counter (Perkin Elmer) and expressed as counts per minute (CPM).
  • STZ mice 11-12 week-old, male, C57B1/6NHsd mice from Envigo RSM Inc. (Indianapolis, Ind.) are allowed to acclimate for a minimum of 3 days. The mice are individually housed in shoebox caging with corn cob bedding and mouse water lixits. Environmental conditions are as follows: photoperiod of 12 hours light and 12 hours dark (may be interrupted for study-related activities), temperature of 20° C. to 26° C., and relative humidity of 30% to 70%.
  • STZ is prepared as follows: add vehicle to pre-weighed STZ to achieve a dosing concentration of 16.67 mg/mL. Gently swirl to mix until powder is dissolved. Solution is kept on wet ice, protected from light and is used within 3 hr of preparation. On days 5 and 9 of pre-dose phase, prior to each STZ administration, following an overnight fast (not to exceed 16 hr), animals are dosed i.p. at a dose volume 6 mL/kg (100 mg/kg), based on most recent body weight. Any animal with a body weight below 19 g is not administered STZ.
  • mice are assigned to the study using a block randomization allocation tool (BRAT) designed to achieve glucometer value (250 mg/dL to 500 mg/dL inclusion criteria) and body weight balance.
  • BRAT block randomization allocation tool
  • a single dose of pre-formulated test article is administered into the subcutaneous space between the shoulder blades (interscapular) at a dose volume of 10 mL/kg. Any possible dosing errors are noted.
  • the INS analogs of Examples 1 to 6 demonstrate a sustained reduction in whole blood glucose levels after a single, 300 nmol/kg injection.
  • the INS analogs of Examples 7 to 18 demonstrate sustained reduction in whole blood glucose levels after a single, 200 nmol/kg injection.
  • STZ is prepared as follows: 19 mL of cold sterile saline is added to a STZ vial (Zanosar®, Teva Parenteral Medicines, Inc., Irvine, Calif.) and is gently mixed until powder is dissolved. Repeat with a second vial of STZ, keep both on wet ice, and shield from light. These solutions are good for 3 hr under stated conditions. On day 8 of pre-dose phase, following a 6-hr fast, animals are dosed i.v. at a dose volume 0.8 mL/kg (40 mg/kg), based on most recent body weight. STZ dosing is done under anesthesia with Isoflurane. Rats are observed until fully awake.
  • mice are assigned to the study using a BRAT designed to achieve glucometer value (450 mg/dL to 550 mg/dL inclusion criteria) and body weight balance. 50 out of the 60 rats are put on study.
  • a single dose of pre-formulated test article (INS analogs at 50, 100, 200 and 400 nmol/kg in 20 mM histidine, 50 mM NaCl, pH 6.0) is administered into the subcutaneous space at a dose volume of 5 mL/kg.
  • Glucose measurements are taken via tail clip using glucometers (AccuChek® Aviva®, Roche, Indianapolis, Ind.) (in duplicate) at 0, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216 and 240 hr post dose.
  • the pharmacokinetics of the INS analogs herein are tested in an STZ-induced diabetic rat model.
  • Male STZ-treated rats are administered single, subcutaneous doses of various INS analogs at 50, 100, 200 or 400 nmol/kg (5 mL/kg dose in 20 mM histidine, 50 mM NaCl, pH 6.0).
  • Blood is collected from each animal pre-dose and at 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216 and 240 hr post-dose.
  • the blood samples are processed to K3EDTA plasma and are stored frozen at about ⁇ 70° C.
  • the INS analog concentrations in plasma are measured at Eli Lilly and Company (Indianapolis, Ind.), and the concentration-time data are used to calculate pharmacokinetic parameters (see, Table 12).
  • Plasma analog concentrations are measured from the animals by immunoaffinity-LC/MS using a Thermo orbitrap mass spectrometer (Q/Exactive or Fusion Lumos) coupled to a Dionex Ultimate 3000 UPLC system.
  • the analogs are immunoprecipitated from K 3 EDTA rat plasma using an anti-camelid-VHH-biotin monoclonal antibody (Eli Lilly and Company, clone 96A3F5) immobilized to streptavidin-coated magnetic beads (Dynal M-280, Thermo E2017-02).
  • the variants are reduced (triethylphosphine, Aldrich 245275-5G), alkylated (2-iodoethanol, Aldrich 176850-25G) and are digested (Trypsin Gold, Promega E2019-12).
  • the subsequent tryptic peptides from various regions of the variants are measured by LC/MS over the range of 0.293 nM to 150 nM as a surrogate measure of intact analog.
  • Examples 29 and 30 are about linear over the range of doses tested (50 to 400 nmol/kg SC). Apparent clearance for the two analogs ranges from 2.9 mL/hr/kg to 4.7 mL/hr/kg, and their elimination half-lives ranges from 25 hr to 42 hr (see, Table 17).
  • nucleic and/or amino acid sequences are referred to in the disclosure and are provided below for reference.
  • NP_001278826.1 FVNQHLCGSHLVEALYLVCGERGFFYTPKTRREAEDLQVGQVELGGGPGAGSLQ PLALEGSLQKRGIVEQCCTSICSLYQLENYCN SEQ ID NO: 3-human INS A chain (21 amino acids; 90-110 of NCBI Ref. No. NP_001278826.1) GIVEQCCTSICSLYQLENYCN SEQ ID NO: 4-human INS B chain (30 amino acids; 25-54 of NCBI Ref. No. NP_001278826.1) FVNQHLCGSHLVEALYLVCGERGFFYTPKT SEQ ID NO: 5-human INS receptor-A (1370 amino acids; NCBI Ref. No.
  • NP_001073285.1 with C-terminal C9 tag MATGGRRGAAAAPLLVAVAALLLGAAGHLYPGEVCPGMDIRNNLTRLHELENC SVIEGHLQILLMFKTRPEDFRDLSFPKLIMITDYLLLFRVYGLESLKDLFPNLTVIR GSRLFFNYALVIFEMVHLKELGLYNLMNITRGSVRIEKNNELCYLATIDWSRILDS VEDNYIVLNKDDNEECGDICPGTAKGKTNCPATVINGQFVERCWTHSHCQKVCP TICKSHGCTAEGLCCHSECLGNCSQPDDPTKCVACRNFYLDGRCVETCPPPYYHF QDWRCVNFSFCQDLHHKCKNSRRQGCHQYVIHNNKCIPECPSGYTMNSSNLLCT PCLGPCPKVCHLLEGEKTIDSVTSAQELRGCTVINGSLIINIRGGNNLAAELEANLG LIEEISGYLKIRRSYALVSLSFFRKLRLIRGETLEIGNYSFYALDNQNLRQLWD

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