WO1997010000A1 - Therapeutic and prophylactic methods using heat shock proteins - Google Patents
Therapeutic and prophylactic methods using heat shock proteins Download PDFInfo
- Publication number
- WO1997010000A1 WO1997010000A1 PCT/US1996/014556 US9614556W WO9710000A1 WO 1997010000 A1 WO1997010000 A1 WO 1997010000A1 US 9614556 W US9614556 W US 9614556W WO 9710000 A1 WO9710000 A1 WO 9710000A1
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- cancer
- carcinoma
- antigen
- heat shock
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Classifications
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- C07K14/46—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates
- C07K14/47—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates from mammals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K39/0005—Vertebrate antigens
- A61K39/0011—Cancer antigens
- A61K39/001176—Heat shock proteins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/04—Antibacterial agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/10—Antimycotics
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/12—Antivirals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
- A61P35/02—Antineoplastic agents specific for leukemia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/60—Medicinal preparations containing antigens or antibodies characteristics by the carrier linked to the antigen
- A61K2039/6031—Proteins
- A61K2039/6043—Heat shock proteins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/62—Medicinal preparations containing antigens or antibodies characterised by the link between antigen and carrier
- A61K2039/622—Medicinal preparations containing antigens or antibodies characterised by the link between antigen and carrier non-covalent binding
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Definitions
- the present invention relates to compositions for the
- compositions of noncovalent complexes of heat shock/stress proteins including, but not limited to, hsp70, hsp90, __ gp96 alone or in combination with each other, and antigenic molecules are used to augment the immune responses to genotoxic and nongenotoxic factors, tumors, pathogens and infectious agents.
- the heat shock proteins include, but are not limited to hsp70, hsp90, gp96, and hsplOO; these hsp families accomplish different kinds of chaperoning functions.
- hsp70 located in the cell cytoplasm, nucleus, mitochondria, or endoplasmic
- reticulum (Lindquist, S., et al . , 1988, Ann . Rev. Genetics 2J2:631-677) are involved in the presentation of antigens to the cells of the immune system, and are also involved in the transfer, folding and assembly of proteins in normal cells. Similarly, Hsp90 located in the cytosol are involved in
- tumor specific antigens were also found on tumors induced with other chemical or physical carcinogens or on spontaneous tumors (Kripke, M.L., 1974, J. Natl . Cancer Inst . 53.:1333-1336; Vaage, J., 1968, Cancer Res . 5 28:2477-2483; Carswell, E.A., et al. , 1970, J. Natl . Cancer Inst . 44.:1281-1288) . Since these studies used protective immunity against the growth of transplanted tumors as the criterion for tumor specific antigens, these antigens are also commonly referred to as "tumor specific transplantation
- carcinogens are mutagens which may cause mutation, leading to the expression of tumor specific antigens (Ames, B.N., 1979, Science 204:587-593; Weisburger, J.H., et al . , 1981, Science 214:401-407) .
- Some carcinogens are mutagens which may cause mutation, leading to the expression of tumor specific antigens (Ames, B.N., 1979, Science 204:587-593; Weisburger, J.H., et al . , 1981, Science 214:401-407) .
- hsp70 was shown to elicit immunity to the tumor from which it was isolated but not to antigenically distinct tumors.
- hsp70 depleted of peptides was found to lose its immunogenic activity (Udono, M., and Srivastava, P.K., 1993, J. Exp . Med. 128:1391-1396) .
- the heat shock proteins are not immunogenic per se, but are carriers of antigenic peptides that elicit specific immunity to cancers (Srivastava, P.K., 1993, Adv. Cancer Res . .62:153-177) .
- Cancer is characterized primarily by an increase in the number of abnormal cells derived from a given normal tissue, invasion of adjacent tissues by these abnormal cells, and lymphatic or blood-borne spread of malignant cells to regional lymph nodes and to distant sites (metastasis) .
- Clinical data and molecular biologic studies indicate that cancer is a multistep process that begins with minor preneoplastic changes, which may under certain conditions progress to neoplasia.
- Pre-malignant abnormal cell growth is exemplified by hyperplasia, metaplasia, or most particularly, dysplasia (for review of such abnormal growth conditions, see Robbins and Angell, 1976, Basic Pathology, 2d Ed., .B. Saunders Co., Philadelphia, pp.
- Hyperplasia is a form of controlled cell proliferation involving an increase in cell number in a tissue or organ, without significant alteration in structure or function.
- endometrial hyperplasia often precedes endometrial cancer.
- Metaplasia is a form of controlled cell growth in which one type of adult or fully differentiated cell substitutes for another type of adult cell. Metaplasia can occur in epithelial or connective tissue cells.
- Atypical metaplasia involves a somewhat disorderly metaplastic epithelium.
- Dysplasia is frequently a forerunner of cancer, and is found mainly in the epithelia; it is the most disorderly form of non-neoplastic cell growth, involving a loss in individual cell uniformity and in the architectural orientation of cells.
- Dysplastic cells often have abnormally large, deeply stained nuclei, and exhibit pleomorphism. Dysplasia characteristically occurs where there exists chronic irritation or inflammation, and is often found in the cervix, respiratory passages, oral cavity, and gall bladder.
- the neoplastic lesion may evolve clonally and develop an increasing capacity for invasion, growth, metastasis, and heterogeneity, especially under conditions in which the neoplastic cells escape the host's immune surveillance (Roitt, I., Brostoff, J and Kale, D., 1993, Immunology, 3rd ed. , Mosby, St. Louis, pps. 17.1-17.12) .
- the present invention provides pharmaceutical compositions, methods, and kits for prevention and treatment of cancer and/or infectious diseases by enhancing the host's immunocompetence and activity of immune effector cells.
- the pharmaceutical compositions of the invention comprise complexes of hsps noncovalently bound to exogenous antigenic molecules.
- the exogenous antigenic molecules differ from the peptides endogenously complexed with hsps in vivo and which copurify with the hsps.
- the exogenous antigenic molecules are antigens/immunogens or antigenic/immunogenic fragments or derivatives thereof.
- antigenic molecules can be selected from among those known in the art or assayed by the ability to bind to antibody or MHC molecule (antigenicity) or generate immune response (immunogenicity) by standard immunoassays known in the art.
- the antigenic molecules are noncovalently complexed with hsps in vi tro prior to administration to a patient.
- the antigenic molecules are molecules that will induce an immune response against the cancer, e . g. , tumor- specific antigens, or tumor-associated antigens, preferably of human tumors.
- the antigenic molecules are molecules that will induce an immune response against the infectious agent, e . g.
- the pharmaceutical compositions of the present invention include hsps complexed not only to a single antigen but also more than one antigen or an entire cocktail of (e.g. , tumor specific) antigens.
- the patient is a human, and the hsps are human hsps.
- the hsps in the complexes can be autologous or allogeneic to the patient.
- the complex of hsp and antigenic molecules comprises hsp70, hsp90, gp96, or a combination thereof.
- the pharmaceutical compositions further comprise effective amounts of a biological response modifier, including but not limited to the cytokines interferon-of (IFN- ⁇ ) , IFN- ⁇ , interleukin-2 (IL-2) , IL-4, IL- 6, tumor necrosis factor (TNF) , or other cytokine growth factor.
- a biological response modifier including but not limited to the cytokines interferon-of (IFN- ⁇ ) , IFN- ⁇ , interleukin-2 (IL-2) , IL-4, IL- 6, tumor necrosis factor (TNF) , or other cytokine growth factor.
- Figure 1 Effect of administration of hsp70 complexed with ovalbumin or cytotoxicity of T cells against the EG7 cell line (expresses ovalbumin antigen) or the EL4 cell line (negative for ovalbumin antigen) .
- Figure IA Two mice in each group were immunized with: a) a control vehicle (squares) ; b) ovalbumin alone (plus sign) ; c) hsp70 alone (triangles) ; or d) hsp70-ovalbumin complex. T cells taken from the immunized mice were tested for cytotoxicity against the EG7 cells ( Figure IA) or EL4 cells ( Figure IB) . The results demonstrate that the hsp70- ovalbumin complex is a far better reagent at inducing a cytotoxic T-lymphocyte response than ovalbumin alone or hsp70 alone ( Figure IA) . The T cells did not respond in the presence of the EL4 cells which lack the ovalbumin antigen (Figure IB) .
- compositions and methods for the prevention and treatment of primary and metastatic cancers and/or infectious diseases are described.
- the invention provides pharmaceutical compositions of hsp noncovalently bound to exogenous antigenic molecules.
- the exogenous antigenic molecules differ from the peptides endogenously complexed with hsps in vivo and which copurify with the hsps.
- the exogenous antigenic molecules are antigens/immunogens or antigenic/immunogenic fragments or derivatives thereof.
- antigenic molecules can be selected from among those known in the art or assayed by the ability to bind to antibody or MHC molecule (antigenicity) or generate immune response (immunogenicity) by standard immunoassays known in the art.
- the antigenic molecules are noncovalently complexed with hsps in vi tro prior to administration to a patient.
- the antigenic molecules are molecules that will induce an immune response against the cancer, e .
- the antigenic molecules are molecules that will induce an immune response against the infectious agent, e . g. , antigens of viruses, bacteria, fungi, parasites etc., preferably agents that infect humans.
- the pharmaceutical compositions of the present invention include hsps complexed not only to a single antigen but also more than one antigen or an entire cocktail of ( e . g. , tumor specific) antigens.
- the patient is a human, and the hsps are human hsps.
- the hsps in the complexes can be autologous or allogeneic to the patient.
- the methods of the invention comprise methods cf eliciting an immune response in an individual in whom the treatment or prevention of infectious diseases or cancer is desired by administering a composition comprising an effective amount of a complex, in which the complex consists essentially of a hsp noncovalently bound to an exogenous antigenic molecule.
- the hsp and/or the antigenic molecule can be isolated from the individual or from others or by recombinant production methods using a cloned hsp originally derived from the individual or from others .
- Exogenous antigens and fragments and derivatives (both peptide and non ⁇ peptide) thereof for use in complexing with hsps, can be selected from among those known in the art, as well as those readily identified by standard immunoassays know in the art by the ability to bind antibody or MHC molecules (antigenicity) or generate immune responses (immunogenicity) .
- the hsps of the present invention that can be used include but are not limited to, hsp70, hsp90, gp96 alone or in combination.
- the hsps are human hsps.
- Heat shock proteins which are also referred to interchangeably herein as stress proteins, useful in the practice of the instant invention can be selected from among any cellular protein that satisfies any one of the following criteria.
- hsps heat shock proteins
- hsp60, hsp70 and hsp90 where the numbers reflect the approximate molecular weight of the stress proteins in kilodaltons. Many members of these families were found subsequently to be induced in response to other stressful stimuli including, but not limited to, nutrient deprivation, metabolic disruption, oxygen radicals, and infection with intracellular pathogens.
- stressful stimuli including, but not limited to, nutrient deprivation, metabolic disruption, oxygen radicals, and infection with intracellular pathogens.
- hsps/stress proteins belonging to all of these three families can be used in the practice of the instant invention.
- the major hsps can accumulate to very high levels in stressed cells, but they occur at low to moderate levels in cells that have been stressed.
- the highly inducible mammalian hsp70 is hardly detectable at normal temperatures but becomes one of the most actively synthesized proteins in the cell upon heat shock (Welch, et al . , 1985, J. Cell . Biol . 101:1198-1211) .
- hsp90 and hsp60 proteins are abundant at normal temperatures in most, but not all, mammalian cells and are further induced by heat (Lai, et al., 1984, Mol . Cell . Biol . 4:2802-10; van Bergen en Henegouwen, et al .
- Heat shock proteins are among the most highly conserved proteins in existence.
- DnaK the hsp70 from E. coli has about 50% amino acid sequence identity with hsp70 proteins from excoriates (Bardwell, et al . , 1984, Proc . Na tl . Acad. Sci . 81:848-852) .
- the hsp60 and hsp90 families also show similarly high levels of intra families conservation (Hickey, et al . , 1989, Mol . Cell . Biol . 9:2615-2626; Jindal, 5 1989, Mol . Cell . Biol . 9:2279-2283) .
- hsp60, hsp70 and hsp90 families are composed of proteins that are related to the stress proteins in sequence, for example, having greater than 35% amino acid identity, but whose expression levels are not altered by 0 stress. Therefore it is contemplated that the definition of stress protein, as used herein, embraces other proteins, muteins, analogs, and variants thereof having at least 35% to 55%, preferably 55% to 75%, and most preferably 75% to 85% amino acid identity with members of the three families whose 5 expression levels in a cell are enhanced in response to a stressful stimulus. The purification of stress proteins belonging to these three families is described below.
- the immunogenic complexes of hsp and exogenous antigenic molecules of the invention include any complex containing an 0 hsp and an exogenous antigenic molecule that is capable of inducing an immune response in a mammal.
- the antigenic molecules are noncovalently associated with the hsps.
- Preferred complexes comprise hsp60, hsp70, or hsp90, noncovalently bound to a protein antigen.
- the complex comprises an hsp called gp96 which is present in the endoplasmic reticulum of eukaryotic cells and is related to the cytoplasmic hsp90s.
- the hsps can be allogeneic to the patient, in a preferred embodiment, the hsps are autologous to (derived 0 from) the patient to whom they are administered.
- the hsps and/or antigenic molecules can be purified from natural sources, chemically synthesized, or recombinantly produced.
- the invention provides methods for determining doses for human cancer immunotherapy by evaluating the optimal dose of 5 hsp noncovalently bound to peptide complexes in experimental tumor models and extrapolating the data. Specifically, a scaling factor not exceeding a fifty fold increase over the effective dose estimated in animals, is used as the optimal prescription method for cancer immunotherapy or vaccination in human subjects.
- the invention provides compositions comprising the hsp- antigenic molecule complexes which enhance the immunocompetence of the host individual and elicit specific immunity against infectious agents or specific immunity against preneoplastic and neoplastic cells.
- the therapeutic regimens and pharmaceutical compositions of the invention are described below. These compositions are believed to have the capacity to prevent the onset and progression of infectious diseases and prevent the development of tumor cells and to inhibit the growth and progression of tumor cells indicating that such compositions can induce specific immunity in infectious diseases and cancer immunotherapy.
- the complexes of the invention can be used to induce an inflammatory reaction at the tumor site and ultimately cause a regression of the tumor burden in the cancer patients treated.
- Cancers which can be treated with complexes of hsps noncovalently bound to exogenous antigenic molecules include, but are not limited to, human sarcomas and carcinomas.
- the invention provides methods of preventing and treating cancer in an individual comprising administering a composition which stimulates the immunocompetence of the host individual and elicits specific immunity against the preneoplastic and/or neoplastic cells.
- preneoplastic refers to a cell which is in transition from a normal to a neoplastic form; and morphological evidence, increasingly supported by molecular biologic studies, indicates that preneoplasia progresses through multiple steps.
- Non-neoplastic cell growth commonly consists of hyperplasia, metaplasia, or most particularly, dysplasia (for review of such abnormal growth conditions (See Robbins and Angell, 1976, Basic Pathology, 2d Ed., W.B. Saunders Co., Philadelphia, pp. 68-79) .
- the therapeutic regimens and pharmaceutical compositions of the invention may be used with additional immune response enhancers or cytokines including, but not limited to, the cytokines IFN- ⁇ , IFN- ⁇ , IL-2, IL-4, IL-6, TNF, or other cytokine affecting immune cells.
- additional immune response enhancers or cytokines including, but not limited to, the cytokines IFN- ⁇ , IFN- ⁇ , IL-2, IL-4, IL-6, TNF, or other cytokine affecting immune cells.
- the complexes of the hsp and antigenic molecule are administered in combination therapy with one or more of these cytokines.
- the invention further relates to administration of complexes of hsp-antigenic molecules to individuals at enhanced risk of cancer due to familial history or environmental risk factors.
- compositions comprising hsp noncovalently bound to exogenous antigenic molecules are administered to elicit an effective specific immune response to the complexed antigenic molecules (and not to the hsp) .
- hsp70, hsp90 and/or gp96 are noncovalently complexed with exogenous antigenic molecules.
- exogenous antigenic molecules are immunogenic or antigenic proteins or other molecules or immunogenic/antigenic fragments or derivatives thereof.
- exogenous antigenic molecules include but are not limited to different tumor specific translatable antigens (e. g.
- HIV-I immunodeficiency virus type I
- HAV-II human immunodeficiency virus type II
- hepatitis type A hepatitis type B
- hepatitis type C influenza, Varicella, adenovirus
- herpes simplex type I HSV-I
- herpes simplex type II HSV-II
- rinderpest rhinovirus, echovirus, rotavirus, respiratory syncytial virus
- papilloma virus papova virus
- cytomegalovirus echinovirus
- arbovirus huntavirus, coxsackie virus, mumps virus, measles virus, rubella virus and polio virus.
- antigens of cancers e.g., tumors
- infectious agents e. g. , viral antigen, bacterial antigens, etc.
- exemplary purification procedures such as described in Sections 5.1.1-5.1.3 below can be employed to purify hsp- peptide complexes, after which the hsps can be purified from
- the endogenous hsp-peptide complexes in the presence of ATP or low pH, for subsequent in vi tro complexing to exogenous antigenic molecules.
- the protocols described hereinbelow may be used to isolate hsps from any eukaryotic cells, for example, tissues, isolated
- hsps can be chemically
- tumor cells are suspended in 3 volumes of IX
- __ Lysis buffer consisting of 5mM sodium phosphate buffer
- the pellet is sonicated, on ice, until >99% cells are lysed as determined by microscopic examination.
- the cells may
- __ be lysed by mechanical shearing and in this approach the cells typically are resuspended in 3OmM sodium bicarbonate pH 7.5, ImM PMSF, incubated on ice for 20 minutes and then homogenized in a dounce homogenizer until >95% cells are lysed.
- the lysate is centrifuged at l,000g for 10 minutes to remove unbroken cells, nuclei and other cellular debris.
- the resulting supernatant is recentrifuged at 100,000g for 90 minutes, the supernatant harvested and then mixed with Con A Sepharose equilibrated with phosphate buffered saline (PBS) containing 2mM Ca 2+ and 2mM Mg 2* .
- PBS phosphate buffered saline
- the supernatant is diluted with an equal volume of 2X lysis buffer prior to mixing with Con A
- Sepharose The supernatant is then allowed to bind to the Con A Sepharose for 2-3 hours at 4°C.
- the material that fails to bind is harvested and dialyzed for 36 hours (three times, 100 volumes each time) against lOmM Tris-Acetate pH 7.5, O.lmM EDTA, lOmM NaCl, ImM PMSF. Then the dialyzate is centrifuged at 17,000 rpm (Sorvall SS34 rotor) for 20 minutes.
- the resulting supernatant is harvested and applied to a Mono Q FPLC column equilibrated in 20mM Tris- Acetate pH 7.5, 20mM NaCl, O.lmM EDTA and 15mM 2- mercaptoethanol.
- the column is then developed with a 20mM to 500mM NaCl gradient and then eluted fractions fractionated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and characterized by immunoblotting using an appropriate anti-hsp70 antibody (such as from clone N27F3-4, from StressGen) .
- SDS-PAGE sodium dodecyl sulfate-polyacrylamide gel electrophoresis
- hsp70-peptide complexes Fractions strongly immunoreactive with the anti-hsp70 antibody are pooled and the hsp70-peptide complexes precipitated with ammonium sulfate; specifically with a 50%- 70% ammonium sulfate cut. The resulting precipitate is then harvested by centrifugation at 17,000 rpm (SS34 Sorvall rotor) and washed with 70% ammonium sulfate. The washed precipitate is then solubilized and any residual ammonium sulfate removed by gel filtration on a Sephadex R G25 column (Pharmacia) . If necessary the hsp70 preparation thus obtained can be repurified through the Mono Q FPCL Column as described above. The hsp70-peptide complex can be purified to apparent homogeneity using this method. Typically lmg of hsp70- peptide complex can be purified from lg of cells/tissue.
- the present invention further describes a new and rapid 5 method for purification of hsp70.
- This improved method uses column chromatography with ATP affixed to a solid substratum (e . g. , ATP-agarose) .
- the hsp70 yields are believed to be increased significantly and have high purity.
- Meth A sarcoma cells (500 million cells) were homogenized in hypotonic buffer and the lysate was centrifuged at 100,000 g for 90 minutes at 4°C. The supernatant was divided into two and was applied to an ADP-agarose or an ATP-agarose column.
- ADP-bound/eluted hsp70 preparation was found to be associated with peptides, while the ATP-bound/eluted hsp70 preparation was not.
- tumor cells are suspended in 3 volumes of IX
- Lysis buffer consisting of 5mM sodium phosphate buffer
- the pellet is sonicated, on ice, until >99% cells are lysed as determined by microscopic examination.
- the cells may be lysed by mechanical shearing and in this approach the
- -_ cells typically are resuspended in 30mM sodium bicarbonate pH 7.5, ImM PMSF, incubated on ice for 20 minutes and then homogenized in a dounce homogenizer until >95% cells are lysed.
- the lysate is centrifuged at l,000g for 10 minutes to remove unbroken cells, nuclei and other cellular debris. 5
- the resulting supernatant is recentrifuged at 100,000g for 90 minutes, the supernatant harvested and then mixed with Con A Sepharose equilibrated with PBS containing 2mM Ca 2+ and 2mM Mg 2* .
- the supernatant is diluted with an equal volume of 2X lysis 0 buffer prior to mixing with Con A Sepharose.
- the supernatant is then allowed to bind to the Con A Sepharose for 2-3 hours at 4°C.
- the material that fails to bind is harvested and dialyzed for 36 hours (three times, 100 volumes each time) against lOmM Tris-Acetate pH 7.5, O.lmM EDTA, lOmM NaCl, ImM
- the eluted fractions are fractionated by SDS-PAGE and fractions containing the hsp90-peptide complexes identified by immunoblotting using an anti-hsp90 antibody such as 3G3 (Affinity Bioreagents) .
- Hsp90-peptide complexes can be purified to apparent homogeneity using this procedure.
- 150-200 ⁇ g of hsp90-peptide complex can be purified from lg of cells/tissue.
- a pellet of tumors is resuspended in 3 volumes of buffer consisting of 3OmM sodium bicarbonate buffer (pH 7.5) and ImM PMSF and the cells allowed to swell on ice 20 minutes.
- __ cell pellet then is homogenized in a Dounce homogenizer (the appropriate clearance of the homogenizer will vary according to each cells type) on ice until >95% cells are lysed.
- the lysate is centrifuged at l,000g for 10 minutes to remove unbroken cells, nuclei and other debris.
- the supernatant from this centrifugation step then is recentrifuged at 100,000g for 90 minutes.
- the gp96-peptide complex can be purified either from the 100,000 pellet or from the supernatant.
- the supernatant When purified from the supernatant, the supernatant is diluted with equal volume of 2X lysis buffer and the supernatant mixed for 2-3 hours at 4°C with Con A Sepharose equilibrated with PBS containing 2mM Ca 2+ and 2mM Mg 2+ . Then, the slurry is packed into a column and washed with IX lysis buffer until the OD 280 drops to baseline. Then, the column is washed with 1/3 column bed volume of 10% ⁇ -methyl mannoside ( ⁇ -MM) dissolved in PBS containing 2mM Ca 2 * and 2mM Mg 2* , the column sealed with a piece of parafilm, and incubated at 37°C for 15 minutes.
- ⁇ -MM ⁇ -methyl mannoside
- the column is cooled to room temperature and the parafilm removed from the bottom of the column.
- Five column volumes of the ⁇ -MM buffer are applied to the column and the eluate analyzed by SDS-PAGE. Typically the resulting material is about 60-95% pure, however this depends upon the cell type and the tissue-to-lysis buffer ratio used.
- the sample is applied to a Mono Q FPLC column (Pharmacia) equilibrated with a buffer containing 5mM sodium phosphate, pH 7.
- the proteins then are eluted from the column with a 0-1M NaCl gradient and the gp96 fraction elutes between 400mM and 550mM NaCl.
- One optional step involves an ammonium sulfate precipitation prior to the Con A purification step and the other optional step involves DEAE-Sepharose purification after the Con A purification step but before the Mono Q FPLC step.
- the supernatant resulting from the 100,000g centrifugation step is brought to a final concentration of 50% ammonium sulfate by the addition of ammonium sulfate.
- the ammonium sulfate is added slowly while gently stirring the solution in a beaker placed in a tray of ice water.
- the solution is stirred from about 1/2 to 12 hours at 4°C and the resulting solution centrifuged at 6,000 rpm (Sorvall SS34 rotor) .
- the supernatant resulting from this step is removed, brought to 70% ammonium sulfate saturation by the addition of ammonium sulfate solution, and centrifuged at 6,000 rpm (Sorvall SS34 rotor) .
- the resulting pellet from this step is harvested and suspended in PBS containing 70% ammonium sulfate in order to rinse the pellet. This mixture is centrifuged at 6,000 rpm (Sorvall SS34 rotor) and the pellet dissolved in PBS containing 2mM Ca 2* and Mg 2* .
- Undissolved material is removed by a brief centrifugation at 15,000 rpm (Sorvall SS34 rotor) . Then, the solution is mixed with Con A Sepharose and the procedure followed as before.
- the gp96 containing fractions eluted from the Con A column are pooled and the buffer exchanged for 5mM sodium phosphate buffer, pH 7,300mM NaCl by dialysis, or preferably by buffer exchange on a Sephadex G25 column.
- the solution is mixed with DEAE-Sepharose previously equilibrated with 5mM sodium phosphate buffer, pH 7, 30OmM NaCl.
- the protein solution and the beads are mixed gently for 1 hour and poured into a column.
- the column is washed with 5mM sodium phosphate buffer, pH 7, 300mM NaCl, until the absorbance at 280nM drops to baseline. Then, the bound protein is eluted from the column with five volumes of 5mM sodium phosphate buffer, pH 7, 700mM NaCl. Protein containing fractions are pooled and diluted with 5mM sodium phosphate buffer, pH 7 in order to lower the salt concentration to 175mM. The resulting material then is applied to the Mono Q FPLC column (Pharmacia) equilibrated with 5mM sodium phosphate buffer, pH 7 and the protein that binds to the Mono Q FPLC column (Pharmacia) is eluted as described before. It is appreciated, however, that one skilled in the art may assess, by routine experimentation, the benefit of incorporating the second optional step into the purification protocol. In addition, it is appreciated also that the benefit of adding each of the optional steps will depend upon the source of the starting material .
- the pellet When the gp96 fraction is isolated from the 100,000g pellet, the pellet is suspended in 5 volumes of PBS containing either 1% sodium deoxycholate or 1% oxtyl glucopyranoside (but without the Mg 2* and Ca 2* ) and incubated on ice for 1 hour. The suspension is centrifuged at 20,000g for 30 minutes and the resulting supernatant dialyzed against several changes of PBS (also without the Mg 2* and Ca 2 *) to remove the detergent. The dialysate is centrifuged at 100,000g for 90 minutes, the supernatant harvested, and calcium and magnesium are added to the supernatant to give final concentrations of 2mM, respectively. Then the sample is purified by either the unmodified or the modified method for isolating gp96-peptide complex from the 100,000g supernatant, see above.
- the gp96-peptide complexes can be purified to apparent homogeneity using this procedure. About 10-20 ⁇ g of gp96 can be isolated from lg cells/tissue.
- immunogenic peptides may be eluted from MHC-peptide complexes using techniques well known in the art (Falk, K. et al . , 1990 Nature 348:248- 251; Elliott, T., et al. , 1990, Nature 348:195-197; Falk, K. , et al . , 1991, Nature 351:290-296) .
- the amino acid sequence of each antigenic peptide may be determined using conventional amino acid sequencing methodologies.
- Such antigenic molecules can then be produced by chemical synthesis or recombinant methods, purified, and complexed to hsps in vi tro.
- potentially immunogenic or antigenic peptides may be isolated from endogenous MHC-peptide complexes for use subsequently as exogenous antigenic molecules, by complexing in vi tro to hsps.
- Exemplary protocols for isolating peptides and/or antigenic components from MHC complexes are set forth below in Section 5.2.1.1.
- MHC-peptide complexes may be isolated by a
- the peptides then may be eluted from the MHC-peptide complex by incubating the complexes in the presence of about 0.1% TFA in acetonitrile.
- the eluted peptides may be fractionated and purified by reverse phase HPLC, as before.
- amino acid sequences of the eluted peptides may be determined either by manual or automated amino acid sequencing techniques well known in the art . Once the amino acid sequence of a potentially protective peptide has been determined the peptide may be synthesized in any desired
- Peptides having the same amino acid sequence as those isolated above may be synthesized by solid-phase peptide synthesis using procedures similar to those described by
- N- ⁇ -protected amino acids having protected side chains are added stepwise to a growing polypeptide chain linked by its C-terminal and to an insoluble polymeric support i . e . , polystyrene beads.
- the peptides are
- N- ⁇ -protected amino acid 35 synthesized by linking an amino group of an N- ⁇ -deprotected amino acid to an ⁇ -carboxy group of an N- ⁇ -protected amino acid that has been activated by reacting it with a reagent such as dicyclohexylcarbodiimide.
- a reagent such as dicyclohexylcarbodiimide.
- the attachment of a free amino group to the activated carboxyl leads to peptide bond formation.
- the most commonly used N- ⁇ -protecting groups include Boc which is acid labile and Fmoc which is base labile.
- the C-terminal N- ⁇ -protected amino acid is first attached to the polystyrene beads.
- the N- ⁇ -protecting group is then removed.
- the deprotected ⁇ -amino group is coupled to the activated ⁇ -carboxylate group of the next N- ⁇ - protected amino acid.
- the process is repeated until the desired peptide is synthesized.
- the resulting peptides are then cleaved from the insoluble polymer support and the amino acid side chains deprotected. Longer peptides can be derived by condensation of protected peptide fragments.
- Antigenic molecules that are not isolated from MHC- peptide complexes can also be used as exogenous antigenic molecules.
- Antigens or antigenic portions thereof can be selected for use as antigenic molecules, for complexing to hsps, from among those known in the art or determined by immunoassay to be able to bind to antibody (antigenicity) , or generate an immune response (immunogenicity) .
- immunoassays known in the art can be used, including but not limited to competitive and non-competitive assay systems using techniques such as radioimmunoassays, ELISA (enzyme linked immunosorbent assay) , "sandwich” immunoassays, immunoradiometric assays, gel diffusion precipitin reactions, immunodiffusion assays, in vivo immunoassays (using colloidal gold, enzyme or radioisotope labels, for example) , western blots, immunoprecipitation reactions, agglutination assays (e . g.
- antibody binding is detected by detecting a label on the primary antibody.
- the primary antibody is detected by detecting binding of a secondary antibody or reagent to the primary antibody.
- the secondary antibody is labelled. Many means are known in the art for detecting binding in an immunoassay and are envisioned for use.
- T cell-mediated responses can be assayed by standard methods, e . g. , in vi tro cytoxicity assays or in vivo delayed-type hypersensitivity assays.
- antigens or derivatives thereof for use as antigenic molecules can also be identified by various criteria, such as the antigen's involvement in neutralization of a pathogen's infectivity (wherein it is desired to treat or prevent infection by such a pathogen) (Norrby, 1985,
- the antigen may be derived from any pathogen, including but not limited to, viruses, bacteria, fungi, protozoa, and parasites.
- pathogen includes but is not limited to intracellular pathogens. An intracellular pathogen that infects a mammal is capable of existing within a mammalian cell and causing a disease in the mammal .
- Antigenic molecules of a pathogen that is not an intracellular pathogen may also be used for complexing to hsps. Where it is desired to treat or prevent a disease caused by a pathogen, the antigen's encoded epitope should preferably display a small or no degree of antigenic variation in time or amongst different isolates of the same pathogen.
- tumor-specific antigens or fragments or derivatives thereof are used.
- tumor specific or tumor-associated antigens include but are not limited to KS 1/4 pan-carcinoma antigen (Perez and Walker,
- melanoma antigen gp75 (Vijayasardahl, et al., 1990, J. Exp . Med. 171 (4) :1375-1380) ; high molecular weight melanoma antigen ( ⁇ atali, et al . , 1987, Cancer 59:55-63) and prostate specific membrane antigen.
- an antigen or fragment or derivative thereof specific to a certain tumor is selected for complexing to hsp and subsequent administration to a patient having that tumor.
- molecules comprising epitopes of known viruses are used.
- such molecules comprise epitopes from proteins of viruses including, but not limited to, hepatitis type A hepatitis type B, hepatitis type C, influenza, varicella, adenovirus, herpes simplex type I (HSV- I), herpes simplex type II (HSV-II) , rinderpest, rhinovirus, echovirus, rotavirus, respiratory syncytial virus, papilloma virus, papova virus, cytomegalovirus, echinovirus, arbovirus, huntavirus, coxsachie virus, mumps virus, measles virus, rubella virus, polio virus, human immunodeficiency virus type I (HIV-I) , and human immunodeficiency virus type II (HIV-II) .
- viruses including, but not limited to, hepatitis type A hepatitis type B, hepatitis type C, influenza
- molecules comprising epitopes of known 5 bacteria are used.
- antigenic epitopes may be from bacteria including, but not limited to, mycobacteria rickettsia, mycoplasma, neisseria and legionella.
- protozoal infectious molecules comprising epitopes of known 10 protozoa are used.
- protozoa include, but are not limited to, leishmania, kokzidioa, and trypanosoma.
- molecules comprising epitopes of known parasites are used.
- antigenic epitopes may 15 be from parasites including, but not limited to, chlamydia and rickettsia.
- exogenous antigenic molecules either purified from natural sources or chemically synthesized or recombinantly produced, may be reconstituted with a variety of naturally purified or chemically synthesized or recombinantly produced stress
- vi tro proteins in vi tro to generate immunogenic noncovalent stress protein-antigenic molecule complexes.
- a preferred, exemplary protocol for noncovalently complexing a stress protein and an exogenous antigenic molecule in vi tro is described below.
- the hsps Prior to complexing, the hsps are pretreated with ATP or
- the antigenic molecules (l ⁇ g) and the pretreated hsp (9 ⁇ g) are admixed to give an approximately 5 antigenic molecule:1 stress protein molar ratio. Then, the mixture is incubated for 15 minutes to 3 hours at room temperature in a suitable binding buffer such as one containing 2OmM sodium phosphate, pH 7.2, 35OmM NaCl, 3mM MgCl 2 and ImM phenyl methyl sulfonyl fluoride (PMSF) . The preparations are centrifuged through Centricon 10 assembly (Millipore) to remove any unbound peptide. The association of the peptides with the stress proteins can be assayed by SDS-PAGE. This is the preferred method for in vi tro complexing of peptides isolated from MHC-peptide complexes of peptides disassociated from endogenous hsp-peptide complexes.
- a suitable binding buffer such as one containing 2OmM sodium phosphate, pH 7.2
- hsps70 preferred for producing complexes of hsps70 to exogenous antigenic molecules that are proteins
- 5-10 micrograms of purified hsp is incubated with equimolar quantities of the antigenic molecule in 20mM sodium phosphate buffer pH 7.5, 0.5M NaCl, 3mM MgCl 2 and ImM ADP in a volume of 100 microliter at 37°C for 1 hr.
- This incubation mixture is further diluted to 1ml in phosphate-buffered saline.
- preferred for producing complexes of gp96 or hsp90 to peptides 5-10 micrograms of purified gp96 or hsp90 is incubated with equimolar or excess quantities of the antigenic peptide in a suitable buffer such as one containing 2OmM sodium phosphate buffer 7.5, 0.5m NaCl, 3mM MgCl 2 at 60-65°C for 5-20 minutes. This incubation mixture is allowed to cool to room temperature and centrifuged more than once if necessary through Centrican 10 assembly (Millipore to remove any unbound peptide) .
- a suitable buffer such as one containing 2OmM sodium phosphate buffer 7.5, 0.5m NaCl, 3mM MgCl 2 at 60-65°C for 5-20 minutes.
- the immunogenic stress protein- antigenic molecule complexes can optionally be assayed in vi tro using for example the mixed lymphocyte target cell assay (MLTC) described below.
- MLTC mixed lymphocyte target cell assay
- the purified stress protein- antigenic molecule complexes can be assayed for
- MLTC mixed lymphocyte target culture assay
- mice are injected subcutaneously with the candidate stress protein-antigenic molecule complexes.
- Other mice are injected with either other stress protein peptide complexes or whole infected cells which act as positive controls for the assay.
- the mice are injected twice, 7-10 days apart. Ten days after the last immunization, the spleens are removed and the lymphocytes
- the released lymphocytes may be restimulated subsequently in vi tro by the addition of dead cells that expressed the complex of interest .
- 8xl0 6 immune spleen cells may be stimulated with 4xl0 4 mitomycin C treated or ⁇ -irradiated (5-10,000 rads)
- infected cells or cells transfected with an appropriate gene, as the case may be) in 3ml RPMI medium containing 10% fetal calf serum.
- 33% secondary mixed lymphocyte culture supernatant may be included in the culture medium as a source of T cell growth factors (See, Glasebrook,
- spleen cells may be cultured without stimulation.
- spleen cells of the immunized mice may also be restimulated with antigenically distinct cells, to determine the
- ,_ lymphocyte culture is added to a target cell suspension to give different effector:target (E:T) ratios (usually 1:1 to 40:1) .
- the target cells are prelabelled by incubating lxlO 6 target cells in culture medium containing 200 mCi 51 Cr/ml for one hour at 37°C. The cells are washed three times following labeling. Each assay point (E:T ratio) is performed in triplicate and the appropriate controls incorporated to measure spontaneous 51 Cr release (no lymphocytes added to assay) and 100% release (cells lysed with detergent) . After incubating the cell mixtures for 4 hours, the cells are peletted by centrifugation at 200g for 5 minutes.
- the amount of 51 Cr released into the supernatant is measured by a gamma counter.
- the percent cytotoxicity is measured as cpm in the test sample minus spontaneously released cpm divided by the total detergent released cpm minus spontaneously released cpm.
- a concentrated hybridoma supernatant derived from K-44 hybridoma cells (an anti-MHC class I hybridoma) is added to the test samples to a final concentration of 12.5%.
- Formulation Complexes of the invention may be formulated into pharmaceutical preparations for administration to mammals for treatment of tumors and infectious diseases.
- Preferred dosages, routes of administration and therapeutic regimens are described in copending application by P. Srivastava entitled “Compositions and Methods for the Prevention and Treatment of Primary and Metastatic Neoplastic Diseases and Infectious Diseases with Heat Shock/Stress Proteins, filed on even date herewith, which is incorporated by reference herein in its entirety.
- compositions are provided, based on a newly-discovered extrapolation and scaling of animal dosage to human, comprising compositions of complexes of antigenic molecules and heat shock/stress proteins, including but not limited to hsp70, hsp90, gp96 either alone or in combination.
- interspecies dose-response equivalence for hsp noncovalently bound to antigenic molecules for a human dose is estimated as the product of the therapeutic dosage observed in mice and a single scaling ratio, not exceeding a 50-fold increase.
- an amount of hsp70- and/or gp96- antigenic molecule complex is administered to a human that is in the range of about 10-600 ⁇ g, preferably 10-100 ⁇ g, most preferably about 25 ⁇ g, given once weekly for about 4-6 weeks, subcutaneously with the site of administration varied sequentially.
- Preferred amounts for hsp90-antigenic molecule complexes are in the range of 50-5,000 ⁇ g, preferably 100 ⁇ g.
- Compositions comprising a compound of the invention formulated in a compatible pharmaceutical carrier may be prepared, packaged, and labelled for treatment of the indicated tumor, such as human sarcomas and carcinomas, e . g.
- fibrosarcoma myxosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma, chordoma, angiosarcoma, endotheliosarcoma, lymphangiosarcoma, lymphangioendotheliosarcoma, synovioma, mesothelioma, Ewing' s tumor, leiomyosarcoma, rhabdomyosarcoma, colon carcinoma, pancreatic cancer, breast cancer, ovarian cancer, prostate cancer, squamous cell carcinoma, basal cell carcinoma, adenocarcinoma, sweat gland carcinoma, sebaceous gland carcinoma, papillary carcinoma, papillary adenocarcinomas, cystadenocarcinoma, medullary carcinoma, bronchogenic carcinoma, renal cell carcinoma, hepatoma, bile duct carcinoma, choriocarcinoma, seminoma, embryonal carcinoma, Wilms' tumor, cervical
- acute lymphocytic leukemia and acute myelocytic leukemia myeloblastic, promyelocytic, myelomonocy ic, monocytic and erythroleukemia
- chronic leukemia chronic myelocytic (granulocytic) leukemia and chronic lymphocytic leukemia
- polycythemia vera lymphoma (Hodgkin's disease and non- Hodgkin's disease), multiple myeloma, Waldenstr ⁇ m' s macroglobulinemia, and heavy chain disease.
- lymphoma Hodgkin's disease and non- Hodgkin's disease
- multiple myeloma Waldenstr ⁇ m' s macroglobulinemia
- heavy chain disease Alternatively, it can be formulated and labeled for treatment of the appropriate infectious disease.
- the complex may be formulated in an appropriate buffer, for example, phosphate buffered saline or other physiologically compatible solutions.
- an appropriate buffer for example, phosphate buffered saline or other physiologically compatible solutions.
- the resulting complex may be formulated with a non-ionic surfactant such as Tween, or polyethylene glycol.
- the compounds and their physiologically acceptable solvates may be formulated for administration by inhalation or insufflation (either through the mouth or the nose) or oral, buccal, parenteral, rectal administration or, in the case of tumors, directly injected into a solid tumor.
- the pharmaceutical preparation may be in liquid form, for example, solutions, syrups or suspensions, or may be presented as a drug product for reconstitution with water or other suitable vehicle before use.
- Such liquid preparations may be prepared by conventional means with pharmaceutically acceptable additives such as suspending agents (e. g. , sorbitol syrup, cellulose derivatives or hydrogenated edible fats) ; emulsifying agents (e. g. , lecithin or acacia); non-aqueous vehicles ( e . g. , almond oil, oily esters, or fractionated vegetable oils) ; and preservatives ( e . g. , methyl or propyl-p-hydroxybenzoates or sorbic acid) .
- suspending agents e. g. , sorbitol syrup, cellulose derivatives or hydrogenated edible fats
- emulsifying agents e. g. , lecithin or acacia
- non-aqueous vehicles e . g.
- compositions may take the form of, for example, tablets or capsules prepared by conventional means with pharmaceutically acceptable excipients such as binding agents (e . g. , pregelatinized maize starch, polyvinyl pyrrolidone or hydroxypropyl methylcellulose); fillers ( e. g. , lactose, microcrystalline cellulose or calcium hydrogen phosphate); lubricants ( e . g. , magnesium stearate, talc or silica); disintegrants (e.g., potato starch or sodium starch glycolate) ; or wetting agents (e.g., sodium lauryl sulphate) .
- the tablets may be coated by methods well-known in the art. Preparations for oral administration may be suitably formulated to give controlled release of the active compound.
- the compositions may take the form of tablets or lozenges formulated in conventional manner.
- the compounds for use according to the present invention are conveniently delivered in the form of an aerosol spray presentation from pressurized packs or a nebulizer, with the use of a suitable propellant, e . g. , dichlorodifluoromethane, trichlorofluoromethane, dichlorotetrafluoroethane, carbon dioxide or other suitable gas.
- a suitable propellant e . g. , dichlorodifluoromethane, trichlorofluoromethane, dichlorotetrafluoroethane, carbon dioxide or other suitable gas.
- the dosage unit may be determined by providing a valve to deliver a metered amount.
- Capsules and cartridges of, e . g. , gelatin for use in an inhaler or insufflator may be formulated containing a powder mix of the compound and a suitable powder base such as lactose or starch.
- the compounds may be formulated for parenteral administration by injection, e . g. , by bolus injection or continuous infusion.
- Formulations for injection may be presented in unit dosage form, e . g. , in ampoules or in multi- dose containers, with an added preservative.
- the compositions may take such forms as suspensions, solutions or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as suspending, stabilizing and/or dispersing agents.
- the active ingredient may be in powder form for constitution with a suitable vehicle, e . g. , sterile pyrogen-free water, before use.
- the compounds may also be formulated in rectal compositions such as suppositories or retention enemas, e . g. , containing conventional suppository bases such as cocoa butter or other glycerides.
- the compounds may also be formulated as a depot preparation. Such long acting formulations may be administered by implantation (for example, subcutaneously or intramuscularly) or by intramuscular injection.
- the compounds may be formulated with suitable polymeric or hydrophobic materials (for example, as an emulsion in an acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, for example, as a sparingly soluble salt.
- suitable polymeric or hydrophobic materials for example, as an emulsion in an acceptable oil
- ion exchange resins for example, as sparingly soluble derivatives, for example, as a sparingly soluble salt.
- Liposomes and emulsions are well known examples of delivery vehicles or carriers for hydrophilic drugs.
- compositions may, if desired, be presented in a pack or dispenser device which may contain one or more unit dosage forms containing the active ingredient.
- the pack may for example comprise metal or plastic foil, such as a blister pack.
- the pack or dispenser device may be accompanied by instructions for administration.
- kits for carrying out the therapeutic regimens of the invention comprise in one or more containers therapeutically or prophylactically effective amounts of the hsp-antigenic molecule complexes in pharmaceutically acceptable form.
- the hsp-antigenic molecule complex in a vial of a kit of the invention may be in the form of a pharmaceutically acceptable solution, e . g. , in combination with sterile saline, dextrose solution, or buffered solution, or other pharmaceutically acceptable sterile fluid.
- the complex may be lyophilized or desiccated; in this instance, the kit optionally further comprises in a container a pharmaceutically acceptable solution (e. g. , saline, dextrose solution, etc.), preferably sterile, to reconstitute the complex to form a solution for injection purposes.
- kits of the invention further comprises a needle or syringe, preferably packaged in sterile form, for injecting the complex, and/or a packaged alcohol pad. Instructions are optionally included for administration of hsp-antigenic molecule complexes by a clinician or by the patient.
- Infectious diseases that can be treated or prevented by the methods of the present invention are caused by infectious agents including, but not limited to viruses, bacteria, fungi protozoa and parasites.
- Viral diseases that can be treated or prevented by the methods of the present invention include, but are not limited to, those caused by hepatitis type A, hepatitis type B, hepatitis type C, influenza, varicella, adenovirus, herpes simplex type I (HSV-I) , herpes simplex type II (HSV-II) , rinderpest, rhinovirus, echovirus, rotavirus, respiratory syncytial virus, papilloma virus, papova virus, cytomegalovirus, echinovirus, arbovirus, huntavirus, coxsachie virus, mumps virus, measles virus, rubella virus, polio virus, human immunodeficiency virus type I (HIV-I) , and human immunodeficiency virus type II (HIV-II) .
- HSV-I herpes simplex type I
- HSV-III herpes simplex type II
- rinderpest rhinovirus
- Bacterial diseases that can be treated or prevented by the methods of the present invention are caused by bacteria including, but not limited to, mycobacteria rickettsia, mycoplasma, neisseria and legionella.
- Protozoal diseases that can be treated or prevented by the methods of the present invention are caused by protozoa including, but not limited to, leishmania, kokzidioa, and trypanosoma.
- Parasitic diseases that can be treated or prevented by the methods of the present invention are caused by parasites including, but not limited to, chlamydia and rickettsia.
- Target Cancers that can be treated or prevented by the methods of the present invention include, but not limited to human sarcomas and carcinomas, e . g. , fibrosarcoma, myxosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma, chordoma, angiosarcoma, endotheliosarcoma, lymphangiosarcoma, lymphangioendotheliosarcoma, synovioma, mesothelioma, Ewing' s tumor, leiomyosarcoma, rhabdomyosarcoma, colon carcinoma, pancreatic cancer, breast cancer, ovarian cancer, prostate cancer, squamous cell carcinoma, basal cell carcinoma, adenocarcinoma, sweat gland carcinoma, sebaceous gland carcinoma, papillary carcinoma, papillary adenocarcinomas, cystadenocarcinoma, medullary carcinoma, bronch
- the cancer is metastatic.
- the patient having a cancer is 0 immunosuppressed by reason of having undergone anti-cancer therapy (e . g. , chemotherapy radiation) prior to administration of the hsp-antigenic molecule complexes of the invention.
- the cancer is a tumor. 5
- Colorectal cancer initially spreads to regional lymph nodes and then through the portal venous circulation to the liver, which represents the most common visceral site of metastasis.
- the symptoms that lead patients with colorectal cancer to seek medical care vary with the anatomical location of the lesion. For example, lesions in the ascending colon frequency ulcerate, which leads to chronic blood loss in the stool.
- Radical resection offers the greatest potential for cure in patients with invasive colorectal cancer.
- the CEA titer is determined. Radiation therapy and chemotherapy are used in patients with advanced colorectal cancer. Results with chemotherapeutic agents (e . g. , 5- fluorouracil) are mixed and fewer than 25 percent of patients experience a greater than 50 percent reduction in tumor mass (Richards, 2d., F., et al. , 1986, J. Clin . Oncol . 4:565) . Patients with widespread metastases have limited survival and systemic chemotherapy has little impact in this group of patients.
- the present invention provides compositions and methods for enhancing tumor specific immunity in individuals suffering from colorectal cancer metastasized to the liver, in order to inhibit the progression of the neoplastic disease.
- gp96 is administered to a patient diagnosed with colorectal cancer, with or without liver metastasis, via one of many different routes of administration, the preferred routes being subcutaneous at different anatomical sites, e . g. , left arm, right arm, left belly, right belly, left thigh, right thigh, etc.
- routes of administration are used in sequence and the site of injection is varied for each weekly injection as described in Section 7.
- the preparations and use of therapeutically effective compositions for the prevention and treatment of primary and metastatic cancers are described in detail in the sections which follow and by way of example, infra .
- Hepatocellular carcinoma is generally a disease of the elderly in the United States. Although many factors may lead to hepatocellular carcinoma, the disease is usually limited to those persons with preexisting liver disease. Approximately 60 to 80 percent of patients in the United States with hepatocellular carcinoma have a cirrhotic liver and about four percent of individuals with a cirrhotic liver eventually develop hepatocellular carcinoma (Niederhuber, J.E., (ed.) , 1993, Current Therapy in Oncology, B.C. Decker, Mosby) . The risk is highest in patients whose liver disease is caused by inherited hemochromatosis or hepatic B viral infection (Bradbear, R.A. , et al . , 1985, J.
- Radical resection offers the only hope for cure in patients with hepatocellular carcinoma. Such operative procedures are associated with five-year survival rates of 12 to 30 percent. Liver transplantation may improve survival of some younger individuals. However, most patients are not surgical candidates because of extensive cirrhosis multifocal tumor pattern or scarcity of compatible donor organs. Chemotherapeutic agents have been administered either by intravenous route or through an intrahepatic arterial catheter. Such therapy has sometimes been combined with irradiation to the liver. Reductions in the size of measurable tumors of 50% or more have been reported in some patients treated with either systemic doxorubicin or 5- fluorouracil . However, chemotherapy often induces immunosuppression and rarely causes the tumor to disappear completely and the duration of response is short.
- the present invention provides compositions and methods for enhancing specific immunity in individuals suffering from hepatocellular carcinoma in order to inhibit the progression of the neoplastic disease and ultimately irradiate all preneoplastic an neoplastic cells.
- breast cancer Another specific aspect of the invention relates to the treatment of breast cancer.
- the American Cancer Society estimated that in 1992 180,000 American women were diagnosed with breast cancer and 46,000 succumbed to the disease (Niederhuber, J.E.ed. Current Therapy in Oncology B.C. Decker, Mosby, 1993) . This makes breast cancer the second major cause of cancer death in women, ranking just behind lung cancer. A disturbing fact is the observation that breast cancer has been increasing at a rate of 3 percent per year since 1980 (Niederhuber, J.E., ed. Current Therapy in Oncology, B.C. Decker, Mosby, (1993)) .
- the treatment of breast cancer presently involves surgery, radiation, hormonal therapy and/or chemotherapy.
- the present invention provides hsp compositions and methods for enhancing specific immunity to preneoplastic and neoplastic mammary cells in women.
- the present invention also provides compositions and methods for preventing the development of neoplastic cells in women at enhanced risk for breast cancer, and for inhibiting cancer cell proliferation and metastasis. These compositions can be applied alone or in combination with each other or with biological response modifiers.
- the preventive and therapeutic methods of the invention are directed at enhancing the immunocompetence of the cancer patient either before surgery, at or after surgery, and to induce tumor-specific immunity to cancer cells, with the objective being inhibition of cancer, and with the ultimate clinical objective being total cancer regression and eradication.
- the effect of immunotherapy with hsp-antigenic molecule complexes on development and progression of neoplastic diseases can be monitored by any methods known to one skilled in the art, including but not limited to measuring: a) delayed hypersensitivity as an assessment of cellular immunity; b) activity of cytolytic T-lymphocytes in vi tro; c) levels of tumor specific antigens, e . g. , carcinoembryonic
- CCA computed tomographic
- Delayed hypersensitivity skin tests are of great value in the overall immunocompetence and cellular immunity to an antigen. Inability to react to a battery of common skin antigens is termed anergy (Sato, T. , et al, 1995, Clin . Immunol . Pathol . 74:35-43) . Proper technique of skin testing requires that the antigens be stored sterile at 4°C, protected from light and reconstituted shorted before use. A 25- or 27-gauge need ensures intradermal, rather than subcutaneous, administration 5 of antigen. Twenty-four and 48 hours after intradermal administration of the antigen, the largest dimensions of both erythema and induration are measured with a ruler. Hypoactivity to any given antigen or group of antigens is confirmed by testing with higher concentrations of antigen 10 or, in ambiguous circumstances, by a repeat test with an intermediate test.
- Peripheral blood derived T lymphocytes isolated by the Ficoll-Hypaque centrifugation gradient technique are restimulated with 4xl0 4 mitomycin C treated tumor cells in 3ml RPMI medium containing 10% fetal calf serum.
- 33% secondary mixed lymphocyte culture _ n supernatant or IL-2 is included in the culture medium as a source of T cell growth factors.
- T cells are cultured without the stimulator tumor cells. In other experiments, T cells
- __ are restimulated with antigenically distinct cells. After 25 six days, the cultures are tested for cytotoxity in a 4 hour 51 Cr-release assay. The spontaneous 51 Cr-release of the targets should reach a level less than 20%.
- a tenfold concentrated supernatant _ n of W6/32 hybridoma is added to the test at a final concentration of 12.5% (Heike M. , et al . , J. Immunotherapy 15:165-174) .
- tumors Although it may not be possible to detect unique tumor antigens on all tumors, many tumors display antigens that distinguish them from normal cells.
- the monoclonal antibody reagents have permitted the isolation and biochemical characterization of the antigens and have been invaluable diagnostically for distinction of transformed from nontransformed cells and for definition of the cell lineage of transformed cells.
- the best-characterized human tumor- associated antigens are the oncofetal antigens. These antigens are expressed during embryogenesis, but are absent or very difficult to detect in normal adult tissue.
- the prototype antigen is carcinoembryonic antigen (CEA) , a glycoprotein found on fetal gut an human colon cancer cells, but not on normal adult colon cells.
- CEA carcinoembryonic antigen
- CEA is shed from colon carcinoma cells and found in the serum, it was originally thought that the presence of this antigen in the serum could be used to screen patients for colon cancer.
- patients with other tumors such as pancreatic and breast cancer, also have elevated serum levels of CEA. Therefore, monitoring the fall and rise of CEA levels in cancer patients undergoing therapy has proven useful for predicting tumor progression and responses to treatment .
- oncofetal antigens have been useful for diagnosing and monitoring human tumors, e . g. , alpha- fetoprotein, an alpha-globulin normally secreted by fetal liver and yolk sac cells, is found in the serum of patients with liver and germinal cell tumors and can be used as a matter of disease status.
- CT remains the choice of techniques for the accurate staging of cancers.
- CT has proved more sensitive and specific than any other imaging techniques for the detection of metastases.
- the levels of a putative biomarker for risk of a specific cancer are measured to monitor the effect of hsp noncovalently bound to peptide complexes.
- serum prostate-specific antigen PSA
- et. al . 1992, J. Urol . 147:841- 845, and Catalona, W.J., et al. , 1993, JAMA 270:948-958
- CEA colorectal cancer
- 16- ⁇ -hydroxylation of estradiol is measured by the procedure described by Schneider, J. et al . , 1982, Proc . Natl . Acad. Sci . USA 79:3047-3051.
- the references cited above are incorporated by reference herein in their entirety.
- hsp-antigenic molecule peptide complexes prepared in vi tro from purified hsp and purified antigen.
- the antigen used is carcinoembryonic antigen (CEA) .
- CEA carcinoembryonic antigen
- Treatment with hsp-antigen complexes is started any time after surgery. However, if the patient has received chemotherapy, hsp-antigen complexes are usually administered after an interval of four weeks or more so as to allow the immune system to recover. The immunocompetence of the patient is tested by procedures described in sections 5.9 above.
- the therapeutic regimen includes weekly injections of the hsp-antigen complex, dissolved in saline or other physiologically compatible solution.
- the dosage used for hsp70 or gp96 is in the range of 10- 600 micrograms, with the preferred dosage being 10-100 micrograms.
- the dosage used for hsp90 is in the range of 50 to 5,000 micrograms, with the preferred dosage being about 100 micrograms.
- the route and site of injection is varied each time, for example, the first injection is given subcutaneously on the left arm, the second injection on the right arm, the third injection on the left abdominal region, the fourth injection on the right abdominal region, the fifth injection on the left thigh, the sixth injection on the right thigh, etc.
- the same site is repeated after a gap of one or more injections.
- injections are split and each half of the dose is administered at a different site on the same day.
- hsp-antigen complexes therapy is monitored by measuring: a) delayed hypersensitivity as an assessment of cellular immunity; b) activity of cytolytic T-lymphocytes in vi tro; c) levels of tumor specific antigens, e . g. , carcinoembryonic (CEA) antigens; d) changes in the morphology of tumors using techniques such as a computed tomographic (CT) scan; and e) changes in putative biomarkers of risk for a particular cancer in individuals at high risk.
- CCA carcinoembryonic
- the therapeutic regimen is developed to maintain and/or boost the immunological responses of the patient, with the ultimate goal of achieving tumor regression and complete eradication of cancer cells.
- Hsp-antigen complexes (comprising gp96, hsp70, hsp90 or a combination thereof) are administered as adjuvant therapy and as prophylactic adjuvant therapy in patients after complete reduction of colorectal cancer to eliminate undetectable micrometastases and to improve survival .
- the therapeutic and prophylactic regimens used in patients suffering from colorectal cancer are the same as those described in Section 6 above for patients recovering with hepatocellular carcinoma.
- the antigen used as the exogenous antigenic molecule is carcinoembryonic antigen.
- the methods of monitoring of patients under clinical evaluation for prevention and treatment of colorectal cancer is done by procedures described in Section 5.9.
- Hsp70-ovalbumin complex was prepared in vi tro . Briefly, 5-10 micrograms of purified hsp70 was incubated with equimolar quantities of ovalbumin in 20 mM sodium phosphate buffer pH 7.5, 0.5 NaCl, 3mM MgCl 2 and ImM ADP in a volume of 100 microliter at 37°C for 1 hour. This incubation mixture was then further diluted to 1ml in phosphate-buffered saline and injected sub-cutaneously into the mammal of choice, the C57BL/6 strain of mice. The injections were repeated once a week interval. The hsp70-ovalbumin complex was prepared fresh for each injection. A total of two injections was administered before sacrificing the animals. Two mice in each group were immunized with: a) control vehicle; b) ovalbumin alone; c) hsp70 alone; or d) hsp70-ovalbumin complex.
- T cells were isolated from the spleen of each mouse using the T cell-gradient centrifugation technique and 8 x IO 5 T cells were incubated with 4 x IO 4 EG7 cells (positive for ovalbumin antigen) or EL4 cells (negative for ovalbumin antigen) .
- the CTL response was measured as % 51 Cr release.
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JP9512062A JPH11513369A (en) | 1995-09-13 | 1996-09-11 | Treatment and prevention methods using heat shock proteins |
AU69734/96A AU727673B2 (en) | 1995-09-13 | 1996-09-11 | Therapeutic and prophylactic methods using heat shock proteins |
CA002231998A CA2231998A1 (en) | 1995-09-13 | 1996-09-11 | Therapeutic and prophylactic methods using heat shock proteins |
EP96930818A EP0851765A4 (en) | 1995-09-13 | 1996-09-11 | Therapeutic and prophylactic methods using heat shock proteins |
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US527,547 | 1995-09-13 | ||
US08/527,547 US5935576A (en) | 1995-09-13 | 1995-09-13 | Compositions and methods for the treatment and prevention of neoplastic diseases using heat shock proteins complexed with exogenous antigens |
US08/711,918 US6030618A (en) | 1995-09-13 | 1996-09-10 | Therapeutic and prophylactic methods using heat shock proteins |
US711,918 | 1996-09-10 |
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JP (1) | JPH11513369A (en) |
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IL102687A (en) * | 1992-07-30 | 1997-06-10 | Yeda Res & Dev | Conjugates of poorly immunogenic antigens and synthetic pepide carriers and vaccines comprising them |
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- 1996-09-11 JP JP9512062A patent/JPH11513369A/en not_active Ceased
- 1996-09-11 WO PCT/US1996/014556 patent/WO1997010000A1/en active Application Filing
- 1996-09-11 EP EP96930818A patent/EP0851765A4/en not_active Ceased
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WO1989012455A1 (en) * | 1988-06-15 | 1989-12-28 | Whitehead Institute For Biomedical Research | Stress proteins and uses therefor |
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Also Published As
Publication number | Publication date |
---|---|
EP0851765A4 (en) | 2000-01-19 |
EP0851765A1 (en) | 1998-07-08 |
CA2231998A1 (en) | 1997-03-20 |
JPH11513369A (en) | 1999-11-16 |
AU727673B2 (en) | 2000-12-21 |
AU6973496A (en) | 1997-04-01 |
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