WO2006038797A1 - Utilisation d'une statine ou d'un precurseur de celle-ci pour le traitement des infections par le vih - Google Patents

Utilisation d'une statine ou d'un precurseur de celle-ci pour le traitement des infections par le vih Download PDF

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Publication number
WO2006038797A1
WO2006038797A1 PCT/NL2005/000714 NL2005000714W WO2006038797A1 WO 2006038797 A1 WO2006038797 A1 WO 2006038797A1 NL 2005000714 W NL2005000714 W NL 2005000714W WO 2006038797 A1 WO2006038797 A1 WO 2006038797A1
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WIPO (PCT)
Prior art keywords
precursor
statin
hiv
infection
cells
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PCT/NL2005/000714
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English (en)
Inventor
Marinus Petrus De Baar
William Anderson Paxton
Georgios Pollakis
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Primagen Holding B.V.
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Publication date
Priority claimed from EP04077770A external-priority patent/EP1658845A1/fr
Application filed by Primagen Holding B.V. filed Critical Primagen Holding B.V.
Publication of WO2006038797A1 publication Critical patent/WO2006038797A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/365—Lactones
    • A61K31/366—Lactones having six-membered rings, e.g. delta-lactones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • A61P31/14—Antivirals for RNA viruses
    • A61P31/18—Antivirals for RNA viruses for HIV

Definitions

  • the invention relates to the fields of virus infection and immune system modulators.
  • HIV-I human immunodeficiency virus type 1
  • Drug intervention strategies have been highly successful in reducing HIV transmission and preventing disease progression, however, they prove expensive and have limitations based on toxicity and drug resistance.
  • protease inhibitors and fusion inhibitors other classes of drugs are currently under development including those that target the virus, such as integrase inhibitors, or the host through targeting HIV-I receptors at the cell surface.
  • New cheaper drug intervention strategies are urgently needed to stem the rise of new HIV-I infections in the regions of the world where cost is a restricting factor.
  • CC- and CXC- chemokine receptors can function as viral co-receptors, in conjunction with the CD4 molecule, to enable HIV-I entry into target cells [I].
  • the CC-chemokine receptor, CCR5, and the CXC- chemokine receptor, CXCR4, are the two most significant with respect to
  • Viruses utilizing the CCR5 receptor are preferentially transmitted and found during the early stages of infection whilst the CXCR4-using viruses (X4) are those more likely associated with later stage disease [2-4].
  • the CC-chemokines RANTES, MIP-Ia and MlP-l ⁇ are the natural ligands for the CCR5 receptor, whilst the CXC-chemokine SDF-I serves as the ligand for CXCR4 [I]. These molecules have been shown to efficiently block viral entry and suppress replication of the appropriate HIV-I strains in vitro.
  • the R5 viral infectivity profiles can be modulated by CCR5 expression at the cell surface as well as cellular secretion profiles of the CC-chemokines [5, 6].
  • a number of clinical studies highlight the ability of chemokine and chemokine receptor expression levels to affect viral replication, with low receptor expression and higher chemokine production levels favouring reduced viral replication or even protection from infection [7, 8]. Some studies, however, indicate that high CC-chemokine levels enhance viral infectivity in vitro or associate with more rapid progression to disease [9, 10].
  • the most compelling evidence linking chemokine and chemokine receptor parameters with disease progression is the association of polymorphisms within the genes coding for these molecules with either protection from infection or altered rates of disease progression [4].
  • CC-chemokines are involved with the induction of inflammatory responses within the host as well as possessing immunomodulatory functions. It has been demonstrated that CC-chemokine levels measured in vivo or ex vivo provide accurate correlates of protection elicited by anti-SIV vaccines in non-human primate models. Lehner et al. has previously documented an increased production of RANTES, MIP- l ⁇ and MlP-l ⁇ by lymph-node CD8+ T cells in macaques immunized by the targeted-iliac-lymph-node route [12].
  • CC- chemokines by virtue of their unique immunomodulatory properties, may represent a new class of adjuvants for vaccines, capable of directing protective immune responses by recruiting and activating specific cells at the site of immunization. It has been suggested that chemokines play a pivotal role in the Thl/Th2 polarization of CD4 + and CD8 + T cell cytokine -secretion patterns, a likely significant determinant of vaccine efficacy [13]. For example, protective responses against viruses are believed to require ThI polarization, which is linked to interferon production and vigorous CTL induction. Therefore regulating CC-chemokine responses may have a significant effect on directing the immune responses mounted against an immunogen and may play an "adjuvant" like role in vaccination protocols.
  • statins traditionally used to lower cholesterol levels in case of hypercholesterolemia, can successfully modulate cell surface expression levels of the CCR5 molecule and secretion levels of the CC-chemokine RANTES.
  • Incubation of CD4 lymphocytes with these compounds had the effect of reducing their in vitro infectivity with CCR5 using viruses but not with CXCR4 using viruses.
  • the effect of incubating CD4 lymphocytes with these statins had the consequences of mimicking the phenotype associated with the heterozygote ⁇ 32CCR5 genotype, demonstrating that statins have the capacity to reduce i? ⁇ vivo viral replication and thereby reduce both HIV-I transmission and rate of disease progression.
  • the invention provides the use of a statin for reducing human immunodeficiency virus infection of cells that are normally susceptible to HIV-infection.
  • the invention further provides the use of a statin for the preparation of a medicament for at least in part reducing human immunodeficiency virus (HIV) infection of cells that are normally susceptible to HIV-infection.
  • HIV viruses can be divided into roughly three groups on the basis of co-receptor usage. Viruses that use receptor CCR5, those that use CXCR4 and those that can utilize both receptors.
  • a statin of the invention inhibits infection of HIV viruses that (partly) utilize the CCR5 receptor for cellular entry, at least in part. Thus in a preferred embodiment said cells express the CCR5 receptor.
  • viruses are similar to the viruses that utilise the CXCR4 co- receptor.
  • entry can be dependent on the presence of the minor co-receptor or not.
  • virus dependents exclusively on the minor co-receptor it is not likely that virus entry can be at least in part inhibited through statins.
  • viruses can utilize more than one co-receptor including CCR5 like, for instance, HIV viruses that can utilize both CXCR4 and CCR5.
  • statins are effective in at least in part inhibiting virus infection.
  • the effectiveness of statins in at least in part inhibiting HIV infection depends on the type of HIV that infects the cells and the fact that many different HIV types exist, it is not possible to give a definitive level of inhibition. Even more so because HIV samples, particularly when obtained from patients, typically consist of a mixture of different strains of HIV that may differ considerably in their co-receptor usage. HIV viruses are currently divided in two major groups, HIV-I and HIV-2. Any virus is inhibited as long as the particular HIV virus utilizes the co-receptor CCR5 for entry into the target cell.
  • Chimearic viruses having the cell entry proteins of HIV and other (capsid) proteins of a different virus.
  • Chimearic viruses comprising at least the gpl20 protein of HIV are capable of entering a HIV susceptible cell in much the same way as a wild-type HIV.
  • HIV is currently also investigated as a gene transfer vehicle or as a vaccine.
  • Such gene transfer vehicles or vaccines typically differ from wild type HIV in that some function of wild type HIV is altered or deleted.
  • Statins can also inhibit infection of such vehicles or vaccines when they utilize the CCR5 co-receptor for entry into the cell.
  • the invention provides a method for at least in part inhibiting cellular entry of a virus like particle wherein said particle comprises at least one HIV derived protein that allows usage of the co-receptor CCR5 for entry of the virus like particle into the target cell.
  • a protein that determines co-receptor usage is gpl20 of HIV.
  • the HIV is HIV-I.
  • a susceptible cell typically expresses human CD4.
  • the CD4 molecule of a chimpanzee is therefore functionally equivalent to a CD4 molecule of a human.
  • a susceptible cell preferably expresses a human CD4 molecule or a functional equivalent thereof.
  • the functional equivalent can be a CD4 molecule of a chimpanzee, and/or a part of a CD4 molecule sufficient to allow infection of a cell otherwise containing all the essential proteins for viral entry.
  • a functional equivalent can also be a derivative of a CD4 molecule.
  • Such derivatives comprises the same HIV virus receptor function in kind but not necessarily in amount as human CD4.
  • murine cells provided with a human CD4 molecule are for the present invention also regarded as susceptible cells.
  • the susceptible cell is a human or chimpanzee cell. Cells from these species closely resemble normal cells of a human individual that is to be treated with a statin according to a method or use of the invention.
  • statins are herein defined as a substance capable of inhibiting the enzyme HMG CoA reductase.
  • the HMG CoA reductase enzyme plays a role in cholesterol synthesis and statins are often given to individuals suffering from elevated levels of cholesterol.
  • statins act through reducing the amount of CCR5 that is available for the virus to facilitate entry. The cells were obtained from normal individuals that were not treated otherwise.
  • Statins were shown to have the effect of modulating CCR5 and RANTES expression levels in a manner that favours the inhibition of CCR5 virus replication.
  • the treatment of the cells with these compounds has the effect of down-modulating CCR5 expression at the cell surface whilst increasing the expression levels of the CC-chemokine RANTES. Both of these characteristics have previously been associated with CD4+ lymphocytes isolated from individuals heterozygous for the ⁇ 32bp deletion in the CCR5 gene and which also are refractory for replication of CCR5 using viruses.
  • statins that was observed in the present invention is not necessarily linked with the HMG CoA reductase inhibiting effect of statins.
  • Some precursors of statins that need to be metabolised into an active statin in a cell are as effective in inhibiting HIV- infection of otherwise susceptible cells as a statin that does not need to be metabolised for HMG CoA reductase inhibition.
  • the invention further provides the use of a statin precursor that after entry into a cell is metabolised into the active statin, for at least in part reducing human immunodeficiency virus (HIV) infection of cells that are normally susceptible to HIV-infection.
  • HIV human immunodeficiency virus
  • the invention further provides the use of said precursor for the preparation of a medicament for at least in part reducing human immunodeficiency virus (HIV) infection of cells that are normally susceptible to HIV-infection. Also provided is the use of said precursor in a method of the invention.
  • the activated statin may exert its effect in the cell wherein it is metabolised but may also migrate out of the cell to exert its effect on a different cell.
  • said statin comprises simvastatin, lovastatin or mevastatin, or a precursor thereof.
  • Statins are not only effective in at least in part inhibiting infection by HIV as described above, but also in reducing the speed with which the virus spreads to uninfected cells.
  • statin or a precursor thereof is used for the preparation of a medicament for the treatment of an HIV-infected individual or an individual at risk of acquiring an HIV-infection. Since statin or precursors thereof act on the level of infectivity they work synergistically with HIV compounds that act on a different level such as nucleotide analogues and other reverse transcriptase inhibitors, protease inhibitors etc. Thus in a preferred embodiment said individual is receiving further medication for the treatment of said HIV-infection.
  • a use or method of the invention is for the treatment of HIV-infected individuals for whom the diagnosis AIDS has not been given or who have a mean CD4 count above 500.
  • the statin is used or said medicament is prepared for individuals who are within three years from seroconverting for HIV specific antibodies.
  • Statins or precursors thereof are most effective early after exposure to the virus up until three years from infection.
  • statins or precursors thereof are still effective, particularly when the individual was on HIV medication in the first three years. Therapy in that period on average significantly reduces the speed with which viruses appear that have co-receptor usage other than CCR5.
  • a use or method of the invention is for the treatment of individuals who are within one year from seroconverting for HIV specific antibodies.
  • statins or precursors thereof are effective in reducing viral load of HIV patients that are otherwise untreated. Statins or precursors thereof also prolong life expectancy in such patients and further prolong the disease-free period prior to the development of AIDS-like symptoms.
  • statins or precursors thereof result in a rise in the CD4 count in the treated individuals but also prolong disease free survival and reduce viral load below a detection level of 1000 particles per ml.
  • the statin is used for the preparation of a medicament for at least in part preventing the infection of a newborn from an HIV-infected woman.
  • said use is for reducing infection and viral load in the HIV-infected woman.
  • the medicament is given to at least reduce the chance of infection of the newborn with HIV virus of the mother.
  • the invention provides a method for augmenting an immune response in a subject comprising providing said subject with a statin or a precursor thereof.
  • the immune system is sometime divided into a ThI and a Th2-type of response.
  • An immune response directed toward a pathogen is typically composed of a ThI and a Th2-type response.
  • the amount with which each type of response is initiated or boosted differs between pathogens but also between individuals.
  • the ratio between the ThI and the Th2-type of response is referred to as the Thl/Th2 balance.
  • the invention provides the use of a statin or precursor thereof wherein said statin or precursor thereof has an immune modulator effect, preferably through its effect on the expression of RANTES. Heightened expression of RANTES is associated with directing a ThI skewing and predictably aids in the induction of more efficient immune responses against viral infections, such as HIV-I [12, 13].
  • This property of the use of a statin or precursor thereof according to the invention can also be used in a different setting than HIV-infected individuals or individuals at risk of acquiring the disease.
  • a statin or precursor thereof is used to at least in part shift the Thl/Th2 balance more towards a more suitable ThI type of response for those diseases.
  • a more Th-I type response is also favoured for immunizations and vaccinations.
  • the invention further provides the use of a statin or precursor thereof as an adjuvant in a vaccine or immunization preparation.
  • the invention provides the use of a statin or precursor thereof for the preparation of a composition for improving an immune response against an immunogenic compound.
  • Statins are typically given to patients in an oral formulation.
  • statin or precursor thereof is provided in the immunizing or vaccine composition. This may be followed up by a suitable number of oral administrations over the next days for further augmentation.
  • a composition of the invention comprises an immunogenic compound, preferably present in a vaccine.
  • CD4 + enriched lymphocytes were prepared by the following protocol. PBMCs were isolated from fresh buffy coats (Sanquin, Amsterdam) by standard Ficoll- Hypaque density centrifugation and frozen in multiple vials at high concentrations, thawed when required and activated with 2 ⁇ g/ml PHA (sigma) and cultured in RPMI media containing 10% FCS, Penicillin (100 U/ml) and Streptomycin (100 U/ml) with recombinant IL-2 (100 U/ml). On day 3 of culture the cells underwent CD4 + enrichment by removing CD8 + lymphocytes with CD8 immunomagnetic beads and magnet (Dynal, Oslo, Norway), giving rise to cultures of > 90% CD4 + lymphocyte purity.
  • statin statin
  • lovastatin lovastatin
  • mevastatin mevastatin
  • the infected cells were plated either undiluted (2.OxIO 5 cells/well) or in 2-fold dilutions with an additional 2.OxIO 5 fresh CD4 + lymphocytes added to each well in fresh media.
  • the culture supernatants were harvested and refreshed on days 7 and 14 with virus replication monitored by measuring CA-p24 levels utilizing a standard ELISA protocol.
  • Antigen p24 measured in cell cultures as a measure of CXCR4 using HIV-I replication with different statins added to the culture.
  • Con means control cells to which no statins were added.
  • the ratio treated/untreated reflects the ratio between cells infected with the virus and cells not infected with the virus in the last culture step to propagate any virus that entered the cells during the incubation of cells with virus (see example 1 for further explanation of culture order).
  • Antigen p24 measured in cell cultures as a measure of CCR5 using HIV-I replication with different statins added to the culture.
  • Con means control cells to which no statins were added.
  • the ratio treated/untreated reflects the ratio between cells infected with the virus and cells not infected with the virus in the last culture step to propagate any virus that entered the cells during the incubation of cells with virus (see example 1 for further explanation of culture order).
  • T-cell clones correlates with the clinical state of human immunodeficiency virus type 1 (HIV- l)-infected individuals and may be responsible for blocking infection with non-syncytium-inducing HIV-I in vitro. Journal of Virology 1998;72:876-81.
  • HIV- l human immunodeficiency virus type 1

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Abstract

L'invention concerne une nouvelle utilisation des statines. Il a été démontré que les statines peuvent réduire l'infection, par le virus de l'immunodéficience humaine (VIH), des cellules qui sont normalement sujettes à une infection par le VIH. Cette invention a trait à des produits pharmaceutiques, à des procédés et à des utilisations d'une statine dans le traitement d'infections.
PCT/NL2005/000714 2004-10-06 2005-10-04 Utilisation d'une statine ou d'un precurseur de celle-ci pour le traitement des infections par le vih WO2006038797A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US61623504P 2004-10-06 2004-10-06
EP04077770A EP1658845A1 (fr) 2004-10-06 2004-10-06 Utilisation des statines et de leurs precurseurs pour le traitement des infections virales
US60/616,235 2004-10-06
EP04077770.8 2004-10-06

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Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000047196A2 (fr) * 1999-02-11 2000-08-17 Hollis-Eden Pharmaceuticals, Inc. Méthodes pour traiter des infections virales

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000047196A2 (fr) * 1999-02-11 2000-08-17 Hollis-Eden Pharmaceuticals, Inc. Méthodes pour traiter des infections virales

Non-Patent Citations (3)

* Cited by examiner, † Cited by third party
Title
DEL REAL GUSTAVO ET AL: "Statins inhibit HIV-1 infection by down-regulating Rho activity.", THE JOURNAL OF EXPERIMENTAL MEDICINE. 16 AUG 2004, vol. 200, no. 4, 16 August 2004 (2004-08-16), pages 541 - 547, XP008036231, ISSN: 0022-1007 *
LUSSO P: "HIV and chemokines: Implications for therapy and vaccine", VACCINE, BUTTERWORTH SCIENTIFIC. GUILDFORD, GB, vol. 20, no. 15, 6 May 2002 (2002-05-06), pages 1964 - 1967, XP004350714, ISSN: 0264-410X *
MAZIERE J C ET AL: "LOVASTATIN INHIBITS HIV-1 EXPRESSION IN H9 HUMAN T LYMPHOCYTES CULTURED IN CHOLESTEROL-POOR MEDIUM", BIOMEDICINE AND PHARMACOTHERAPY, ELSEVIER, PARIS, FR, vol. 48, no. 2, 1994, pages 63 - 67, XP000965739, ISSN: 0753-3322 *

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