WO2005085323A2 - Methods and compositions for treatment of autoimmune diseases - Google Patents
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Definitions
- An autoimmune disease results when a host's immune response fails to distinguish foreign antigens from self molecules (autoantigens) thereby eliciting an aberrant immune response.
- the immune response towards self molecules in an autoimmune disease results in a deviation from the normal state of self-tolerance, which involves the destruction of T cells and B cells capable of reacting against autoantigens, which has been prevented by events that occur in the development of the immune system early in life.
- the cell surface proteins that play a central role in regulation of immune responses through their ability to bind and present processed peptides to T cells are the majorhistocompatibility complex (MHC) molecules (Rothbard et al. (1991) Annu. Rev. Immunol. 9:527).
- MHC majorhistocompatibility complex
- HLA locus encodes major histocompatibility complex (MHC) genes of human. MHC molecules exist in two forms, class I and class II, both encoded within a single gene complex. MHC genes are highly polymorphic: some loci have up to several hundred alleles in the human population (Hansen et al. 1993 In “Fundamental Immunology” Ed. Paul, W.E., Raven Press, New York, NY, p.577).
- Class I MHC molecules are 45 kDa transmembrane glycoproteins, noncovalently associated with another glycoprotein, the 12 kDa ⁇ -2 microglobulin. The latter is not inserted into the cell membrane, and is encoded outside the MHC region of the genome.
- Human class I molecules are of three different isotypes, termed HLA-A, -B, and -C, encoded in separate loci. The tissue expression of class I molecules is ubiquitous and codominant. The three-dimensional structure of several human and murine class I molecules have been resolved (Bjorkman et al. (1987) Nature 329: 506; Garrett et al.
- Class II MHC molecules are noncovalently associated heterodimers of two transmembrane glycoproteins, the 35 kDa chain and the 28 kDa ⁇ chain. In humans, class II molecules occur as three different isotypes, termed HLA-DP, -DQ, and -DR. There are a minimum of six a and eight ⁇ genes, which are arranged in distinct clusters. Polymorphism in DR is restricted to the ⁇ chain, whereas both chains are polymorphic in the DP and DQ isotypes. Structural variation in class II gene products is linked to functional features of immune recognition, leading to individual variations in histocompatibility, immune recognition, and susceptibility to disease.
- Two types of dimers on the cell-surface are made up of DRce polypeptide associated with DR i, DR/3 2 , DR/3 3 , or DR/3 polypeptide.
- the two types of structural variations comprise primary amino acid sequences which differ by as much as 35%.
- the class II polypeptide chains possess domains that are specific structural subunits containing variable sequences that distinguish among class II genes and class II ⁇ genes. These allelic variation sites form antigen binding clefts, which represent individual structural differences in immune recognition.
- Class II molecules are expressed codominantly, but in contrast to class I, exhibit a restricted tissue distribution: they are present only on the surface of cells of the immune system.
- Such cells include antigen-presenting cells, for example, macrophages, dendritic cells, and Langerhans cells; epithelial tissue cells that interact with immune system, including thymic epithelial cells; B lymphocytes, monocytes and mast cells; and T cells when they are induced.
- antigen-presenting cells for example, macrophages, dendritic cells, and Langerhans cells
- epithelial tissue cells that interact with immune system including thymic epithelial cells
- B lymphocytes monocytes and mast cells
- T cells when they are induced.
- the peptide binding site is composed of the first domains of the and ⁇ chains, which, in contrast to class I, is open on both sides, allowing the binding of longer (12-24 residues long) peptides (Chicz et al (1992) Nature, 358: 764).
- An additional binding site on the second domain of both and ⁇ chains interacts with the CD4 molecule, expressed selectively on helper T (Th) cells.
- This molecule has a co-receptor function for T helper (Th) cells, analogous to that of CD8 for cytotoxic T (Tc) cells.
- T helper 1 T helper 1
- Th2 T helper 2
- Thl cells participate in providing cell-mediated immunity, which is generally pro-inflammatoiy.
- Thl cells produce pro-inflammatory cytokines such as interferon(IFN)- ⁇ and interleukin (IL)-2.
- Th2 cells participate in providing humoral immunity, which is generally non- inflammatory.
- Th2 cells produce non-inflammatory cytokines such as IL-4, IL-5, IL-10, and IL-13.
- the activated T cells may also be induced to proliferate or to undergo apoptosis.
- peptides bound to, and presented by, MHC molecules may activate either Thl or Th2, shifting the balance of pro-inflammatory and non-inflammatory responses, depending on the identity of the peptides.
- autoimmune diseases are strongly associated with specific alleles of the major histocompatibility complex (reviewed in Tiwari and Terasaki (1985), "HLA and disease association,” New York; Springer Verlag).
- Autoimmune diseases include rheumatoid arthritis (RA), multiple sclerosis (MS), human type I or insulin-dependent diabetes mellitus (IDDM), autoimmune uveitis, primary biliary cirrhosis (PBC) and celiac disease.
- RA rheumatoid arthritis
- MS multiple sclerosis
- IDDM insulin-dependent diabetes mellitus
- PBC primary biliary cirrhosis
- celiac disease Although a few class I-associated diseases exist, most autoimmune conditions have been found to be associated with class II alleles.
- MHC class II molecules are of great importance in the selection and activation of CD4+ T lymphocytes, which regulate the immune responses against protein antigens.
- Genomic analysis has identified specific individual allelic variants of HLA in associations with Hodgkin's disease, multiple sclerosis, rheumatoid arthritis, pemphigus vulgaris, insulin dependent diabetes mellitus (IDDM, Type I diabetes), and celiac disease, among others (Thomson (1995) Crit. Rev. Clin. Lab. Sci. 32: 183- 219; Nepom and Erlich (1991) Annu. Rev. Immunol 9: 493-525; Tiwari, above).
- Type 1 diabetes i.e., Insulin-dependent diabetes mellitus, (IDDM)
- IDDM Insulin-dependent diabetes mellitus
- vascular disease i.e., microvascular disease, eye complications, diabetic nephropathy, diabetic neuropathy, diabetic foot problems, and skin and mucous membrane problems.
- IDDM is a progressive autoimmune disease, in which the ⁇ cells of the pancreas that produce insulin are slowly destroyed by the body's own immune system.
- Certain proteins such as glutamic acid decarboxylase (GAD), insulin, and islet cell antigens, serve as autoantigens, becoming targets of self-attack of the immune system.
- GAD glutamic acid decarboxylase
- IPD insulin
- IPD islet cell antigens
- HLA-DQ molecules are the combined protein products of specific HLA-DQB1 and DQA1 alleles known as DQB 1*0201, DQB1*0302, DQB1*0304, DQB1*0401, DQB1*0501, DQB1*0502; and DQA1*0301, DQA1*0302, DQA1*0303, DQA1*0501.
- Alleles maybe encoded on one haplotype (“cis" alleles) such as DQB1*0201-DQA1*0501-
- the alleles may be encoded on different haplotypes ("trans" alleles).
- An example of "trans” alleles is the combination of DQB1*0201 on DQB1*0201-DQ A 1*0501- DRB1*0301, or DQAl*0301 on DQBl*0301-DQAl*0301-DRBl*0404.
- Individuals carrying both DQB1*0201-DQA1*0501 and DQB1*0302-DQA1*03 haplotypes have the highest risk of developing IDDM. (Yu et al. (2000) Eur. J.
- IDDM oral sulfonylureas and insulin injections are the only two therapeutic agents available in the United States for treatment of IDDM. Both agents have the potential for inducing hypoglycemia as a side effect, reducing the blood glucose concentration to dangerous levels. There is no generally applicable and consistently effective means of maintaining an essentially normal fluctuation in glucose levels in IDDM. An ideal treatment would minimize the risks of hypoglycemia while keeping the glucose levels below a target value.
- the drug regimen is combined with regulation of dietary intake of carbohydrates to keep glucose levels in control.
- Celiac disease also known as celiac sprue or gluten-sensitive enteropathy, is a disease that results from defective gastrointestinal absorption due to hypersensitivity to cereal grain storage proteins, including glutens or its product gliadin and glutenin, present in wheat, barley, oats, and rye.
- the disease is caused by CD4 T cells that recognize gliadin as dietary antigen and these cells induce a Thl- mediated chronic inflammatory response, which damages the villi, causing symptoms including diarrhea, weight loss, and steatorrhea, villous atrophy, and malabsorption.
- celiac patients may suffer from conditions that are consequences of malabsorption and malnutrition.
- Celiac disease is considered to be the most common genetic disease in Europe, and an estimated one in 4,700 Americans have been diagnosed with this disease, though a study suggests that as many as 1 in every 250 Americans may have some form of this disease.
- Celiac disease is associated with alleles DQB1*0302 and DQB1*0201 combined with DQA1*0301 and DQA1*0501. 95% of patients carry either DQB1*0201 or DQB1*0302 (Sollid et al (1993) Gastroenterol 105: 910).
- the strong HLA association is believed to be due to the capacity of DQ molecules encoded by DQB1*0201, DQA1*0501, DQB 1*0302 and DQA1*0301 to efficiently present deaminated variants of glutamine-rich peptides derived from gliadin and glutenin.
- the same therapeutic application may therefore be useful in this disease as in IDDM.
- MHC-II molecules activate T helper (Th) cells that are central to immunoregulation, and are responsible for most of the immunopathology in inflammatory diseases.
- Th T helper
- MHC-II molecules are expressed selectively on cells of the immune system, whereas MHC-I are present on most somatic cells.
- a pharmaceutical agent targeting class II MHC molecules offers several advantages over most available immunosuppressive drugs.
- Third, the methods and compounds could be applied without any specific knowledge of the actual autoantigens causing the disease.
- the present invention provides methods and compositions for treating autoimmune diseases and other unwanted immune reactions comprising administering a copolymer that binds to one or more HLA-DQ molecules and modulates DQ-restricted T cell responses.
- the copolymers of the invention bind to HLA-DQA1 molecules, and in even more preferably to one or more of HLA molecules encoded in the alleles DQA1*0501- DQB1*0201, DQA1*0301, DQB1*0401, and DQAl*0301-DQBl*0302.
- Exemplary disorders that can be treated using the subject DQ-directed copolymers include insulin-dependent diabetes mellitus (IDDM); celiac disease; rheumatoid arthritis; steroid sensitive nephrotic syndrome; mesengial IgA nephropathy; narcolepsy; neurological multiple sclerosis; relapsive polychondritis ; dermatological disorders such as dermatitis herpetiformis, atopic dermatitis, Behcet's disease, pemphigus, psoriasis; primary Sj ⁇ gren's syndrome; systemic vasculitides; erythematosus; gastrointestinal disorders such as Crohn's disease; respiratory disorders such as Sommer type hypersensitivity pneumonitis, and autoimmune thyroid disease (AITD).
- IDDM insulin-dependent diabetes mellitus
- celiac disease rheumatoid arthritis
- steroid sensitive nephrotic syndrome mesengial IgA nephropathy
- the copolymers of the present invention bind to certain HLA-DQ molecules that predispose the carrier of such molecules to IDDM and celiac disease.
- HLA-DQ molecules are the combined protein products of specific HLA-DQB1 and DQAl alleles known as DQB1*0201, DQB1*0302, DQB1*0304, DQB1*0401, DQB1*0501, DQB1*0502; and DQA1*0301, DQA1*0302, DQA1*0303, DQA1*0501.
- alleles maybe encoded on the same haplotypes ("cis” alleles) such as DQB 1 *0201 -DQAl *0501 - DRB1*0301 and DQBl*0302-DQAl*0301-DRBl*0401.
- the resulting HLA molecule comprising polypeptide products of "cis” alleles are herein referred to as "cis dimer.”
- the alleles may be encoded on different haplotypes ("trans” alleles).
- the HLA molecule comprising polypeptide products of "trans” alleles are herein referred to as "trans” dimer.
- trans alleles is the combination of DQB 1*0201 on DQB 1*0201 -DQAl *0501 -DRB 1*0301 and DQA1*0301 on DQBl*0301-DQAl*0301-DRBl*0404.
- An aspect of the invention is a copolymer composition formed by random synthesis (polymerization) of the various amino acid residues.
- Such composition comprises a terpolymer, which is copolymers with a random sequence of at least three different amino acid residues wherein at least one amino acid is selected from each group of:
- the copolymer is, for example, a terpolymer comprising a group of three amino acid residues in Table 1 below.
- the copolymers are synthesized to have a molar input ratio of the amino acid components is about 2: 5: 3 for relative amounts of amino acids of the first group, the second group, and the third group, respectively.
- the molar input ratio of the amino acid components is about 2: 25: 15 for relative amounts of amino acids of the first group, the second group, and the third group, respectively.
- the molar input ratio of the amino acid components is about 2: 1 : 0.6 for relative amounts of the first group, the second group, and the third group, respectively.
- the copolymer compositions are tetrapolymers, comprising four amino acid residues, at least one amino acid residue selected from each of the above three groups.
- the copolymer of the invention is, for example, a tetrapolymer comprising a group of four amino acid residues in Table 2 below.
- Preferred embodiments of the inventions are copolymer compositions comprising a random sequence of one of the following sets of amino acid residues:
- aspartic acid alanine, leucine, and glutamic acid (DALE);
- aspartic acid alanine, isoleucine, and glutamic acid (DAIE);
- aspartic acid alanine, valine, and glutamic acid (DANE);
- aspartic acid alanine, threonine, and glutamic acid (DATE);
- DGLE aspartic acid, glycine, leucine, and glutamic acid
- DGIE glutamic acid
- aspartic acid glycine, valine, and glutamic acid (DGNE); or
- aspartic acid glycine, threonine, and glutamic acid (DGTE).
- these compositions are synthesized to have a molar output ratio of amino acid components, as they appear above, of about 1:10:3:1, or 1:15:3:1 respectively.
- the molar output ratio of amino acid components is about 1 :25:15:5, respectively.
- the molar output ratio of amino acid components is about 1:3:1.5:0.2, respectively.
- Molar output ratios have a variability range of about 10% between the different amino acids.
- a preferred molar input ratio for the synthesis of a copolymer composition for D:A:X:E or D:G:X:E is about 1:5:3:1, wherein X is L, I, N, S, or T.
- the molar input ratio of these amino acids is about 1:25:15:5, or 1:1:1.5:0.2.
- the subject DQ-directed copolymers are a mixture of copolymers with randomized or partially randomized amino acid sequences containing amino acid residues wherein at least one amino acid is selected from each group of:
- hydrophobic aliphatic residues such as leucine (L), isoleucine (I), valine (N), methionine (M)
- the copolymer is derived using the amino acids glutamic acid (E) and/or aspartic acid (D), leucine (L), serine (S) and alanine (A), and is referred to herein as an "ELSA" copolymer.
- the subject DQ-directed copolymers are a mixture of randomized or partially randomized amino acid sequence containing at least five different amino acid residues wherein at least one amino acid is selected from each group of:
- acid residues such as aspartic acid (D), glutamic acid (E)
- D aspartic acid
- E glutamic acid
- hydrophobic aliphatic residues such as leucine (L), isoleucine (I), valine (V), methionine (M)
- small aliphatic residues such as alanine (A), glycine (G)).
- Another exemplary copolymer is derived using the amino acid residues glutamic acid (E) and/or aspartic acid (D), leucine (L), tyrosine (Y) and valine (V), and is referred to herein as a "DLYV" copolymer.
- any of the copolymers can further comprise an additional amino acid residue, wherein the additional amino acid residue is found at a certain amino acid sequence position in an autoantigenic peptide for an autoimmune disease, such as diabetes.
- Such amino acid influences the affinity of the peptide for a functional binding to the class II MHC protein associated with the autoimmune disease.
- Such copolymer has T cell stimulatory activity when in a complex with a class II MHC protein.
- an additional amino acid to any of the combination above is a lysine residue (K).
- K residue is present in sufficient molar output ratio to increase T-cell stimulation by the copolymer complexed with a class II MHC protein.
- the K residue may be present in sufficient molar output ratio to increase aqueous solubility of the copolymer.
- the copolymer may contain proline (P) residues.
- a certain ratio of amino acids to be incorporated into the random copolymer may be used.
- Preferred random copolymers of the present invention comprise amino acid residues K, E, A, S, V, and P.
- a preferred molar input ratio of K: E: A: S: V is 0.3: 0.7: 9: 0.5: 0.5: 0.3.
- the copolymer amino acid sequence is not completely random, and has "anchor" residues which occur with regular spacing in the resulting polymer.
- the copolymer has a general sequence:
- Xai and Xa 2 are each an acidic amino acid residue selected from glutamic acid and aspartic acid, X is any selected amino acid residue, and 2 ⁇ n ⁇ 8.
- the copolymer can be synthesized to have one of the general sequences:
- X is A, S, V, K, or P.
- the molar input ratio of A: S: V: K: P is 5:
- the copolymer is capable of binding to a class II MHC protein, for example, a human class II MHC protein such as HLA-DQ2 encoded by alleles DQA1*0501-DQB1*0201 or HLA-DQ8 encoded by alleles DQAl *03-DQB 1*0302 allele. Further, the copolymer is capable of binding to a class II MHC protein of a subject animal such as a mouse, for example, IA g7 protein.
- the copolymers compositions of the present invention bind to one or more DQ isotypes with an average K d of l ⁇ M or less, and more preferably an average K d less than lOOnM, lOnM or even InM.
- Another way to identify preferred copolymers is based on competitive binding assays, such as described in Sidney et al. (2002) J. Immunol. 169: 5098, which is expressed as an IC50 value.
- Preferred copolymers of the present invention have ICso's less than l ⁇ M, more preferably less than 500nM, and even more preferably less than lOOnM.
- the copolymer provided herein is at least about 30 residues in length, at least about 40 residues in length, or the copolymer is at least about 50 residues in length. Further, the copolymer is no greater than about 90 residues in length, no greater than about 80 residues in length, or no greater than about 70 residues in length.
- the random copolymers are about 10 to 100 amino acid residues long, more preferably 20 to 80 amino acid residues long, 30 to 70 amino acid residues long, even more preferably 40 to 60 amino acid residues long, and most preferably about 50 amino acid residues long.
- a typical preparation of random copolymers is a mixture of peptides of various lengths, the majority of which are of the desired length but containing shorter or longer peptides inevitably created by the currently available synthetic processes.
- the subject copolymers are formulated for use as a medicament so as to have a polydispersity less than 25,000, and more preferably less than 10000, 5000, 1000, 500, 100, 50, or less than 10.
- Another aspect of the invention is methods of treatment of an autoimmune disease comprising administering a copolymer composition that functionally binds to an HLA-DQ molecule associated with the autoimmune disease, thereby activating T cell recognition.
- the subject copolymers bind to autoimmune-associated HLA-DQ istotypes, such as one or more of DQB1*0201, DQB1*0302, DQB1*0304, DQB 1*0401, DQB1*0501, DQB1*0502; and DQA1*0301, DQA1*0302, DQA1*0303, DQA1*0501, with a K d at least 10 times less than the copolymer's K d for binding HLA-DR molecules and/or other DQ isotypes.
- Another aspect of the invention is methods of treatment of an unwanted immune response which are mediated by HLA-DQ molecules comprising administering a copolymer composition that functionally binds to an HLA-DQ molecule associated with such unwanted immune responses.
- Yet another aspect of the invention is methods of treatment of allergies and allergic reactions mediated by HLA-DQ molecules comprising administering a copolymer composition that functionally binds to an HLA-DQ molecule associated with the allergy.
- An aspect of the invention also provides methods of treatment of a disease treatable by administration of a copolymer composition that functionally binds to an HLA-DQ molecule associated with such a disease.
- a preferred embodiment of the invention provides a method for treating a diabetic condition in a subject, comprising administering to the subject a composition comprising a copolymer having amino acids polymerized in a random sequence, the amino acids comprising at least one residue from each of the following groups:
- the acidic residue is glutamic acid and/or aspartic acid
- the neutral residue is alanine and/or glycine
- the hydrophobic aliphatic amino acid is leucine, isoleucine, valine, and/or threonine.
- the subject of the treatment can be a human.
- the subject is a non-human animal, such as a rodent, including a rat, mouse, or hamster.
- the subject is a non-obese diabetic (NOD) mouse or a streptozoticin- induced diabetic mouse.
- NOD non-obese diabetic
- the method of treatment is carried out using any of the copolymers of invention, preferably, a copolymer that comprises a polypeptide comprising at least one amino acid residue selected from each of the following groups:
- the copolymer may comprise proline (P).
- the methods allow continuous treatment of autoimmune diseases by a sustamed-release carrier such as transdermal patches, implantable medical devices coated with sustained-release fonnulations, or implantable or injectable pharmaceutical formulation suitable for sustamed-release of the active components.
- a sustamed-release carrier such as transdermal patches, implantable medical devices coated with sustained-release fonnulations, or implantable or injectable pharmaceutical formulation suitable for sustamed-release of the active components.
- the methods for treatment of the present invention also provide for administration of the copolymer in combination with other drugs.
- the subject copolymers can be administered conjointly with other active ingredients, such as anti-inflammatory agents, growth factors, cytokines, immunosuppressant agents, or anti-hypertensive drugs, drugs to treat lipid disorders or anti-obesity drugs in diabetic patients.
- the subject copolymers can be used in conjunction with cyclooxygenase inhibitors, and inhibitors of TNF- ⁇ , IL-1 or ICAM-1.
- the additional agent is an immune suppressive agent.
- the immune suppressive agent can be a drug or a protein.
- the drug is at least one of a rapamycin; a corticosteroid; an azathioprine; mycophenolate mofetil; a cyclosporine; a cyclophosphamide; a methotrexate; a 6-mercaptopurine; FK506; 15-deoxyspergualin; a sphingosine-1- phosphate receptor agonist such as FTY 720 (2-amino-2-(2-[4-octylphenyl]ethyl)- 1,3-propanediol hydrochloride), and other phosphonate analogs (Forrest et al.
- the protein is at least one of hul 124; BTI-322; allotrap-HLA-B270; OKT4A; Enlimomab; ABX-CBL; OKT3; ATGAM; basiliximab; daclizumab; thymoglobulin; ISAtx247; Medi-500; Medi-507; Alefacept; efalizumab; infliximab; and an interferon.
- anti-hypertensive drugs include ⁇ -blockers, cathepsin S inhibitors, and ACE inhibitors.
- drugs to treat lipid disorders include HMG-CoA reductase inhibitors, nicotmic acid, bile acid sequestrants, and fibric acid derivatives.
- anti-obesity drugs include P-3 agonists, CB-1 antagonists, appetite suppressants, such as, for example, sibutramine (Meridia), and lipase inhibitors, such as, for example, orlistat (Xenical).
- the copolymers of the present invention may also be conjointly administered with other known therapies for the treatment of diabetes, including PPAR agonists, sulfonylurea drugs, non-sulfonylurea secretagogues, ⁇ -glucosidase inhibitors, insulin sensitizers, insulin secretagogues, hepatic glucose output lowering compounds, and insulin.
- other known therapies for the treatment of diabetes including PPAR agonists, sulfonylurea drugs, non-sulfonylurea secretagogues, ⁇ -glucosidase inhibitors, insulin sensitizers, insulin secretagogues, hepatic glucose output lowering compounds, and insulin.
- the amount of the therapeutic agent is less than prior to administering the copolymer for the same subject.
- Such therapies may be administered prior to, concurrently with or following administration of the compound of the invention.
- Insulin includes both long and short acting forms and formulations of insulin.
- PPAR agonist may include agonists of any of the PPAR subunits or combinations thereof.
- PPAR agonists may include agonists of PPAR- ⁇ , PPAR- ⁇ , PPAR-67, or any combination of two or three of the subunits of PPAR.
- PPAR agonists include, for example, rosiglitazone and pioglitazone.
- Sulfonylurea drugs include, for example, glyburide, glimepiride, chlo ⁇ ropamide, and glipizide.
- c-glucosidase inhibitors that may be useful in treating diabetes when administered with a copolymer of the invention include acarbose, miglitol and voglibose.
- Insulin sensitizers that may be useful in treating diabetes when administered with a subject copolymer include thiozolidinediones and non-thiozolidinediones.
- Hepatic glucose output lowering compounds that may be useful include metformin, such as Glucophage ® and Glucophage ® XR.
- Insulin secretagogues that may be useful in treating diabetes when administered with a copolymer of the invention include sulfonylurea and non- sulfonylurea drugs: GLP-1, GIP, PAC/VPAC receptor agonists, secretin, nateglinide, nieglitinide, repaglinide, glibenclamide, glimepiride, chlo ⁇ ropamide, glipizide.
- GLP-1 includes derivatives of GLP-1 with longer half-lives than native GLP-1, such as, for example, fatty-acid derivatized GLP-1 and exendin.
- the method provides observing the frequency of diabetic episodes or the severity of diabetic episodes to gauge effectiveness of the treatment.
- the method of treatment provides observing a physiological parameter of the diabetic condition after administering copolymer. For example, effective treatment is monitored by measuring parameters such as decrease in free blood glucose, increase in blood insulin, increase in pancreatic insulin, increase in pancreatic mass, or increase in number of beta islet cells.
- the copolymer is administered to a patient by injection, such as intravenous, subcutaneous, intramuscular, or intraperitoneal injection, or by intravenous infusion (or drip).
- injection such as intravenous, subcutaneous, intramuscular, or intraperitoneal injection, or by intravenous infusion (or drip).
- the copolymer is administered by oral, transdermal, pulmonary or intraperitoneal administration.
- the present invention also provides methods to prophylactically treat subjects that are at risk of developing autoimmune diseases, unwanted immune response, allergies, or any disease treatable by administering a copolymer composition, comprising administering the copolymer, so as to prevent or delay the onset of such diseases or conditions.
- kits for treating a diabetic subject comprising a copolymer having a random sequence of amino acids according to any of the amino acid copolymer compositions herein, and a container.
- the kit can further comprise instructions for use.
- the kit can provide the copolymer in a unit dose.
- compositions comprising a copolymer of the present invention.
- the composition in some embodiments further comprises a pharmaceutically acceptable carrier and/or excipient.
- the pharmaceutical composition comprises one or more therapeutically effective copolymers that bind to HLA-DQ molecules, and a pharmaceutically acceptable carrier.
- the pharmaceutical composition may be formulated for various routes of administration, including oral, intravenous, intramuscular, subcutaneous, transdermal, pulmonary or intraperitoneal administration.
- the pharmaceutical composition is suitable for sustained release of the active ingredients, the composition comprising biologically compatible polymers or matrices that allow slow release of the therapeutically active copolymers.
- sustained release formulations may be in a form of, for example, transdermal patches, implants, or suppositories.
- the pharmaceutical composition further comprises other pharmaceutically active components, for co-administering an additional drug or agent conjointly with a copolymer as described above.
- the additional agent may be other copolymers, such as copolymers that cause HLA-DR mediated activation of T cells.
- Exemplary DR-directed copolymers include Copaxone ® (glatiramer acetate, such as described in US Patents 3,849,550 and 6,214,791), YFAK and other copolymers described in PCT publication WO03/029276, and te ⁇ olymers described in PCT publication WOOO/05250.
- Another embodiment of the invention provides a method of manufacture of a medicament for treatment of an autoimmune disease such as diabetes or celiac disease; unwanted immune response; allergy; or any disease treatable by administering a copolymer of the present invention, comprising formulating any of the copolymers described herein, for administering to a subject in need of such treatment.
- the composition may be provided in a unit dose effective for treatment of an autoimmune disease, an unwanted immune response, allergy, or any disease treatable by administering a copolymer of the present invention.
- the autoimmune response may be celiac disease or a diabetic condition, which may be pre-diabetes; insulin-dependent diabetes mellitus (IDDM, type I diabetes), or type II diabetes.
- IDDM insulin-dependent diabetes mellitus
- the subject can be a human.
- the subject is a non-human animal, such as a rodent, such as a rat, mouse, or hamster.
- the subject is a non-diabetic obese (NOD) mouse or a streptozoticin-induced diabetic mouse.
- NOD non-diabetic obese
- the unit dose is in an amount appropriate for the body size of the subject.
- Another aspect of the present invention provides methods to screen for and identify copolymers that bind to HLA-DQ molecules and prevent autoimmune responses. Such methods allow identifying copolymers that are effective for treating autoimmune diseases.
- the subject DQ-directed copolymers are modified, or labeled, with a moiety that facilitates the detection of the copolymers.
- the copolymers are biotinylated.
- the copolymers are modified with FITC.
- Exemplary copolymers are random copolymers as described above, modified with biotin or FITC.
- the copolymers with "anchor" residues which occur with regular spacing in the resulting polymer are modified with biotin or FITC.
- modified copolymers can be synthesized to have one of the general formulae:
- n 4.
- modified copolymers are used in assays and diagnostics, for example in enzyme-linked immunosorbent assay (ELISA).
- ELISA enzyme-linked immunosorbent assay
- the labeled copolymers can also be used to determine the best sequence or preferred sequence among the copolymers that bind to an HLA molecule. Additionally, the labeled copolymer can be used in screening for other compounds not related to copolymers of the present invention that bind to or associate with HLA-DQ molecules.
- the methods of screening can be used for in vivo assay in non-human animals such as a rodent, such as a rat, mouse, or hamster.
- a rodent such as a rat, mouse, or hamster.
- Figure 1 shows the results obtained from a competition assay of semi- random copolymers RSP-001, RSP-002, and RSP-003 binding to HLA-DQ8 in competition with RSP-006 (biotinylated RSP-003), with data calculated as extent of competition from amount of observed complexes remaining shown on the ordinate, less background negative control, as a function of increased competitor shown on the abscissa.
- Afu as indicated on the ordinate means arbitrary fluorescence unit.
- Figure 2 shows the results of a competition assay of random copolymers RSP-008 (DAVE), RSP-009 (DATE), and RSP-010 (DALE) binding to HLA-DQ8 in competition with RSP-006.
- Figure 3 shows the results of a competition assay of random copolymer CO- 14 (YFAK) binding to HLA-DQ8 in competition with RSP-006.
- Figure 4 shows the results of a direct binding assay of biotinylated random copolymers RSP-004, RSP-005, and RSP-006 to HLA-DQ8.
- Figure 5 shows the results of a direct binding assay of biotinylated random copolymers RSP-004, RSP-005, and RSP-006 to HLA-DR2.
- Figure 6 shows the results of a competition assay of RSP-008
- Figure 7 shows RSP-001 's capability to immunize mice as demonstrated by the T cell response to the copolymer after immunization.
- Figure 8 shows RSP-002's capability to immunize mice demonstrated by the T cell response to the copolymer after immunization.
- Figure 9 shows RSP-003 's capability to immunize mice demonstrated by the T cell response to the copolymer after immunization.
- FIG. 10 shows RSP-OlO (DALE) immunize mice demonstrated by the T cell response to the copolymer after immunization.
- HLA-DQ subclass of the alleles include IDDM and celiac disease. It is possible to identify individuals at risk of developing the diseases based on the identification of MHC class II alleles that confer susceptibility.
- Random synthetic copolymers can be used to treat autoimmune diseases that are associated with HLA-DQ gene products by competing with candidate autoantigens for binding to these protein receptor molecules, or by inducing T cell anergy or even T cell apoptosis, or by suppression of T cells, such that subsequent T cell response to an autoantigen is inhibited in vivo.
- synthetic copolymers having one or more additional components, such as amino acid analogs or derivatives added in varying quantities into the polymerization reaction can be effective inhibitors of a variety of autoimmune T cell responses. See PCT/US02/31399 by Strominger et al , and Fridkis-Hareli et al. (2002) J. Clin.
- a major goal in the treatment of autoimmune diseases has been development of antigen-specific immunomodulating therapies that interfere with the trimolecular interaction of the autoreactive T cell receptor (TCR) with the autoantigenic peptides presented by self MHC receptors at the surface of antigen-presenting cells.
- TCR autoreactive T cell receptor
- These immunotherapies of T cell-mediated autoimmune diseases have been successful in animal models with known target antigens (see, for example, Weiner (1997) Immunol Today 18:335-343; Nicholson et al. (1997) Proc. Natl Acad. Sci. USA 94:9279-9284).
- APL altered peptide ligands
- IDM Insulin-dependent diabetes mellitus
- HLA-DR and HLA-DQ subclass alleles may be monitored for autoantibodies to islet antigens which indicate onset of the disease. Treatment of such individuals at the onset of the disease to suppress autoimmune response and therefore any further destruction of the tissue is expected to be efficacious.
- T lymphocytes are able to recognize foreign antigen via their T cell receptor (TCR).
- TCR T cell receptor
- the TCR binds to a major histocompatibility protein (MHC), which is a membrane bound glycoprotein on the cell surface of specialized antigen presenting cells.
- MHC major histocompatibility protein
- Class I molecules are complexed with such processed peptides derived from self or foreign proteins inside the cell, while class II molecules are in complex with those from outside the cell.
- Such peptide binds non-covalently to a MHC at its peptide binding groove, with a binding affinity (K ) in the range of 10 "6 M.
- K binding affinity
- the peptide binding groove of a class II MHC is open on either end and thus able to accommodate peptides of lengths ranging from 9 to 75 amino acid residues.
- Glatiramer acetate also known as Copaxone ® , copolymer-1, Copl,
- YEAK or GLAT is a random amino acid copolymer composed of tyrosine (Y), glutamic acid (E), alanine (A), and lysine (K) in a molar ratio of approximately 1:1.5:5:3.
- Glatiramer acetate is synthesized in solution using N-carboxyamino acid anhydrides (Teitelbaum et al. (1971) Eur. J. Immunol. 1:242-248). It has been successfully developed and approved as a treatment for multiple sclerosis (MS), particularly, relapsing forms of MS (Bornstein et al. (1987) NewEng J. Med. 317: 408-414; Johnson et al. (1995) Neurol.
- MS multiple sclerosis
- glatiramer acetate and other related random copolymers were used to define the genetic bases of immune responsiveness, now known as class II MHC genes (McDevitt and Sela (1965) J. Exp. Med. 122: 517-532; McDevitt and Sela (1967) J. Exp. Med. 126: 969-978).
- Glatiramer acetate was found to be effective in suppression of experimental allergic encephalomyelitis (Teitelbaum et al. (1971) Eur. J. Immunol 1 : 242-248; Teitelbaum et al. (1973) Eur. J. Immunol. 3: 273-279;
- glatiramer acetate Although there is not a complete understanding of the mechanism of action of glatiramer acetate, it is likely that a pre-requisite for its biological activity involves an ability to bind human MHC class II molecules.
- the MHC allele most commonly associated with MS is HLA-DR2 (DRB1*1501), and glatiramer acetate has been shown to bind to this MHC class II molecule and activate a significant proportion (typically 15 - 20 %) of an individual's T cells. Activation of T cells by glatiramer acetate is restricted to HLA-DR molecules, and little response is generated through the HLA-DQ molecules. (Brenner et al. (2001) J. Neuroimmunol.
- Peptide binding to class II molecules requires the presence of defined side chains at anchor positions, which all together form a particular binding motif. These anchor positions have been determined as amino acid position 1 to position 9 (or PI to P9). The most important contacts for a peptide to make for optimal class II binding are PI, P4, P7, and P9. For the class II MHC proteins associated with diabetes, the most important positions of a peptide for interaction with protein pockets are PI and P9. The PI and P9 pockets are considered to be "promiscuous" in that these are large pockets that can accommodate a variety of different amino acid side chains.
- a compound that replaces an autoantigenic peptide may activate a different set of T cells than the autoantigenic peptide would (Vignali and Strominger (1994) J. Exp. Med. 179: 1945-1956).
- the autoimmune response is characterized by undesirable inflammatory responses mediated by Thl cells
- activation of Th2 cells to produce or increase production of an immunosuppressive cytokine IL-10 instead of Thl cells may alleviate the symptoms of the autoimmune reaction and result in suppression of undesired immune response.
- P2 P4 and P5. See Wuche ⁇ fennig et al. (1994) J. Exp. Med.
- a first group of amino acids was chosen herein that when inco ⁇ orated into a copolymer will occupy PI and P9 pockets.
- the first group of amino acids was chosen on the basis of a number of different criteria, for example, analysis of data shown herein in Table 4, and includes aspartic acid (D), glutamic acid (E), asparagine (N) and glutamine (Q).
- D aspartic acid
- E glutamic acid
- N asparagine
- Q glutamine
- a second group of amino acids are chosen to interact with the TCR when occupying the P4 position, which can also be promiscuous. See Herman et al. (1999) J. Immunol 163: 6275.
- the second group of amino acids is valine (V), isoleucine (I), leucine (L), serine (S) and threonine (T). Additional amino acids may be used, such as lysine (K), that affect the charge of the copolymer, and therefore presumably the aqueous solubility, and in addition may when occupying a position in the copolymer, interact with the TCR to alter the response of a T cell.
- V valine
- I isoleucine
- L leucine
- S serine
- T threonine
- Additional amino acids may be used, such as lysine (K), that affect the charge of the copolymer, and therefore presumably the aqueous solubility, and in addition may when occupying a position in the copolymer, interact with the TCR to alter the response of a T cell.
- allelic variations means a distinct antigenic form of a serum protein that results from allelic variations present on the immunoglobulin heavy chain constant region.
- the term "anergy” means unresponsiveness of the immune system of a subject, either on the cellular level or on the organismic level, to an antigen.
- autoimmune condition means a disease state caused by an inappropriate immune response that is directed to a self-encoded entity which is known as an autoantigen.
- An autoimmune disease is a class of disorder which include Hashimoto's thyroiditis; idiopathic myxedema, a severe hypothyroidism; multiple sclerosis, a demyelinating disease marked by patches or hardened tissue in the brain or the spinal cord; myasthenia gravis which is a disease having progressive weakness of muscles caused by autoimmune attack on acetylcholine receptors at neuromuscular junctions; Guillain-Barre syndrome, a polyneuritis; systemic lupus erythematosis; uveitis; autoimmune oophoritis; chronic immune thrombocytopenic pu ⁇ ura; colitis; diabetes; celiac disease which is gluten intolerance; Grave's disease, which is a form of hypothyroidism; psoriasis;
- binding refers to a direct association between two molecules, due to, for example, covalent, electrostatic, hydrophobic, ionic, and/or hydrogen-bond interactions under physiological conditions, and including interactions such as salt bridges and water bridges.
- cis refers to two alleles encoded by gene loci on the same haplotype while “trans” refers to two alleles encoded by genes on two different haplotypes.
- trans dimer When two polypeptides that form an HLA protein are from cis alleles, the product is herein referred to as "cis dimer.” When two polypeptides that form an HLA protein are from trans alleles, the product is herein referred to as "trans dimer.”
- copolymer means a polymer of amino acids having a random amino acid sequence comprising a plurality of amino acid residues of different kinds. Amino acid residues may be naturally occurring or synthetic analogs. Copolymers also include derivatives, including chemically modified polypeptides and peptidomimetics, and may include chemical bonds other than naturally occurring peptide bonds.
- diabetes means any manifested symptoms of diabetes in any mammal including experimental animal models, and including human forms such as insulin-dependent diabetes mellitus (IDDM, type I diabetes), that is linked genetically to alleles DQA1*0501-DQB1*0201 (alleles for HLA-DQ2) or DQA1*03-DQB1*0302 (alleles for DQ8), type II diabetes, early stage diabetes, and a pre-diabetic condition characterized by mildly decreased insulin or mildly elevated blood glucose levels. While the current diabetes epidemic is primarily type II or adult onset diabetes and is characterized as insulin resistance, the disease may manifest as damage to beta cells and insulin insufficiency.
- IDDM insulin-dependent diabetes mellitus
- pre-diabetic condition describes a condition in a mammal not formally diagnosed with diabetes, but is suspected of having a diabetic or related condition by, for example, demonstrating a symptom in terms of insulin or glucose level and having susceptibility to diabetes or a related condition due to family history, genetic predisposition, or obesity in the case of type II diabetes, or when a mammal is subject to risk of recurrence of diabetes when it has previously had diabetes or a related condition.
- haplotype is defined as a contiguous region of genomic
- heterologous cell means a cell for production of an MHC protein which is unrelated to a cell of a subject, e.g., the heterologous cell is not a cell of a mammal.
- the heterologous cell for example can be from a cold blooded animal, for example, from an invertebrate; the heterologous cell is an insect cell, or a cell of a microorganism such as a yeast cell.
- HLA molecule means any class II major histocompatibility complex glycoproteins.
- HLA-DQ molecule or "HLA- DR molecule” each refers to any one of HLA-DQ subtypes or HLA-DR subtypes.
- IC50 means the concentration of an agent that produces a
- molar input ratio means the molar ratio of amino acids used to prepare a random copolymer. The input molar ratio determines how much of each amino acid is used to synthesize a random copolymer.
- molar output ratio means the molar ratio of the amino acids that comprise a random copolymer composition.
- the output molar ratio can be determined by amino acid composition analysis of a random copolymer composition sample. In general, smaller amino acids are more efficiently inco ⁇ orated into a polypeptide, resulting in a higher output ratio of the amino acid in comparison to other amino acid components than indicated by the input molar ratio.
- MHC activity refers to the ability of an MHC molecule to stimulate an immune response, e.g., by activating T cells.
- An inhibitor of MHC activity is capable of suppressing this activity, and thus inhibits the activation of T cells by MHC.
- a subject inhibitor selectively inhibits activation by a particular class II MHC isotype or allotype.
- Such inhibitors may be capable of suppressing a particular undesirable MHC activity without interfering with all MHC activity in an organism, thereby selectively treating an unwanted immune response in an animal, such as a mammal, preferably a human, without compromising the animal's immune response in general.
- antigen binding groove or "peptide binding groove” refers to a three dimensional antigen interactive site on the surface of the Class II MHC protein molecule (Stern et al. (1994) Nature 368: 215) that is formed by surfaces of both the ⁇ and ⁇ subunits of the Class II MHC protein molecule.
- surface of a class II MHC HLA protein includes the portion of the protein molecule in its three-dimensional configuration which is in contact with its external environment, including those features of the protein that interact with aqueous solvent and are capable of binding to other cell components such as nucleic acids, other proteins, and peptides.
- PI pocket and P4 pocket include three dimensional polymo ⁇ hic regions on the peptide binding surface of the Class II MHC protein molecule that accommodate amino acid residue side chains from a peptide that is bound to the class II MHC protein (Fridkis-Hareli et al (1998) J. Immunol.
- P-l position and P5 position refer to amino acid residues on the Class II MHC protein molecule peptide complex which directly contact the T-cell receptor (Fridkis-Hareli et al. (2000) Human Immunol. 61:640; Fridkis-Hareli et /.( 2001) Human Immunol. 62:753-763).
- the P-l position refers to the amino acid which precedes the amino acid residue of the peptide that occupies the PI pocket.
- the P5 position refers to the amino acid residue that follows the amino acid residue that occupies the P4 pocket in amino acid sequence of a peptide or polypeptide.
- the P2, P3, and P5 residues are TCR contact residues.
- the P9 position refers to the amino acid residue located four positions beyond the P5 position in amino acid sequence of a peptide or polypeptide.
- patient refers to an animal, preferably a mammal, including humans as well as livestock and other veterinary subjects.
- peptide refers to unmodified amino acid chains, and also include minor modifications, such as phosphorylations, glycosylations and lipid modifications.
- peptide and peptidomimetic are not mutually exclusive and include substantial overlap.
- a "peptidomimetic” includes any modified form of an amino acid chain, such as a phosphorylation, capping, fatty acid modification, and including unnatural backbone and/or side chain structures. As described below, a peptidomimetic comprises the structural continuum between an amino acid chain and a non-peptide small molecule. Peptidomimetics generally retain a recognizable peptide-like polymer unit structure. Thus, a peptidomimetic may retain the function of binding to a HLA protein fonning a complex which activates autoreactive T cells in a patient suffering from an autoimmune disease.
- amino acid residue is known in the art.
- the abbreviations used herein for designating the amino acids and the protective groups are based on recommendations of the IUPAC-IUB Commission on Biochemical Nomenclature (see Biochemistry (1972) 11: 1726-1732).
- the amino acids used in the application of this invention are those naturally occurring amino acids found in proteins, or the naturally occurring anabolic or catabolic products of such amino acids which contain amino and carboxyl groups.
- Particularly suitable amino acid side chains include side chains selected from those of the following amino acids: glycine (G), alanine (A), valine (V), cysteine (C), leucine (L), isoleucine, serine (S), threonine (T), methionine (M), glutamic acid (E), aspartic acid (D), glutamine (Q), asparagine (N), lysine (K), arginine (R), proline (P), histidine (H), phenylalanine (F), tyrosine (Y), and tryptophan (W).
- Most of the amino acids used in the copolymers of the present invention may exist in particular geometric or stereoisomeric forms.
- amino acids used to form the subject copolymers are (L)-isomers, although (D)-isomers may be included in the copolymers such as at non-anchor positions or in the case of peptidomimetic versions of the copolymers.
- amino acid can include one or more components which are amino acid derivatives and/or amino acid analogs as defined herein. For example, in a copolymer compositing having "tyrosine" residues, a portion of one or more of those residues can be substituted with homotyrosine.
- amino acid residue further includes analogs, derivatives, and congeners of any specific amino acid referred to herein, as well as C-terminal or N-terminal protected amino acid derivatives.
- derivative of an amino acid means a chemically related form of that amino acid having an additional substituent, for example, N-carboxyanhydride group, a ⁇ -benzyl group, an e,N-trifluoroacetyl group, a halide group attached to an atom of the amino acid, or the amino acid may be modified with an N-terminal or C-terminal protecting group.
- amino acid analog means a chemically related form of that amino acid having a different configuration, for example, an isomer, or an organic molecule with the approximate size, charge, and shape of the amino acid.
- the present invention contemplates the use of amino acid analogs wherein a side chain is lengthened or shortened while still providing a carboxyl, amino or other reactive precursor functional group for cyclization, as well as amino acid analogs having variant side chains with appropriate functional groups.
- the subject compound can include an amino acid analog such as, for example, cyanoalanine, canavanine, djenkolic acid, norleucine, 3-phosphoserine, homoserine, dihydroxy-phenylalanine, 5-hydroxytryptophan, 1-methylhistidine, 3- methylhistidine, diaminopimelic acid, ornitl ine, or diaminobutyric acid.
- amino acid herein includes variations of natural amino acids, including amino acids in a polypeptide form with one or more non-peptide or peptidomimetic bonds between two adjacent residues.
- hydrophobic amino acid means aliphatic amino acids alanine (A), glycine (G), isoleucine (I), leucine (L), proline (P), and valine (V), the terms in parentheses being the one letter standard code abbreviations for each amino acid, and aromatic amino acids tryptophan (W), phenylalanine (F), and tyrosine (Y). These amino acids confer hydrophobicity as a function of the length of aliphatic and size of aromatic side chains, when found as residues within a protein or a peptide.
- hydrophilic hydroxy amino acid means serine (S) or threonine (T).
- charged amino acid means amino acids aspartic acid (D), glutamic acid (E), histidine (H), arginine (R) and lysine (K), which confer a positive (H, K, and R) or negative (D, E) charge at physiological values of pH in aqueous solutions on peptides or proteins containing these residues. Histidine (H) is hydrophobic at pH 7, and charged at pH 6.
- Prevent means to delay or preclude the onset of, for example, one or more symptoms, of a disorder or condition.
- prodrug is intended to encompass compounds that, under physiological conditions, are converted into the inhibitor agents of the present invention.
- a common method for making a prodrug is to select moieties which are hydrolyzed under physiological conditions to provide the desired biologically active drug.
- the prodrug is converted by an enzymatic activity of the patient or alternatively of a target pathogen.
- Treat means at least lessening the severity or ameliorating the effects of, for example, one or more symptoms, of a disorder or condition.
- ED 50 means the dose of a drug that produces 50% of its maximum response or effect. Alternatively, it may refer to the dose that produces a pre-determined response in 50% of test subjects or preparations.
- LD 50 means the dose of a drug that is lethal in 50% of test subjects.
- therapeutic index refers to the therapeutic index of a drug defined as LD50/ED50.
- structure-activity relationship refers to the way in which altering the molecular structure of drugs alters their interaction with a receptor, enzyme, etc.
- aliphatic refers to a linear, branched, cyclic alkane, alkene, or alkyne.
- aliphatic groups in the present invention are linear or branched and have from 1 to about 20 carbon atoms.
- alkyl refers to the radical of saturated aliphatic groups, including straight-chain alkyl groups, branched-chain alkyl groups, cycloalkyl (alicyclic) groups, alkyl substituted cycloalkyl groups, and cycloalkyl substituted alkyl groups.
- a straight chain or branched chain alkyl has about 30 or fewer carbon atoms in its backbone (e.g., C ⁇ -C 30 for straight chain, C 3 - C 3 o for branched chain), and alternatively, about 20 or fewer carbon atoms.
- cycloalkyls have from about 3 to about 10 carbon atoms in their ring structure, and alternatively about 5, 6 or 7 carbons in the ring structure.
- alkyl (or “lower alkyl”) includes both
- unsubstituted alkyls and “substituted alkyls”, the latter of which refers to alkyl moieties having substituents replacing a hydrogen on one or more carbons of the hydrocarbon backbone.
- substituents may include, for example, a halogen, a hydroxyl, a carbonyl (such as a carboxyl, an alkoxycarbonyl, a formyl, or an acyl), a thiocarbonyl (such as a thioester, a thioacetate, or a thioformate), an alkoxyl, a phosphoryl, a phosphonate, a phosphinate, an amino, an amido, an amidine, an imine, a cyano, a nitro, an azido, a sulfhydryl, an alkylthio, a sulfate, a sulfonate, a sulfamoyl, a
- the moieties substituted on the hydrocarbon chain may themselves be substituted, if appropriate.
- the substituents of a substituted alkyl may include substituted and unsubstituted forms of amino, azido, imino, amido, phosphoryl (including phosphonate and phosphinate), sulfonyl (including sulfate, sulfonamido, sulfamoyl and sulfonate), and silyl groups, as well as ethers, alkylthios, carbonyls (including ketones, aldehydes, carboxylates, and esters), -CF 3 , -CN and the like.
- Cycloalkyls may be further substituted with alkyls, alkenyls, alkoxys, alkylthios, aminoalkyls, carbonyl- substituted alkyls, -CF 3 , -CN, and the like.
- heteroatom refers to an atom of any element other than carbon or hydrogen.
- Illustrative heteroatoms include boron, nitrogen, oxygen, phosphorus, sulfur and selenium, and alternatively oxygen, nitrogen or sulfur.
- aryl includes 5-, 6- and 7-membered single-ring aromatic groups that may include from zero to four heteroatoms, for example, benzene, pyrrole, furan, thiophene, imidazole, oxazole, thiazole, triazole, pyrazole, pyridine, pyrazine, pyridazine and pyrimidine, and the like.
- aryl groups having heteroatoms in the ring structure may also be referred to as "aryl heterocycles" or “heteroaromatics.”
- the aromatic ring may be substituted at one or more ring positions with such substituents as described above, for example, halogen, azide, alkyl, aralkyl, alkenyl, alkynyl, cycloalkyl, hydroxyl, alkoxyl, amino, nitro, sulfliydryl, imino, amido, phosphonate, phosphinate, carbonyl, carboxyl, silyl, ether, alkylthio, sulfonyl, sulfonamido, ketone, aldehyde, ester, heterocyclyl, aromatic or heteroaromatic moieties, -CF 3 , -CN, or the like.
- aryl also includes polycyclic ring systems having two or more cyclic rings in which two or more carbons are common to two adjoining rings (the rings are "fused rings") wherein at least one of the rings is aromatic, e.g., the other cyclic rings may be cycloalkyls, cycloalkenyls, cycloalkynyls, aryls and/or heterocyclyls.
- the other cyclic rings may be cycloalkyls, cycloalkenyls, cycloalkynyls, aryls and/or heterocyclyls.
- the present invention provides compounds that bind to and activate T cells in an HLA-DQ-mediated manner in addition to, or instead of, an HLA-DR- mediated manner.
- the present invention also provides compounds that bind to class II MHC molecules and prevent auto-antigeiiic peptides from activating T cells in an HLA-DQ-mediated manner.
- An aspect of the invention a copolymer composition formed by random synthesis (polymerization) of the various amino acid residues.
- Such composition comprises a te ⁇ olymer, which is copolymers with a random sequence of at least three different amino acid residues wherein at least one amino acid is selected from each group of:
- the copolymer is, for example, a te ⁇ olymer comprising three amino acid residues selected from the groups of three amino acid residues in Table 1:
- the copolymers are synthesized to have a molar input ratio of the amino acid components is about 2: 5: 3 for relative amounts of amino acids of the first group, the second group, and the third group, respectively.
- the molar input ratio of the amino acid components is about 2: 25: 15 for relative amounts of amino acids of the first group, the second group, and the third group, respectively.
- the molar input ratio of the amino acid components is about 2: 1: 0.6 for relative amounts of the first group, the second group, and the third group, respectively.
- the subject DQ-directed copolymers are tetrapolymers or pentapolymers, each of which copolymer is a mixture of randomized or partially randomized amino acid sequence containing at least four different amino acid residues wherein at least one amino acid is selected from each group of:
- the copolymer may contain proline (P) residues.
- the acidic amino acid side chain serves as a key anchor residue for the P9 pocket of HLA encoded by alleles DQAl *03-DQB 1 *0302 and HLA encoded by alleles DQAl *0501 -DQB 1*0201, based on the /357 polymorphism that is linked to disease susceptibility.
- the aliphatic side chain serves as a good anchor for the second relevant pocket, P4.
- the remaining pockets are best suited to accommodate small, neutral, or hydrophobic residues. Therefore, in one embodiment, a copolymer that binds to an HLA-DQ molecule comprises a plurality of amino acid residues selected from the above-described four groups.
- the copolymer is derived using the amino acids glutamic acid (E) and/or aspartic acid (D), leucine (L), serine (S) and alanine (A), and is referred to herein as an "ELSA" copolymer.
- the subject DQ-directed copolymers are a mixture of randomized or partially randomized amino acid sequence containing at least four different amino acid residues wherein at least one amino acid is selected from each group of:
- hydrophobic aliphatic residues such as leucine (L), isoleucine (I), valine (V), methionine (M)
- bulky hydrophobic residues such as tyrosine (Y), phenylalanine (F), leucine (L), methionine (M)
- acid residues such as aspartic acid (D), glutamic acid (E)
- the copolymer may contain proline (P) residues.
- An exemplary copolymer is derived using the amino acid residues glutamic acid (E) and/or aspartic acid (D), leucine (L), tyrosine (Y) and valine (V), and is refe ⁇ ed to herein as an "DLYV" copolymer.
- the copolymer is a tetrapolymer comprising combination of four amino acid residues, such combination selected from the groups of four amino acid residues in Table 2:
- Table 2 Tetrapolymer compositions aspartic acid: alanine: leucine: glutamic acid (DALE) aspartic acid: alanine: leucine: glutamine (DALQ) aspartic acid: alanine: isoleucine: glutamic acid (DAIE) aspartic acid: alanine: isoleucine: glutamine (DAIQ) aspartic acid: alanine: valine: glutamic acid (DAVE) aspartic acid: alanine: valine: glutamine (DAVQ) aspartic acid: alanine: threonine: glutamic acid (DATE) aspartic acid: alanine: threonine: glutamine (DATQ) aspartic acid: alanine: serine: glutamic acid (DASE) aspartic acid: alanine: serine: glutamine (DASQ) asparagine: alanine: leucine: glutamic acid (NALE) asparagine:
- Prefe ⁇ ed embodiments of the inventions are copolymer compositions comprising a random sequence of one of the following sets of amino acid residues:
- aspartic acid alanine, leucine, and glutamic acid (DALE);
- aspartic acid alanine, isoleucine, and glutamic acid (DAIE);
- aspartic acid alanine, valine, and glutamic acid (DAVE);
- aspartic acid alanine, threonine, and glutamic acid (DATE);
- aspartic acid glycine, isoleucine, and glutamic acid (DGIE);
- compositions are synthesized to have a molar output ratio of amino acid components, as they appear above, of about 1:10:3:1, or 1:15:3:1 respectively.
- the molar output ratio of amino acid components is about 1 :25: 15:5, respectively.
- the molar output ratio of amino acid components is about 1:3:1.5:0.2, respectively.
- Molar output ratios have a variability range of about 10% between the different amino acids.
- any of the copolymers can further comprise an additional amino acid residue, wherein the copolymer has T cell stimulatory activity in a complex with a class II MHC protein, wherein the additional amino acid residue is found in an autoantigenic peptide for diabetes.
- an additional amino acid to any of the combination above is a lysine residue (K).
- K residue is present in sufficient molar output ratio to increase T-cell stimulation by the copolymer complexed with a class II MHC protein. Further, the K residue present in sufficient molar output ratio to increase aqueous solubility of the copolymer.
- a certain ratio of amino acids to be inco ⁇ orated into the random copolymer may be used.
- Preferred random copolymers of the present invention comprise amino acid residues K, E, A, S, V, and P. More preferably, the molar input ratio of K: E: A: S: V is 0.3: 0.7: 9: 0.5: 0.5: 0.3.
- the copolymer can be a semi-random
- the copolymer has a general sequence:
- X is any amino acid residue
- X i and Xa 2 are acidic amino acid residues selected from glutamic acid and aspartic acid.
- one of X i and X 2 may be a valine.
- the copolymer can be synthesized to have one of the general sequences:
- the molar input ratio of A: S: V: K: P is 5:
- the peptides may have a length of 9 to 25 amino acid residues.
- the peptide is 13 amino acid-residues long.
- a peptide of a defined sequence length of 9 to 25 amino acids may contain from 2 to 20 fixed residues.
- An individual fixed residue of a peptide described in this invention may bind to the peptide binding grove of a class II MCH molecule at any of the positions PI, P4, P7, or P9.
- such peptide contains 2 or 3 fixed residues.
- a peptide of a defined sequence length of 13 amino acids will contain 2 fixed residues, either E or D or any combination thereof.
- a peptide of a defined sequence length of 13 amino acids will contain 3 fixed residues.
- the peptides may be multimers of a defined sequence, wherein the number of the repeating units preferably ranges from 2 to 8. More preferably, the number of the repeating units is 3 to 6. Most preferably, the number of repeating units is 4.
- a multimer of the instant invention comprises a peptide of a defined sequence length of 13 amino acids containing 2 fixed residues, either E or D or any combination thereof.
- the copolymers compositions of the present invention bind to one or more DQ isotypes with an average K of l ⁇ M or less, and more preferably an average Kd less than lOOnM, lOnM or even InM.
- Another way to identify prefe ⁇ ed copolymers is based on competitive binding assays, such as described in Sidney et al. (2002) J. Immunol. 169: 5098, which is expressed as an IC 50 value, or a value of the competitor at which 50% of the binding is inhibited.
- Prefe ⁇ ed copolymers of the present invention have ICso's less than l ⁇ M, more preferably less than 500nM, and even more less than lOOnM.
- the copolymer provided herein is at least about 30 residues in length, at least about 40 residues in length, or the copolymer is at least about 50 residues in length. Further, the copolymer is no greater than about 90 residues in length, no greater than about 80 residues in length, or no greater than about 70 residues in length.
- the random copolymers are about 10 to 100 amino acid residues long, more preferably 20 to 80 amino acid residues long, even more preferably 40 to 60 amino acid residues long, and most preferably about 50 amino acid residues long.
- a typical preparation of random copolymers is a mixture of peptides of various lengths, the majority of which are of the desired length but containing shorter or longer peptides inevitably created by the cu ⁇ ently available synthetic processes.
- the peptides are synthesized by solid phase chemistry.
- the subject copolymers are formulated for use as a medicament so as to have a polydispersity less than 25,000, and more preferably less than 10000, 5000 or even 1000.
- the compounds of the invention which reduce HLA-DQ mediated autoimmune responses have therapeutic value in the prevention or treatment of various class II MHC-related diseases or disorders such as Insulin-dependent diabetes mellitus (IDDM), celiac disease, dermatitis he ⁇ etiformis and autoimmune thyroid disease (AITD).
- IDDM Insulin-dependent diabetes mellitus
- celiac disease celiac disease
- AITD autoimmune thyroid disease
- the compounds of the invention may be administered to a patient for treatment of an immune disorder, for example, involving undesirable or inappropriate immune activity, or may be used to prepare a therapeutic medicament.
- an effective dose of a compound of the invention may be therapeutically applied to ameliorate or to prevent insulin-dependent diabetes, celiac disease, and other diseases.
- An effective dose of a compound of the invention for the treatment of a disorder involving undesirable or inappropriate MHC activity, such as an autoimmune disorder can be determined by standard means known in the art taking into account routine safety studies, toxicity studies, dose concentration studies and method of delivery, e.g. , bolus, continuous or repeated.
- the compounds of the present invention are random or semi-random copolymers of amino acids residues described above or analogs thereof (such as to form peptidomimetics), which can be synthesized using readily available technology and materials.
- a copolymer of the invention can be synthesized using Fmoc or t-boc initiating amino acid analogs, or the like, which are immobilized on a resin in an automated peptide synthesis apparatus for further polymerization (solid state synthesis).
- the amino acids are polymerized in molar ratios that can be adjusted to provide a copolymer with optimal binding characteristics.
- Examples of such resin supports for peptide synthesis include a
- Synthesis procedures can include providing a solution which is a mixture of the chosen amino acids in an activated form, for example, activated as an N-carboxy anhydride, in the appropriate molar ratios of each of the appropriately derivatized amino acid precursors (derivatized to protect certain functional groups, such as the e amino group of L-lysine, for example the precursor e,N-trifluoroacetyl-L-lysine).
- the synthesis procedure can involve online mixing during the synthetic procedure of derivatized precursors of the selected amino acids in the prefe ⁇ ed molar ratios.
- the molar output ratio of the amino acids differs from the molar input ratio, that is, the molar ratio of amino acids used in the synthesis mixture differs from the molar ratio of amino acids in the synthesized random copolymer.
- the molar output ratio is determined by a routine amino acid composition analysis after hydrolysis of the copolymer composition. Molar output ratios have a variability range of about 10% between the different amino acids.
- Reagents for synthesis, for deblocking, and for cleavage of the complete copolymer molecules for removal from the resin are available from manufacturers of the apparatus (Applied Biosystems Peptide Synthesizer, Foster City, CA, or Advanced ChemTech, Louisville, KY); see e.g., Bodansky, Principles of Peptide Synthesis, 2nd Ed., Springer- Verlag, 1991, the contents of which are herein inco ⁇ orated by reference.
- Additional amino acids or analogs or derivatives of amino acids can be added to the at least three amino acids selected to comprise the copolymers, to substitute for a small proportion of those amino acids, to provide, for example, a copolymer having increased protease resistance and therefore having enhanced pharmacological properties such as longer in vivo lifetime.
- Examples of analogs are homotyrosine, or other substituted tyrosine derivatives, and aminobutyric acid, each available as an Fmoc derivative from Advanced ChemTech.
- Copolymer synthesis services also can be obtained commercially, for example, at Chiron Technologies, Clayton, Australia, the Harvard Medical School Biopolymer Laboratory, Boston, MA, and at Advanced ChemTech, Inc., Louisville, KY.
- the compounds of the present invention include such linear copolymers that are further modified by substituting or appending different chemical moieties.
- such modification is at a residue location and in an amount sufficient to inhibit proteolytic degradation of the copolymer in a subject.
- the amino acid modification may be the presence in the sequence of at least one proline residue; the residue is present in at least one of carboxy- and amino termini; further, the proline can be present within four residues of at least one of the carboxy- and amino-termini.
- the amino acid modification may be the presence of a D-amino acid.
- the subject copolymer is a peptidomimetic.
- Peptidomimetics are compounds based on, or derived from, peptides and proteins.
- the copolymer peptidomimetics of the present invention typically can be obtained by structural modification of one or more native amino acid residues, e.g., using unnatural amino acids, conformational restraints, isosteric replacement, and the like.
- the subject peptidomimetics constitute the continuum of structural space between peptides and non-peptide synthetic structures.
- Such peptidomimetics can have such attributes as being non- hydrolyzable (e.g., increased stability against proteases or other physiological conditions which degrade the co ⁇ esponding peptide copolymers), increased specificity and/or potency.
- peptide analogs of the present invention can be generated using, for example, benzodiazepines (e.g., see Freidinger et al. in “Peptides: Chemistry and Biology," G.R. Marshall ed., ESCOM Publisher: Leiden, Netherlands, 1988), substituted gamma lactam rings (Garvey et al in "Peptides: Chemistry and Biology," G.R.
- su ⁇ ogates have been developed for the amide bond of peptides. Frequently exploited su ⁇ ogates for the amide bond include the following groups (i) trans-olefins, (ii) fluoroalkene, (iii) methyleneamino, (iv) phosphonamides, and (v) sulfonamides.
- peptidomimetics based on more substantial modifications of the backbone of the copolymer can be used.
- Peptidomimetics which fall in this category include (i) retro-inverso analogs, and (ii) N-alkyl glycine analogs (so-called peptoids).
- the peptidomimetic can be derived as a retro-inverso analog.
- Retro-inverso analogs can be made according to the methods known in the art, such as that described by the Sisto et al. U.S. Patent 4,522,752.
- sites which are most susceptible to proteolysis are typically altered, with less susceptible amide linkages being optional for mimetic switching
- the final product, or intermediates thereof, can be purified by HPLC.
- the peptidomimetic can be derived as a retro-enantio copolymer.
- Retro-enantio analogs such as this can be synthesized commercially available D-amino acids (or analogs thereof) and standard solid- or solution-phase peptide-synthesis techniques.
- trans-olefm derivatives can be made.
- a trans-olefm analog of a copolymer can be synthesized according to the method of Shue et al. (1987) Tetrahedron Lett. 28: 3225 and also according to other methods known in the art. It will be appreciated that variations in the cited procedure, or other procedures available, may be necessary according to the nature of the reagent used.
- pseudodipeptides synthesized by the above method to other pseudodipeptides, to make copolymers with several olefinic functionalities in place of amide functionalities.
- pseudodipeptides co ⁇ esponding to certain di-peptide sequences could be made and then coupled together by standard techniques to yield an analog of the copolymer peptide which has alternating olefinic bonds between residues.
- Still another class of peptidomimetic derivatives includes phosphonate derivatives.
- the synthesis of such phosphonate derivatives can be adapted from known synthesis schemes. See, for example, Loots et al. in “Peptides: Chemistry and Biology,” (Escom Science Publishers, Leiden, 1988, p. 118); Petrillo et al. in “Peptides: Structure and Function (Proceedings of the 9th American Peptide Symposium),” Pierce Chemical Co. Rockland, IL, 1985).
- the modification may be introduction of carbohydrate or lipid moieties.
- Such modifications also change the solubility of the copolymers into various medium so that they may advantageously be prepared into a suitable pharmaceutical composition.
- Modifying lipid groups include farnesyl group or myristoyl group.
- Modifying carbohydrate groups include single sugars or oligosaccharides of any naturally occu ⁇ ing and synthetic sugar and sugar alcohols, for example glucose, galactose, rhamnose, mannose, arabinose, and other sugars, and their respective alcohols.
- One aspect of the present invention provides methods to treat a subject having an autoimmune disease by administering one or more copolymers of the present invention to the subject in a therapeutically effective amount.
- Other aspects of the present invention provides methods to treat a subject having an unwanted immune response, allergy, or any disease treatable by administering a copolymer of the invention described herein.
- the method of treatment provided by the present invention is particularly suitable for treatment of Type I, or insulin-dependent, diabetes mellitus, celiac disease, or any other autoimmune disease mediated through HLA-DQ molecules.
- an embodiment of the invention is to administer a suitable daily dose of a therapeutic copolymer composition that will be the lowest effective dose to produce a therapeutic effect, for example, mitigating symptom.
- the therapeutic copolymers are preferably administered at a dose per subject per day of at least about 2 mg, at least about 5 mg, at least about 10 mg, or at least about 20 mg as appropriate minimal starting dosages.
- a dose of about 0.01 to about 500 mg/kg can be administered.
- the effective dosage of the compound of the present invention is about 50 to about 400 micrograms of the compound per kilogram of the subject per day.
- the dose of the composition of the invention will vary depending on the subject and upon the particular route of administration used. It is routine in the art to adjust the dosage to suit the individual subjects. For example, a single bolus can be administered, several divided doses can be administered over time, or the dose can be proportionally reduced or increased as indicated by the exigencies of the disease situation. Additionally, the effective amount may be based upon, among other things, the size of the compound, the biodegradability of the compound, the bioactivity of the compound and the bioavailability of the compound. If the compound does not degrade quickly, is bioavailable and highly active, a smaller amount will be required to be effective.
- the actual dosage suitable for a subject can easily be determined as a routine practice by one skilled in the art, for example a physician or a veterinarian given a general starting point.
- An improvement in the symptoms as a result of such administration is noted by a decrease in frequency of recu ⁇ ences of episodes of diabetes, by decrease in severity of symptoms, and by elimination of recu ⁇ ent episodes for a period of time after the start of administration.
- a therapeutically effective dosage preferably reduces symptoms and frequency of recu ⁇ ences by at least about 20%, for example, by at least about 40%, by at least about 60%, and by at least about 80%, or by about 100% elimination of one or more symptoms, or elimination of recu ⁇ ences of the autoimmune disease, relative to untreated subjects.
- the compound may be delivered hourly, daily, weekly, monthly, yearly (e.g., in a time release form) or as a one-time delivery.
- the delivery may be continuous delivery for a period of time, e.g., intravenous delivery.
- the agent is administered at least once per day.
- the agent is administered daily.
- the agent is administered every other day.
- the agent is administered every 6 to 8 days.
- the agent is administered weekly.
- the period of time of treatment can be at least about one month, at least about six months, or at least about one year.
- the route of administration can be oral, intraperitoneal, transdermal, subcutaneous, by intravenous or intramuscular injection, by inhalation, topical, intralesional, infusion; liposome- mediated delivery; topical, intrathecal, gingival pocket, rectal, intrabronchial, nasal, transmucosal, intestinal, ocular or otic delivery, or any other methods known in the art as one skilled in the art may easily perceive.
- Other embodiments of the compositions of the invention inco ⁇ orate particulate forms protective coatings, protease inhibitors or permeation enhancers for various routes of administration, including parenteral, pulmonary, nasal and oral.
- An embodiment of the method of present invention is to administer the copolymers of the present invention in a sustained release form.
- Such method comprises applying a sustained-release transdermal patch or implanting a sustained- release capsule or a coated implantable medical device so that a therapeutically effective dose of the copolymer of the present invention is continuously delivered to a subject of such a method.
- the compounds and/or agents of the subject invention may be delivered via a capsule which allows sustained-release of the agent or the peptide over a period of time.
- Controlled or sustained-release compositions include fo ⁇ nulation in lipophilic depots (e.g., fatty acids, waxes, oils).
- particulate compositions coated with polymers e.g., poloxamers or poloxamines
- a source of a copolymer is stereotactically provided within or proximate to the area of autoimmune attack, for example, near the pancreas for the treatment of IDDM.
- the methods further comprise administering at least one additional therapeutic agent.
- an agent can be another copolymer such as Copaxone ® that binds to a different HLA molecule, which may be an HLA-DQ molecule or an HLA-DR molecule; an antibody or a fragment of an antibody which binds to an unwanted inflammatory molecule or cytokine such as interleukin-6, interleukin-8, granulocyte macrophage colony stimulating factor, and tumor necrosis factor-or, an enzyme inhibitor such as a protease inhibitor such as ⁇ i-antitrypsin, aprotinin, inhibitor of a kallikrein; a cyclooxygenase inhibitor; an antibiotic such as amoxicillin, rifampicin, erythromycin; an antiviral agent such as acyclovir; a steroidal anti-inflammatory such as a glucocorticoid; sex steroid such as progesterone;
- cytokines and growth factors may be interferon- ?, tumor necrosis factors, antiangiogenic factors, erythropoietins, thrombopoietins, interleukins, maturation factors, chemotactic protein, and their variants and derivatives that retain similar physiological activities.
- Another embodiment of the methods of invention further comprises administration of anti-obesity drugs.
- Anti-obesity drugs include P-3 agonists, CB-1 antagonists, appetite suppressants, such as, for example, sibutramine (Meridia), and lipase inhibitors, such as, for example, orlistat (Xenical).
- a copolymer of the invention is administered in combination with drugs commonly used to treat lipid disorders in diabetic patients.
- drugs include, but are not limited to, HMG-CoA reductase inhibitors, nicotinic acid, bile acid sequestrants, and fibric acid derivatives.
- a copolymer of the invention is administered in combination with anti-hypertensive drugs such as /3-blockers, cathepsin S inhibitors and ACE inhibitors.
- a copolymer of the present invention may be administered with one more of any of the foregoing additional therapeutic agents.
- the additional agent or agents may be administered as an added part of the phannaceutical composition as described below or may be administered as a separate composition, concomitantly or within a time period when the physiological effect of the additional agent overlaps with the physiological effect of the copolymer of the present invention. More specifically, an additional agent may be administered concomitantly or one week, several days, 24 hours, 8 hours, or immediately before the administration of the copolymer. Alternatively, an additional agent may be administered one week, several days, 24 hours, 8 hours, or immediately after the administration of the copolymer.
- Another embodiment of the present invention is a method for prophylactically treating a subject at risk of developing an autoimmune disease by administering a copolymer of the present invention, so that the onset of the disease is delayed or prevented.
- a subject at risk is identified by, for example, dete ⁇ nining the genetic susceptibility to an autoimmune disease by testing for alleles of HLA that are associated with such autoimmune disease, and/or based on familial history, or other genetic markers that co ⁇ elate with such autoimmune disease.
- Such prophylactic treatment may additionally comprise a second copolymer that binds to a second HLA molecule associated with the autoimmune disease to be treated.
- the second HLA molecule may be a HLA-DQ or HLA-DR molecule.
- the autoimmune disease to be prophylactically treated is IDDM or celiac disease.
- Prophylactic treatments using a copolymer composition of the present invention are also suitable for preventing unwanted immune responses, such as host- graft disease or graft-host disease or graft rejection after organ transplantation.
- a copolymer of the invention may be administered to a subject prior to, during, and after transplantation, either alone or with traditional immunosuppressant dmgs. Such administration may take place one week, several days, 24 hours, 8 hours or immediately before transplantation, and may continue to be administered to a patient after transplantation in a treatment regimen for another 60-100 days, but at least 60 days, after the transplantation day.
- Prophylactic treatments using a copolymer composition of the invention is also suitable for preventing allergies, or any disease treatable by administration of a copolymer of the present invention.
- compositions comprising a pharmaceutically effective amount of a copolymer composition of the present invention and an acceptable carrier and/or excipients.
- a pharmaceutically acceptable ca ⁇ ier includes any solvents, dispersion media, or coatings that are physiologically compatible. Preferably, the ca ⁇ ier is suitable for intravenous, intramuscular, oral, intraperitoneal, transdermal, topical, or subcutaneous administration.
- One exemplary pharmaceutically acceptable carrier is physiological saline.
- Other pharmaceutically acceptable carriers and their formulations are well-known and generally described in, for example, Remington 's Pharmaceutical Science (18 th Ed., ed. Gennaro, Mack Publishing Co., Easton, PA, 1990).
- compositions are well-known in the art and can be found in, for example, Handbook of Pharmaceutical Excipients (4 ed., Ed. Rowe et al. Pharmaceutical Press, Washington, D.C.).
- the composition can be formulated as a solution, microemulsion, liposome, capsule, tablet, or other forms suitable for various routes of administration described above in for the methods of treatment.
- the active component which comprises the copolymer may be coated in a material to protect it from inactivation by the environment prior to reaching the target site of action.
- the pharmaceutical compositions are sustained release formulations.
- Copolymers of the present invention may be admixed with biologically compatible polymers or matrices which control the release rate of the copolymers into the immediate environment.
- Controlled or sustained release compositions include formulation in lipophilic depots (e.g., fatty acids, waxes, oils), implants, transdermal patches, and microencapsulated delivery systems.
- particulate compositions coated with polymers e.g., poloxamers or poloxamines.
- Other embodiments of the compositions of the invention inco ⁇ orate particulate forms protective coatings, protease inhibitors or permeation enhancers for various routes of administration, including parenteral, pulmonary, nasal and oral.
- Acceptable carriers include carboxymethyl cellulose (CMC) and modified CMC. See, e.g., Sustained and Controlled Release Drug Delivery Systems, J.R. Robinson, Ed., Marcel Dekker, Inc., NY, 1978.
- the pharmaceutical composition may also include additional therapeutically active ingredients.
- additional ingredient can be another copolymer such as Copaxone that binds to a different HLA molecule, an antibody or a fragment of an antibody which binds to an unwanted inflammatory molecule or cytokine such as interleukin-6, interleukin-8, granulocyte macrophage colony stimulating factor, and tumor necrosis factor-o;; an enzyme inhibitor such as a protease inhibitor such as ⁇ i-antitrypsin, aprotinin, inhibitor of a kallikrein; a cyclooxygenase inhibitor; an antibiotic such as amoxicillin, rifampicin, erythromycin; an antiviral agent such as acyclovir; a steroidal anti-inflammatory such as a glucocorticoid; sex steroid such as progesterone; a non-steroidal anti- inflammatory such as aspirin, ibuprofen, or acet
- An embodiment of the therapeutic composition of the invention may comprise a copolymer in combination with one or more anti-obesity drugs, such as P- 3 agonists, CB-1 antagonists, appetite suppressants, such as, for example, sibutramine (Meridia), and lipase inhibitors, such as, for example, orlistat (Xenical).
- anti-obesity drugs such as P- 3 agonists, CB-1 antagonists, appetite suppressants, such as, for example, sibutramine (Meridia), and lipase inhibitors, such as, for example, orlistat (Xenical).
- One or more drugs commonly used to treat lipid disorders in diabetic patients may be the additional therapeutically active ingredients of the composition of the invention.
- Such drugs include, but are not limited to, HMG-CoA reductase inhibitors, nicotinic acid, bile acid sequestrants, and fibric acid derivatives.
- Anti-hypertensive drugs such as, for example, /3-blockers, cathepsin S inhibitors and ACE inhibitors, may be the additional therapeutically active ingredients of the composition of the invention.
- /3-blockers are: acebutolol, bisoprolol, esmolol, propanolol, atenolol, labetalol, carvedilol, and metoprolol.
- ACE inhibitors examples include captopril, enalapril, lisinopril, benazepril, fosinopril, ramipril, quinapril, perindopril, trandolapril, and moexipril.
- cathepsin S specific inhibitors are: furanone derivatives having a structure represented by Formula (I) below:
- R6 H, Ar-Cl-7-alkyl, Cl-3-alkyl-SO2-R ix , Cl-3-alkyl-C(O)-NHR ix or CH2XAr; where X and Ar are as defined herein; and pharmaceutically acceptable salts thereof.
- the compounds of formula (I) are disclosed in a published PCT application WO 00/69855, the disclosure of which is inco ⁇ orated herein in its entirety.
- Other examples of cathepsin S inhibitors are furanone derivatives having a structure represented by Formula (II) below:
- R" single or multiple ring substitution combinations taken from: H, Cl-7-alkyl, C3-6-cycloalkyl, OH, SH, amine, halogen;
- R3 Cl-7-alkyl, C2-7-alkenyl, C3-7-cycloalkyl, Ar, Ar-Cl-7-alkyl;
- R4 H, Cl-7-alkyl, C3-7-cycloalkyl; C2-7-alkenyl, Ar, Ar-Cl-7-alkyl;
- R5 Cl-7-alkyl, hydroxyl- or halo-substituted Cl-C7-alkylhalogen, Ar-Cl-7-alkyl, C0-3-alkyl-CONR3R4 or R iv ;
- R IV Cl-7-alkyl, hydroxyl- or halo-substituted Cl-C7-alkylhalogen, Ar-Cl-7-alkyl, C0-3-alkyl-CONR3R4 or
- R v , R vi H, Cl-7-alkyl;
- A N, CH;
- B N, O, S, CH;
- R viii O, Cl-7-alkyl;
- R6 H, Cl-7-alkyl, AR-Cl-7-alkyl, Cl-3-alkyl-SO2-R ix , Cl-3-alkyl-C(O)-NHR ix or CH2XAr;
- R 1 is Cl-7-alkyl, Ar-Cl-7-alkyl,C3-C6-cycloalkyl and pharmaceutically acceptable salts thereof.
- the compounds of Formula (II) are disclosed in a published PCT application WO 02/40462, the disclosure of which is inco ⁇ orated herein in its entirety.
- cathepsin S inhibitors examples include: l-[3-[4-(6-Chloro-2,3- dihydro-3-methyl-2-oxo-lH-benzimidazol-l-yl)-l-piperidinyl]propyl]-4,5,6,7- tetrahydro-5-(methylsulfonyl)-3-[4-(trifluoromethyl)phenyl]-lH-pyrazolo[4,3- cjpyridine (JNJ 10329670) (Thurmond et al (2004) J Pharmacol. Exp. Ther. 308(1): 268-76, Epub 2003 Oct 17); CLIK-60 (Katunuma et al FEBSLett.
- the pharmaceutical composition of the present invention is preferably sterile and non-pyrogenic at the time of delivery, and is preferably stable under the conditions of manufacture and storage.
- Another aspect of the present invention provides methods for identifying a therapeutic copolymer capable of reducing severity and frequency of episodes of an autoimmune disease.
- the subject DQ-directed copolymers are modified, or labeled, with a moiety that facilitates the detection of the copolymers.
- the copolymers are biotinylated.
- the copolymers are modified with FITC.
- Exemplary copolymers are random copolymers as described above, modified with biotin or FITC.
- the copolymers with "anchor" residues which occur with regular spacing in the resulting polymer are modified with biotin or FITC.
- modified copolymers can be synthesized to have one of the general formulae:
- A, S, V, K, or P the molar input ratio of which are 5: 1 : 1 : 1 : 0.5, 2 ⁇ ⁇ S, and the spacer comprises two to 6 amino acid residues, preferably with the amino acid sequence SGSG.
- n 4.
- modified copolymers are used in assays and diagnostics, for example in enzyme-linked immunosorbent assay (ELISA).
- ELISA enzyme-linked immunosorbent assay
- the labeled copolymers can also be used to determine the best sequence or prefe ⁇ ed sequence among the copolymers that bind to an HLA molecule. Additionally, the labeled copolymer can be used in screening for other compounds not related to copolymers of the present invention but binds or associate with HLA-DQ molecules.
- a copolymer that is therapeutically effective to treat autoimmune disease can be identified by the following method: (1) a copolymer of the present invention is synthesized as described above; (2) determining binding of such copolymer to an HLA-DQ molecule; (3) comparing binding of the copolymer to the HLA-DQ molecule with binding of a known autoantigenic peptide to the HLA-DQ; (4) selecting a copolymer which binds to the HLA-DQ molecule substantially more strongly than the tested known autoantigenic peptide; and (5) determining activation of and anti-inflammatory cytokine production by T helper cells moderated by the HLA-DQ molecule presenting such selected copolymer.
- Examples of an autoantigenic peptide are: a peptide comprising amino acid residues 9-23 of human insulin; a peptide comprising amino acid residues 206- 220 of human GAD; or a peptide comprising amino acid residues 441-460 of human HSP60.
- the HLA-DQ molecule that the copolymer is tested against may be any HLA-DQ molecule described herein.
- the methods of screening can be used for in vivo assay in non-human animals such as a rodent, such as a rat, mouse, or hamster.
- the rodent may be a model for human diseases, such as the NOD mice for human diabetes.
- Example 1 Binding of copolymers to HLA-DQ
- HLA-DQ8 was engineered to be a soluble protein by replacing the transmembrane and intracellular segments of DQ and DQ ⁇ with leucine zipper dimerization domains from the transcription factors Fos and Jun. See Hausmann et al. (1999) J. Exp. Med. 189: 1723-1734.
- the expressed recombinant protein was purified from the concentrated supernatants by affinity chromatography using monoclonal antibody 9.3.F10 (HB 180, American Type Culture Collection) and anion-exchange chromatography using Mono Q HR column (Pharmacia Biotech).
- Copolymer binding assays were performed with biotinylated copolymers.
- copolymer candidates and soluble HLA-DQ8 were incubated and the formed complex was captured using monoclonal antibody 9.3.F10, which binds specifically to HLA-DQ8.
- the captured complex was quantitated by detection with europium-labeled streptavidin.
- biotinylated copolymers were preincubated with soluble HLA-DQ8.
- Copolymers with binding affinity stronger than or comparative to the autoantigenic peptides are selected.
- Prefe ⁇ ed copolymers form complexes with HLA-DQ8 with a half-life of longer than 12 hours.
- copolymers to be selected form complexes with HLA-DQ 8 with a half-life of longer than 24 hours, 48 hours, or even more preferably, 72 hours.
- copolymers used in the experiments have the following amino acid composition and, if applicable, anchor amino acids:
- RSP-002 [XXEXXXXXXDXX] 4
- RSP-003 [XXEXXVXXXXDXX] 4
- X is a mixture of A, K, S, V, P with a molar input ratio of
- RSP-008 a random mixture of DAVE
- RSP-009 a random mixture of DATE
- RSP-OlO a random mixture of DALE
- CO-14 YFAK with the molar input ratio of the four amino acid residues about 1 : 1.2: 18:6 in the resulting random copolymer composition.
- Figure 1 shows the results of a competition assay, where non-labeled random copolymers RSP-OOl, RSP-002 and RSP-003 competed for binding to HLA-DQ8 with RSP-006, which is a biotinylated RSP-003.
- Figure 2 shows the results obtained using the competition assay for non-labeled random copolymers RSP-008 (DAVE), RSP-009 (DATE), and RSP-OlO (DALE) binding to HLA-DQ8 in competition with RSP-006.
- Figure 3 shows the results obtained using the competition assay for CO-14 (YFAK), a copolymer composition originally of interest because of its affinity to HLA-DR molecules.
- the graphs show results that are co ⁇ ected for the nonspecific control, and shows the amounts of random copolymers that were displaced.
- Figure 4 shows the results of a direct binding assay of biotinylated random copolymers RSP-004 (biotinylated RSP-OOl), RSP-005 (biotinylated RSP-002), and RSP-006 (biotinylated RSP-006).
- RSP-004 biotinylated RSP-OOl
- RSP-005 biotinylated RSP-002
- RSP-006 biotinylated RSP-006
- Figures 5 and 6 are control experiments showing the binding of these random copolymers to HLA-DR2 protein.
- Figure 5 is a direct binding assay of biotinylated random copolymers RSP-004, RSP-005, and RSP-006. The results indicate that these random copolymers are specific to HLA-DQ8 by about a factor of 10.
- Figure 6 shows the results of competition assay of RSP-008 (DAVE), RSP-009 (DATE), and RSP-010 (DALE) to HLA-DR2 in competition with CLIP (class II- associated invariant chain peptide; Riberdy et al. (1992) Nature 360(6403) :474-7), which binds to various class II proteins with moderate affinity.
- CLIP class II- associated invariant chain peptide
- a "class” of random copolymers comprise copolymer compositions that share structural features such as the same anchor residues or comparable amino acid composition. This is suggested by the observation that RP-006 peptide can more completely displace RSP-OOl, 002, and 003, which are in the same class of copolymers as RP-006, but cannot displace other copolymers such as RSP-008, 009 or 010 as efficiently.
- dissociation constants of the random copolymers tested against HLA-DR2 are about 10-20 ⁇ g/ml, and thus about 10 times larger than the values for HLA-DQ8.
- the copolymers selected by the binding assays are incubated with human PBMCs from subjects with the HLA-DQ2 encoded by alleles DQA1*0501-DQB1*0201 or HLA-DQ8 encoded by alleles DQAl *03-DQB 1*0302 allele.
- the restriction element(s) for the resulting cell lines can be determined with anti-DR and anti-DQ antibodies.
- a "humanized" mouse model of diabetes in which the mice lack endogenous class II genes but transgenetically express human HLA-DQ8 and DR3 proteins is used in the studies herein.
- GAD65 is injected into these transgenic mice which are thus immunized with GAD65.
- HLA-DR3 and DQ8 and their bound peptide fragments from GAD65 are purified from mouse spleen and lymph nodes after the appearance of GAD65 antibody.
- the obtained peptide pool is fractionated and the T-cells generated from the immunized transgenic mice are tested for their response to these peptides.
- GAD65 peptides are presented by both DR and DQ proteins in these transgenic animals is determined, and the sequences of the peptides associated with each type of protein is compared, to determine whether they are the same or overlapping peptides. Moreover, whether the presence of one class II MHC protein influences the peptide repertoire present associated with the other protein is determined from comparison of single and double transgenic animals.
- Soluble HLA-DQ molecules were expressed in Drosophila S2 cells and purified as described (Kalandadze et al. 1996. J Biol Chem. 271 :20156-20162). Cells were grown at 26°C in roller bottles in ExCell 401 medium (JRH Biosciences, Lenexa, KS) supplemented with 0-5% fetal bovine serum (Sigma Chemicals, St. Louis, MO). Cells were harvested 4-5 days after induction by 1 mM CuSO 4 .
- HPLC separation and microsequencmg of bound copolymers are separated from unbound material and pool sequenced as previously described (Fridkis-Hareli, M. et al (1999) J. Immunol. 162:4697-4704). Briefly, the fractionation is by microbore HPLC using a Zorbax C18 1.0 mm reverse-phase column on a Hewlett-Packard 1090 HPLC with 1040 diode a ⁇ ay detector.
- Copolymers are eluted at a flow rate of 54 ⁇ l/min with a gradient of 0.055% trifluoroacetic acid (TFA) in acetonitrile (0% at 0 to 10 min, 33% at 73 min and 60% at 105 min).
- TFA trifluoroacetic acid
- Strategies for peak selection, reverse phase separation and Edman microsequencmg have been previously described (Chicz, R.M. et al (1993) J. Exp Med.118 21 -Al; Godkin et ⁇ /. (1997) Int. Immunol 9:905-11). Pooled fractions are submitted to automated Edman degradation on a Hewlett-Packard G1005A (Palo Alto, CA) protein sequencer using the manufacturer's Routine 3.5.
- binding buffer is 20 mM 2-[N-mo ⁇ holino]ethanesulfonic acid (MES), 140 mM NaCl, 0.05% NaN 3 , pH 5.0, unless otherwise specified;
- PBS is 150 mM sodium chloride, 7.5 mM Na 2 HPO , 2.5 mM NaH 2 PO 4 , pH 7.2;
- TBS is 137 mM sodium chloride, 25 mM Tris pH 8.0, 2.7 M potassium chloride;
- TTBS is TBS plus 0.05% Tween-20.
- the immunoassay plates Prior to adding samples, the immunoassay plates (96-well microtiter,
- PRO-BINDTM Falcon, Lincoln Park, NJ
- PRO-BINDTM Falcon, Lincoln Park, NJ
- PBS 100 ⁇ l total
- the wells were then blocked with TBS/3% bovine serum albumin (BSA) for 1 hr at 37°C and washed three times with TTBS.
- BSA bovine serum albumin
- Inhibition reaction was carried out by co-incubating a biotinylated peptide, final concentration 0.13 ⁇ M in 50 ⁇ l of the binding buffer, with unlabeled inhibitors (random copolymers or control peptides) and HLA-DQ molecules for 40 hr at 37°C. Bound peptide-biotin was detected using streptavidm-conjugated alkaline phosphatase, as follows.
- HLA-DQ8 purified on a small scale. Purification from HLA-DQ8 protein isolated from lg of cells. Priess cells (HLA-DR4, HLA-DQ8 homozygous) are the standard in this investigation. POROS immunoaffinity columns (BioCAD instrument) were used to isolate HLA-DQ8 (as well as HLA-DR4) from 20 grams of cells. Peptides were eluted from 1/20 of this material (equivalent of to lg of cells).
- MS-MS (Table 3). Many of these represented nested peptide sets. One peptide in particular derived from a Class I MHC protein was present in 10 different sequences differing only at the N- or C- terminus of the peptide. The core in this set was readily identified. This represents the largest number of peptides isolated from HLA-DQ8 protein and identified, and this critical number provides a consensus for analysis of such sites on the protein as the PI and P9 positions (see Table 4). In the previous two studies of HLA-DQ8 (1, 2), sequences of eight peptides were reported in one and the other described only peptide pool sequencing.
- Proteoglycan 1 1 SLDRNLPSDSQDLGQHGLEEDFM*L (15 nested) (SEQ ID NO: 3! Class I histocompatibility antigen 2 RPAGDGTFQKWAAVWPSGEEQR (10 nested) (SEQ ID NO: 4( 3 GPEYWDRETQISKTNT (SEQ ID NO: 4 4 LNEDLSSWTAADTAA (SEQ ID NO: 4: P60 5 YRDEDGDLVAFSSDEELT (6 nested) (SEQ ID NO: 4.' Calnexin 6 IDIEDDLDDVIEEVEDSKP (2) (SEQ ID NO: 7 KPDDWDEDAPAKIPDEE (5 nested) (SEQ ID NO: 4.' 8 KPEDWDEDM*DGEWEAPG (SEQ ID NO: 4( Alzheimer's disease amyloid A4 protein homolog precursor 9 ADGSEDKWEVAEEEEVA (7 nested) (SEQ ID NO: 4 Chain A, rabbit serum transfe ⁇ in 10 APEEGYLSV
- Protein disulfide isomerase related protein (calcium-binding protein, intestinal-related) 34 SNRENAIEDEEEEEEE (SEQ ID NO: 11
- the eluted peptides were found to be generally acidic, with su ⁇ rising ove ⁇ epresentation of both aspartic acid (D) and glutamic acid (E). Alignment of the peptides with E or D near the carboxy terminus of the core, i.e., at P9, is shown in Table 6. A preference for an acidic amino acid at PI was also evident in the alignment which is more than that observed with mouse protein I- A 87 (Suri et al (2002) J. Immunol. 168(3): 1235-43). The distinction between preferences from one species to another may be especially significant for immune recognition.
- Putative PI and P9 residues are in bold type. Possible multiple candidates are shown for most of these peptides.
- Example 5 Copolymers for the treatment of diabetes: Copaxone ® control.
- Copaxone ® control To develop a copolymer that could prevent progression of diabetes in the Non-obese diabetic (NOD) mouse, the consensus amino acids observed for PI and P9 positions herein in Table 6 were used as the basis of choice of amino acid residues, i.e., which amino acids to use to obtain a copolymer having a random sequence.
- NOD mice are obtained from Jackson Laboratories, Bar Harbor, ME, and are used as an experimental system (Shi et al. (2001) Proc. Natl Acad. Sci. USA 98: 6777-6782). These mice begin to develop diabetes at about 13-15 weeks and data are obtained after about 30 weeks to obtain data, such as a frequency of symptoms for comparison of treated and untreated groups of mice. NOD mice were treated herein with Copaxone ® , and no difference was found between the untreated animals and animals treated with Copaxone ® . In the experiment, lO ⁇ g of Copaxone ® was injected into mice three times a week (equivalent to the human dose on a weight ratio basis. A higher dose, 33 ⁇ g Copaxone ® /mouse three times a week, is also employed. These experiments test the hypothesis that Copaxone ® would be ineffective.
- NOD mouse is a widely studied murine model for human insulin- dependent diabetes mellitus.
- I-A 7 is expressed, a class II MHC molecule that shares structural and peptide-binding similarities with HLA-DQ8, and in mouse confers susceptibility to IDDM.
- Experiments were carried out to determine whether administrations of semi-random copolymers which contain anchor residues, can prime NOD mice so that the mice will generate T cell responses that can be measured by in vitro T cell assays.
- mice were immunized by subcutaneous injection between the shoulders on Day 1 with 50 or 250 ⁇ g of RSP-OOl, RSP-002, RSP-003, or RSP- OlO, alone or with complete Freund's adjuvant (CFA).
- CFA complete Freund's adjuvant
- RSP-OOl 002 and 003, on days 3, 5, 8, 10 and 12
- RSP-OlO the same injection was repeated on day 8.
- Control group animals were injected with sodium phosphate buffer. On day 15, mice were sacrificed and spleens were collected. Splenocytes were restimulated in vitro with various concentrations of same copolymer used for immunization.
- At least 3 replicates were plated for each treatment group for restimulation.
- tritiated thymidine was added to triplicate wells, and the cells were harvested on day 3 to measure the inco ⁇ oration of radioactivity, which shows the proliferation of the primed T cells in response to an antigen.
- Induction of tolerance to autoimmune diseases by administration of copolymers and/or auto antigenic peptides is a topic of great practical as well as theoretical interest. Identification of peptides derived from GAD65 and presented by DR and DQ proteins will allow design of amino acid-based human therapeutics.
- the immune system is able to distinguish foreign molecules from the endogenous or "self cell components such as proteins. Once a foreign molecule is recognized, the immune system enlists participation of a variety of cells (e.g. B and T cells) and molecules to mount an appropriate response to eliminate them. Autoimmunity occurs when an immune response is mounted against self- components.
- the protein to be recognized by T cells is cleaved, for example, proteolytically, into small fragments (peptides), which are then associated with major histocompatibility complex (MHC) molecules and transported to the cell surface.
- MHC major histocompatibility complex
- MHC molecules are HLA-DR4, DR3, HLA-DQ2 encoded by DQA1*0501-DQB1*0201 allele or HLA-DQ8 encoded by DQAl *03-DQB 1*0302 allele, certain alleles of which have been shown to be associated with the greater risk for insulin-dependent diabetes mellitus (IDDM).
- IDDM is thought to be a T cell- mediated autoimmune disease in which T cells destroy the insulin-secreting ⁇ cells of the pancreatic islets of Langerhans.
- the peptides derived from glutamic acid decarboxylase (GAD65) an enzyme mainly restricted to brain and ⁇ cells found in pancreatic islets, have been implicated in the pathogenesis of the disease.
- GAD65 is injected into these transgenic mice which are then immunized with GAD65.
- Microscale purification of DR3 and DQ8 proteins will be used to obtain these proteins, using the purification procedure that was optimized above using human B cell lines WT20 and Priess cells. This procedure is used applying the materials from transgenic mice. The peptide pool was fractionated and the sequence of the peptides was analyzed. T cell hybridomas are generated from the spleens and lymph nodes of immunized transgenic mice and tested for their response to these peptides.
- the GAD65 peptides are identified from amino acid sequence data, using sequences to be obtained from several peptides in each pool. Finally, the peptides identified are synthesized and mice are immunized with them to determine whether these are immunogenic.
- Contemplated equivalents of the copolymers, subunits and other compositions described above include such materials which otherwise co ⁇ espond thereto, and which have the same general properties thereof (e.g., biocompatible, antineoplastic), wherein one or more simple variations of substituents are made which do not adversely affect the efficacy of such molecule to achieve its intended pu ⁇ ose.
- the compounds of the present invention may be prepared by the methods illustrated in the general reaction schemes as, for example, described below, or by modifications thereof, using readily available starting materials, reagents, and conventional synthesis procedures. In these reactions, it is also possible to make use of variants that are in themselves known, but are not mentioned here.
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CA002558655A CA2558655A1 (en) | 2004-03-01 | 2005-03-01 | Methods and compositions for treatment of autoimmune diseases |
AU2005219876A AU2005219876A1 (en) | 2004-03-01 | 2005-03-01 | Methods and compositions for treatment of autoimmune diseases |
RU2006134701/04A RU2006134701A (en) | 2004-03-01 | 2005-03-01 | METHODS AND COMPOSITIONS FOR TREATMENT OF AUTOIMMUNE DISEASES |
EP05724381A EP1725603A2 (en) | 2004-03-01 | 2005-03-01 | Methods and compositions for treatment of autoimmune diseases |
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NZ549731A NZ549731A (en) | 2004-03-01 | 2005-03-01 | Methods and compositions for treatment of autoimmune diseases |
US10/591,315 US20080194462A1 (en) | 2004-03-01 | 2005-09-15 | Methods and Compositions for Treatment of Autoimmune Diseases |
IL177849A IL177849A0 (en) | 2004-03-01 | 2006-09-01 | Methods and compositions for treatment of autoimmune diseases |
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2005
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- 2005-03-01 MX MXPA06010043A patent/MXPA06010043A/en not_active Application Discontinuation
- 2005-03-01 RU RU2006134701/04A patent/RU2006134701A/en unknown
- 2005-03-01 EP EP05724381A patent/EP1725603A2/en not_active Withdrawn
- 2005-03-01 BR BRPI0508382-6A patent/BRPI0508382A/en not_active IP Right Cessation
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- 2005-03-01 CA CA002558655A patent/CA2558655A1/en not_active Abandoned
- 2005-03-01 JP JP2007501960A patent/JP2007527873A/en not_active Withdrawn
- 2005-03-01 AU AU2005219876A patent/AU2005219876A1/en not_active Abandoned
- 2005-03-01 WO PCT/US2005/006822 patent/WO2005085323A2/en active Application Filing
- 2005-09-15 US US10/591,315 patent/US20080194462A1/en not_active Abandoned
-
2006
- 2006-09-01 IL IL177849A patent/IL177849A0/en unknown
- 2006-09-28 NO NO20064389A patent/NO20064389L/en not_active Application Discontinuation
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2011
- 2011-07-25 JP JP2011162044A patent/JP2012001547A/en active Pending
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Also Published As
Publication number | Publication date |
---|---|
JP2007527873A (en) | 2007-10-04 |
CA2558655A1 (en) | 2005-09-15 |
EP1725603A2 (en) | 2006-11-29 |
KR20060125916A (en) | 2006-12-06 |
BRPI0508382A (en) | 2007-07-31 |
WO2005085323A3 (en) | 2007-02-15 |
NZ549731A (en) | 2009-11-27 |
MXPA06010043A (en) | 2007-03-07 |
US20080194462A1 (en) | 2008-08-14 |
AU2005219876A1 (en) | 2005-09-15 |
IL177849A0 (en) | 2006-12-31 |
RU2006134701A (en) | 2008-04-10 |
JP2012001547A (en) | 2012-01-05 |
NO20064389L (en) | 2006-12-01 |
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