Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/04—Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
  • A61K38/08—Peptides having 5 to 11 amino acids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
  • A61K38/22—Hormones
  • A61K38/2292—Thymosin; Related peptides
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P27/00—Drugs for disorders of the senses
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P27/00—Drugs for disorders of the senses
  • A61P27/02—Ophthalmic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P27/00—Drugs for disorders of the senses
  • A61P27/02—Ophthalmic agents
  • A61P27/04—Artificial tears; Irrigation solutions
• • 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
  • A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0048—Eye, e.g. artificial tears

Definitions

• the present invention relates to the field of the treatment of eye disorders such as "dry eye syndrome.”
• Dry eye syndrome may occur not only with advancing age due to normal aging of the glands of the eye, but also due to other degenerative changes and environmental factors and can occur at any age. Dry eye syndrome results from deleterious changes in the physiological, biochemical and im unological properties of the eye.
• dry eye results from disorders of the various glands which work together to produce normal tears. Tears themselves are a complex combination of substances which form three layers on the eye.
• the very thin outer layer contains lipids from the Meibomian glands in the eyelid, to reduce evaporation.
• the lacrimal glands produce the middle watery layer that keeps the salinity and the acidity of the tears at proper levels. This middle layer also carries antibodies and other immune defense agents to defend the eye against infection.
• the inner mucous layer helps the tear film "stick" to the cornea and stay intact.
• Sj ⁇ gren's syndrome is an immune system disorder characterized by inflammation and dryness of the mouth, eyes, and other mucous membranes, damages the lacrimal glands, and this damage affects tear production. Decreased sensitivity of the cornea can also lead to insufficient production of tears. This lack of sensitivity can be brought on by a disease known as "neurotrophic keratitis" as well as by some types of contact lens wear. Excessive evaporation of tears can also cause dry eye syndrome.
• Such evaporation may be caused by "meibomitis," which results from infection and inflammation of the meibomian glands in the eyelids.
• People with unusually large eyes, as well as those who suffer from thyroid disease, may also experience dry eye syndrome caused by excessive evaporation. Dry eye can also result from unusual facial anatomy or irregularities in the cornea, resulting in uneven or inadequate tear coverage of the eye.
• Some patients suffer from dry eye as a result of medications such as antibiotics, antihistamines, diuretics, and anti-diarrheals, which can dry up the mucous membranes.
• Hormonal changes such as may be associated with menopause and the aging process, can also affect secretions of T ⁇ 4 from the tear glands and result in dry eyes and inflamation of the eye.
• Dry eyes are typically treated by applying artificial tears and ointments. These give temporary relief, but usually do not arrest or reverse damage to the eye. Eye drops which are aimed at restoring the electrolyte balance of the tears and promoted healing of the cornea are in development. There is also evidence that dry eye may be treated with hormone therapy or antibodies. In addition, Some forms of dry eye benefit from the placement of tiny plugs in the ducts that drain tears from the eye. For severe forms of dry eye, special goggles called "moisture-chamber spectacles" can be worn.
• a method of treatment for promoting reversal of or inhibiting eye degeneration comprises administering to a subject in need of such treatment an effective amount of a composition comprising an eye degeneration-inhibiting polypeptide comprising amino acid sequence LKKTET, or a conservative variant thereof having eye degeneration- inhibiting activity.
• the present invention is based on a discovery that actin-sequestering peptides such as thymosin ⁇ 4 (T ⁇ 4) and other actin-sequestering peptides containing amino acid sequence LKKTET or conservative variants thereof, promote reversal of or inhibit eye degeneration such as may be associated with or result from dry eye syndrome.
• actin-sequestering peptides such as thymosin ⁇ 4 (T ⁇ 4) and other actin-sequestering peptides containing amino acid sequence LKKTET or conservative variants thereof, promote reversal of or inhibit eye degeneration such as may be associated with or result from dry eye syndrome.
• the potential clinical applications might include disorders due to inflammatory conditions e.g., dry eyes, uveitis, ulceris, post operative cataract surgery, LASIK or PRK, corneal melts due to rheumatoid arthritis, systemic lupus erythematosus, Mooren's ulcers,
• keratitis due to bacterial, viral, mycobacterial or fungal pathogens. Still other applications could be due to metabolic diseases of the eye such as caused by diabetes (keratopathy and retinopathy) or as a result of chemical injury, trauma and abrasions.
• Thymosin ⁇ 4 was initially identified as a protein that is up regulated during endothelial cell migration and differentiation in vitro. Thymosin ⁇ 4 was originally isolated from the thymus and is a 43 amino acid, 4.9 kDa ubiquitous polypeptide identified in a variety of tissues. Several roles have been ascribed to this protein including a role in a endothelial cell differentiation and migration, T cell differentiation, actin sequestration and vascularization.
• the invention is a method of treatment for promoting reversal of or inhibiting dry eye syndrome comprising administering to a subject in need of such treatment an effective amount of a composition comprising an agent that stimulates production of an eye degeneration-inhibiting polypeptide comprising amino acid sequence LKKTET, or a conservative variant thereof having eye degeneration-inhibiting activity, preferably Thymosin ⁇ 4, an isoform of Thymosin ⁇ 4, oxidized Thymosin ⁇ 4 or an antagonist of Thymosin ⁇ 4.
• a composition comprising an agent that stimulates production of an eye degeneration-inhibiting polypeptide comprising amino acid sequence LKKTET, or a conservative variant thereof having eye degeneration-inhibiting activity, preferably Thymosin ⁇ 4, an isoform of Thymosin ⁇ 4, oxidized Thymosin ⁇ 4 or an antagonist of Thymosin ⁇ 4.
• the present invention promotes the healing and reversal of inflammatory, degenerative, immunological and other disorders of the eye and surrounding tissue.
• compositions which may be used in accordance with the present invention include Thymosin ⁇ 4 (T ⁇ 4), T ⁇ 4 isoforms, oxidized T ⁇ 4, polypeptides comprising the amino acid sequence LKKTET or conservative variants thereof having eye degeneration-inhibiting activity.
• T ⁇ 4 Thymosin ⁇ 4
• T ⁇ 4 isoforms oxidized T ⁇ 4
• polypeptides comprising the amino acid sequence LKKTET or conservative variants thereof having eye degeneration-inhibiting activity.
• International Application Serial No. PCT/US99/17282 discloses isoforms of T ⁇ 4 which may be useful in accordance with the present invention as well as amino acid sequence LKKTET and conservative variants thereof having eye degeneration-inhibiting activity, which may be utilized with the present invention.
• PCT/GB99/00833 discloses oxidized Thymosin ⁇ 4 which may be utilized in accordance with the present invention.
• oxidized Thymosin ⁇ 4 discloses oxidized Thymosin ⁇ 4 which may be utilized in accordance with the present invention.
• the present invention is described primarily hereinafter with respect to T ⁇ 4 and T ⁇ 4 isoforms, it is to be understood that the following description is intended to be equally applicable to amino acid sequence LKKTET, conservative variants thereof having eye degeneration-inhibiting activity, as well as oxidized Thymosin ⁇ 4.
• the invention provides a method of treatment for promoting reversal of or inhibiting eye degeneration, such as may be associated with dry eye syndrome, comprising administering to a subject in need of such treatment an effective amount of a composition comprising an eye degeneration-inhibiting polypeptide comprising amino acid sequence LKKTET, or a conservative variant thereof having eye degeneration- inhibiting activity.
• the contacting may be topically or systemically.
• topical administration include, for example, contacting the eye with a solution, lotion, salve, gel, cream, paste, spray, suspension, dispersion, hydrogel, ointment, or oil comprising T ⁇ 4.
• Systemic administration includes, for example, intravenous, intraperitoneal, intramuscular injections of a composition containing T ⁇ 4 or a T ⁇ 4 isofor .
• a subject may be any mammal, preferably human.
• a composition in accordance with the present invention can be administered daily, every other day, etc., with a single application or multiple applications per day of administration, such as applications 2, 3, 4 or more times per day of administration.
• T ⁇ 4 isoforms have been identified and have about 70%, or about 75%, or about 80% or more homology to the known amino acid sequence of T ⁇ 4.
• Such isoforms include, for example, T ⁇ 4 ala , T ⁇ 9, T ⁇ 10, T ⁇ 11 , T ⁇ 12, T ⁇ 13, T ⁇ 14 and T ⁇ 15. Similar to T ⁇ 4, the T ⁇ 10 and T ⁇ 15 isoforms have been shown to sequester actin.
• T ⁇ 4, T ⁇ 10 and T ⁇ 15, as well as these other isoforms share an amino acid sequence, LKKTET, that appears to be involved in mediating actin sequestration or binding.
• the activity of T ⁇ 4 isoforms may be due, in part, to the ability to polymerize actin.
• T ⁇ 4 can modulate actin polymerization in the eye (e.g. ⁇ -thymosins appear to depolymerize F-actin by sequestering free G-actin).
• T ⁇ 4's ability to modulate actin polymerization may therefore be due to all, or in part, its ability to bind to or sequester actin via the LKKTET sequence.
• T ⁇ 4 other proteins which bind or sequester actin, or modulate actin polymerization, including T ⁇ 4 isoforms having the amino acid sequence LKKTET, are likely to reduce dry eye syndrome, alone or in a combination with T ⁇ 4, as set forth herein.
• T ⁇ 4 isoforms such as T ⁇ 4 ala , T ⁇ 9, T ⁇ 10, T ⁇ 11 , T ⁇ 12, T ⁇ 13, T ⁇ 14 and T ⁇ 15, as well as T ⁇ 4 isoforms not yet identified, will be useful in the methods of the invention.
• T ⁇ 4 isoforms are useful in the methods of the invention, including the methods practiced in a subject.
• the invention therefore further provides pharmaceutical compositions comprising T ⁇ 4, as well as T ⁇ 4 isoforms T ⁇ 4 ala , T ⁇ 9, T ⁇ 10, T ⁇ 11 , T ⁇ 12, T ⁇ 13, T ⁇ 14 and T ⁇ 15, and a pharmaceutically acceptable carrier.
• proteins having actin sequestering or binding capability or that can mobilize actin or modulate actin polymerization, as demonstrated in an appropriate sequestering, binding, mobilization or polymerization assay, or identified by the presence of an amino acid sequence that mediates actin binding, such as LKKTET, for example, can similarly be employed in the methods of the invention.
• proteins include gelsolin, vitamin D binding protein (DBP), profilin, cofilin, depactin, Dnasel, vilin, fragmin, severin, capping protein, ⁇ -actinin, actobindin and acumentin, for example.
• the invention further provides pharmaceutical compositions comprising gelsolin, vitamin D binding protein (DBP), profilin, cofilin, depactin, Dnasel, vilin, fragmin, severin, capping protein, ⁇ -actinin, actobindin and acumentin as set forth herein.
• DBP vitamin D binding protein
• profilin cofilin
• depactin Dnasel
• vilin fragmin
• severin capping protein
• ⁇ -actinin actobindin and acumentin
• the invention includes the use of a dry eye syndrome reducing polypeptide comprising the amino acid sequence LKKTET and conservative variants thereof.
• conservative variant or grammatical variations thereof denotes the replacement of an amino acid residue by another, biologically similar residue.
• conservative variations include the replacement of a hydrophobic residue such as isoleucine, valine, leucine or methionine for another, the replacement of a polar residue for another, such as the substitution of arginine for lysine, glutamic for aspartic acids, or glutamine for asparagine, and the like.
• T ⁇ 4 has been localized to a number of tissue and cell types and thus, agents which stimulate the production of T ⁇ 4 can be added to or comprise a composition to effect T ⁇ 4 production from a tissue and/or a cell.
• agents include members of the family of growth factors, such as insulin-like growth factor (IGF-1), platelet derived growth factor (PDGF), epidermal growth factor (EGF), transforming growth factor beta (TGF- ⁇ ), basic fibroblast growth factor (bFGF), thymosin ⁇ 1 (T ⁇ 1) and vascular endothelial growth factor (VEGF).
• IGF-1 insulin-like growth factor
• PDGF platelet derived growth factor
• EGF epidermal growth factor
• TGF- ⁇ transforming growth factor beta
• bFGF basic fibroblast growth factor
• T ⁇ 1 thymosin ⁇ 1
• VEGF vascular endothelial growth factor
• T ⁇ 4 compositions of the invention may reduce dry eye syndrome by effectuating growth of the connective tissue through extracellular matrix
• agents that assist or stimulate dry eye syndrome reduction may be added to a composition along with T ⁇ 4 or a T ⁇ 4 isoform.
• agents include angiogenic agents, growth factors, agents that direct differentiation of cells, agents that promote migration of cells and agents that stimulate the provision of extracellular matrix material in the eye.
• T ⁇ 4 or a T ⁇ 4 isoform alone or in combination can be added in combination with any one or more of the following agents: VEGF, KGF, FGF, PDGF, TGF ⁇ , IGF-1 , IGF-2, IL-1 , prothymosin ⁇ and thymosin ⁇ 1 in an effective amount.
• the invention also includes a pharmaceutical composition comprising a therapeutically effective amount of T ⁇ 4 or a T ⁇ 4 isoform in a pharmaceutically acceptable carrier.
• a pharmaceutically acceptable carrier include those listed above with reference to parenteral administration.
• T ⁇ 4 may be administered in any suitable amount which are effective for the treatment of dry eye or similar disorders.
• T ⁇ 4 may be administered in dosages within the range of about 0.1-50 micrograms of T ⁇ 4, more preferably in amounts of about 1-25 micrograms T ⁇ 4.
• the T ⁇ 4 may be administered as a one-time treatment, or may be administered daily, twice per day, three times per day, etc., or on alternate days and the like, until the desired results are obtained.
• Suitable topical formulations include T ⁇ 4 or a T ⁇ 4 isoform at a concentration within the range of about 0.001 - 10% by weight, more preferably within the range of about 0.01 - 0.1% by weight, most preferably about 0.05% by weight.
• the therapeutic approaches described herein involve various routes of administration or delivery of reagents or compositions comprising the T ⁇ 4 or other compounds of the invention, including any conventional administration techniques (for example, but not limited to, topical administration, local administration, or systemic administration), to a subject.
• the methods and compositions using or containing T ⁇ 4 or other compounds of the invention may be formulated into pharmaceutical compositions by admixture with pharmaceutically acceptable non-toxic excipients or carriers.
• the invention includes use of antibodies which interact with T ⁇ 4 peptide or functional fragments thereof.
• Antibodies which consist essentially of pooled monoclonal antibodies with different epitopic specificities, as well as distinct monoclonal antibody preparations are provided.
• Monoclonal antibodies are made from antigen containing fragments of the protein by methods well known to those skilled in the art as disclosed in PCT/US99/17282, supra.
• the term antibody as used in this invention is meant to include monoclonal and polyclonal antibodies.
• the invention provides a method of treating a subject by administering an effective amount of an agent which modulates T ⁇ 4 gene expression.
• modulate refers to inhibition or suppression of T ⁇ 4 expression when T ⁇ 4 is over expressed, and induction of expression when T ⁇ 4 is under expressed.
• effective amount means that amount of T ⁇ 4 agent which is effective in modulating T ⁇ 4 gene expression resulting in reducing the symptoms of the T ⁇ 4 associated dry eye syndrome.
• An agent which modulates T ⁇ 4 or T ⁇ 4 isoform gene expression may be a polynucleotide for example.
• the polynucleotide may be an antisense, a triplex agent, or a ribozyme.
• an antisense directed to the structural gene region or to the promoter region of T ⁇ 4 may be utilized.
• the invention provides a method for utilizing compounds that modulate T ⁇ 4 activity.
• Compounds that affect T ⁇ 4 activity include peptides, peptidomimetics, polypeptides, chemical compounds, minerals such as zincs, and biological agents.
• the present invention may promote reversal of or inhibit eye degeneration associated with dry eye syndrome by inducing terminal deoxynucleotidyl transferase (a non-template directed DNA polymerase), to decrease the levels of one or more inflammatory cytokines, and to act as a chemotactic factor for endothelial cells, and thereby inhibit or promote reversal of degenerative changes in the eyes brought about by aging or other degenerative or environmental factors.
• terminal deoxynucleotidyl transferase a non-template directed DNA polymerase
• T ⁇ 4 Tears from healthy young people under the age of 40 and older people over the age of 40 were examined for levels of T ⁇ 4. It was found that T ⁇ 4 is present at highest levels in tears of healthy young people, and that T ⁇ 4 in tears decreases significantly with age and menopause. Thus, dry eye syndrome and inflammation of eyes may be due to deficiency of T ⁇ 4 in tears. Therefore, administering T ⁇ 4 may reduce inflammation, promote healing of inflamed eyes and mucosa, and stimulate production of tears via healing of the glands of the eye responsible for tear production.
• Disks of WhatmanTM filter paper (size 50) were cut with a 2 mm diameter trephine. The disks were soaked in 1.0 N NaOH and applied to the central cornea of isoflourane- anesthetized mice for 30 seconds. The eyes then were irrigated with 10 ml of PBS and subsequently treated with either T ⁇ 4 (5 mg-5 ml) or a similar volume of PBS (as control) topically twice daily for seven days. After seven days, marked differences between the PBS-treated and the T ⁇ 4-treated eyes were noted. The PBS-treated eyes exhibit markedly edematous and inflamed corneas and the anterior chamber contained marked hyphema and an intense inflammatory cell infiltrate.
• the T ⁇ 4-treated corneas showed decreased stromal edema and more regularly arranged stromal lamellae.
• the overall anatomical integrity of the anterior segment of the T ⁇ 4-treated as compared to PBS-treated eyes was markedly more normal in appearance.

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• 2002
  • 2002-03-14 JP JP2002572907A patent/JP2005506293A/ja active Pending
  • 2002-03-14 WO PCT/US2002/007730 patent/WO2002074193A2/en not_active Ceased
  • 2002-03-14 EP EP02725151A patent/EP1383529A4/en not_active Withdrawn
  • 2002-03-14 US US10/471,621 patent/US20040131626A1/en not_active Abandoned
  • 2002-03-14 CN CNA2007101700684A patent/CN101195025A/zh active Pending
  • 2002-03-14 MX MXPA03008359A patent/MXPA03008359A/es not_active Application Discontinuation
  • 2002-03-14 CA CA002441147A patent/CA2441147A1/en not_active Abandoned
  • 2002-03-14 CN CNB028059174A patent/CN100360174C/zh not_active Expired - Fee Related
  • 2002-03-14 AU AU2002255736A patent/AU2002255736B2/en not_active Ceased
• 2008
  • 2008-12-19 AU AU2008261127A patent/AU2008261127A1/en not_active Abandoned
• 2009
  • 2009-05-18 JP JP2009120011A patent/JP2009179638A/ja not_active Withdrawn

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