WO2001058957A2 - Enhancing the circulating half-life of antibody-based fusion proteins - Google Patents
Enhancing the circulating half-life of antibody-based fusion proteins Download PDFInfo
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- WO2001058957A2 WO2001058957A2 PCT/US2001/004455 US0104455W WO0158957A2 WO 2001058957 A2 WO2001058957 A2 WO 2001058957A2 US 0104455 W US0104455 W US 0104455W WO 0158957 A2 WO0158957 A2 WO 0158957A2
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- A61K47/6801—Drug-antibody or immunoglobulin conjugates defined by the pharmacologically or therapeutically active agent
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- A61K47/6851—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment the modifying agent being an antibody or an immunoglobulin bearing at least one antigen-binding site the antibody targeting a determinant of a tumour cell
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- C07K16/28—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
- C07K16/30—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants from tumour cells
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Definitions
- the present invention relates generally to fusion proteins. More specifically, the present invention relates to methods of enhancing the circulating half-life of antibody-based fusion proteins.
- Proteins can be joined together through either chemical or genetic manipulation using methods known in the art. See, for example, Gillies et al, Proc. Natl. Acad. Sci. USA S :1428- 1432 (1992); and U.S. Patent No. 5,650,150.
- antibody-cytokine fusion proteins have been shown to have a significantly lower in vivo circulating half-life than the free antibody.
- Gillies et al. reported that all of the fusion proteins tested had an ⁇ phase (distribution phase) half-life of less than
- Immunoglobulin G (IgG) molecules interact with multiple classes of cellular receptors including three classes of Fc ⁇ receptors (Fc ⁇ R) specific for the IgG class of antibody, namely Fc ⁇ RI, Fc ⁇ RII and Fc ⁇ RIII. They also interact with the FcRp class of receptor in a pH-dependent manner with little or no binding at neutral pH but high binding at a pH of 6.0.
- Fc ⁇ R Fc ⁇ receptors
- the serum half-life of an antibody is influenced by the ability of that antibody to bind to an Fc receptor (FcR) and to the Fc protection receptor (FcRp).
- the serum half-life of immunoglobulin fusion proteins is also influenced, for example, by the ability to bind to such receptors (Gillies et al. , Cancer Res. 59:2159-66 (1999)).
- the invention discloses the surprising observation that, within fusion proteins comprising an immunoglobulin (Ig) moiety and a non-immunoglobulin (non-Ig) moiety, alteration of amino acids near thejunction of the two moieties dramatically increases the serum half-life of the fusion protein.
- the observation is surprising because the amino acid changes affect protein surfaces that are distinct from the interaction surfaces of the Fc region with the Fc receptors and with the Fc protection receptor.
- the amino acid changes of the invention have their effect even when the known Fc receptor and Fc protection receptor are not primarily determining the serum half-life of the fusion protein.
- the amino acid alterations of the invention can be combined with amino acid alterations affecting the interaction with Fc receptor and/or Fc protection receptor to achieve synergistic effects.
- the present invention provides fusion proteins containing an immunoglobulin in which the serum half-life is improved as a result of alterations that are at sites distinct from the Fc region's interaction surface with Fc receptor and Fc protection receptor (FcRp).
- the present invention also provides methods for the production of fusion proteins between an immunoglobulin moiety and a second, non-immunoglobulin protein having an improved serum half-life.
- the alterations in the amino acid sequence of the fusion protein are preferentially at the junction of the Ig moiety and the non-Ig moiety.
- the junction region of the fusion protein contains alterations that, relative to the naturally occurring sequences of the Ig heavy chain and non-Ig protein, preferably lie within about 10 amino acids of the junction point. More preferably, the amino acid changes cause an increase in hydrophobicity. Even more preferably, the amino acid changes involve changing the C-terminal lysine of the antibody moiety to a hydrophobic amino acid such as alanine or leucine.
- the fusion protein of the invention comprises an Ig heavy chain, preferably located N-terminal to a second, non-Ig protein.
- the binding affinity of fusion proteins for FcRp is optimized by alteration of the interaction surface of the Fc moiety that contacts FcRp.
- the important sequences for the binding of IgG to the FcRp receptor have been reported to be located in the CH2 and CH3 domains.
- alterations of the fusion junction in a fusion protein are combined with alterations of Fc's interaction surface with FcRp to produce a synergistic effect. In some cases it may be useful to increase the interaction of the Fc moiety with FcRp at pH 6, and it may also be useful to decrease the interaction of the Fc moiety with FcRp at pH 8. Such modifications include alterations of residues necessary for contacting
- an antibody-based fusion protein with enhanced in vivo circulating half-life is obtained by first linking the coding sequences of an Ig constant region and a second, non-immunoglobulin protein and then introducing a mutation (such as a point mutation, a deletion, an insertion, or a genetic rearrangement) in an IgG constant region at or near one or more amino acid selected from He 253, His 310 and His 435.
- a mutation such as a point mutation, a deletion, an insertion, or a genetic rearrangement
- the resulting antibody-based fusion proteins have a longer in vivo circulating half-life than the unmodified fusion proteins.
- the Ig component of the fusion protein has at least a portion of the constant region of an IgG that has reduced binding affinity for at least one of Fc ⁇ RI, Fc ⁇ RII or Fc ⁇ RIII.
- the gamma4 chain of IgG may be used instead of gammal .
- the alteration has the advantage that the gamma4 chain results in a longer serum half-life, functioning synergistically with one or more mutations at the fusion junction.
- IgG2 may also be used instead of IgGl .
- a fusion protein in an alternative embodiment of the invention, includes a mutant IgGl constant region, for example an IgGl constant region having one or more mutations or deletions of Leu 234 , Leu 235 , Gly 2 6 , Gly 237 , Asn 297 , or Pro 331 .
- a fusion protein includes a mutant IgG3 constant region, for example an IgG3 constant region having one or more mutations or deletions of Leu 281 , Leu 282 , Gly 283 , Gly 28 , Asn 344 , or Pro 378 .
- the second, non-immunoglobulin moiety of the fusion protein is a cytokine.
- cytokine is used herein to describe naturally occurring or recombinant proteins, analogs thereof, and fragments thereof which elicit a specific biological response in a cell which has a receptor for that cytokine.
- cytokines are proteins that may be produced and excreted by a cell.
- Cytokines preferably include interleukins such as interleukin-2 (IL-2), IL-4, IL-5, IL-6, IL-7, IL-10, IL-12, IL-13, IL-14, IL-15, IL-16 and IL-18, hematopoietic factors such as granulocyte-macrophage colony stimulating factor (GM-CSF), granulocyte colony stimulating factor (G-CSF) and erythropoeitin, tumor necrosis factors (TNF) such as TNF ⁇ , lymphokines such as lymphotoxin, regulators of metabolic processes such as leptin, interferons such as interferon ⁇ , interferon ⁇ , and interferon ⁇ , and chemokines.
- interleukin-2 IL-2
- IL-4 interleukin-5
- IL-6 IL-7
- IL-10 IL-12
- IL-13 IL-13
- IL-14 IL-15
- IL-16 and IL-18 hematop
- the antibody-cytokine fusion protein of the present invention displays cytokine biological activity.
- the second, non-immunoglobulin moiety of the fusion protein is a ligand-binding protein with biological activity.
- ligand-binding proteins may, for example, (1) block receptor-ligand interactions at the cell surface; or (2) neutralize the biological activity of a molecule (e.g., a cytokine) in the fluid phase of the blood, thereby preventing it from reaching its cellular target.
- ligand-binding proteins include CD4, CTLA-4, TNF receptors, or interleukin receptors such as the IL-1 and IL-4 receptors.
- the antibody-receptor fusion protein of the present invention displays the biological activity of the ligand-binding protein.
- the second, non-immunoglobulin moiety of the fusion protein is a protein toxin.
- the antibody-toxin fusion protein of the present invention displays the toxic activity of the protein toxin.
- the second, non-immunoglobulin moiety of the fusion protein is a hormone, neurotrophin, body-weight regulator, serum protein, clotting factor, protease, extracellular matrix component, angiogenic factor, anti-angiogenic factor, or another secreted protein or secreted domain.
- a hormone for example, CD26, IgE receptor, polymeric IgA receptor, other antibody receptors, Factor NIII, Factor IX, Factor X, TrkA, PSA, PSMA, Flt-3 Ligand, endostatin, angiostatin, and domains of these proteins.
- the second, non-immunoglobulin moiety is a non-human or non-mammalian protein.
- HIN gpl20 HIN Tat, surface proteins of other viruses such as adenovirus, and RSN, other HIN components, parasitic surface proteins such as malarial antigens, and bacterial surface proteins are preferred.
- these non-human proteins may be used, for example, as antigens, or because they have useful activities.
- the second, non- immunoglobulin moiety may be streptokinase, staphylokinase, urokinase, tissue plasminogen activator, or other proteins with useful enzymatic activities.
- the non-immunoglobulin moiety can be a portion of a protein.
- the non-Ig protein moiety is a protein portion that substantially retains the functional and or structural properties of an intact protein.
- the non- Ig protein moiety is a functional or structural portion of a protein described herein.
- the antibody-based fusion protein comprises a variable region specific for a target antigen as well as a constant region, either of which is linked through a peptide bond to a second, non-immunoglobulin protein.
- the constant region may be the constant region normally associated with the variable region, or a different one, e.g., variable and constant regions from different species.
- the heavy chain may include any combination of one or more CHI, CH2, or CH3 domains.
- the heavy chain includes CHI, CH2, and CH3 domains, and more preferably, only CH2 and CH3 domains.
- the antibody- based one fusion protein comprises an Fv region with fused heavy and light chain variable regions.
- fusion protein constructs having a binding domain comprising framework regions and variable regions (i.e., complementarity determining regions) from different species, such as are disclosed by Winter, et al., Great Britain Patent No. 2,188, 638.
- Antibody-based fusion proteins comprising a variable region preferably display antigen- binding specificity.
- the antibody-based fusion protein further comprises a light chain. The invention thus provides fusion proteins in which the antigen-binding specificity and activity of an antibody are combined with the potent biological activity of a second, non-immunoglobulin protein, such as a cytokine.
- a fusion protein of the present invention can be used to deliver selectively the second, non-immunoglobulin protein to a target cell in vivo so that the second, non-immunoglobulin protein can exert a localized biological effect.
- the antibody-based fusion protein comprises a heavy chain constant region linked through a peptide bond to a second, non-immunoglobulin protein, but does not comprise a heavy chain variable region.
- the invention thus further provides fusion proteins which retain the potent biological activity of a second, non- immunoglobulin protein, but which lack the antigen-binding specificity and activity of an antibody.
- the fusion protein comprises two chimeric chains comprising at least a portion of a heavy chain and a second, non-Ig protein linked by a disulfide bond.
- the fusion proteins of the invention are useful to treat cancer, viral infections, immune disorders, and to enhance the growth (including proliferation) of specific cell types.
- the invention also features DNA constructs encoding the above-described fusion proteins, and cell lines, e.g., myelomas, transfected with these constructs.
- Figure 1 shows the pharmacokinetic behavior of the KS-IL-2 fusion protein and various mutant fusion proteins containing substitutions of the antibody heavy chain's C-terminal lysine moiety or other alterations described in the Examples.
- Levels of antibody or fusion protein were measured by an ELISA that tests for IL-2 ( Figure 1 A) or human Fc ( Figure IB).
- Figure 2 shows the pharmacokinetic properties of KS-IL-2 fusion proteins carrying either the gammal or gamma4 chain with either the wild-type lysine or the lysine-to-alanine mutation at the C-terminus of the antibody heavy chain. Levels of antibody or fusion protein were measured by an ELISA that tests for the IL-2 moiety.
- Figure 3 shows the pharmacokinetic properties of fusions of a human antibody to Tumor
- Necrosis Factor alpha (TNFalpha). Levels of fusion protein were measured by an ELISA that tests for the human Fc region. Shown are the levels of an intact antibody-TNFalpha fusion protein (black diamonds) and the levels of an otherwise identical fusion protein in which the C- terminal lysine of the antibody moiety has been deleted (gray squares).
- Figure 4 shows the binding of antibody-IL-2 fusion proteins to membranes of fixed J774 cells, which are rich in the Fc ⁇ R class of receptor. Shown are the binding of a non-mutant KS- IL-12 fusion protein (black diamonds) and a KS-IL-12 fusion protein carrying a mutation of the heavy chain C-terminal Lysine to Alanine (gray squares).
- Figure 5 shows the effect of antibody-cytokine fusion protein treatment of Balb/C mice bearing subcutaneous tumors derived from CT26 colon carcinoma cells that were engineered to express human EpCAM, the antigen for KS.
- the present invention provides antibody fusion proteins having one or more mutations at thejunction between the Ig and non-Ig moieties which increase the circulating half lives of the fusion proteins.
- the mutant fusion proteins of the invention have the advantageous property that their serum half-life is improved without affecting the interaction of the antibody moiety with either of the two known pharmacokinetic-determining receptors in the body: Fc receptor and FcRp.
- an antibody-based fusion protein of the invention comprises a portion of an immunoglobulin (Ig) protein joined to a non-immunoglobulin (non-Ig) protein, such that the amino acid sequence of the region spanning the junction between the Ig and non-Ig proteins has at least one mutation when compared to the wild-type amino acid sequences of the Ig and non-Ig proteins.
- Ig immunoglobulin
- non-Ig non-immunoglobulin
- At least one mutation is in the C-terminal region of the Ig portion. In another embodiment, at least one mutation is in the N-terminal region of the non-Ig protein. In a further embodiment, the fusion protein contains at least one mutation in the C-terminal region of the Ig portion, and at least one mutation in the N-terminal region of the non-Ig protein.
- a mutation may be a point mutation, an insertion, a deletion, or a gene rearrangement. In preferred embodiments the mutation increases the hydrophobicity of the junction region.
- the mutation replaces a charged or ionizable amino acid with a non-charged or hydrophobic amino acid (e.g., a Lys, Arg or other ionizable residue is replaced with an Ala, Leu, Gly, Trp or other non-charged or hydrophobic residue).
- a non-charged or hydrophobic amino acid e.g., a Lys, Arg or other ionizable residue is replaced with an Ala, Leu, Gly, Trp or other non-charged or hydrophobic residue.
- a spacer or linker peptide is inserted between the Ig and non- Ig proteins.
- the spacer or linker peptide is preferably non-charged, more preferably non-polar, and or hydrophobic.
- the length of a spacer or linker peptide is preferably between 1 and about 100 amino acids, more preferably between 1 and about 50 amino acids, or between 1 and about 25 amino acids, and even more preferably between 1 and about 15 amino acids.
- the Ig and non-Ig moieties of the fusion protein are joined via a spacer or linker peptide, and there is at least one mutation in either one or both of the Ig and non- Ig moieties.
- an immunoglobulin (Ig) chain is an immunoglobulin protein or a portion of an immunoglobulin protein that includes a variable or a constant domain.
- An Ig chain is preferably a portion of an immunoglobulin heavy chain, for example, an immunoglobulin variable region capable of binding a preselected cell-type.
- the Ig chain comprises a variable region specific for a target antigen as well as a constant region.
- the constant region may be the constant region normally associated with the variable region, or a different one, e.g., variable and constant regions from different species.
- an Ig chain includes a heavy chain.
- the heavy chain may include any combination of one or more CHI, CH2, or CH3 domains.
- the heavy chain includes CHI, CH2, and CH3 domains, and more preferably only CH2 and CH3 domains.
- the portion of the immunoglobulin includes an Fv region with fused heavy and light chain variable regions.
- a non-immunoglobulin protein includes a naturally occurring protein that is not an immunoglobulin, or a synthetic or recombinant protein that is not an immunoglobulin, or a fragment of any of the above.
- a non- immunoglobulin protein includes a functional domain such as a ligand binding domain, an enzymatic domain, a regulatory domain, or a domain that interacts with one or more cellular factors.
- a non-immunoglobulin domain comprises a structural domain or an epitope.
- the Ig chain is joined to the non-Ig protein via a gene fusion.
- the gene fusion is synthetic or recombinant, and is generated using standard techniques of chemical synthesis or molecular biology.
- a mutation is introduced as part of the gene fusion construct.
- a mutation may be introduced subsequently, using known methods of mutagenesis (for example by exposing the gene fusion construct to irradiation, or chemical or biological mutagenesis).
- a junction region is the region of the fusion protein surrounding the junction point between the Ig and non-Ig moieties of the fusion protein.
- thejunction region includes the C-terminal portion of the Ig moiety and the N-terminal portion of the non-Ig moiety. In one embodiment, thejunction region also comprises a spacer or linker peptide inserted at the junction point between the Ig and non-Ig moieties.
- a mutation in the Ig moiety is in the C-terminal portion of the Ig moiety, preferably within about 100 residues, more preferably within about 50 residues, or about 25 residues, and even more preferably within about 10 residues from the C-terminus of the Ig moiety.
- a mutation in the non-Ig moiety is in the N-terminal portion of the non-Ig moiety, preferably within about 100 residues, more preferably within about 50 residues, or about 25 residues, and even more preferably within about 10 residues from the N-terminus of the non-Ig moiety.
- a mutation is in the C-terminal region of the Ig moiety, but the mutation is not in part of the Ig protein that interacts with the Fc receptor (FcR) or FcRp.
- An antibody fusion protein having a mutation according to the invention has an increased in vivo circulating half-life when compared to the circulating half-life of a corresponding antibody fusion protein without the mutation.
- the circulating half-life of an antibody fusion protein can be measured by assaying the serum level of the fusion protein as a function of time.
- Experimental evidence indicates that the effects of preferred mutations of the invention are not dependent on interactions with FcR or FcRp.
- preferred mutations that increase the circulating half-life of a fusion protein do not affect regions of the antibody that, on the three dimensional structure, are part of the interaction surface that binds to FcR or to FcRp.
- preferred mutations of the invention can cause an improvement in serum half-life even when the interaction with FcR is removed by use of an IgG-gamma4 chain and the interaction with FcRp is removed by performing the pharmacokinetic study in a beta2-microglobulin mutant mouse in which FcRp is defective.
- preferred mutations of the invention do not significantly affect the binding of Ig fusion proteins to FcR on J774 cells.
- the structure of the Fc/FcRp complex indicates that FcRp binds to the side of the Fc region, with contacts in both the CH2 and CH3 domains, and that the contacted region is not particularly close to the C-terminus of the Fc region. Thus, alteration of the very C-terminal region of the Fc is not expected to alter the interaction with FcRp.
- mutations in the fusion junction region that increase the circulatory half life of a fusion protein according to the invention also reduce cleavage of the fusion protein in a protease cleavage assay, as illustrated in Example 15. It is further believed that protease digestion may contribute to the disappearance of intact proteins form the body, including fusion proteins.
- protease digestion of non-denatured proteins involves access by a protease to an exposed sequence in the correct conformation, as well as recognition of a specific sequence of amino acids.
- mutations in the fusion junction that affect the general conformation of a protein and thus affect accessibility of proteases to their cleavage sites may contribute to protease resistance and to improved pharmacokinetics.
- mutations that alter specific protease recognition sequences may contribute to protease resistance and to improved pharmacokinetics.
- a feature of mutations of the invention is that they can be combined with other mutations or substitutions in the antibody moiety to synergistically modulate serum half-life or other properties of the Ig moiety.
- one or more mutations of the invention that increase the circulating half-life of an antibody fusion protein can be combined with one or more mutations that affect the interaction between the antibody fusion protein and FcR or FcRp.
- the mutations of the invention can be used with a wide variety of antibody moieties and with a wide variety of non-Ig fusion partners.
- the immunoglobulins include IgG, IgM, IgA, IgD, and IgE.
- the non-Ig fusion partners include cytokines, other secreted proteins, enzymes, or soluble fragments of transmembrane receptors, such as ligand-binding domains.
- an antibody-based fusion protein with an enhanced in vivo circulating half-life can be further enhanced by modifying within the Fc portion itself.
- These may be residues including or adjacent to He 253, His 310 or His 435 or other residues that can effect the ionic environments of these residues when the protein is folded in its 3 -dimensional structure.
- the resulting proteins can be tested for optimal binding at pH 6 and at pH 7.4-8 and those with high levels of binding at pH 6 and low binding at pH 8 are selected for use in vivo.
- Such mutations can be usefully combined with thejunction mutations of the invention.
- Methods and compositions of the invention are useful when coadministered with angiogenesis inhibitors such as those disclosed in PCT/US99/08335 (WO 99/52562) or prostaglandin inhibitors such as those disclosed in PCT/US99/08376 (WO 99/53958).
- Methods and compositions of the invention can also be used in multiple cytokine protein complexes such as those disclosed in PCT/US00/21715. Methods and compositions of the invention are also useful in combination with other mutations disclosed in PCT/US99/03966 (WO 99/43713) that increase the circulating half-life of a fusion protein.
- Non-limiting methods for synthesizing useful embodiments of the invention are described in the Examples herein, as well as assays useful for testing pharmacokinetic activities, both in vitro and in pre-clinical in vivo animal models.
- the preferred gene construct encoding a chimeric chain includes, in 5' to 3' orientation, a DNA segment which encodes at least a portion of an immunoglobulin and DNA which encodes a second, non-immunoglobulin protein.
- An alternative preferred gene construct includes, in 5' to 3' orientation, a DNA segment which encodes a second, non-immunoglobulin protein and DNA which encodes at least a portion of an immunoglobulin.
- the fused gene is assembled in or inserted into an expression vector for transfection of the appropriate recipient cells where it is expressed.
- the invention also provides methods for identifying mutations that increase the circulatory half-life of an antibody-based fusion protein.
- the methods comprise introducing one or more mutations in a region spanning the junction between the Ig moiety and the non-Ig moiety of an antibody-based fusion protein.
- the circulating half-life of the mutated fusion protein is assayed, preferably by monitoring its serum level in vivo as a function of time.
- a mutation that increases the circulatory half-life of an antibody-based fusion protein is a mutation that reduces cleavage of the fusion protein in a protease cleavage assay, as discussed in Example 15.
- the mutation is preferably a mutation in a region spanning thejunction between the Ig moiety and the non-Ig moiety of the fusion protein (for example, a mutation in the junction region discussed above).
- the mutation may be any mutation in the fusion protein that reduces protease cleavage and increases the circulatory half life of the fusion protein, as described in Example 16.
- the invention provides methods for screening mutations in proteins in general, and preferably in an Ig-cytokine fusion protein, to identify mutations that increase the circulatory half-life of the fusion protein.
- the invention is illustrated further by the following non-limiting examples.
- the amino acid residue numbers used herein refer to the IgGl amino acid sequence.
- One of ordinary skill in the art will understand that corresponding mutations in fusion proteins involving other Ig proteins are useful to increase their circulating half-lives. Accordingly, the teachings presented herein are applicable to other Ig molecules such as
- Example 1 Construction of antibody-IL-2 genes with substitutions of the Lvs codon at the fusion junction
- the amino acid sequence at the junction of the antibody-IL-2 fusion protein is
- SerProGlyLys-AlaProThr (SEQ ID NO: 1), in which the SerProGlyLys (SEQ ID No. 2) is the normal carboxy terminus of the heavy chain of the antibody, and AlaProThr is the N-terminal sequence of mature IL-2.
- substitutions or deletion of the residue were made by mutagenesis, as described below.
- the IL-2 cDNA was constructed by chemical synthesis and it contains a new and unique PvuII restriction site [Gillies at al, (1992) Proc. Natl. Acad. Sci. 89:1428-1432]. Both the Xmal and PvuII sites are unique in the expression vector, and they facilitated mutagenesis of the lysine codon which lies at the junction of the CH3 and the IL-2 DNA.
- Substitution or deletion of the Lys codon was achieved by replacing the Xmal-PvuII fragment in the immunocytokine expression vector with an oligonucleotide duplex encoding the desired mutation.
- the variable regions of the heavy and light chains were derived from the humanized KS antibody, which recognized a human antigen called EpCAM (Epithelial cell adhesion molecule).
- EpCAM Ephelial cell adhesion molecule.
- the sequences of the oligonucleotide duplexes used in the present invention are listed below, where the codons in bold encode the desired mutations, and the sequences in italics, CCCGG and CAG are the cohesive end of the Xmal site and the blunt end of the PvuII site, respectively.
- oligonucleotide duplex with 5'-hydroxyl ends were used in the ligation to the Xmal-PvuII digested expression vector.
- the use of oligonucleotides with 5'- hydroxyl ends eliminated self ligation of the oligonucleotide duplex.
- a Narl restriction site (GGCGCC) was also introduced by silent mutation to facilitate screening of recombinant clones.
- a Narl restriction site (GGCGCC) was also introduced by silent mutation to facilitate screening of recombinant clones.
- a Fspl restriction site (TGCGCA was also introduced by silent mutation to facilitate screening of recombinant clones.
- Example 2 Construction of antibody-IL-2 genes encoding extra amino acid residues at the fusion junction It is common in the art to separate domains in fusion proteins with flexible linkers containing amino acid residues such as glycine and serine. The importance of the spacing between the CH3 and IL-2 was studied in the following mutagenesis experiments. Blunt ended oligonucleotide duplexes encoding different number of amino acid residues were inserted into the Smal endonuclease restriction site (same recognition site as the Xmal mentioned above) of the huKS-IL-2 expression vector by ligation; and the correct orientation of insertion was confirmed by DNA sequencing. As discussed above, oligonucleotide duplexes with 5'-hydroxyl ends were used to eliminate self ligation.
- linker oligonucleotide duplex
- the sequence GCATGC encodes a Sphl restriction site, which facilitated screening of recombinants containing the linker insertion.
- the linker put a Cys residue at the original position of the Lys residue, for a possible interchain disulphide bond formation.
- the original Lys residue was pushed back by 3 amino acid residues (AlaCysGly).
- linker oligonucleotide duplex
- the sequence GGATCC encodes a BamHI restriction site, which facilitated screening of recombinants containing the linker insertion.
- linker oligonucleotide duplex
- the sequence GGATCC encodes a BamHI restriction site, which facilitated screening of recombinants containing the linker insertion.
- proline in the sequence ProGlyLys at the carboxyl terminus of CH3 is mutated to
- TNF ⁇ cytokine
- the complete cDNA sequence of TNF ⁇ was published by Nedwin at al. in Nucleic Acids Res. (1985) 13:6361-6373, and the expression of an antibody-TNF ⁇ also has been described by Gillies at al. in Bioconjugate Chem. (1993) 4:230-235.
- the fusion junction of the antibody-TNF ⁇ has the sequence SerProGlyLys- NalArgSerSerSer (SEQ ID NO: 34), where Nal is the ⁇ -terminal residue of the mature T ⁇ F ⁇ .
- D ⁇ A encoding huKS-(deleted Lys)-T ⁇ F ⁇ was constructed by an overlapping PCR method [Daugherty at al, (1991) Nucleic Acids Res. 19:2471-2476] with mutagenic primers encoding the deletion of the Lys residue.
- TNF ⁇ therefore encodes the peptide sequence SerProGly-NalArgSerSerSer (SEQ ID NO: 35) at the fusion junction. Additional modifications of this fusion protein according to the new invention might include the removal of the Arg residue in the amino terminal sequence of TNF to further reduce the overall charge of the junction region.
- Example 6 Construction of huKS-fEU)-(Lvs to AlaVIL-2 DNA
- All the antibody-cytokine fusion proteins mentioned in the examples above were based on a certain allotype of the human IgGl represented by the myeloma H chain, KOL.
- KOL human IgGl represented by the myeloma H chain
- the EU allotype differs from the KOL allotype in three amino acid residues in the constant regions.
- the EU allotype contains Lys-229 at the end of CHI, and Asp- 356 and Leu-358 at the beginning of CH3.
- the KOL allotype contains Arg-229, Glu-356 and Met-358 at the corresponding positions.
- the DNA encoding the EU allotype was obtained by mutagenesis of the KOL DNA using the overlapping PCR method. The resultant EU DNA was then used to replace the corresponding fragment of the KOL DNA to generate the expression vector for producing huKS-(EU)-(Lys to Ala)-IL-2.
- Example 7 Transfection of cells and Expression of Proteins
- the plasmid was introduced into Baby Hamster Kidney (BHK) cells by lipofection using Lipofectamine Plus (Life Technologies, Gaithersburg, MD) according to supplier's protocol.
- plasmid DNA was introduced into the mouse myeloma NS/0 cells by electroporation.
- NS/0 cells were grown in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum, 2 mM glutamine and penicillin/streptomycin.
- About 5xl0 6 cells were washed once with PBS and resuspended in 0.5 ml PBS.
- Ten ⁇ g of linearized plasmid DNA were then incubated with the cells in a Gene Pulser Cuvette (0.4 cm electrode gap, BioRad) on ice for 10 min.
- Electroporation was performed using a Gene Pulser (BioRad, Hercules, CA) with settings at 0.25 V and 500 ⁇ F. Cells were allowed to recover for 10 min. on ice, after which they were resuspended in growth medium and then plated onto two 96 well plates. Stably transfected clones were selected by growth in the presence of 100 nM methotrexate (MTX), which was introduced two days post-transfection. The cells were fed every 3 days for two to three more times, and MTX-resistant clones appeared in 2 to 3 weeks. Supernatants from clones were assayed by anti-Fc ELISA to identify high producers. High producing clones were isolated and propagated in growth medium containing 100 nM MTX.
- MTX methotrexate
- antibody-cytokine fusion proteins in the conditioned media were captured on Protein A Sepharose (Repligen, Cambridge, MA) and then eluted by boiling in the protein sample buffer with or without 2-mercaptoethanol. After electrophoresis on an SDS gel, the protein bands were visualized by Coomassie staining. The antibody heavy chain-IL-2 and the light chain had apparent MW of about 67 and 28 kD respectively, on SDS-PAGE.
- the fusion proteins bound on Protein A Sepharose were eluted in a sodium phosphate buffer (100 mM NaH 2 PO , pH 3, and 150 mM NaCl). The eluate was then immediately neutralized with 0. IN NaOH.
- Example 8 ELISA Procedures ELISAs were used to determine the concentrations of protein products in the supernatants of MTX-resistant clones and other test samples.
- the anti-huFc ELISA consists of a capturing step using goat anti-human IgG (against both heavy and light chains) and a detection step using the horseradish peroxidase-conjugated F(ab') 2 fragment of goat anti-human IgG, Fc fragment specific. Therefore, the anti-huFc ELISA measures human IgG, either as an antibody by itself or as a cytokine fusion protein. To determine the concentration of the intact antibody-IL-2 fusion protein, an IL-2-detection ELISA was used.
- the anti-huFc ELISA is described in detail below.
- Test samples were diluted to the proper concentrations in sample buffer, which contains 1% BSA/1% goat serum/0.05% Tween in PBS.
- a standard curve was prepared with a chimeric antibody (with a human Fc), the concentration of which was known.
- serial dilutions are made in the sample buffer to give a standard curve ranging from 125 ng/mL to 3.9 ng/mL.
- the diluted samples and standards were added to the plate, 100 ⁇ L/well and the plate was incubated at 37°C for 2 hr. After incubation, the plate was washed 8 times with 0.05% Tween in PBS.
- the substrate solution was added to the plate at 100 ⁇ L/well.
- the substrate solution was prepared by dissolving 30 mg of OPD (o-phenylenediamine dihydrochloride, 1 tablet) into 15 mL of 0.025 M Citric acid/0.05 M Na 2 HPO 4 buffer, pH 5, which contained 0.03% of freshly added H 2 O 2 .
- OPD o-phenylenediamine dihydrochloride
- the color was allowed to develop for 30 min. at room temperature in the dark.
- the developing time is subject to change, depending on lot to lot variability of the coated plates, the secondary antibody, etc. Watch the color development in the standard curve to determine when to stop the reaction.
- the reaction was stopped by adding 4N H 2 SO , 100 ⁇ L/well.
- the plate was read by a plate reader, which was set at both 490 and 650 nm and programmed to subtract the background OD at 650 nm from the OD at 490 nm.
- Example 9 Pharmacokinetic behavior of antibody-cytokine fusion proteins carrying alterations at the fusion junction.
- the fusion proteins were tested for their pharmacokinetic behavior following intravenous injection into Balb/c mice. Blood was collected from mice by retro-orbital bleeding and stored at 4°C in Eppendorf micro-centrifuge tubes. In some cases, two different ELISA methods were used to measure both the amount of human antibody and the amount of second, fused non-Ig protein remaining in the blood at various time points. Alternatively, the presence of the non-Ig moiety was inferred by Western blot analysis of pharmacokinetic time points.
- the KS(gamrnal)- ⁇ L-2 fusion mutant proteins were injected into mice, and the effect on serum half-life was determined. Some of the results are shown in Figure 1 and Figure 2.
- the effect of deletion of the antibody heavy chain's C-terminal lysine was examined in an IgG(gammal)-IL-2 fusion in which the antibody had a different binding specificity.
- the pharmacokinetic properties of a 14.18(Lys -> Ala)-IL-2 were superior to 14.18-IL-2 to an extent that was similar to the improvement of KS(Lys - Ala)-IL-2 as compared to KS-IL-2.
- KS(Lys - deleted)-TNF alpha were significantly improved as compared to KS-TNFalpha ( Figure 3).
- the pharmacokinetic profile of the KS- TNFalpha fusion protein was unusual in that, when the levels of human antibody are measured by Fc ELISA, there was a sharp drop in the level of detected protein within the first 30 minutes, followed by a slow increase in the level of human Fc-reactive material. This effect was highly reproducible.
- KS-TNFalpha fusion protein carrying a deletion of the C-terminal lysine indicated that this protein survived primarily in an intact form, with TNF still present.
- a KS-TNFalpha fusion protein was expressed in which the first eight amino acids of the mature TNFalpha sequence were deleted. The pharmacokinetic properties of the deleted KS-TNFalpha fusion protein were superior to corresponding proteins having the entire mature TNF sequence. This is likely due to removal of the charged Arg residue at the +2 position of the mature TNF which increases the hydrophobicity of the junctional region.
- Example 10 Combining mutations at the fusion junction with a change in Ig type from gammal to gamma4 leads to a svnergistic enhancement of serum half-life that is independent of FcRp function.
- fusion proteins that comprise a gamma4 Fc region generally have a superior pharmacokinetic properties as compared to fusion proteins having the gammal chain.
- junction mutations affect pharmacokinetics through an effect on an Fc receptor interaction, an FcRp interaction, or both
- the pharmacokinetic properties of gammal- and gamma4-containing fusion proteins with or without junction mutations were examined in mice that were either normal or defective in FcRp. The results of these pharmacokinetic experiments are shown in Figure 2.
- Figure 2 shows the pharmacokinetic behavior of a KS(gammal)-IL-2 fusion protein, a
- KS(gamma4)-IL-2 fusion protein a KS(gammal)(Lys-to-Ala)-IL-2 fusion protein, and a KS(gamma4)(Lys-to-Ala)-IL-2 fusion protein. Normal mice and mutant mice defective in beta2 microglobulin were examined.
- Figure 2 also shows the pharmacokinetic properties of the same proteins when injected into mutant mice lacking the beta2-microglobulin protein, which is an essential subunit of FcRp (Junghans and Anderson, Proc. Nat Acad. Sci. (1996) 93:5512-5516).
- these mutant mice are defective in FcRp activity.
- the catabolism of antibodies is about 10-fold faster in such mutant mice than in normal mice.
- the data of Figure 2 indicated that the KS (gammal) antibody, a KS (gammal )-IL-2 fusion protein, a KS (gamma4)-IL-2 fusion protein, a KS (gammal )(Lys-to-Ala)-IL-2 fusion protein, and a KS (gamma4)(Lys-to-Ala)-IL-2 fusion protein all were catabolized more rapidly in the beta2-microglobulin mutant mice than in wild-type mice.
- the relative order of serum half-lives is the same for these proteins in both mouse strains: the unfused antibody has the best pharmacokinetics, followed by the KS(gamma4)(Lys-to-Ala)-IL-2 fusion protein, the
- KS(gammal)(Lys-to-Ala)-IL-2 fusion protein the KS(gamma4)-IL-2 fusion protein, with the KS(gammal)-IL-2 fusion protein having the worst pharmacokinetic properties. If a junction mutation had its effect exclusively by changing the interaction of a fusion protein with FcRp, then in the absence of FcRp function, thejunction mutation should have no effect on pharmacokinetics.
- a mutation in a gene encoding the heavy chain of the intact, unfused KS antibody is engineered to change the C-terminal lysine to an alanine.
- the wild-type and mutant forms of KS are expressed and purified by the methods described above, and the pharmacokinetic properties are compared. The pharmacokinetic behaviors of the wild-type and mutant antibodies are found to be indistinguishable.
- Example 13 Treatment of colon carcinoma in a mammal with an antibody-cytokine fusion protein containing a junction mutation.
- CT26 is a colon carcinoma cell line derived from Balb/C mice. By standard genetic engineering techniques, this cell line was engineered to express the human epithelial cell adhesion molecule (EpCAM), which is the antigen recognized by the KS antibody; these cells are termed CT26/E ⁇ CAM cells (Gillies at al. Journal of Immunology (1998) 160:6195-6203).
- EpCAM human epithelial cell adhesion molecule
- mice were subcutaneously inoculated with 2x10 6 CT26/EpCAM cells. When tumors reached a volume of about 50-200 cubic millimeters, mice were randomized into three groups of 7 mice for further study. Beginning at day 0, tumor-bearing mice were treated with PBS, about 10 micrograms of KS-IL2 with an IgGl heavy chain (KS-IL2gammal), or about 10 micrograms of KS-IL2 with an IgGl heavy chain and the Lys to Ala mutation described in the previous examples (KS-IL2gammal [Lys to Ala]). Mice were injected intravenously, once per day for five days. Tumor sizes were measured with calipers.
- KS- IL2gammal caused a significant decrease in the volume of many, but not all tumors.
- tumors were still measurable on day 21.
- the tumors shrank, so that by day 21, the tumors in all seven animals were unmeasurable, and by day 16, only two of seven mice had measurable tumors.
- black diamonds indicate average tumor volumes in mice that were injected with PBS as controls on days 0, 1, 2, 3, and 4. Filled circles indicate average tumor volumes in mice treated with 10 micrograms of KS-IL2 gammal. Intravenous injections were performed.
- the x-axis indicates the number of days elapsed following the first injection; the y-axis indicates the average tumor volume in cubic milliliters.
- Example 14 Inhibition of metastasis in a mammal treated with an antibody-cytokine fusion protein containing a junction mutation.
- Lewis Lung Carcinoma is a lung carcinoma cell line derived from C57/B16 mice. By standard genetic engineering techniques, this cell line was engineered to express the human epithelial cell adhesion molecule (EpCAM), which is the antigen recognized by the KS antibody; these cells are termed LLC/EpCAM cells. C57/B16 mice were intravenously injected with lxlO 6 LLC/EpCAM cells.
- EpCAM human epithelial cell adhesion molecule
- mice were randomized into three groups of 6 mice and treated with either PBS, about 20 micrograms of KS-IL2, or about 20 micrograms of KS-Ala-IL2 (KS-IL2 with a Lys to Ala change at the C-terminus of the Ig moiety). Metastases were quantitated on day 24. As indicated in the table below, the PBS-treated group had large numbers of metastases into the lungs. Animals treated with KS- ⁇ l-IL2 had a significantly reduced number of metastases. However, animals treated with KS- ⁇ l-ala-IL2 had even fewer metastases than animals treated with KS- ⁇ l-IL2, and in one animal, no metastases at all were detected.
- PBS >250, >250, >250, >250, 0.92 +/- 0.14
- Examples 13 and 14 illustrate that antibody-cytokine fusion proteins can inhibit establishment of metastases as well as growth of tumor cells at the primary site.
- the results indicate that antibody-cytokine fusion proteins can inhibit disease resulting from a variety of different tumor types, such as colon cancer and lung cancer.
- antibody-cytokine fusion proteins with at least one amino acid change in the linker region in accordance with the invention are more effective at inhibiting metastases and tumor growth that antibody-cytokine fusion proteins with no amino acid change in the linker region.
- Example 15 Assay of antibody fusion proteins with junction mutations for resistance to proteases.
- KS-IL2 and KS-Ala-IL2 were treated with various proteases for various times, and the resulting products were analyzed by SDS-PAGE.
- 4 micrograms of KS-IL2 and KS-Ala-IL2 were treated with 0.1 mU or 0.4 mU of Cathepsin D (Enzyme Systems, Livermore, California) for about 16 hours at 37 degrees C and analyzed by SDS-PAGE. Buffer conditions were used according to the manufacturer's instructions.
- KS-IL2 When KS-IL2 was treated with 0.4 mU of Cathepsin D, about 50% of the KS-IL2 heavy chain was converted to various lower molecular weight forms.
- the dominant digestion product had a molecular weight slightly less than that of KS-IL2 heavy chain, but much larger than the KS heavy chain. This result indicates that most of the cleavage by Cathepsin D was not taking place at the heavy chain-IL2 junction.
- KS-IL2 and KS-Ala-IL2 were treated with 25 mU or 50 mU of Cathepsin L (Enzyme Systems, Livermore, California) for about 16 hours at 37 degrees C and analyzed by SDS-PAGE. Buffer conditions were used according to the manufacturer's instructions.
- Cathepsin L Enzyme Systems, Livermore, California
- Buffer conditions were used according to the manufacturer's instructions.
- KS-IL2 was treated with 50 mU of Cathepsin L, almost all of the KS-IL2 heavy chain was converted to various lower molecular weight forms.
- the dominant digestion product had a molecular weight about the same as the KS heavy chain. This result indicates that much of the cleavage by Cathepsin L was taking place near or at the heavy chain- IL2 junction.
- KS-IL2 and KS-Ala-IL2 were treated with 0.04 mU, 0.1 mU or 0.2 mU of plasmin (Sigma, St. Louis, Minnesota) for about 16 hours at 37 degrees C and analyzed by SDS-PAGE. Buffer conditions were used according to the manufacturer's instructions.
- KS-IL2 was treated with 0.04 mU of plasmin, about 3/4 of the KS-IL2 heavy chain was converted to a lower molecular weight form with an apparent molecular weight about 30 amino acids greater than that of the KS heavy chain.
- KS- Ala-IL2 was cleaved with plasmin, a species with a molecular size about 90 amino acids greater than the KS-IL2 heavy chain accumulated to a significant extent; in the KS-IL2 digestions by plasmin, this +90 species was probably rapidly cleaved to the lower molecular weight +30 species, and thus failed to accumulate. Nonetheless, the Lys-to-Ala mutation caused a significant stabilization of intact KS-IL2 in the presence of plasmin. In each case, the antibody light chain was uncleaved under the conditions used.
- the Lys-to-Ala mutation caused a general resistance to protease cleavage, even to cleavages that do not take place at the site of the mutation.
- the Lys-to-Ala mutation may cause the IL-2 moiety of KS to become more resistant to proteases.
- Proteases may play an important role in the pharmacokinetic properties of antibody fusion proteins. For example, when antibody fusion proteins are taken up by cells bearing an Fc receptor and transported into the early endosome, it may be that the antibody moiety is resistant to the proteolytic conditions used, but that the fusion partner moiety is more sensitive, resulting in partial or complete digestion of the antibody fusion protein.
- Example 16 Use of protease digestion to evaluate mutations in antibody fusion proteins.
- This example provides a general method for improving the pharmacokinetic properties of a protein.
- a protein is tested for its pharmacokinetic properties and also its sensitivity to proteases.
- Variant proteins are generated and tested for greater resistance to proteolysis. Those variants with enhanced resistance to proteolysis are then tested for their pharmacokinetic properties. It is found that the proportion of proteolysis-resistant proteins with improved pharmacokinetic properties is greater than for the population of variant proteins as a whole.
- Some variant proteins with improved pharmacokinetic properties have one or more amino acid substitutions that do not cause a profound change in the protein structure that can be inferred by inspection of the encoding sequence, such as introduction of anN-linked glycosylation site.
- Nariant proteins are generated by, for example, mutagenesis of an expression construct and isolation of clones expressing individual variant proteins. Any of a variety of mutagenesis techniques is used, including site-directed mutagenesis, random mutagenesis, PCR-mutagenesis, and mutagenesis techniques that generate hybrid sequences from related genes. It is useful to use intracellular proteases, such as endosomal proteases, for these assays.
- extracellular proteases such as trypsin, chymotrypsin, plasmin, other digestive protease, other serum proteases such as clotting factors, and tissue-specific proteases.
- tumor-specific proteases are used to test variant proteins and identify those variants that have improved pharmacokinetic properties and stability within the tumor microenvironment.
- proteins that are to be orally delivered are tested for their resistance to enzymes present in the gastro-intestinal tract, such as trypsin and chymotrypsin. It is found that variant proteins with enhanced resistance to gastro-intestinal enzymes have improved pharmacokinetic properties, such as a greater AUC (Area Under the Curve).
- an expression construct encoding a fusion protein containing part or all of an antibody is mutagenized. Clones are generated, the corresponding proteins are expressed, and the proteins are tested, either individually or in small pools, for relative sensitivity to proteases. Variant antibody fusion proteins with enhanced resistance to proteases are then tested for their pharmacokinetic properties, and a significant number of the protease-resistant antibody fusion protein variants have improved pharmacokinetic properties.
- the nucleic acids encoding the improved variant fusion proteins are sequenced, and some improved variants are found to contain mutations at sites other than the fusion protein junction that cause the phenotype of enhanced resistance to proteolysis and improved pharmacokinetics.
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| HU0204475A HUP0204475A2 (en) | 2000-02-11 | 2001-02-09 | Enhancing the circulating half-life of antibody-based fusion proteins |
| DE60122286T DE60122286T2 (de) | 2000-02-11 | 2001-02-09 | Steigerung der zirkulierenden halbwertzeit von auf antikörpern basierenden fusionsproteinen |
| EP01916083A EP1252192B1 (en) | 2000-02-11 | 2001-02-09 | Enhancing the circulating half-life of antibody-based fusion proteins |
| AU4314801A AU4314801A (en) | 2000-02-11 | 2001-02-09 | Enhancing the circulating half-life of antibody-based fusion proteins |
| MXPA02007733A MXPA02007733A (es) | 2000-02-11 | 2001-02-09 | Mejoramiento de la vida media circulante de proteinas de fusion basadas en anticuerpos. |
| JP2001558103A JP5179689B2 (ja) | 2000-02-11 | 2001-02-09 | 抗体ベース融合タンパク質の循環系内半減期の増強 |
| CA2399832A CA2399832C (en) | 2000-02-11 | 2001-02-09 | Enhancing the circulating half-life of antibody-based fusion proteins |
| SI200130649T SI1252192T1 (sl) | 2000-02-11 | 2001-02-09 | Povecanje cirkulacijskega razpolovnega casa fuzijskih proteinov na osnovi protiteles |
| CN018058639A CN1406249B (zh) | 2000-02-11 | 2001-02-09 | 增加基于抗体的融合蛋白的循环半衰期 |
| NO20023774A NO20023774D0 (no) | 2000-02-11 | 2002-08-09 | Ökning av antistoffbaserte fusjonsproteiners halveringstid i blodomlöpet |
| CY20061101528T CY1105725T1 (el) | 2000-02-11 | 2006-10-24 | Ενισχυοντας την κυκλοφορουσα ημιπεριοδο - ζωης των με βαση - αντισωματα χιμαιρικων πρωτεϊνων |
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| US7091321B2 (en) | 2000-02-11 | 2006-08-15 | Emd Lexigen Research Center Corp. | Enhancing the circulating half-life of antibody-based fusion proteins |
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| US7183387B1 (en) | 1999-01-15 | 2007-02-27 | Genentech, Inc. | Polypeptide variants with altered effector function |
| US7211253B1 (en) | 1999-11-12 | 2007-05-01 | Merck Patentgesellschaft Mit Beschrankter Haftung | Erythropoietin forms with improved properties |
| US7217798B2 (en) | 2003-10-15 | 2007-05-15 | Pdl Biopharma, Inc. | Alteration of Fc-fusion protein serum half-lives by mutagenesis |
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| WO2007147898A1 (en) * | 2006-06-22 | 2007-12-27 | Novo Nordisk A/S | Soluble heterodimeric receptors and uses thereof |
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| NO20023774L (no) | 2002-08-09 |
| US7507406B2 (en) | 2009-03-24 |
| US20090264627A1 (en) | 2009-10-22 |
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| US7790415B2 (en) | 2010-09-07 |
| DE60122286D1 (de) | 2006-09-28 |
| CN1406249A (zh) | 2003-03-26 |
| EP1252192A2 (en) | 2002-10-30 |
| US20060034836A1 (en) | 2006-02-16 |
| US20020147311A1 (en) | 2002-10-10 |
| EP1252192B1 (en) | 2006-08-16 |
| PT1252192E (pt) | 2007-01-31 |
| NO20023774D0 (no) | 2002-08-09 |
| US7091321B2 (en) | 2006-08-15 |
| JP2012176969A (ja) | 2012-09-13 |
| HUP0204475A2 (en) | 2003-04-28 |
| JP2003522200A (ja) | 2003-07-22 |
| WO2001058957A3 (en) | 2002-05-02 |
| JP5572665B2 (ja) | 2014-08-13 |
| CY1105725T1 (el) | 2010-12-22 |
| MXPA02007733A (es) | 2004-09-10 |
| DE60122286T2 (de) | 2007-08-02 |
| CA2399832A1 (en) | 2001-08-16 |
| ES2269366T3 (es) | 2007-04-01 |
| CN1406249B (zh) | 2010-06-16 |
| ATE336514T1 (de) | 2006-09-15 |
| AU4314801A (en) | 2001-08-20 |
| CA2399832C (en) | 2011-09-20 |
| JP5179689B2 (ja) | 2013-04-10 |
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