WO2006127900A2 - Tl1a in the treatment of disease - Google Patents

Tl1a in the treatment of disease Download PDF

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Publication number
WO2006127900A2
WO2006127900A2 PCT/US2006/020234 US2006020234W WO2006127900A2 WO 2006127900 A2 WO2006127900 A2 WO 2006127900A2 US 2006020234 W US2006020234 W US 2006020234W WO 2006127900 A2 WO2006127900 A2 WO 2006127900A2
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agent
tlla
antibody
polypeptide
subject
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PCT/US2006/020234
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French (fr)
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WO2006127900A3 (en
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Linda Burkly
Anna Borodovsky
Timothy Zheng
Xingwen Dong
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Biogen Idec Ma Inc.
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Priority to US11/921,048 priority Critical patent/US20090317388A1/en
Publication of WO2006127900A2 publication Critical patent/WO2006127900A2/en
Publication of WO2006127900A3 publication Critical patent/WO2006127900A3/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/177—Receptors; Cell surface antigens; Cell surface determinants
    • A—HUMAN NECESSITIES
    • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
    • A01K—ANIMAL HUSBANDRY; AVICULTURE; APICULTURE; PISCICULTURE; FISHING; REARING OR BREEDING ANIMALS, NOT OTHERWISE PROVIDED FOR; NEW BREEDS OF ANIMALS
    • A01K67/00—Rearing or breeding animals, not otherwise provided for; New or modified breeds of animals
    • A01K67/027—New or modified breeds of vertebrates
    • A01K67/0275—Genetically modified vertebrates, e.g. transgenic
    • A01K67/0276—Knock-out vertebrates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/19—Cytokines; Lymphokines; Interferons
    • A61K38/21—Interferons [IFN]
    • A61K38/215—IFN-beta
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/04—Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00—Drugs for immunological or allergic disorders
    • A61P37/02—Immunomodulators
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09—Recombinant DNA-technology
    • C12N15/63—Introduction of foreign genetic material using vectors; Vectors; Use of hosts therefor; Regulation of expression
    • C12N15/79—Vectors or expression systems specially adapted for eukaryotic hosts
    • C12N15/85—Vectors or expression systems specially adapted for eukaryotic hosts for animal cells
    • C12N15/8509—Vectors or expression systems specially adapted for eukaryotic hosts for animal cells for producing genetically modified animals, e.g. transgenic
    • A—HUMAN NECESSITIES
    • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
    • A01K—ANIMAL HUSBANDRY; AVICULTURE; APICULTURE; PISCICULTURE; FISHING; REARING OR BREEDING ANIMALS, NOT OTHERWISE PROVIDED FOR; NEW BREEDS OF ANIMALS
    • A01K2227/00—Animals characterised by species
    • A01K2227/10—Mammal
    • A01K2227/105—Murine
    • A—HUMAN NECESSITIES
    • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
    • A01K—ANIMAL HUSBANDRY; AVICULTURE; APICULTURE; PISCICULTURE; FISHING; REARING OR BREEDING ANIMALS, NOT OTHERWISE PROVIDED FOR; NEW BREEDS OF ANIMALS
    • A01K2267/00—Animals characterised by purpose
    • A01K2267/03—Animal model, e.g. for test or diseases
    • A01K2267/0306—Animal model for genetic diseases
    • A01K2267/0325—Animal model for autoimmune diseases
    • A—HUMAN NECESSITIES
    • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
    • A01K—ANIMAL HUSBANDRY; AVICULTURE; APICULTURE; PISCICULTURE; FISHING; REARING OR BREEDING ANIMALS, NOT OTHERWISE PROVIDED FOR; NEW BREEDS OF ANIMALS
    • A01K2267/00—Animals characterised by purpose
    • A01K2267/03—Animal model, e.g. for test or diseases
    • A01K2267/035—Animal model for multifactorial diseases
    • A01K2267/0368—Animal model for inflammation

Definitions

  • TLlA is a TNF superfamily member expressed by antigen presenting and endothelial cells.
  • DR3 the receptor for TLlA, is expressed on activated lymphocytes and peripheral blood monocytes.
  • TLlA is localized in macrophages and in a small subset of CCR9+ T cells in CD specimens and in plasma cells in UC specimens; DR3 is primarily expressed on lymphocytes. TLlA costimulates secretion of the ThI cytokine IFNgamma but not Th2 cytokines IL-4 and IL-10 by lamina intestinal lymphocytes (LPL) and synergizes with IL- 12 and BL- 18 for IFNgamma production in vitro.
  • LPL lamina limba lymphocytes
  • the invention features a method of treating multiple sclerosis
  • the method includes administering, to a subject who has multiple sclerosis, an agent that blocks TLlA signaling, e.g., an agent that blocks TLlA interaction with DR3.
  • the agent can be, e.g., a blocking anti-TLIA antibody or anti-DR3 antibody, a decoy DR3 polypeptide (e.g., a soluble DR3-Fc fusion protein), or a nucleic acid antagonist of TLlA or DR3.
  • the agent is an antibody that is a full length IgG.
  • the agent is an antigen-binding fragment of a full length IgG, e.g., the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment.
  • the antibody is a human, humanized or humaneered antibody or antigen-binding fragment thereof.
  • the agent is a soluble form of a TLlA receptor (e.g., DR3).
  • the soluble form of the receptor is fused with a heterologous polypeptide, e.g., an antibody Fc region.
  • the agent is administered in an amount sufficient to do one or more of the following: a) decrease severity or decrease frequency of relapse; b) prevent an increase in EDSS score, e.g., over a period of time, e.g., over 3 months, 6 months, a year or longer; c) decrease EDSS score (e.g., a decrease of greater than 1, 1.5, 2, 2.5, or 3 points, e.g., over at least three months, six months, one year, or longer); d) decrease the number of new MRI lesions; e)reduce the rate of appearance of new MRI lesions; and f) prevent an increase in MRI lesion area.
  • the subject may be evaluated, before or after the administration, by MRI and/or neurological exam.
  • the subject has relapsing-remitting (RR) MS, primary- progressive (PP) MS, secondary-progressive (SP) MS, or progressive-relapsing (PR) MS.
  • the agent is administered in combination with another therapy for MS, e.g., Copaxone; interferons, e.g., human interferon beta- Ia (e.g., AVONEX® or Rebif®) and interferon beta- Ib (BETASERONTM; human interferon beta substituted at position 17); glatiramer acetate (also termed Copolymer 1, Cop-1; COPAXONETM); Tysabri ⁇ (natalizumab) ro another anti-VLA4 antibody, e.g., one that competes with or binds an epitope overlapping that of rituximab; Rituxan® (rituximab) or another anti-CD20 antibody, e.g., one that compete
  • the agent is administered at a dose between 0.1-100 mg/kg, between 0.1-10 mg/kg, between 1 mg/kg -100 mg/kg, between 0.5-20 mg/kg, or between 1-10 mg/kg.
  • the dose is administered more than once, e.g., at periodic intervals over a period of time (a course of treatment).
  • the dose may be administered every 2 months, every 6 weeks, monthly, biweekly, weekly, or daily, as appropriate, over a period of time to encompass at least 2 doses, 3 doses, 5 doses, 10 doses, or more.
  • the invention features a method of treating ulcerative colitis
  • the method includes administering, to a subject who has UC, an agent that blocks TLlA signaling, e.g., an agent that blocks TLlA interaction with DR3.
  • the agent can be, e.g., a blocking anti-TLl A antibody or anti-DR3 antibody, a soluble decoy DR3 polypeptide (e.g., a soluble DR3-Fc fusion protein), or a nucleic acid antagonist of TLlA or DR3, such as an aptamer or antisense molecule.
  • the agent is an anti-TLl A or anti-DR3 antibody that is a full length IgG.
  • the agent is an antigen-binding fragment of a full length IgG, e.g., the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment.
  • the antibody is a human, humanized or humaneered antibody or antigen-binding fragment thereof.
  • the agent is a soluble form of a TLlA receptor (e.g.,
  • the soluble form of the receptor is fused with a heterologous polypeptide, e.g., an antibody Fc region.
  • the agent is administered in an amount sufficient to do one or more of the following: a) decrease severity or decrease frequency of colitis flare-ups; b) prevent or decrease the extent of weight loss; (c) improve the presence or extent of ulcers or inflammation, e.g., over a period of time, e.g., over 3 months, 6 months, a year or longer.
  • the subject may be evaluated, before or after the administration, with one or more of the following: colonoscopy with or without biopsy, barium enema, CBC blood test, sedimentation rate (ESR), CRP (C-reactive protein) test.
  • ESR sedimentation rate
  • CRP C-reactive protein
  • the agent is administered in combination with another therapy for UC, e.g., corticosteroids to reduce inflammation; aminosalicylates; immunosuppressants, such as azathioprine; 6-MP, cyclosporine, and methotrexate.
  • the agent is administered at a dose between 0.1-100 mg/kg, between 0.1-10 mg/kg, between 1 mg/kg -100 mg/kg, between 0.5-20 mg/kg, or between 1-10 mg/kg.
  • the dose is administered more than once, e.g., at periodic intervals over a period of time (a course of treatment). For example, the dose may be administered every 2 months, every 6 weeks, monthly, biweekly, weekly, or daily, as appropriate, over a period of time to encompass at least 2 doses, 3 doses, 5 doses, 10 doses, or more.
  • the invention features methods for modulating an innate immunity response in a subject by modulating TLlA signaling.
  • a method to reduce an innate immunity response in a subject in need thereof.
  • the method includes administering, to a subject who has a hyper- responsive innate immunity response, an agent that blocks TLlA signaling, e.g., an agent that blocks TLlA interaction with DR3.
  • the agent can be, e.g., a blocking anti-TLl A antibody, anti-DR3 antibody, or a soluble DR3 (e.g., a soluble DR3-Fc fusion protein).
  • the subject in need of reducing an innate immunity response has an autoimmune disease, e.g., rheumatoid arthritis, SLE, Grave's Disease, Wegener's granulomatosis, Sjogren's syndrome, scleroderma, type 1 diabetes mellitus; a neuroinflammatory disease, e.g., MS, ALS, Alzheimer's Disease.
  • the agent is administered in an amount sufficient to reduce the number and/or activity of innate immune cell types such as macrophages, monocytes, dendritic cells and neutrophils.
  • the agent is administered in an amount sufficient to reduce production by such innate immune cell types of proinflammatory cytokines, e.g., IL-6, IL-12, IL-23, TNF, IFNgamma, EL-I, IL-8, IL-10, type 1 interferons, IL-I l, IL-23, 11-27, GM-CSF, G-CSF, M-CSF and chemokines including but not limited to MC?-lalpha, MIP-lbeta, CXCLl 1, RANTES, TARC, MCP-5, eotaxin and those referenced herein (e.g., Rot and von Adrian, 2004, Ann. Rev. Immunol. 22:891-928; Moser et al., 2004, Trends in Immunol 25: 75-84).
  • proinflammatory cytokines e.g., IL-6, IL-12, IL-23, TNF, IFNgamma, EL-I, IL-8, IL-10
  • the method also includes evaluating the subject for a marker of innate immunity response, e.g., evaluating the subject for numbers and/or activity (e.g.,. phagocytic activity) of immune cells (i.e. white blood cells, lymphocytes, neutrophils, monocytes), or macrophage release of proinflammatory cytokines, e.g., as described hereinabove.
  • the evaluation can be performed before and/or after the administration.
  • the subject is evaluated for such a marker periodically (e.g., at least 2 times) over a period of time after the administration.
  • the agent is an antibody that is a full length IgG.
  • the agent is an antigen-binding fragment of a full length IgG, e.g., the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment.
  • the antibody is a human, humanized or humaneered antibody or antigen-binding fragment thereof.
  • the antibody can be, e.g., an anti-TLl A antibody or an anti-DR3 antibody.
  • the agent is a soluble form of a TLlA receptor (e.g.,
  • the soluble form of the receptor is fused with a heterologous polypeptide, e.g., an antibody Fc region.
  • the agent is administered at a dose between 0.01-100 mg/kg, between .01-10 mg/kg, between 0.01 mg/kg -1 mg/kg, between 0.05-10 mg/kg, or between 1-10 mg/kg.
  • the dose is administered more than once, e.g., at periodic intervals over a period of time (a course of treatment). For example, the dose may be administered every 2 months, every 6 weeks, monthly, biweekly, weekly, or daily, as appropriate, over a period of time to encompass at least 2 doses, 3 doses, 5 doses, 10 doses, or more.
  • Conditions which may benefit from reducing the innate immunity response include conditions in which innate immunity is hyper-responsive, e.g., conditions in which innate immune response to a pathogen leads to an inflammatory disorder, e.g., to an acute flare-up of an inflammatory disorder.
  • the subject has an inflammatory disease or autoimmune disease and is at risk for acute flare-ups, e.g., an acute flare-up of IBD or colitis.
  • a method to enhance an innate immunity response in a subject in need thereof.
  • the method includes administering an agent that enhances TLlA signaling in an amount that stimulates innate immunity, e.g., an amount that causes an enhancement in resistance to, reduction in susceptibility to, or decrease in pathogenic effects of, an infective agent such as a bacterial or viral infection; or a cancer cell.
  • An agent that enhances TLlA signaling can be, e.g., a soluble TLlA, a multimerized TLlA such as a trimerized TLlA (e.g., as described for CD40L in Morris et al. (1999) J. Biol. Chem. 274:418-423), and an anti-DR3 agonist antibody.
  • the agent is administered in an amount sufficient to increase the number and/or activity of innate immune cell types such as macrophages, monocytes, dendritic cells and neutrophils.
  • the agent is administered in an amount sufficient to increase production by such innate immune cell types of proinflammatory cytokines, e.g., IL-6, IL-12, IL-23, TNF, IFNgamma, IL-I, IL-8, EL-IO, type 1 interferons, EL-Il, EL-23, 11-27, GM-CSF, G-CSF, M-CSF and chemokines including but not limited to MEP-lalpha, MEP-lbeta, CXCLl 1, RANTES, TARC, MCP-5, eotaxin and those referenced herein (e.g., Rot and von Adrian, 2004, Ann. Rev. Immunol. 22:891-928; Moser et al., 2004, Trends in Immunol 25
  • the method also includes evaluating the subject for a marker of innate immunity response, e.g., evaluating the subject for numbers and/or activity (e.g., phagocytic activity) of immune cells (i.e. white blood cells, lymphocytes, neutrophils, monocytes), or macrophage release of proinflammatory cytokines, e.g., as described hereinabove.
  • the evaluation can be performed before and/or after the administration.
  • the subject is evaluated for such a marker periodically (e.g., at least 2 times) over a period of time after the administration.
  • the agent is an anti-DR3 agonist antibody that is a full length IgG.
  • the agent is an antigen-binding fragment of a full length IgG, e.g., the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment.
  • the antibody is a human, humanized or humaneered antibody or antigen-binding fragment thereof. The antibody can be, e.g., an anti-DR3 antibody.
  • the agent is a soluble form of TLlA.
  • the soluble TLlA is fused with a heterologous polypeptide, e.g., an antibody Fc region.
  • the agent is administered at a dose between 0.1- 100 mg/kg, between .1-10 mg/kg, between 1 mg/kg -100 mg/kg, between 0.5-20 mg/kg, or between 1-10 mg/kg.
  • the dose is administered more than once, e.g., at periodic intervals over a period of time (a course of treatment). For example, the dose may be administered every 2 months, every 6 weeks, monthly, biweekly, weekly, or daily, as appropriate, over a period of time to encompass at least 2 doses, 3 doses, 5 doses, 10 doses, or more.
  • Conditions which may benefit from enhanced innate immunity response include conditions associated with inadequate innate immunity response including hypo- responsiveness to LPS, susceptibility to infection or sepsis (e.g., by gram-negative bacteria), susceptibility to chronic airway disease, susceptibility to asthma, susceptibility to arthritis, susceptibility to pyelonephritis, susceptibility to gall bladder disease, susceptibility to pneumonia, susceptibility to bronchitis, susceptibility to chronic obstructive pulmonary disease, severity of cystic fibrosis, and susceptibility to local and systemic inflammatory conditions, e.g., systemic inflammatory response syndrome (SIRS), local gram negative bacterial infection, or acute respiratory distress syndrome (ARDS), and susceptibility to cancer or decreased ability of the innate immune system to reject cancer cells.
  • SIRS systemic inflammatory response syndrome
  • ARDS acute respiratory distress syndrome
  • certain patients can benefit from enhanced innate immunity response, e.g., (i) patients having opportunistic infections, Pneumocystis infection, cytomegalovirus infection, herpes virus infection, mycobacterium infection, or human immunodeficiency virus (HIV) infection; (ii) patients exposed to radiation or one or more chemotherapeutic antiproliferative drugs; (iii) patients who have cancer; (iv) patients having chronic respiratory disease or upper airways disease, (e.g., sinusitis or parasinusitis, rhinovirus or influenza infection, pleuritis, and the like); (v) patients having chronic eye-ear-nose or throat infections (e.g., otitis media, conjunctivitis, uveitis or keratitis); (vi) patients having bronchial allergy and/or asthma; (vii) patients having a chronic liver infection (e.g., chronic hepatitis); and (viii) other immunocompromised patients
  • the subject has cancer or has susceptibility to cancer.
  • the subject has a family history of cancer or carries a genetic marker for susceptibility to cancer, such as BRCAl or BRCA2, or one or more other genes that are causally implicated in oncogenesis.
  • a census of such genes is provided in Futreal et al.
  • the subject has defective phagocytic function, e.g., defective macrophage function.
  • the subject has chronic granulomatous disease.
  • the subject has defective phagocytic function and has Alzheimer's Disease.
  • treating refers to administering a therapy in an amount, manner, and/or mode effective to improve or prevent a condition, symptom, or parameter associated with a disorder or to prevent onset, progression, or exacerbation of the disorder (including secondary damage caused by the disorder), to either a statistically significant degree or to a degree detectable to one skilled in the art. Accordingly, treating can achieve therapeutic and/or prophylactic benefits.
  • An effective amount, manner, or mode can vary depending on the subject and may be tailored to the subject.
  • Figure 1 is a restriction map of the murine Tnfsf 15 locus and the thymidine kinase (TK) and neomycin (neo) containing targeting construct derived from it. Restriction enzyme sites indicated are: E - EcoRI, X - Xbal, Bg - BgIII, Ba - BamHI. Exons are represented as black boxes, arrows indicate direction of transcription.
  • B RT-PCR analysis of TLlA mRNA in TLlA-/- and WT kidneys.
  • FIG. 2 shows EAE clinical course in TLlA-/- animals.
  • B EAE statistical parameters for results shown in A. Day of onset was calculated for diseased animals only, p- values are shown for TLlA-/- vs. WT group based on the Mann-Whitney non-parametric test.
  • Figure 3 shows the MOG-specific cytokine response.
  • A-E Cytokine secretion in wild type (white bars) and TLlA "7" (grey bars) lymph node cultures. Cells were cultured as in Figure 5B, except 50 ug/ml MOG peptide was used. 72hr supernatants from 5 individuals/group were analyzed: A - IFN ⁇ , B - GM-CSF, C - TNF ⁇ , D - IL-4, E - IL-5. Results shown are mean values +/- SEM. Asterisks indicate statistically significant differences (two-tail t-test p ⁇ 0.05).
  • DSS-induced colitis 8-12 week old female C57BL/6 TLlA 7" (round symbols) and WT animals (square symbols) were fed with 3.5% (wt/vol) DSS dissolved in water for 5 days (days 0-4). DSS is stopped and normal drinking water restored during days 5-13. Body weight, stool consistency, and the presence of occult or visible blood in the stool were determined daily.
  • FIG. 5 shows that TLlA deficient mice develop fewer colonic ulcers, less epithelial damage and less cell infiltration during DSS treatment.
  • A mucosal ulceration
  • C epithelial damage
  • D inflammatory cell infiltration into the colonic tissue
  • B total histological score (the combined scores of epithelium cell damage and cell infiltration)
  • antagonizing (e.g.. blocking) the TLlA pathway is effective to reduce pathogenesis in animal models of multiple sclerosis and ulcerative colitis.
  • the data also supports a role for TLlA in the innate immunity response, e.g., in the pathogenesis of ulcerative colitis.
  • TLlA (TNFSF15) is the ligand for DR3 (TNFRSF12) and is a member of the tumor necrosis factor superfamily (TNFSF).
  • the amino acid sequence of human TLlA is shown below.
  • a soluble TLlA lacks the transmembrane domain and cytosolic domain. It can include amino acids 93 to 251 of SEQ ID NO:1, or an N- or C-terminal truncation thereof (e.g., a truncation lacking up to 10 (e.g., up to 8, 6, 4, 2) residues at the N- and/or C-terminal end of amino acids 93-251 of SEQ ED NO: 1), and having DR3 binding activity.
  • a soluble TLlA includes amino acids 73-251 of SEQ ID NO:1; amino acids 103-251 of SEQ ID NO:1, amino acids 93-251 of SEQ ID NO:1; amino acids 93-245 of SEQ ID NO:1.
  • polypeptides that include a sequence that has at least 95% identity (e.g., 96%, 97%, 98%, 99% identity) to soluble TLlA, e.g., to amino acids 103-251 of SEQ ID NO: 1, and has DR3 binding activity.
  • Residues 1-24 of SEQ ID NO:2 correspond to the signal peptide of DR3 ; residues 25-206 of SEQ ID NO:2 correspond to the extracellular domain of the mature protein; residues 207-226 of SEQ ID NO: 2 correspond to the transmembrane domain.
  • the cytoplasmic domain includes a death domain (DD) at residues 335-419 of SEQ ID NO:2.
  • a soluble decoy DR3 lacks the transmembrane domain and cytosolic domain, e.g., it includes residues 25-181 of SEQ ID NO:2 (the extracellular domain), or a functional N- or C-terminal truncation thereof, e.g., a truncation lacking 10 (e.g., 9, 8, 7, 6, 5, 4, 3, 2) or fewer residues at the N- and/or C-terminus.
  • soluble decoy DR3 polypeptides include polypeptides including amino acids 25-181 of SEQ ID NO:2, amino acids 25-191 of SEQ ID NO:2, amino acids 40-206 of SEQ ID NO:2, amino acids 30-200 of SEQ ID NO:2, amino acids 40-181 of SEQ ID NO:2. Also included are polypeptides having at least 95% identity (e.g., 96%, 97%, 98%, 99% identity) to a functional portion of the extracellular domain of DR3 (residues 25-181 of SEQ ID NO:2), and having TLlA binding activity.
  • polypeptides having at least 95% identity e.g., 96%, 97%, 98%, 99% identity
  • Antibodies that block TLlA function e.g., antibodies that bind to TLlA or
  • DR3 can be generated by immunization, e.g., using an animal, or by in vitro methods such as phage display.
  • AU or part of TLlA or DR3 can be used as an immunogen.
  • the extracellular region of TLl A or DR3 can be used as an immunogen.
  • the immunized animal contains immunoglobulin producing cells with natural, human, or partially human immunoglobulin loci.
  • the non-human animal includes at least a part of a human immunoglobulin gene. For example, it is possible to engineer mouse strains deficient in mouse antibody production with large fragments of the human Ig loci.
  • antigen-specific monoclonal antibodies derived from the genes with the desired specificity may be produced and selected. See, e.g., XenoMouseTM, Green et al. Nature Genetics 7:13-21 (1994), US 2003-0070185, US Pat. No. 5,789,650, and WO 96/34096.
  • Non-human antibodies to TLlA or DR3 can also be produced, e.g., in a rodent.
  • the non-human antibody can be humanized, e.g., as described in US Pat. No. 6,602,503, EP 239 400, US Pat. No. 5,693,761, and US Pat. No. 6,407,213.
  • EP 239400 (Winter et al.) describes altering antibodies by substitution (within a given variable region) of their complementarity determining regions (CDRs) for one species with those from another.
  • CDR-substituted antibodies can be less likely to elicit an immune response in humans compared to true chimeric antibodies because the CDR-substituted antibodies contain considerably less non-human components.
  • CDRs of a murine antibody substituted into the corresponding regions in a human antibody by using recombinant nucleic acid technology to produce sequences encoding the desired substituted antibody.
  • Human constant region gene segments of the desired isotype usually gamma I for CH and kappa for CL
  • the humanized heavy and light chain genes can be co-expressed in mammalian cells to produce soluble humanized antibody.
  • Non-human antibodies can be modified to include substitutions that insert human immunoglobulin sequences, e.g., consensus human amino acid residues at particular positions, e.g., at one or more (preferably at least five, ten, twelve, or all) of the following positions: (in the FR of the variable domain of the light chain) 4L, 35L, 36L, 38L, 43L, 44L, 58L, 46L, 62L, 63L, 64L, 65L, 66L, 67L, 68L, 69L, 7OL, 71L, 73L, 85L, 87L, 98L, and/or (in the FR of the variable domain of the heavy chain) 2H, 4H, 24H, 36H, 37H, 39H, 43H, 45H, 49H, 58H, 6OH, 67H, 68H, 69H, 7OH, 73H, 74H, 75H, 78H, 91H, 92H, 93H, and
  • Fully human monoclonal antibodies can be produced, e.g., using in vitro- primed human splenocytes, as described by Boerner et al., 1991, J. Immunol., 147, 86-95. They may be prepared by repertoire cloning as described by Persson et al., 1991, Proc. Nat. Acad. Sci. USA, 88: 2432-2436 or by Huang and Stollar, 1991, J. Immunol. Methods 141, 227-236; also US Pat. No. 5,798,230.
  • Antibodies can be produced in prokaryotic and eukaryotic cells.
  • the antibodies e.g., scFv's
  • a yeast cell such as Pichia (see, e.g., Powers et al. (2001) J Immunol Methods. 251:123-35), Hanseula, or Saccharomyces.
  • antibodies, particularly full length antibodies, e.g., IgG' s are produced in mammalian cells.
  • Exemplary mammalian host cells for recombinant expression include Chinese Hamster Ovary (CHO cells) (including dhfr- CHO cells, described in Urlaub and Chasin (1980) Proc. Natl.
  • lymphocytic cell lines e.g., NSO myeloma cells and SP2 cells, COS cells, K562, and a cell from a transgenic animal, e.g., a transgenic mammal.
  • the cell is a mammary epithelial cell.
  • the recombinant expression vectors may carry additional nucleic acid sequences, such as sequences that regulate replication of the vector in host cells (e.g., origins of replication) and selectable marker genes.
  • the selectable marker gene facilitates selection of host cells into which the vector has been introduced (see e.g., US Pat. Nos. 4,399,216, 4,634,665 and 5,179,017).
  • Exemplary selectable marker genes include the dihydrofolate reductase (DHFR) gene (for use in dhfr- host cells with methotrexate selection/amplification) and the neo gene (for G418 selection).
  • DHFR dihydrofolate reductase
  • a recombinant expression vector encoding both the antibody heavy chain and the antibody light chain is introduced into dhfr- CHO cells by calcium phosphate-mediated transfection.
  • the antibody heavy and light chain genes are each operatively linked to enhancer/promoter regulatory elements (e.g., derived from SV40, CMV, adenovirus and the like, such as a CMV enhancer/ AdMLP promoter regulatory element or an SV40 enhancer/AdMLP promoter regulatory element) to drive high levels of transcription of the genes.
  • the recombinant expression vector also carries a DHFR gene, which allows for selection of CHO cells that have been transfected with the vector using methotrexate selection/amplification.
  • the selected transformant host cells are cultured to allow for expression of the antibody heavy and light chains and intact antibody is recovered from the culture medium.
  • Standard molecular biology techniques are used to prepare the recombinant expression vector, to transfect the host cells, to select for transformants, to culture the host cells, and to recover the antibody from the culture medium. For example, some antibodies can be isolated by affinity chromatography with a Protein A or Protein G.
  • Antibodies may also include modifications, e.g., modifications that alter Fc function, e.g., to decrease or remove interaction with an Fc receptor or with CIq, or both.
  • modifications e.g., modifications that alter Fc function, e.g., to decrease or remove interaction with an Fc receptor or with CIq, or both.
  • the human IgGl constant region can be mutated at one or more residues, e.g., one or more of residues 234 and 237, e.g., according to the numbering in US Pat. No. 5,648,260.
  • Other exemplary modifications include those described in US Pat. No. 5,648,260.
  • the antibody production system may be designed to synthesize antibodies in which the Fc region is glycosylated.
  • the Fc domain of IgG molecules is glycosylated at asparagine 297 in the CH2 domain.
  • This asparagine is the site for modification with biantennary-type oligosaccharides. This glycosylation participates in effector functions mediated by FcD receptors and complement C 1 q (Burton and Woof (1992) Adv. Immunol. 51 : 1-84; Jefferis et al. (1998) Immunol. Rev. 163:59-76).
  • the Fc domain can be produced in a mammalian expression system that appropriately glycosylates the residue corresponding to asparagine 297.
  • the Fc domain can also include other eukaryotic post-translational modifications.
  • Antibodies can also be produced by
  • Pat. No. 5,849,992 describes a method for expressing an antibody in the mammary gland of a transgenic mammal.
  • a transgene is constructed that includes a milk-specific promoter and nucleic acid sequences encoding the antibody of interest, e.g., an antibody described herein, and a signal sequence for secretion.
  • the milk produced by females of such transgenic mammals includes, secreted-therein, the antibody of interest, e.g., an antibody described herein.
  • the antibody can be purified from the milk, or for some applications, used directly.
  • Antibodies can be modified, e.g., with a moiety that improves its stabilization and/or retention in circulation, e.g., in blood, serum, lymph, bronchoalveolar lavage, or other tissues, e.g., by at least 1.5, 2, 5, 10, or 50 fold.
  • an antibody can be associated with a polymer, e.g., a substantially non-antigenic polymer, such as a polyalkylene oxide or a polyethylene oxide. Suitable polymers will vary substantially by weight. Polymers having molecular number average weights ranging from about 200 to about 35,000 daltons (or about 1,000 to about 15,000, and 2,000 to about 12,500) can be used.
  • a water soluble polymer e.g., a hydrophilic polyvinyl polymer, e.g. polyvinylalcohol or polyvinylpyrrolidone.
  • polymers include polyalkylene oxide homopolymers such as polyethylene glycol (PEG) or polypropylene glycols, polyoxyethylenated polyols, copolymers thereof and block copolymers thereof, provided that the water solubility of the block copolymers is maintained.
  • PEG polyethylene glycol
  • polypropylene glycols polypropylene glycols
  • polyoxyethylenated polyols polyoxyethylenated polyols
  • copolymers thereof and block copolymers thereof provided that the water solubility of the block copolymers is maintained.
  • Additional useful polymers include polyoxyalkylenes such as polyoxyethylene, polyoxypropylene, and block copolymers of polyoxyethylene and polyoxypropylene (Pluronics); polymethacrylates; carbomers; branched or unbranched polysaccharides that comprise the saccharide monomers D-mannose, D- and L-galactose, fucose, fructose, D-xylose, L-arabinose, D-glucuronic acid, sialic acid, D-galacturonic acid, D-mannuronic acid (e.g.
  • polymannuronic acid or alginic acid
  • D-glucosamine D- galactosamine
  • D-glucose and neuraminic acid including homopolysaccharides and heteropolysaccharides such as lactose, amylopectin, starch, hydroxyethyl starch, amylose, dextrane sulfate, dextran, dextrins, glycogen, or the polysaccharide subunit of acid mucopolysaccharides, e.g. hyaluronic acid; polymers of sugar alcohols such as polysorbitol and polymannitol; heparin or heparan.
  • a soluble TLlA receptor e.g., a soluble DR3 receptor or fusion protein.
  • a protein including a TLl A-binding portion of the extracellular domain of DR3 can be fused to an Fc region, i.e., to the C-terminal portion of an Ig heavy chain constant region.
  • Fc region can be an IgA, IgD, or IgG Fc (e.g., an IgGl or IgG4 Fc) region (hinge-CH2-CH3).
  • the DR3 portion of the fusion protein preferably includes at least a portion of the extracellular region of DR3 (a TLlA binding portion) and preferably lacks a transmembrane domain, such that the DR3 moiety is soluble.
  • the soluble DR3 is typically comprised of amino acids 1-199 or a functional (e.g., TLlA binding) fragment thereof of SEQ ID NO:2.
  • the signal sequence is a polynucleotide that encodes an amino acid sequence that initiates transport of a protein across the membrane of the endoplasmic reticulum.
  • Signal sequences useful for constructing a fusion protein include antibody light chain signal sequences, e.g., antibody 14.18 (Gillies et.al., 1989, J. Immunol. Meth., 125: 191-202), antibody heavy chain signal sequences, e.g., the MOPC141 antibody heavy chain signal sequence (Sakano et al., 1980, Nature 286:5774). Alternatively, other signal sequences can be used. See, for example, Watson, 1984, Nucleic Acids Research 12:5145).
  • the signal peptide is usually cleaved in the lumen of the endoplasmic reticulum by signal peptidases. This results in the secretion of a fusion protein containing the Fc region and the TLl A or DR3 moiety.
  • the DNA sequence encodes a proteolytic cleavage site between the secretion cassette and the DR3 moiety.
  • a cleavage site provides for the proteolytic cleavage of the encoded fusion protein, thus separating the Fc domain from the target protein.
  • Useful proteolytic cleavage sites include amino acids sequences recognized by proteolytic enzymes such as trypsin, plasmin, thrombin, factor Xa, or enterokinase K.
  • the secretion cassette can be incorporated into a replicable expression vector.
  • Useful vectors include linear nucleic acids, plasmids, phagemids, cosmids and the like.
  • An exemplary expression vector is pdC, in which the transcription of the immunofusin DNA is placed under the control of the enhancer and promoter of the human cytomegalovirus. See, e.g., Lo et al., 1991, Biochim. Biophys. Acta 1088:712; and Lo et al., 1998, Protein Engineering 11 :495- 500.
  • An appropriate host cell can be transformed or transfected with a DNA that encodes a TLlA or DR3 polypeptide, and is used for the expression and secretion of the TLlA or DR3 polypeptide.
  • Preferred host cells include immortal hybridoma cells, myeloma cells, 293 cells, Chinese hamster ovary (CHO) cells, HeIa cells, and COS cells.
  • Certain sites preferably can be deleted from the Fc region during the construction of the secretion cassette.
  • the binding site for the heavy chain binding protein Bip (Hendershot et al., 1987, Immunol. Today 8:111-114)
  • Bip can be deleted from the CH2 domain of the Fc region of IgE, such that this site does not interfere with the efficient secretion of the immunofusin.
  • Transmembrane domain sequences such as those present in IgM, can be deleted.
  • the IgGl Fc region is one example.
  • the Fc region of the other subclasses of immunoglobulin gamma (gamma-2, gamma-3 and gamma-4) can be used in the secretion cassette.
  • the IgGl Fc region of immunoglobulin gamma-1 is preferably used in the secretion cassette includes the hinge region (at least part), the CH2 region, and all or part of the CH3 region.
  • the Fc region of immunoglobulin gamma-1 is a CH2-deleted-Fc, which includes part of the hinge region and the CH3 region, but not the CH2 region.
  • DR3 fusion proteins can be constructed in several different configurations. In one configuration the C-terminus of the DR3 moiety is fused directly to the N-terminus of the Fc moiety. In a slightly different configuration, a short polypeptide, e.g., 2-10 amino acids, is incorporated into the fusion between the N-terminus of the DR3 moiety and the C-terminus of the Fc moiety.
  • Such a linker can provide conformational flexibility, which may improve biological activity in some circumstances. If a sufficient portion of the hinge region is retained in the Fc moiety, the DR3 -Fc fusion will dimerize, thus forming a divalent molecule. A homogeneous population of monomeric Fc fusions will yield monospecific, bivalent dimers. A mixture of two monomeric Fc fusions each having a different specificity will yield bispecific, bivalent dimers.
  • Some methods described herein relate to administering an effective amount of a TLlA or DR3 polynucleotide antagonist.
  • the polynucleotide antagonist prevents expression of the target gene (knockdown).
  • Such polynucleotide antagonists include, but are not limited to antisense molecules, ribozymes, aptamers, siRNA, shRNA and RNAi.
  • binding molecules are separately administered to the subject (see, for example, O'Connor (1991) Neurochem. 56:560), but such binding molecules may also be expressed in vivo from polynucleotides taken up by a host cell and expressed in vivo. See also Oligodeoxynucleotides as Antisense Inhibitors of Gene Expression. CRC Press, Boca Raton, FIa. (1988).
  • RNAi refers to the expression of an RNA which interferes with the expression of the targeted mRNA. Specifically, the RNAi silences a targeted gene via interacting with the specific mRNA (e.g. TLlA or DR3) through a siRNA (short interfering RNA). The ds RNA complex is then targeted for degradation by the cell. Additional RNAi molecules include Short hairpin RNA (shRNA); also short interfering hairpin. The shRNA molecule contains sense and antisense sequences from a target gene connected by a loop. The shRNA is transported from the nucleus into the cytoplasm, it is degraded along with the mRNA. Pol in or U6 promoters can be used to express RNAs for RNAI.
  • RNAi is mediated by double stranded RNA (dsRNA) molecules that have sequence-specific homology to their "target" mRNAs (Caplen et al. (2001) Proc Natl Acad Sci USA 98:9742-9747). Biochemical studies in Drosophila cell-free lysates indicates that the mediators of RNA-dependent gene silencing are 21-25 nucleotide "small interfering" RNA duplexes (siRNAs). Accordingly, siRNA molecules are advantageously used in methods described herein.
  • the siRNAs are derived from the processing of dsRNA by an RNase known as DICER (Bernstein et al. (2001) Nature 409:363-366).
  • siRNA duplex products are recruited into a multi-protein siRNA complex termed RISC (RNA Induced Silencing Complex).
  • RISC RNA Induced Silencing Complex
  • RNAi is contemplated as a therapeutic modality, such as inhibiting or blocking the infection, replication and/or growth of viruses (Gitlin et al. (2002) Nature 418:379-380; Capodici et al. (2002) J Immunol 169:5196-5201), and reducing expression of oncogenes (Scherr et al (2003) Blood 101(4):1566-9).
  • RNAi has been used to modulate gene expression in mammalian (mouse) and amphibian (Xenopus) embryos (Calegari et al., Proc Natl Acad Sci USA 99:14236-14240, 2002; and Zhou, et al., Nucleic Acids Res 30:1664-1669, 2002), and in postnatal mice (Lewis et al., Nat Genet 32: 107-108, 2002), and to reduce trangsene expression in adult transgenic mice (McCaffrey et al., Nature 418:38-39, 2002).
  • RNAi molecules that mediate RNAi, including without limitation siRNA
  • chemical synthesis Hohjoh, FEBS Lett 521:195-199, 2002
  • hydrolysis of dsRNA Yang et al., Proc Natl Acad Sci USA 99:9942-9947, 2002
  • T7 RNA polymerase Trigger RNA polymerase
  • hydrolysis of double-stranded RNA using a nuclease such as E. coli RNase III
  • siRNA examples include: Bernstein et al., Nature 409:363-366,
  • shRNA short hairpin RNA
  • the length of the stem and loop of functional shRNAs varies; stem lengths can range anywhere from about 25 to about 30 nt, and loop size can range between 4 to about 25 nt without affecting silencing activity. While not wishing to be bound by any particular theory, it is believed that these shRNAs resemble the dsRNA products of the DICER RNase and, in any event, have the same capacity for inhibiting expression of a specific gene.
  • the shRNA is expressed from a lentiviral vector, e.g., pLL3.7.
  • Antisense technology can be used to control gene expression through antisense
  • the 5' non-coding portion of a polynucleotide that encodes TLlA or DR3 may be used to design an antisense RNA oligonucleotide of from about 10 to 40 base pairs in length.
  • a DNA oligonucleotide is designed to be complementary to a region of the gene involved in transcription thereby preventing transcription and the production of the target protein.
  • the antisense RNA oligonucleotide hybridizes to the mRNA in vivo and blocks translation of the mRNA molecule into the target polypeptide.
  • antisense nucleic acids specific for the TLlA or DR3 gene are produced intracellularly by transcription from an exogenous sequence.
  • a vector or a portion thereof is transcribed, producing an antisense nucleic acid (RNA).
  • RNA antisense nucleic acid
  • Such a vector can remain episomal or become chromosomally integrated, as long as it can be transcribed to produce the desired antisense RNA.
  • Such vectors can be constructed by recombinant DNA technology methods standard in the art.
  • Vectors can be plasmid, viral, or others known in the art, used for replication and expression in vertebrate cells.
  • Expression of the antisense molecule can be by any promoter known in the art to act in vertebrate, preferably human cells, such as those described elsewhere herein. Absolute complementarity of an antisense molecule, although preferred, is not required.
  • a sequence complementary to at least a portion of an RNA encoding TLlA or DR3, means a sequence having sufficient complementarity to be able to hybridize with the RNA, forming a stable duplex; or triplex formation may be assayed.
  • the ability to hybridize will depend on both the degree of complementarity and the length of the antisense nucleic acid. Generally, the larger the hybridizing nucleic acid, the more base mismatches it may contain and still form a stable duplex (or triplex as the case may be).
  • One skilled in the art can ascertain a tolerable degree of mismatch by use of standard procedures to determine the melting point of the hybridized complex.
  • Oligonucleotides that are complementary to the 5' end of a messenger RNA should work most efficiently at inhibiting translation.
  • sequences complementary to the 3' untranslated sequences of mRNAs have been shown to be effective at inhibiting translation of mRNAs as well. See generally, Wagner, R., Nature 372:333-335 (1994).
  • oligonucleotides complementary to either the 5'- or 3'-non-translated, non-coding regions could be used in an antisense approach to inhibit translation of TLlA or DR3.
  • Oligonucleotides complementary to the 5' untranslated region of the mRNA should include the complement of the AUG start codon.
  • Antisense oligonucleotides complementary to mRNA coding regions are less efficient inhibitors of translation but could be used in accordance with the invention.
  • Antisense nucleic acids should be at least six nucleotides in length, and are preferably oligonucleotides ranging from 6 to about 50 nucleotides in length. In specific aspects the oligonucleotide is at least 10 nucleotides, at least 17 nucleotides, at least 25 nucleotides or at least 50 nucleotides.
  • Polynucleotides for use the therapeutic methods disclosed herein can be DNA or RNA or chimeric mixtures or derivatives or modified versions thereof, single-stranded or double-stranded.
  • the oligonucleotide can be modified at the base moiety, sugar moiety, or phosphate backbone, for example, to improve stability of the molecule, hybridization, etc.
  • the oligonucleotide may include other appended groups such as peptides (e.g., for targeting host cell receptors in vivo), or agents facilitating transport across the cell membrane (see, e.g., Letsinger et al., Proc. Natl. Acad. Sci. USA.
  • the oligonucleotide may be conjugated to another molecule, e.g., a peptide, hybridization triggered cross-linking agent, transport agent, hybridization-triggered cleavage agent, etc.
  • An antisense oligonucleotide for use in the therapeutic methods disclosed herein may comprise at least one modified base moiety which is selected from the group including, but not limited to, 5-fluorouracil, 5-bromouracil, 5-chlorouracil, 5-iodouracil, hypoxanthine, xantine, 4-acetylcytosine, 5-(carboxyhydroxylmethyl) uracil, 5- carboxymethylaminomethyl-2-thiouridine, 5-carboxymethylaminomethyluracil, dihydrouracil, beta-D-galactosylqueosine, inosine, N-6-isopentenyladenine, 1-methylguanine, 1-methylinosine, 2,2-dimethylguanine, 2-methyladenine, 2-methylguanine, 3-methylcytosine, 5-methylcytosine, N-6-adenine, 7-methylguanine, 5-methylaminomethyluracil, 5- methoxyaminomethyl-2-thiouraci
  • 5'methoxycarboxymethyluracil 5-methoxyuracil, 2-methylthio-N-6-isopentenyladenine, uracil-5-oxyacetic acid (v), wybutoxosine, pseudouracil, queosine, 2-thiocytosine, 5-methyl- 2-thiouracil, 2-thiouracil, 4-thiouracil, 5-methyluracil, uracil-5-oxyacetic acid methylester, uracil-5-oxyacetic acid (v), 5-methyl-2-thiouracil, 3(3-amino-3-N-2-carboxypropyl) uracil, (acp3)w, and 2,6-diaminopurine.
  • An antisense oligonucleotide for use in the therapeutic methods disclosed herein may also comprise at least one modified sugar moiety selected from the group including, but not limited to, arabinose, 2-fluoroarabinose, xylulose, and hexose.
  • an antisense oligonucleotide for use in the therapeutic methods disclosed herein comprises at least one modified phosphate backbone selected from the group including, but not limited to, a phosphorothioate, a phosphorodithioate, a phosphoramidothioate, a phosphoramidate, a phosphordiamidate, a methylphosphonate, an alkyl phosphotriester, and a formacetal or analog thereof.
  • an antisense oligonucleotide for use in the therapeutic methods disclosed herein is an alpha-anomeric oligonucleotide.
  • oligonucleotide forms specific double-stranded hybrids with complementary RNA in which, contrary to the usual situation, the strands run parallel to each other (Gautier et al., Nucl. Acids Res. 15:6625-6641(1987)).
  • the oligonucleotide is a 2'-.beta.-methylribonucleotide (Inoue et al., Nucl. Acids Res. 15:6131-6148(1987)), or a chimeric RNA-DNA analogue (Inoue et al., FEBS Lett. 215:327-330(1987)).
  • Polynucleotides may be synthesized by standard methods known in the art, e.g. by use of an automated DNA synthesizer (such as are commercially available from Biosearch, Applied Biosystems, etc.).
  • an automated DNA synthesizer such as are commercially available from Biosearch, Applied Biosystems, etc.
  • phosphorothioate oligonucleotides may be synthesized by the method of Stein et al., Nucl. Acids Res. 16:3209 (1988)
  • methylphosphonate oligonucleotides can be prepared by use of controlled pore glass polymer supports (Sarin et al., Proc. Natl. Acad. Sci. USA. 85:7448-7451(1988)), etc.
  • Polynucleotide compositions for use in the therapeutic methods disclosed herein further include catalytic RNA, or a ribozyme (See, e.g., PCT International Publication WO 90/11364, published Oct. 4, 1990; Sarver et al., Science 247: 1222-1225 (1990).
  • the use of hammerhead ribozymes is preferred. Hammerhead ribozymes cleave mRNAs at locations dictated by flanking regions that form complementary base pairs with the target mRNA. The sole requirement is that the target mRNA have the following sequence of two bases: 5'-UG-3'.
  • ribozyme is engineered so that the cleavage recognition site is located near the 5' end of the target mRNA; i.e., to increase efficiency and minimize the intracellular accumulation of non-functional mRNA transcripts.
  • ribozymes for use in the therapeutic methods disclosed herein can be composed of modified oligonucleotides (e.g. for improved stability, targeting, etc.) and may be delivered to cells which express TLlA or DR3 in vivo. DNA constructs encoding the ribozyme may be introduced into the cell in the same manner as described above for the introduction of antisense encoding DNA.
  • a preferred method of delivery involves using a DNA construct "encoding" the ribozyme under the control of a strong constitutive promoter, such as, for example, pol III or pol II promoter, so that transfected cells will produce sufficient quantities of the ribozyme to destroy endogenous TLlA or DR3 messages and inhibit translation. Since ribozymes unlike antisense molecules, are catalytic, a lower intracellular concentration is required for efficiency.
  • Aptamers are short oligonucleotide sequences that can be used to recognize and specifically bind almost any molecule, including cell surface proteins.
  • the systematic evolution of ligands by exponential enrichment (SELEX) process is powerful and can be used to readily identify such aptamers.
  • Aptamers can be made for a wide range of proteins of importance for therapy and diagnostics, such as growth factors and cell surface antigens.
  • These oligonucleotides bind their targets with similar affinities and specificities as antibodies do (See Ulrich (2006) Handb Exp Pharmacol. 173:305-26).
  • Macugen® is an approved aptamer therapeutic which is also the first anti-angiogenic agent approved for a common eye disorder.
  • An agent described herein can be formulated as a pharmaceutical composition.
  • a pharmaceutical composition typically includes a pharmaceutically acceptable carrier.
  • pharmaceutically acceptable carrier includes any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like that are physiologically compatible.
  • a "pharmaceutically acceptable salt” refers to a salt that retains the desired biological activity of the parent compound and does not impart any undesired toxicological effects (see e.g., Berge, S.M., et al. (1977) J. Pharm. Sci. 66:1-19). Examples of such salts include acid addition salts and base addition salts.
  • Acid addition salts include those derived from nontoxic inorganic acids, such as hydrochloric, nitric, phosphoric, sulfuric, hydrobromic, hydroiodic, and the like, as well as from nontoxic organic acids such as aliphatic mono- and dicarboxylic acids, phenyl-substituted alkanoic acids, hydroxy alkanoic acids, aromatic acids, aliphatic and aromatic sulfonic acids and the like.
  • Base addition salts include those derived from alkaline earth metals, such as sodium, potassium, magnesium, calcium and the like, as well as from nontoxic organic amines, such as N,N'- dibenzylethylenediamine, N-methylglucamine, chloroprocaine, choline, diethanolamine, ethylenediamine, procaine and the like.
  • Agents described herein can be formulated according to standard methods.
  • an agent e.g., an antibody
  • excipient materials such as sodium chloride, sodium dibasic phosphate heptahydrate, sodium monobasic phosphate, and polysorbate 80. It can be provided, for example, in a buffered solution at a concentration of about 20 mg/ml and can be stored at 2-8 0 C.
  • Pharmaceutical compositions may also be in a variety of other forms. These include, for example, liquid, semi-solid and solid dosage forms, such as liquid solutions (e.g., injectable and infusible solutions), dispersions or suspensions, tablets, pills, powders, liposomes and suppositories. The preferred form can depend on the intended mode of administration and therapeutic application. Typically compositions for the agents described herein are in the form of injectable or infusible solutions.
  • compositions can be administered by a parenteral mode (e.g., intravenous, subcutaneous, intraperitoneal, or intramuscular injection).
  • parenteral administration e.g., intravenous, subcutaneous, intraperitoneal, or intramuscular injection.
  • parenteral administration e.g., intravenous, subcutaneous, intraperitoneal, or intramuscular injection.
  • parenteral administration e.g., intravenous, subcutaneous, intraperitoneal, or intramuscular injection.
  • parenteral administration e.g., intravenous, subcutaneous, intraperitoneal, or intramuscular injection.
  • compositions typically must be sterile and stable under the conditions of manufacture and storage. A pharmaceutical composition can also be tested to insure it meets regulatory and industry standards for administration.
  • the composition can be formulated as a solution, microemulsion, dispersion, liposome, or other ordered structure suitable to high drug concentration.
  • Sterile injectable solutions can be prepared by incorporating an agent described herein in the required amount in an appropriate solvent with one or a combination of ingredients enumerated above, as required, followed by filtered sterilization.
  • dispersions are prepared by incorporating an agent described herein into a sterile vehicle that contains a basic dispersion medium and the required other ingredients from those enumerated above.
  • the preferred methods of preparation are vacuum drying and freeze-drying that yields a powder of an agent described herein plus any additional desired ingredient from a previously sterile-filtered solution thereof.
  • the proper fluidity of a solution can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersion and by the use of surfactants.
  • Prolonged absorption of injectable compositions can be brought about by including in the composition an agent that delays absorption, for example, monostearate salts and gelatin.
  • An agent described herein can be administered to a subject, e.g., a human subject, by a variety of methods.
  • the route of administration is one of: intravenous injection or infusion, subcutaneous injection, or intramuscular injection.
  • An antibody can be administered as a fixed dose, or in a mg/kg dose, but preferably as a fixed dose.
  • the antibody can be administered intravenously (IV), subcutaneously (SC) or intramuscularly (IM).
  • Dosage regimens are adjusted to provide the desired response, e.g., a therapeutic response.
  • doses in the range of 0.1-100 mg/kg, 1 mg/kg -100 mg/kg, 0.5-20 mg/kg, .1-10 mg/kg or 1- 10 mg/kg can be administered.
  • a particular dose may be administered more than once, e.g., at periodic intervals over a period of time (a course of treatment).
  • the dose may be administered every 2 months, every 6 weeks, monthly, biweekly, weekly, or daily, as appropriate, over a period of time to encompass at least 2 doses, 3 doses, 5 doses, 10 doses, or more.
  • the active agent may be prepared with a carrier that will protect the compound against rapid release, such as a controlled release formulation, including implants, and microencapsulated delivery systems.
  • a controlled release formulation including implants, and microencapsulated delivery systems.
  • Biodegradable, biocompatible polymers can be used, such as ethylene vinyl acetate, polyanhydrides, polyglycolic acid, collagen, polyorthoesters, and polylactic acid. Many methods for the preparation of such formulations are patented or generally known. See, e.g., Sustained and Controlled Release Drug Delivery Systems, J.R. Robinson, ed., Marcel Dekker, Inc., New York, 1978.
  • Pharmaceutical compositions can be administered with medical devices.
  • compositions can be administered with a needleless hypodermic injection device, such as the devices disclosed in US Pat. Nos. 5,399,163, 5,383,851, 5,312,335, 5,064,413, 4,941,880, 4,790,824, or 4,596,556.
  • a needleless hypodermic injection device such as the devices disclosed in US Pat. Nos. 5,399,163, 5,383,851, 5,312,335, 5,064,413, 4,941,880, 4,790,824, or 4,596,556.
  • implants and modules include: US Pat. No. 4,487,603, which discloses an implantable micro-infusion pump for dispensing medication at a controlled rate; US Pat. No. 4,486,194, which discloses a therapeutic device for administering medicants through the skin; US Pat. No. 4,447,233, which discloses a medication infusion pump for delivering medication at a precise infusion rate; US Pat. No.
  • Dosage unit form or "fixed dose” as used herein refers to physically discrete units suited as unitary dosages for the subjects to be treated; each unit contains a predetermined quantity of active compound calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier and optionally in association with the other agent.
  • a pharmaceutical composition may include a "therapeutically effective amount" of an agent described herein.
  • a therapeutically effective amount of an agent may also vary according to factors such as the disease state, age, sex, and weight of the individual, and the ability of the compound to elicit a desired response in the individual, e.g., amelioration of at least one disorder parameter, e.g., a multiple sclerosis parameter, or amelioration of at least one symptom of the disorder, e.g., multiple sclerosis.
  • a therapeutically effective amount is also one in which any toxic or detrimental effects of the composition is outweighed by the therapeutically beneficial effects.
  • MS Multiple sclerosis
  • MS is a central nervous system disease that is characterized by inflammation and loss of myelin sheaths.
  • MS may be identified by criteria establishing a diagnosis of clinically definite MS as defined by the workshop on the diagnosis of MS (Poser et al., Ann. Neurol. 13:227, 1983). Briefly, an individual with clinically definite MS has had two attacks and clinical evidence of either two lesions or clinical evidence of one lesion and paraclinical evidence of another, separate lesion.
  • Definite MS may also be diagnosed by evidence of two attacks and oligoclonal bands of IgG in cerebrospinal fluid or by combination of an attack, clinical evidence of two lesions and oligoclonal band of IgG in cerebrospinal fluid.
  • the McDonald criteria can also be used to diagnose MS. (McDonald et al., 2001, Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the Diagnosis of Multiple Sclerosis, Ann Neurol 50: 121-127).
  • the McDonald criteria include the use of MRI evidence of CNS impairment over time to be used in diagnosis of MS, in the absence of multiple clinical attacks. Effective treatment of multiple sclerosis may be evaluated in several different ways. The following parameters can be used to gauge effectiveness of treatment.
  • EDSS extended disability status scale
  • MRI magnetic resonance imaging
  • the EDSS is a means to grade clinical impairment due to MS (Kurtzke, Neurology 33:1444, 1983).
  • Eight functional systems are evaluated for the type and severity of neurologic impairment. Briefly, prior to treatment, patients are evaluated for impairment in the following systems: pyramidal, cerebella, brainstem, sensory, bowel and bladder, visual, cerebral, and other.
  • Follow-ups are conducted at defined intervals. The scale ranges from O (normal) to 10 (death due to MS). A decrease of one full step indicates an effective treatment (Kurtzke, Ann. Neurol. 36:573-79, 1994).
  • MRI can be used to measure active lesions using gadolinium-DTPA-enhanced imaging (McDonald et al. Ann. Neurol. 36:14, 1994) or the location and extent of lesions using T2 -weighted techniques. Briefly, baseline MRIs are obtained. The same imaging plane and patient position are used for each subsequent study. Positioning and imaging sequences can be chosen to maximize lesion detection and facilitate lesion tracing. The same positioning and imaging sequences can be used on subsequent studies. The presence, location and extent of MS lesions can be determined by radiologists. Areas of lesions can be outlined and summed slice by slice for total lesion area.
  • Exemplary symptoms associated with multiple sclerosis include: optic neuritis, diplopia, nystagmus, ocular dysmetria, internuclear ophthalmoplegia, movement and sound phosphenes, afferent pupillary defect, paresis, monoparesis, paraparesis, hemiparesis, quadraparesis, plegia, paraplegia, hemiplegia, tetraplegia, quadraplegia, spasticity, dysarthria, muscle atrophy, spasms, cramps, hypotonia, clonus, myoclonus, myokymia, restless leg syndrome, footdrop, dysfunctional reflexes, paraesthesia, anaesthesia, neuralgia, neuropathic and neurogenic pain, l'hermitte's, proprioceptive dysfunction, trigeminal neuralgia, ataxia, intention tremor,
  • MS Each case of MS displays one of several patterns of presentation and subsequent course. Most commonly, MS first manifests itself as a series of attacks followed by complete or partial remissions as symptoms mysteriously lessen, only to return later after a period of stability. This is called relapsing-remitting (RR) MS.
  • Primary-progressive (PP) MS is characterized by a gradual clinical decline with no distinct remissions, although there may be temporary plateaus or minor relief from symptoms.
  • Secondary-progressive (SP) MS begins with a relapsing-remitting course followed by a later primary-progressive course. Rarely, patients may have a progressive-relapsing (PR) course in which the disease takes a progressive path punctuated by acute attacks. PP, SP, and PR are sometimes lumped together and called chronic progressive MS.
  • PR progressive-relapsing
  • Innate immunity is the body's first, generalized line of defense against pathogens, which includes the rapid inflammation of tissues that takes place shortly after injury or infection, hindering the entrance and spread of disease. Innate immune responses are effected by a wide array of effector cells, including phagocytic cells (neutrophils, monocytes, macrophages and dendritic cells), cells that release inflammatory mediators (basophils, mast cells, and eosinophils), and natural killer cells, which are especially adept at destroying cells infected with viruses.
  • phagocytic cells neutrils, monocytes, macrophages and dendritic cells
  • cells that release inflammatory mediators basophils, mast cells, and eosinophils
  • natural killer cells Another component of the innate immune system is the complement system. Complement proteins are normally inactive components of the blood.
  • cytokines such as the interferons.
  • Methods described herein can be used to modulate innate immunity. Reducing the innate immunity response in a subject in need thereof, e.g., a subject exhibiting a pathogenically increased innate immunity response can be achieved by administering a TLlA blocking agent described herein. Increasing the innate immunity response in a subject in need thereof, e.g., a subject exhibiting an inadequate innate immunity response, can be achieved by administering a TLlA agonist agent, e.g., an anti-DR3 agonist antibody or other agonist described herein.
  • a TLlA agonist agent e.g., an anti-DR3 agonist antibody or other agonist described herein.
  • Example 1 Role of TLlA in an animal model of multiple sclerosis
  • TLlA deficient mice were generated and were found to be phenotypically normal, with a unaltered distribution of immune cell subsets.
  • MOG induced EAE an animal model for multiple sclerosis (MS).
  • TLlA-/- animals have a lower incidence of EAE, a milder disease course and a lower level of inflammatory infiltrates in the CNS then wild type animals.
  • TLlA deficient T cells have a comparable proliferative capacity but secrete lower levels of ThI cytokines, especially IFN and GM-CSF in response to stimulation with MOG peptide.
  • TLlA deficient T cells from MOG stimulated cultures also display a reduced level of cell surface markers and adhesion molecules characteristic of the effector T cell phenotype.
  • TLlA deficient mice were generated by replacing exon 4 of the TLlA (Tnfs/15) locus with a neomycin cassette (FIG. IA). Exon 4 encodes amino acids 103-251 of TLlA encompassing the TNF-homology domain, essential for TLlA function. Lack of TLlA expression was confirmed by RT-PCR of kidney tissues (FIG. IB) which contain high levels of TLlA mRNA. TLlA deficient mice were phenotypically normal and similar immune cell numbers and proportions were observed in the lymph nodes, spleen, thymus and bone marrow. Surface marker phenotype of lymph node cells is shown; no differences in marker expression were observed between TLlA "7" and WT animals (not shown). Decreased severity of EAE in TLlA "7' animals
  • TLlA 7" mice and WT controls were immunized s.c. with 200 ⁇ g of MOG 3S-S5 peptide and given 50 ng of pertussis toxin i.p. on the day of immunization.
  • TLlA 7" and WT animals exhibited similar timing of disease onset.
  • TLlA deficient mice consistently showed a significantly reduced disease severity as manifested by a lower maximal disease score as well as lower scores throughout the course of the disease (FIG. 2).
  • Disease incidence was similar in the two groups, with a consistent though not statistically significant, trend towards lower incidence in the TLlA "7" mice.
  • TLl A "7" mice show a reduced level of T cell infiltration into the CNS [000111] Histological examination of the spinal cords was performed to determine whether the difference in clinical symptoms between TLlA " ' " and WT mice was reflected in the degree of inflammatory infiltration and demyelination in the CNS. TLlA "7' mice exhibited fewer mononuclear infiltrates and demyelination foci than wild-type control animals at day 27 post-immunization. These results indicate that the observed reduced clinical disease in the KO animals is likely due to decreased CNS inflammation and damage.
  • TLlA may be involved in the generation and/or function of MOG-specific T cells during the course of EAE, the levels of T-cell infiltration were quantified by image analysis of anti-CD3 staining. TL1A ";' animals had fewer CD3 positive cells per spinal cord cross- section then wild type counterparts.
  • CD4 + T cells start accumulating in the CNS of WT mice one or two days prior to the onset of clinical symptoms and their levels peak at day 5-7 after disease onset.
  • CD45 + CD4 + cells in the TLl A ' ' ' CNS was consistently reduced as compared to WT CNS over the course of the study (not shown).
  • Absolute numbers of CD45 + CD4 + cell were also examined and showed a similar trend (not shown).
  • TLlA expression on antigen presenting cells has been suggested. Additionally, human recombinant soluble TLlA potentiates T cell responses under the conditions of suboptimal polyclonal stimulation in vitro.
  • TLl A '1' mice To examine whether the reduced clinical severity and T cell infiltration in TLl A '1' mice is due to impaired antigen- specific T cell expansion, we used two independent systems. The role of TLl A in priming of na ⁇ ve T cells was addressed using the OT-2 ovalbumin (OVA) specific TCR-transgenic system. CFSE-labeled na ⁇ ve CD4 + T cells from OT-2 transgenic mice were transferred into TLl A "A or WT hosts.
  • OVA ovalbumin
  • TLlA knock-out where both the T cells and the APCs lack TLlA
  • MOG-specific recall response TLlA " ' " and WT animals were immunized with MOG35.55 in CFA and in vitro T cell proliferation was examined on day 10.
  • T cell proliferation in response to MOG 3S-S5 or anti-CD3 stimulation was comparable in lymph node cultures from TLl A '1' and WT mice. The results from these two experimental systems indicate that TLlA does not play a significant role in CD4 T cell proliferation during initial priming or subsequent expansion of antigen-activated T cells.
  • TLlA deficient T cells have an impaired cytokine response
  • Th2-type cytokines IL-4 and EL-5 secreted in response to MOG 3S-5S or anti-CD3 stimulation were comparable (FIG. 3D, 3E).
  • TLlA " ' lymph node cultures secreted significantly lower levels of IFN ⁇ , TNF ⁇ and GM-CSF in response to MOG stimulation as well as a lower level of IFN ⁇ in response to anti-CD3 stimulation (FIG. 3A, B and C).
  • T cells from TLlA deficient animals display at altered surface marker phenotype.
  • differentiation into effector T cells is reflected by a coordinated change in the pattern of surface molecules after antigen stimulation; the acquired pattern indicative of T cell activation and altered migratory capacity.
  • Several of these molecules function in the homing of effector T cells out of the primary lymphoid organs and into the target tissue and may affect the ability to TLlA deficient T cells to infiltrate into the CNS.
  • TLlA " ' " and WT animals were immunized with MOG 35-5S peptide in CFA and draining LN cells cultured in the presence of MOG peptide, anti-CD3 or media alone and analyzed by FACS. Forward/side scatter profiles of the CD4 + cells), with gating on the larger CD4 + cells were analysed of the activated portion of the population. It should be noted that this population is not limited to MOG-specific activated T cells and likely contains bystander activated T cells as well. TLl A ";” animals showed a small but significant decrease (mean value of 24.8+1.5% WT vs. 21.8+1.03% KO for cohorts of 5 animals) in the number of activated T cells on the basis of cell size recovered after culture.
  • TLlA-/- Analysis of the activated CD4+ T cell population revealed an alteration in the surface marker profile in TLlA-/- as compared to WT cultures.
  • TLlA deficient cultures contained a larger percentage of cells expressing high levels of CD62L, the adhesion molecule present on na ⁇ ve, lymph node resident T cells, which is downregulated with activation.
  • TLlA-/- cultures exhibited a lower percentage of cells expressing E-selectin ligand, while the level of ⁇ 4-integrin positive cells was somewhat increased in the KO. Expression of three other adhesion molecules CD44, LFA-I and P-selectin ligand was unaffected.
  • TLlA-/- cultures also showed a significant reduction as compared to WT in the percentage of cells expressing CD25 though not in their MFI values, as well as reduction in both the percent positive and MFI values for the early activation marker CD69.
  • the expression of two co-stimulatory TNF family receptors was also examined. While the percentage of cells positive for OX40 was slightly but significantly lower in the absence of TLlA with an accompanying reduction in MFI, the pattern of CD27 expression was markedly altered, with higher levels observed on TLlA-/- cells, resembling a na ⁇ ve phenotype.
  • the overall alteration in surface marker profile indicates that antigen-activated TLlA-/- T cells do not acquire the full effector phenotype.
  • Example 2 Role of TLlA in an animal model of UC and innate immunity
  • TLlA deficient mice were generated and were found to be phenotypically normal; with an unaltered distribution of immune cell subsets and apparently normal organ histology including colon.
  • DSS distal sodium sulfate
  • UC ulcerative colitis
  • TLlA-/- animals were found to have a reduced severity of acute DSS colitis as compared to wildtype animals, as measured by reduced weight loss and clinical score (FIG. 4), as well as reduced histological score including ulcers, infiltration, goblet cell loss and crypt changes (FIG. 5). Immunohistochemical staining showed that the infiltrates associated with the ulcers included F4/80+ macrophages but not T lymphocytes (not shown). These data reveal a role for the TLlA pathway in the pathogenesis of UC and suggest that blocking TLlA can be useful to treat UC.

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Abstract

Methods of modulating TL1A for the treatment of disease are disclosed.

Description

TLlA IN TREATMENT OF DISEASE
BACKGROUND
[0001] TLlA is a TNF superfamily member expressed by antigen presenting and endothelial cells. DR3, the receptor for TLlA, is expressed on activated lymphocytes and peripheral blood monocytes. (See Migone et al. (2002) Immunity 16:479-492). It has been reported that TLlA and DR3 expression are increased in the lamina propria of inflammatory bowel disease (IBD) intestinal tissue from both Crohn's disease (CD) and ulcerative colitis (UC) subjects, but a therapeutic effect of TLlA reduction has not been established. TLlA is localized in macrophages and in a small subset of CCR9+ T cells in CD specimens and in plasma cells in UC specimens; DR3 is primarily expressed on lymphocytes. TLlA costimulates secretion of the ThI cytokine IFNgamma but not Th2 cytokines IL-4 and IL-10 by lamina propria lymphocytes (LPL) and synergizes with IL- 12 and BL- 18 for IFNgamma production in vitro. These data suggest that TLlA may play a role in the pathogenesis of ThI mediated CD (Bamias et al., 2003, J Immunol. 171(9):4868-74; Prehn et al., 2004, CHn Immunol 112(l):66-77).
SUMMARY OF THE INVENTION
[0002] In one aspect, the invention features a method of treating multiple sclerosis
(MS). The method includes administering, to a subject who has multiple sclerosis, an agent that blocks TLlA signaling, e.g., an agent that blocks TLlA interaction with DR3. The agent can be, e.g., a blocking anti-TLIA antibody or anti-DR3 antibody, a decoy DR3 polypeptide (e.g., a soluble DR3-Fc fusion protein), or a nucleic acid antagonist of TLlA or DR3. [0003] In one embodiment, the agent is an antibody that is a full length IgG. In other embodiments, the agent is an antigen-binding fragment of a full length IgG, e.g., the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment. In preferred embodiments, the antibody is a human, humanized or humaneered antibody or antigen-binding fragment thereof.
[0004] In one embodiment, the agent is a soluble form of a TLlA receptor (e.g., DR3).
In some cases, the soluble form of the receptor is fused with a heterologous polypeptide, e.g., an antibody Fc region.
[0005] In one embodiment, the agent is administered in an amount sufficient to do one or more of the following: a) decrease severity or decrease frequency of relapse; b) prevent an increase in EDSS score, e.g., over a period of time, e.g., over 3 months, 6 months, a year or longer; c) decrease EDSS score (e.g., a decrease of greater than 1, 1.5, 2, 2.5, or 3 points, e.g., over at least three months, six months, one year, or longer); d) decrease the number of new MRI lesions; e)reduce the rate of appearance of new MRI lesions; and f) prevent an increase in MRI lesion area. The subject may be evaluated, before or after the administration, by MRI and/or neurological exam.
[0006] In one embodiment, the subject has relapsing-remitting (RR) MS, primary- progressive (PP) MS, secondary-progressive (SP) MS, or progressive-relapsing (PR) MS. [0007] In one embodiment, the agent is administered in combination with another therapy for MS, e.g., Copaxone; interferons, e.g., human interferon beta- Ia (e.g., AVONEX® or Rebif®) and interferon beta- Ib (BETASERON™; human interferon beta substituted at position 17); glatiramer acetate (also termed Copolymer 1, Cop-1; COPAXONE™); Tysabri© (natalizumab) ro another anti-VLA4 antibody, e.g., one that competes with or binds an epitope overlapping that of rituximab; Rituxan® (rituximab) or another anti-CD20 antibody, e.g., one that competes with or binds an overlapping epitope with rituximab; mixtoxantrone (NOVANTRONE®, Lederle); a corticosteroid. [0008] In one embodiment, the agent is administered at a dose between 0.1-100 mg/kg, between 0.1-10 mg/kg, between 1 mg/kg -100 mg/kg, between 0.5-20 mg/kg, or between 1-10 mg/kg. In the most typical embodiment, the dose is administered more than once, e.g., at periodic intervals over a period of time (a course of treatment). For example, the dose may be administered every 2 months, every 6 weeks, monthly, biweekly, weekly, or daily, as appropriate, over a period of time to encompass at least 2 doses, 3 doses, 5 doses, 10 doses, or more.
[0009] In another aspect, the invention features a method of treating ulcerative colitis
(UC). The method includes administering, to a subject who has UC, an agent that blocks TLlA signaling, e.g., an agent that blocks TLlA interaction with DR3. The agent can be, e.g., a blocking anti-TLl A antibody or anti-DR3 antibody, a soluble decoy DR3 polypeptide (e.g., a soluble DR3-Fc fusion protein), or a nucleic acid antagonist of TLlA or DR3, such as an aptamer or antisense molecule.
[00010] In one embodiment, the agent is an anti-TLl A or anti-DR3 antibody that is a full length IgG. In other embodiments, the agent is an antigen-binding fragment of a full length IgG, e.g., the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment. In preferred embodiments, the antibody is a human, humanized or humaneered antibody or antigen-binding fragment thereof. [00011] In one embodiment, the agent is a soluble form of a TLlA receptor (e.g.,
DR3). In some cases, the soluble form of the receptor is fused with a heterologous polypeptide, e.g., an antibody Fc region.
[00012] In one embodiment, the agent is administered in an amount sufficient to do one or more of the following: a) decrease severity or decrease frequency of colitis flare-ups; b) prevent or decrease the extent of weight loss; (c) improve the presence or extent of ulcers or inflammation, e.g., over a period of time, e.g., over 3 months, 6 months, a year or longer. The subject may be evaluated, before or after the administration, with one or more of the following: colonoscopy with or without biopsy, barium enema, CBC blood test, sedimentation rate (ESR), CRP (C-reactive protein) test. [00013] In one embodiment, the subject has an acute flare-up of UC.
[00014] In one embodiment, the agent is administered in combination with another therapy for UC, e.g., corticosteroids to reduce inflammation; aminosalicylates; immunosuppressants, such as azathioprine; 6-MP, cyclosporine, and methotrexate. [00015] In one embodiment, the agent is administered at a dose between 0.1-100 mg/kg, between 0.1-10 mg/kg, between 1 mg/kg -100 mg/kg, between 0.5-20 mg/kg, or between 1-10 mg/kg. In the most typical embodiment, the dose is administered more than once, e.g., at periodic intervals over a period of time (a course of treatment). For example, the dose may be administered every 2 months, every 6 weeks, monthly, biweekly, weekly, or daily, as appropriate, over a period of time to encompass at least 2 doses, 3 doses, 5 doses, 10 doses, or more.
[00016] In another aspect, the invention features methods for modulating an innate immunity response in a subject by modulating TLlA signaling.
[00017] In one aspect, a method is provided to reduce an innate immunity response in a subject in need thereof. The method includes administering, to a subject who has a hyper- responsive innate immunity response, an agent that blocks TLlA signaling, e.g., an agent that blocks TLlA interaction with DR3. The agent can be, e.g., a blocking anti-TLl A antibody, anti-DR3 antibody, or a soluble DR3 (e.g., a soluble DR3-Fc fusion protein). [00018] In some embodiments, the subject in need of reducing an innate immunity response has an autoimmune disease, e.g., rheumatoid arthritis, SLE, Grave's Disease, Wegener's granulomatosis, Sjogren's syndrome, scleroderma, type 1 diabetes mellitus; a neuroinflammatory disease, e.g., MS, ALS, Alzheimer's Disease. [00019] In one embodiment, the agent is administered in an amount sufficient to reduce the number and/or activity of innate immune cell types such as macrophages, monocytes, dendritic cells and neutrophils. In one embodiment, the agent is administered in an amount sufficient to reduce production by such innate immune cell types of proinflammatory cytokines, e.g., IL-6, IL-12, IL-23, TNF, IFNgamma, EL-I, IL-8, IL-10, type 1 interferons, IL-I l, IL-23, 11-27, GM-CSF, G-CSF, M-CSF and chemokines including but not limited to MC?-lalpha, MIP-lbeta, CXCLl 1, RANTES, TARC, MCP-5, eotaxin and those referenced herein (e.g., Rot and von Adrian, 2004, Ann. Rev. Immunol. 22:891-928; Moser et al., 2004, Trends in Immunol 25: 75-84).
[00020] In one embodiment, the method also includes evaluating the subject for a marker of innate immunity response, e.g., evaluating the subject for numbers and/or activity (e.g.,. phagocytic activity) of immune cells (i.e. white blood cells, lymphocytes, neutrophils, monocytes), or macrophage release of proinflammatory cytokines, e.g., as described hereinabove. The evaluation can be performed before and/or after the administration. In one embodiment, the subject is evaluated for such a marker periodically (e.g., at least 2 times) over a period of time after the administration.
[00021] In one embodiment, the agent is an antibody that is a full length IgG. In other embodiments, the agent is an antigen-binding fragment of a full length IgG, e.g., the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment. In preferred embodiments, the antibody is a human, humanized or humaneered antibody or antigen-binding fragment thereof. The antibody can be, e.g., an anti-TLl A antibody or an anti-DR3 antibody.
[00022] In one embodiment, the agent is a soluble form of a TLlA receptor (e.g.,
DR3), e.g., a polypeptide. In some cases, the soluble form of the receptor is fused with a heterologous polypeptide, e.g., an antibody Fc region.
[00023] In one embodiment, the agent is administered at a dose between 0.01-100 mg/kg, between .01-10 mg/kg, between 0.01 mg/kg -1 mg/kg, between 0.05-10 mg/kg, or between 1-10 mg/kg. In the most typical embodiment, the dose is administered more than once, e.g., at periodic intervals over a period of time (a course of treatment). For example, the dose may be administered every 2 months, every 6 weeks, monthly, biweekly, weekly, or daily, as appropriate, over a period of time to encompass at least 2 doses, 3 doses, 5 doses, 10 doses, or more. [00024] Conditions which may benefit from reducing the innate immunity response include conditions in which innate immunity is hyper-responsive, e.g., conditions in which innate immune response to a pathogen leads to an inflammatory disorder, e.g., to an acute flare-up of an inflammatory disorder. In one embodiment, the subject has an inflammatory disease or autoimmune disease and is at risk for acute flare-ups, e.g., an acute flare-up of IBD or colitis.
[00025] In another aspect, a method is provided to enhance an innate immunity response in a subject in need thereof. The method includes administering an agent that enhances TLlA signaling in an amount that stimulates innate immunity, e.g., an amount that causes an enhancement in resistance to, reduction in susceptibility to, or decrease in pathogenic effects of, an infective agent such as a bacterial or viral infection; or a cancer cell. An agent that enhances TLlA signaling can be, e.g., a soluble TLlA, a multimerized TLlA such as a trimerized TLlA (e.g., as described for CD40L in Morris et al. (1999) J. Biol. Chem. 274:418-423), and an anti-DR3 agonist antibody.
[00026] In one embodiment, the agent is administered in an amount sufficient to increase the number and/or activity of innate immune cell types such as macrophages, monocytes, dendritic cells and neutrophils. In one embodiment, the agent is administered in an amount sufficient to increase production by such innate immune cell types of proinflammatory cytokines, e.g., IL-6, IL-12, IL-23, TNF, IFNgamma, IL-I, IL-8, EL-IO, type 1 interferons, EL-Il, EL-23, 11-27, GM-CSF, G-CSF, M-CSF and chemokines including but not limited to MEP-lalpha, MEP-lbeta, CXCLl 1, RANTES, TARC, MCP-5, eotaxin and those referenced herein (e.g., Rot and von Adrian, 2004, Ann. Rev. Immunol. 22:891-928; Moser et al., 2004, Trends in Immunol 25: 75-84)
[00027] In one embodiment, the method also includes evaluating the subject for a marker of innate immunity response, e.g., evaluating the subject for numbers and/or activity (e.g., phagocytic activity) of immune cells (i.e. white blood cells, lymphocytes, neutrophils, monocytes), or macrophage release of proinflammatory cytokines, e.g., as described hereinabove. The evaluation can be performed before and/or after the administration. In one embodiment, the subject is evaluated for such a marker periodically (e.g., at least 2 times) over a period of time after the administration.
[00028] In one embodiment, the agent is an anti-DR3 agonist antibody that is a full length IgG. In other embodiments, the agent is an antigen-binding fragment of a full length IgG, e.g., the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment. In preferred embodiments, the antibody is a human, humanized or humaneered antibody or antigen-binding fragment thereof. The antibody can be, e.g., an anti-DR3 antibody.
[00029] In one embodiment, the agent is a soluble form of TLlA. In some cases, the soluble TLlA is fused with a heterologous polypeptide, e.g., an antibody Fc region. [00030] In one embodiment, the agent is administered at a dose between 0.1- 100 mg/kg, between .1-10 mg/kg, between 1 mg/kg -100 mg/kg, between 0.5-20 mg/kg, or between 1-10 mg/kg. In the most typical embodiment, the dose is administered more than once, e.g., at periodic intervals over a period of time (a course of treatment). For example, the dose may be administered every 2 months, every 6 weeks, monthly, biweekly, weekly, or daily, as appropriate, over a period of time to encompass at least 2 doses, 3 doses, 5 doses, 10 doses, or more.
[00031] Conditions which may benefit from enhanced innate immunity response include conditions associated with inadequate innate immunity response including hypo- responsiveness to LPS, susceptibility to infection or sepsis (e.g., by gram-negative bacteria), susceptibility to chronic airway disease, susceptibility to asthma, susceptibility to arthritis, susceptibility to pyelonephritis, susceptibility to gall bladder disease, susceptibility to pneumonia, susceptibility to bronchitis, susceptibility to chronic obstructive pulmonary disease, severity of cystic fibrosis, and susceptibility to local and systemic inflammatory conditions, e.g., systemic inflammatory response syndrome (SIRS), local gram negative bacterial infection, or acute respiratory distress syndrome (ARDS), and susceptibility to cancer or decreased ability of the innate immune system to reject cancer cells. In some embodiments, certain patients can benefit from enhanced innate immunity response, e.g., (i) patients having opportunistic infections, Pneumocystis infection, cytomegalovirus infection, herpes virus infection, mycobacterium infection, or human immunodeficiency virus (HIV) infection; (ii) patients exposed to radiation or one or more chemotherapeutic antiproliferative drugs; (iii) patients who have cancer; (iv) patients having chronic respiratory disease or upper airways disease, (e.g., sinusitis or parasinusitis, rhinovirus or influenza infection, pleuritis, and the like); (v) patients having chronic eye-ear-nose or throat infections (e.g., otitis media, conjunctivitis, uveitis or keratitis); (vi) patients having bronchial allergy and/or asthma; (vii) patients having a chronic liver infection (e.g., chronic hepatitis); and (viii) other immunocompromised patients.
[00032] In one embodiment, the subject has cancer or has susceptibility to cancer. For example, the subject has a family history of cancer or carries a genetic marker for susceptibility to cancer, such as BRCAl or BRCA2, or one or more other genes that are causally implicated in oncogenesis. A census of such genes is provided in Futreal et al.
(2004) Nature Reviews Cancer 4: 177-183.
[00033] In one embodiment, the subject has defective phagocytic function, e.g., defective macrophage function. In another embodiment, the subject has chronic granulomatous disease. In one embodiment, the subject has defective phagocytic function and has Alzheimer's Disease.
[00034] As used herein, the term "treating" refers to administering a therapy in an amount, manner, and/or mode effective to improve or prevent a condition, symptom, or parameter associated with a disorder or to prevent onset, progression, or exacerbation of the disorder (including secondary damage caused by the disorder), to either a statistically significant degree or to a degree detectable to one skilled in the art. Accordingly, treating can achieve therapeutic and/or prophylactic benefits. An effective amount, manner, or mode can vary depending on the subject and may be tailored to the subject.
[00035] Each of the limitations of the invention can encompass various embodiments of the invention. It is, therefore anticipated that each of the limitations of the invention involving any one element or combinations of elements can be included in each aspect of the invention.
BRIEF DESCRIPTION OF THE FIGURES
[00036] Figure 1 is a restriction map of the murine Tnfsf 15 locus and the thymidine kinase (TK) and neomycin (neo) containing targeting construct derived from it. Restriction enzyme sites indicated are: E - EcoRI, X - Xbal, Bg - BgIII, Ba - BamHI. Exons are represented as black boxes, arrows indicate direction of transcription. B. RT-PCR analysis of TLlA mRNA in TLlA-/- and WT kidneys.
[00037] Figure 2 shows EAE clinical course in TLlA-/- animals. A. EAE disease course in C57BL/6 TLlA"7" (round symbols) and wild type (square symbols) mice. Mice were immunized with MOG3S-Ss and pertussis toxin as described in Examples. Values represent the mean clinical score for each group, error bars are SEM. Disease course representative of 4 independent experiments, n=7-10 animals per group. B. EAE statistical parameters for results shown in A. Day of onset was calculated for diseased animals only, p- values are shown for TLlA-/- vs. WT group based on the Mann-Whitney non-parametric test. [00038] Figure 3 shows the MOG-specific cytokine response. A-E. Cytokine secretion in wild type (white bars) and TLlA"7" (grey bars) lymph node cultures. Cells were cultured as in Figure 5B, except 50 ug/ml MOG peptide was used. 72hr supernatants from 5 individuals/group were analyzed: A - IFNγ, B - GM-CSF, C - TNFα, D - IL-4, E - IL-5. Results shown are mean values +/- SEM. Asterisks indicate statistically significant differences (two-tail t-test p<0.05).
[00039] Figure 4 shows that deficiency of TLlA protects against the development of
DSS-induced colitis. 8-12 week old female C57BL/6 TLlA7" (round symbols) and WT animals (square symbols) were fed with 3.5% (wt/vol) DSS dissolved in water for 5 days (days 0-4). DSS is stopped and normal drinking water restored during days 5-13. Body weight, stool consistency, and the presence of occult or visible blood in the stool were determined daily. Disease Score (A) is the combined scores of weight loss, stool consistency and bleeding divided by 3. Values represent the mean clinical score for each group, error bars are SEM. Disease course representative of 3 independent experiments, n=10-ll animals per group. Statistical analysis was performed using Mann- Whitney non-parametric test. *, p < 0.05 for comparison of TLlA7" with WT mice.
[00040] Figure 5 shows that TLlA deficient mice develop fewer colonic ulcers, less epithelial damage and less cell infiltration during DSS treatment. 8-12 week old female C57BL/6 TLlA7" (open bars) and WT animals (closed bars) were fed with 3.5% (wt/vol) DSS dissolved in water for 5 days (days 0-4). DSS is stopped and normal drinking water restored during days 5-13. (n=10-13 animals per group). Mice were sacrificed at day 5, 11 and 13. Colons were paraffin embedded and stained with H&E. The extent of mucosal ulceration (A), epithelial damage (C), inflammatory cell infiltration into the colonic tissue (D), and total histological score (the combined scores of epithelium cell damage and cell infiltration) (B) was quantified as described in Materials and Methods. Statistical analysis was performed using Mann- Whitney non-parametric U test. *, p < 0.05 for comparison of TLlA7" with WT mice, and p=0.09 for ulcer index on day 11 not including results from two WT mice that did not survive the DSS treatment. Statistical analysis for C and D are not shown.
DETAILED DESCRIPTION
[00041] The inventors have discovered that antagonizing (e.g.. blocking) the TLlA pathway is effective to reduce pathogenesis in animal models of multiple sclerosis and ulcerative colitis. The data also supports a role for TLlA in the innate immunity response, e.g., in the pathogenesis of ulcerative colitis.
[00042] TLlA (TNFSF15) is the ligand for DR3 (TNFRSF12) and is a member of the tumor necrosis factor superfamily (TNFSF). The amino acid sequence of human TLlA is shown below.
1 MAEDLGLSFG ETASVEMLPE HGSCRPKARS SSARWALTCC LVLLPFLAGL TTYLLVSQLR
61 AQGEACVQFQ ALKGQEFAPS HQQVYAPLRA DGDKPRAHLT WRQTPTQHF KNQFPALHWE
121 HELGLAFTKN RMNYTNKFLL IPESGDYFIY SQVTFRGMTS ECSEIRQAGR PNKPDSITW
181 ITKVTDSYPE PTQLLMGTKS VCEVGSNWFQ PIYLGAMFSL QEGDKLMVNV SDISLVDYTK
241 EDKTFFGAFL L ( SEQ ID NO : 1 )
[00043] A soluble TLlA lacks the transmembrane domain and cytosolic domain. It can include amino acids 93 to 251 of SEQ ID NO:1, or an N- or C-terminal truncation thereof (e.g., a truncation lacking up to 10 (e.g., up to 8, 6, 4, 2) residues at the N- and/or C-terminal end of amino acids 93-251 of SEQ ED NO: 1), and having DR3 binding activity. In one embodiment, a soluble TLlA includes amino acids 73-251 of SEQ ID NO:1; amino acids 103-251 of SEQ ID NO:1, amino acids 93-251 of SEQ ID NO:1; amino acids 93-245 of SEQ ID NO:1. Also included are polypeptides that include a sequence that has at least 95% identity (e.g., 96%, 97%, 98%, 99% identity) to soluble TLlA, e.g., to amino acids 103-251 of SEQ ID NO: 1, and has DR3 binding activity.
[00044] The amino acid sequence of DR3 (the receptor for TLlA) is shown below (see
Bodmer et al. (1997) Immunity 6:79-88).
1 MEQRPRGCAA VAAALLLVLL GARAQGGTRS PRCDCAGDFH KKIGLFCCRG CPAGHYLKAP
61 CTEPCGNΞTC LVCPQDTFLA WENHHNSECA RCQACDEQAS QVALENCSAV ADTRCGCKPG
121 WFVECQVSQC VSSSPFYCQP CLDCGALHRH TRLLCSRRDT DCGTCLPGFY EHGDGCVSCP
181 TSTLGSCPER CAAVCGWRQM FWVQVLLAGL WPLLLGATL TYTYRHCWPH KPLVTADEAG
241 MEALTPPPAT HLSPLDSAHT LLAPPDSSEK ICTVQLVGNS WTPGYPETQE ALCPQVTWSW
301 DQLPSRALGP AAAPTLSPES PAGSPAMMLQ PGPQLYDVMD AVPARRWKEF VRTLGLREAE
361 IEAVEVEIGR FRDQQYEMLK RWRQQQPAGL GAVYAALERM GLDGCVEDLR SRLQRGP
(SEQ ID NO:2)
[00045] Residues 1-24 of SEQ ID NO:2 correspond to the signal peptide of DR3 ; residues 25-206 of SEQ ID NO:2 correspond to the extracellular domain of the mature protein; residues 207-226 of SEQ ID NO: 2 correspond to the transmembrane domain. The cytoplasmic domain includes a death domain (DD) at residues 335-419 of SEQ ID NO:2. A soluble decoy DR3 lacks the transmembrane domain and cytosolic domain, e.g., it includes residues 25-181 of SEQ ID NO:2 (the extracellular domain), or a functional N- or C-terminal truncation thereof, e.g., a truncation lacking 10 (e.g., 9, 8, 7, 6, 5, 4, 3, 2) or fewer residues at the N- and/or C-terminus. Examples of soluble decoy DR3 polypeptides include polypeptides including amino acids 25-181 of SEQ ID NO:2, amino acids 25-191 of SEQ ID NO:2, amino acids 40-206 of SEQ ID NO:2, amino acids 30-200 of SEQ ID NO:2, amino acids 40-181 of SEQ ID NO:2. Also included are polypeptides having at least 95% identity (e.g., 96%, 97%, 98%, 99% identity) to a functional portion of the extracellular domain of DR3 (residues 25-181 of SEQ ID NO:2), and having TLlA binding activity.
Antibodies
[00046] Antibodies that block TLlA function, e.g., antibodies that bind to TLlA or
DR3 can be generated by immunization, e.g., using an animal, or by in vitro methods such as phage display. AU or part of TLlA or DR3 can be used as an immunogen. For example, the extracellular region of TLl A or DR3 can be used as an immunogen. In one embodiment, the immunized animal contains immunoglobulin producing cells with natural, human, or partially human immunoglobulin loci. In one embodiment, the non-human animal includes at least a part of a human immunoglobulin gene. For example, it is possible to engineer mouse strains deficient in mouse antibody production with large fragments of the human Ig loci. Using the hybridoma technology, antigen-specific monoclonal antibodies derived from the genes with the desired specificity may be produced and selected. See, e.g., XenoMouse™, Green et al. Nature Genetics 7:13-21 (1994), US 2003-0070185, US Pat. No. 5,789,650, and WO 96/34096.
[00047] Non-human antibodies to TLlA or DR3 can also be produced, e.g., in a rodent. The non-human antibody can be humanized, e.g., as described in US Pat. No. 6,602,503, EP 239 400, US Pat. No. 5,693,761, and US Pat. No. 6,407,213. [00048] EP 239400 (Winter et al.) describes altering antibodies by substitution (within a given variable region) of their complementarity determining regions (CDRs) for one species with those from another. CDR-substituted antibodies can be less likely to elicit an immune response in humans compared to true chimeric antibodies because the CDR-substituted antibodies contain considerably less non-human components. (Riechmann et al., 1988, Nature 332, 323-327; Verhoeyen et al., 1988, Science 239, 1534-1536). Typically, CDRs of a murine antibody substituted into the corresponding regions in a human antibody by using recombinant nucleic acid technology to produce sequences encoding the desired substituted antibody. Human constant region gene segments of the desired isotype (usually gamma I for CH and kappa for CL) can be added and the humanized heavy and light chain genes can be co-expressed in mammalian cells to produce soluble humanized antibody. [00049] Queen et al. (Proc. Natl. Acad. Sci. U. S. A. 86: 10029-33, 1989) and WO
90/07861 have described a process that includes choosing human V framework regions by computer analysis for optimal protein sequence homology to the V region framework of the original murine antibody, and modeling the tertiary structure of the murine V region to visualize framework amino acid residues that are likely to interact with the murine CDRs. These murine amino acid residues are then superimposed on the homologous human framework. See also US Pat. Nos. 5,693,762; 5,693,761 ; 5,585,089; and 5,530,101. Tempest et al., 1991, Biotechnology 9:266-271, utilize, as standard, the V region frameworks derived from NEWM and REI heavy and light chains, respectively, for CDR-grafting without radical introduction of mouse residues. An advantage of using the Tempest et al. approach to construct NEWM and REI based humanized antibodies is that the three dimensional structures of NEWM and REI variable regions are known from x-ray crystallography and thus specific interactions between CDRs and V region framework residues can be modeled. [00050] Non-human antibodies can be modified to include substitutions that insert human immunoglobulin sequences, e.g., consensus human amino acid residues at particular positions, e.g., at one or more (preferably at least five, ten, twelve, or all) of the following positions: (in the FR of the variable domain of the light chain) 4L, 35L, 36L, 38L, 43L, 44L, 58L, 46L, 62L, 63L, 64L, 65L, 66L, 67L, 68L, 69L, 7OL, 71L, 73L, 85L, 87L, 98L, and/or (in the FR of the variable domain of the heavy chain) 2H, 4H, 24H, 36H, 37H, 39H, 43H, 45H, 49H, 58H, 6OH, 67H, 68H, 69H, 7OH, 73H, 74H, 75H, 78H, 91H, 92H, 93H, and/or 103H (according to the Kabat numbering). See, e.g., US Pat. No. 6,407,213. [00051] Fully human monoclonal antibodies can be produced, e.g., using in vitro- primed human splenocytes, as described by Boerner et al., 1991, J. Immunol., 147, 86-95. They may be prepared by repertoire cloning as described by Persson et al., 1991, Proc. Nat. Acad. Sci. USA, 88: 2432-2436 or by Huang and Stollar, 1991, J. Immunol. Methods 141, 227-236; also US Pat. No. 5,798,230. Large nonimmunized human phage display libraries • may also be used to isolate high affinity antibodies that can be developed as human therapeutics using standard phage technology (see, e.g., Vaughan et al, 1996; Hoogenboom et al. (1998) Immunotechnology 4:1-20; and Hoogenboom et al. (2000) Immunol Today 2:371- 8; US 2003-0232333). Antibody Production
[00052] Antibodies can be produced in prokaryotic and eukaryotic cells. In one embodiment, the antibodies (e.g., scFv's) are expressed in a yeast cell such as Pichia (see, e.g., Powers et al. (2001) J Immunol Methods. 251:123-35), Hanseula, or Saccharomyces. [00053] In one embodiment, antibodies, particularly full length antibodies, e.g., IgG' s, are produced in mammalian cells. Exemplary mammalian host cells for recombinant expression include Chinese Hamster Ovary (CHO cells) (including dhfr- CHO cells, described in Urlaub and Chasin (1980) Proc. Natl. Acad. Sci. USA 77:4216-4220, used with a DHFR selectable marker, e.g., as described in Kaufman and Sharp (1982) MoI. Biol. 159:601-621), lymphocytic cell lines, e.g., NSO myeloma cells and SP2 cells, COS cells, K562, and a cell from a transgenic animal, e.g., a transgenic mammal. For example, the cell is a mammary epithelial cell.
[00054] In addition to the nucleic acid sequence encoding the immunoglobulin domain, the recombinant expression vectors may carry additional nucleic acid sequences, such as sequences that regulate replication of the vector in host cells (e.g., origins of replication) and selectable marker genes. The selectable marker gene facilitates selection of host cells into which the vector has been introduced (see e.g., US Pat. Nos. 4,399,216, 4,634,665 and 5,179,017). Exemplary selectable marker genes include the dihydrofolate reductase (DHFR) gene (for use in dhfr- host cells with methotrexate selection/amplification) and the neo gene (for G418 selection).
[00055] In an exemplary system for recombinant expression of an antibody (e.g., a full length antibody or an antigen-binding portion thereof), a recombinant expression vector encoding both the antibody heavy chain and the antibody light chain is introduced into dhfr- CHO cells by calcium phosphate-mediated transfection. Within the recombinant expression vector, the antibody heavy and light chain genes are each operatively linked to enhancer/promoter regulatory elements (e.g., derived from SV40, CMV, adenovirus and the like, such as a CMV enhancer/ AdMLP promoter regulatory element or an SV40 enhancer/AdMLP promoter regulatory element) to drive high levels of transcription of the genes. The recombinant expression vector also carries a DHFR gene, which allows for selection of CHO cells that have been transfected with the vector using methotrexate selection/amplification. The selected transformant host cells are cultured to allow for expression of the antibody heavy and light chains and intact antibody is recovered from the culture medium. Standard molecular biology techniques are used to prepare the recombinant expression vector, to transfect the host cells, to select for transformants, to culture the host cells, and to recover the antibody from the culture medium. For example, some antibodies can be isolated by affinity chromatography with a Protein A or Protein G. [00056] Antibodies may also include modifications, e.g., modifications that alter Fc function, e.g., to decrease or remove interaction with an Fc receptor or with CIq, or both. For example, the human IgGl constant region can be mutated at one or more residues, e.g., one or more of residues 234 and 237, e.g., according to the numbering in US Pat. No. 5,648,260. Other exemplary modifications include those described in US Pat. No. 5,648,260.
[00057] For some antibodies that include an Fc domain, the antibody production system may be designed to synthesize antibodies in which the Fc region is glycosylated. For example, the Fc domain of IgG molecules is glycosylated at asparagine 297 in the CH2 domain. This asparagine is the site for modification with biantennary-type oligosaccharides. This glycosylation participates in effector functions mediated by FcD receptors and complement C 1 q (Burton and Woof (1992) Adv. Immunol. 51 : 1-84; Jefferis et al. (1998) Immunol. Rev. 163:59-76). The Fc domain can be produced in a mammalian expression system that appropriately glycosylates the residue corresponding to asparagine 297. The Fc domain can also include other eukaryotic post-translational modifications. [00058] Antibodies can also be produced by a transgenic animal. For example, US
Pat. No. 5,849,992 describes a method for expressing an antibody in the mammary gland of a transgenic mammal. A transgene is constructed that includes a milk-specific promoter and nucleic acid sequences encoding the antibody of interest, e.g., an antibody described herein, and a signal sequence for secretion. The milk produced by females of such transgenic mammals includes, secreted-therein, the antibody of interest, e.g., an antibody described herein. The antibody can be purified from the milk, or for some applications, used directly. [00059] Antibodies can be modified, e.g., with a moiety that improves its stabilization and/or retention in circulation, e.g., in blood, serum, lymph, bronchoalveolar lavage, or other tissues, e.g., by at least 1.5, 2, 5, 10, or 50 fold.
[00060] For example, an antibody can be associated with a polymer, e.g., a substantially non-antigenic polymer, such as a polyalkylene oxide or a polyethylene oxide. Suitable polymers will vary substantially by weight. Polymers having molecular number average weights ranging from about 200 to about 35,000 daltons (or about 1,000 to about 15,000, and 2,000 to about 12,500) can be used. [00061] For example, an antibody can be conjugated to a water soluble polymer, e.g., a hydrophilic polyvinyl polymer, e.g. polyvinylalcohol or polyvinylpyrrolidone. A non- limiting list of such polymers include polyalkylene oxide homopolymers such as polyethylene glycol (PEG) or polypropylene glycols, polyoxyethylenated polyols, copolymers thereof and block copolymers thereof, provided that the water solubility of the block copolymers is maintained. Additional useful polymers include polyoxyalkylenes such as polyoxyethylene, polyoxypropylene, and block copolymers of polyoxyethylene and polyoxypropylene (Pluronics); polymethacrylates; carbomers; branched or unbranched polysaccharides that comprise the saccharide monomers D-mannose, D- and L-galactose, fucose, fructose, D-xylose, L-arabinose, D-glucuronic acid, sialic acid, D-galacturonic acid, D-mannuronic acid (e.g. polymannuronic acid, or alginic acid), D-glucosamine, D- galactosamine, D-glucose and neuraminic acid including homopolysaccharides and heteropolysaccharides such as lactose, amylopectin, starch, hydroxyethyl starch, amylose, dextrane sulfate, dextran, dextrins, glycogen, or the polysaccharide subunit of acid mucopolysaccharides, e.g. hyaluronic acid; polymers of sugar alcohols such as polysorbitol and polymannitol; heparin or heparan.
Soluble Receptors
[00062] Some embodiments of the invention involve the use of a soluble TLlA receptor, e.g., a soluble DR3 receptor or fusion protein. For example, a protein including a TLl A-binding portion of the extracellular domain of DR3 can be fused to an Fc region, i.e., to the C-terminal portion of an Ig heavy chain constant region. Such a fusion may have improved solubility and/or in vivo stability relative to a soluble DR3 alone. The Fc region used can be an IgA, IgD, or IgG Fc (e.g., an IgGl or IgG4 Fc) region (hinge-CH2-CH3). Alternatively, it can be an IgE or IgM Fc region (hinge-CH2-CH3-CH4). Materials and methods for constructing and expressing DNA encoding Fc fusions are known in the art. [00063] The DR3 portion of the fusion protein preferably includes at least a portion of the extracellular region of DR3 (a TLlA binding portion) and preferably lacks a transmembrane domain, such that the DR3 moiety is soluble. The soluble DR3 is typically comprised of amino acids 1-199 or a functional (e.g., TLlA binding) fragment thereof of SEQ ID NO:2.
[00064] The signal sequence is a polynucleotide that encodes an amino acid sequence that initiates transport of a protein across the membrane of the endoplasmic reticulum. Signal sequences useful for constructing a fusion protein include antibody light chain signal sequences, e.g., antibody 14.18 (Gillies et.al., 1989, J. Immunol. Meth., 125: 191-202), antibody heavy chain signal sequences, e.g., the MOPC141 antibody heavy chain signal sequence (Sakano et al., 1980, Nature 286:5774). Alternatively, other signal sequences can be used. See, for example, Watson, 1984, Nucleic Acids Research 12:5145). The signal peptide is usually cleaved in the lumen of the endoplasmic reticulum by signal peptidases. This results in the secretion of a fusion protein containing the Fc region and the TLl A or DR3 moiety.
[00065] In some embodiments the DNA sequence encodes a proteolytic cleavage site between the secretion cassette and the DR3 moiety. A cleavage site provides for the proteolytic cleavage of the encoded fusion protein, thus separating the Fc domain from the target protein. Useful proteolytic cleavage sites include amino acids sequences recognized by proteolytic enzymes such as trypsin, plasmin, thrombin, factor Xa, or enterokinase K. The secretion cassette can be incorporated into a replicable expression vector. Useful vectors include linear nucleic acids, plasmids, phagemids, cosmids and the like. An exemplary expression vector is pdC, in which the transcription of the immunofusin DNA is placed under the control of the enhancer and promoter of the human cytomegalovirus. See, e.g., Lo et al., 1991, Biochim. Biophys. Acta 1088:712; and Lo et al., 1998, Protein Engineering 11 :495- 500. An appropriate host cell can be transformed or transfected with a DNA that encodes a TLlA or DR3 polypeptide, and is used for the expression and secretion of the TLlA or DR3 polypeptide. Preferred host cells include immortal hybridoma cells, myeloma cells, 293 cells, Chinese hamster ovary (CHO) cells, HeIa cells, and COS cells. [00066] Certain sites preferably can be deleted from the Fc region during the construction of the secretion cassette. For example, since coexpression with the light chain is unnecessary, the binding site for the heavy chain binding protein, Bip (Hendershot et al., 1987, Immunol. Today 8:111-114), can be deleted from the CH2 domain of the Fc region of IgE, such that this site does not interfere with the efficient secretion of the immunofusin. Transmembrane domain sequences, such as those present in IgM, can be deleted. [00067] The IgGl Fc region is one example. Alternatively, the Fc region of the other subclasses of immunoglobulin gamma (gamma-2, gamma-3 and gamma-4) can be used in the secretion cassette. The IgGl Fc region of immunoglobulin gamma-1 is preferably used in the secretion cassette includes the hinge region (at least part), the CH2 region, and all or part of the CH3 region. In some embodiments, the Fc region of immunoglobulin gamma-1 is a CH2-deleted-Fc, which includes part of the hinge region and the CH3 region, but not the CH2 region. A CH2-deleted-Fc has been described by Gillies et al, 1990, Hum. Antibod. Hybridomas, 1:47. In some embodiments, the Fc regions of IgA, IgD, IgE, or IgM, are used. [00068] DR3 fusion proteins can be constructed in several different configurations. In one configuration the C-terminus of the DR3 moiety is fused directly to the N-terminus of the Fc moiety. In a slightly different configuration, a short polypeptide, e.g., 2-10 amino acids, is incorporated into the fusion between the N-terminus of the DR3 moiety and the C-terminus of the Fc moiety. Such a linker can provide conformational flexibility, which may improve biological activity in some circumstances. If a sufficient portion of the hinge region is retained in the Fc moiety, the DR3 -Fc fusion will dimerize, thus forming a divalent molecule. A homogeneous population of monomeric Fc fusions will yield monospecific, bivalent dimers. A mixture of two monomeric Fc fusions each having a different specificity will yield bispecific, bivalent dimers.
Polynucleotide Antagonists
[00069] Some methods described herein relate to administering an effective amount of a TLlA or DR3 polynucleotide antagonist. The polynucleotide antagonist prevents expression of the target gene (knockdown). Such polynucleotide antagonists include, but are not limited to antisense molecules, ribozymes, aptamers, siRNA, shRNA and RNAi. Typically, such binding molecules are separately administered to the subject (see, for example, O'Connor (1991) Neurochem. 56:560), but such binding molecules may also be expressed in vivo from polynucleotides taken up by a host cell and expressed in vivo. See also Oligodeoxynucleotides as Antisense Inhibitors of Gene Expression. CRC Press, Boca Raton, FIa. (1988).
RNAi
[00070] RNAi refers to the expression of an RNA which interferes with the expression of the targeted mRNA. Specifically, the RNAi silences a targeted gene via interacting with the specific mRNA (e.g. TLlA or DR3) through a siRNA (short interfering RNA). The ds RNA complex is then targeted for degradation by the cell. Additional RNAi molecules include Short hairpin RNA (shRNA); also short interfering hairpin. The shRNA molecule contains sense and antisense sequences from a target gene connected by a loop. The shRNA is transported from the nucleus into the cytoplasm, it is degraded along with the mRNA. Pol in or U6 promoters can be used to express RNAs for RNAI.
[00071] RNAi is mediated by double stranded RNA (dsRNA) molecules that have sequence-specific homology to their "target" mRNAs (Caplen et al. (2001) Proc Natl Acad Sci USA 98:9742-9747). Biochemical studies in Drosophila cell-free lysates indicates that the mediators of RNA-dependent gene silencing are 21-25 nucleotide "small interfering" RNA duplexes (siRNAs). Accordingly, siRNA molecules are advantageously used in methods described herein. The siRNAs are derived from the processing of dsRNA by an RNase known as DICER (Bernstein et al. (2001) Nature 409:363-366). It appears that siRNA duplex products are recruited into a multi-protein siRNA complex termed RISC (RNA Induced Silencing Complex). Without wishing to be bound by any particular theory, it is believed that a RISC is guided to a target mRNA, where the siRNA duplex interacts sequence-specifically to mediate cleavage in a catalytic fashion (Bernstein et al. (2001) Nature 409:363-366; Boutla et al. (2001) CurrBiol 11: 1776-1780).
[00072] RNAi is contemplated as a therapeutic modality, such as inhibiting or blocking the infection, replication and/or growth of viruses (Gitlin et al. (2002) Nature 418:379-380; Capodici et al. (2002) J Immunol 169:5196-5201), and reducing expression of oncogenes (Scherr et al (2003) Blood 101(4):1566-9). RNAi has been used to modulate gene expression in mammalian (mouse) and amphibian (Xenopus) embryos (Calegari et al., Proc Natl Acad Sci USA 99:14236-14240, 2002; and Zhou, et al., Nucleic Acids Res 30:1664-1669, 2002), and in postnatal mice (Lewis et al., Nat Genet 32: 107-108, 2002), and to reduce trangsene expression in adult transgenic mice (McCaffrey et al., Nature 418:38-39, 2002). Methods have been described for determining the efficacy and specificity of siRNAs in cell culture and in vivo (see, e.g., Bertrand et al., Biochem Biophys Res Commun 296:1000-1004, 2002; Lassus et al., Sci STKE 2002(147):PL13, 2002; and Leirdal et al., Biochem Biophys Res Commun 295:744-748, 2002).
[00073] Molecules that mediate RNAi, including without limitation siRNA, can be produced in vitro by chemical synthesis (Hohjoh, FEBS Lett 521:195-199, 2002), hydrolysis of dsRNA (Yang et al., Proc Natl Acad Sci USA 99:9942-9947, 2002), by in vitro transcription with T7 RNA polymerase (Donzeet et al., Nucleic Acids Res 30:e46, 2002; Yu et al., Proc Natl Acad Sci USA 99:6047-6052, 2002), and by hydrolysis of double-stranded RNA using a nuclease such as E. coli RNase III (Yang et al., Proc Natl Acad Sci USA 99:9942-9947, 2002).
[00074] References regarding siRNA include: Bernstein et al., Nature 409:363-366,
2001; Boutla et al., Curr Biol 11:1776-1780, 2001; Cullen, Nat Immunol. 3:597-599, 2002; Caplen et al., Proc Natl Acad Sci USA 98:9742-9747, 2001; Hamilton et al., Science 286:950-952, 1999; Nagase et al., DNA Res. 6:63-70, 1999; Napoli et al., Plant Cell 2:279- 289, 1990; Nicholson et al., Mamm. Genome 13:67-73, 2002; Parrish et al., MoI Cell 6:1077- 1087, 2000; Romano et al., MoI Microbiol 6:3343-3353, 1992; Tabara et al., Cell 99:123- 132, 1999; and Tuschl, Chembiochem. 2:239-245, 2001.
[00075] Paddison et al. (Genes & Dev. 16:948-958, 2002) have used small RNA molecules folded into hairpins as a means to effect RNAi. Accordingly, such short hairpin RNA (shRNA) molecules are also advantageously used in the methods of the invention. The length of the stem and loop of functional shRNAs varies; stem lengths can range anywhere from about 25 to about 30 nt, and loop size can range between 4 to about 25 nt without affecting silencing activity. While not wishing to be bound by any particular theory, it is believed that these shRNAs resemble the dsRNA products of the DICER RNase and, in any event, have the same capacity for inhibiting expression of a specific gene. In some embodiments of the invention, the shRNA is expressed from a lentiviral vector, e.g., pLL3.7.
Antisense
[00076] Antisense technology can be used to control gene expression through antisense
DNA or RNA, or through triple-helix formation. Antisense techniques are discussed for example, in Okano, J. Neurochem. 56:560 (1991); Oligodeoxynucleotides as Antisense Inhibitors of Gene Expression, CRC Press, Boca Raton, FIa. (1988). Triple helix formation is discussed in, for instance, Lee et al., Nucleic Acids Research 6:3073 (1979); Cooney et al., Science 241:456 (1988); and Dervan et al., Science 251:1300 (1991). The methods are based on binding of a polynucleotide to a complementary DNA or RNA.
[00077] For example, the 5' non-coding portion of a polynucleotide that encodes TLlA or DR3 may be used to design an antisense RNA oligonucleotide of from about 10 to 40 base pairs in length. A DNA oligonucleotide is designed to be complementary to a region of the gene involved in transcription thereby preventing transcription and the production of the target protein. The antisense RNA oligonucleotide hybridizes to the mRNA in vivo and blocks translation of the mRNA molecule into the target polypeptide. [00078] In one embodiment, antisense nucleic acids specific for the TLlA or DR3 gene are produced intracellularly by transcription from an exogenous sequence. For example, a vector or a portion thereof, is transcribed, producing an antisense nucleic acid (RNA). Such a vector can remain episomal or become chromosomally integrated, as long as it can be transcribed to produce the desired antisense RNA. Such vectors can be constructed by recombinant DNA technology methods standard in the art. Vectors can be plasmid, viral, or others known in the art, used for replication and expression in vertebrate cells. Expression of the antisense molecule, can be by any promoter known in the art to act in vertebrate, preferably human cells, such as those described elsewhere herein. Absolute complementarity of an antisense molecule, although preferred, is not required. A sequence complementary to at least a portion of an RNA encoding TLlA or DR3, means a sequence having sufficient complementarity to be able to hybridize with the RNA, forming a stable duplex; or triplex formation may be assayed. The ability to hybridize will depend on both the degree of complementarity and the length of the antisense nucleic acid. Generally, the larger the hybridizing nucleic acid, the more base mismatches it may contain and still form a stable duplex (or triplex as the case may be). One skilled in the art can ascertain a tolerable degree of mismatch by use of standard procedures to determine the melting point of the hybridized complex.
[00079] Oligonucleotides that are complementary to the 5' end of a messenger RNA, e.g., the 5' untranslated sequence up to and including the AUG initiation codon, should work most efficiently at inhibiting translation. However, sequences complementary to the 3' untranslated sequences of mRNAs have been shown to be effective at inhibiting translation of mRNAs as well. See generally, Wagner, R., Nature 372:333-335 (1994). Thus, oligonucleotides complementary to either the 5'- or 3'-non-translated, non-coding regions could be used in an antisense approach to inhibit translation of TLlA or DR3. Oligonucleotides complementary to the 5' untranslated region of the mRNA should include the complement of the AUG start codon. Antisense oligonucleotides complementary to mRNA coding regions are less efficient inhibitors of translation but could be used in accordance with the invention. Antisense nucleic acids should be at least six nucleotides in length, and are preferably oligonucleotides ranging from 6 to about 50 nucleotides in length. In specific aspects the oligonucleotide is at least 10 nucleotides, at least 17 nucleotides, at least 25 nucleotides or at least 50 nucleotides.
[00080] Polynucleotides for use the therapeutic methods disclosed herein can be DNA or RNA or chimeric mixtures or derivatives or modified versions thereof, single-stranded or double-stranded. The oligonucleotide can be modified at the base moiety, sugar moiety, or phosphate backbone, for example, to improve stability of the molecule, hybridization, etc. The oligonucleotide may include other appended groups such as peptides (e.g., for targeting host cell receptors in vivo), or agents facilitating transport across the cell membrane (see, e.g., Letsinger et al., Proc. Natl. Acad. Sci. USA. 86:6553-6556 (1989); Lemaitre et al., Proc. Natl. Acad. Sci. USA 84:648-652 (1987)); PCT Publication No. WO88/09810, published Dec. 15, 1988) or the blood-brain barrier (see, e.g., PCT Publication No. WO89/10134, published Apr. 25, 1988), hybridization-triggered cleavage agents. (See, e.g., Krol et al., BioTechniques 6:958-976 (1988)) or intercalating agents. (See, e.g., Zon, Pharm. Res. 5:539- 549(1988)). To this end, the oligonucleotide may be conjugated to another molecule, e.g., a peptide, hybridization triggered cross-linking agent, transport agent, hybridization-triggered cleavage agent, etc.
[00081] An antisense oligonucleotide for use in the therapeutic methods disclosed herein may comprise at least one modified base moiety which is selected from the group including, but not limited to, 5-fluorouracil, 5-bromouracil, 5-chlorouracil, 5-iodouracil, hypoxanthine, xantine, 4-acetylcytosine, 5-(carboxyhydroxylmethyl) uracil, 5- carboxymethylaminomethyl-2-thiouridine, 5-carboxymethylaminomethyluracil, dihydrouracil, beta-D-galactosylqueosine, inosine, N-6-isopentenyladenine, 1-methylguanine, 1-methylinosine, 2,2-dimethylguanine, 2-methyladenine, 2-methylguanine, 3-methylcytosine, 5-methylcytosine, N-6-adenine, 7-methylguanine, 5-methylaminomethyluracil, 5- methoxyaminomethyl-2-thiouracil, beta-D-mannosylqueosine,
5'methoxycarboxymethyluracil, 5-methoxyuracil, 2-methylthio-N-6-isopentenyladenine, uracil-5-oxyacetic acid (v), wybutoxosine, pseudouracil, queosine, 2-thiocytosine, 5-methyl- 2-thiouracil, 2-thiouracil, 4-thiouracil, 5-methyluracil, uracil-5-oxyacetic acid methylester, uracil-5-oxyacetic acid (v), 5-methyl-2-thiouracil, 3(3-amino-3-N-2-carboxypropyl) uracil, (acp3)w, and 2,6-diaminopurine.
[00082] An antisense oligonucleotide for use in the therapeutic methods disclosed herein may also comprise at least one modified sugar moiety selected from the group including, but not limited to, arabinose, 2-fluoroarabinose, xylulose, and hexose. [00083] In yet another embodiment, an antisense oligonucleotide for use in the therapeutic methods disclosed herein comprises at least one modified phosphate backbone selected from the group including, but not limited to, a phosphorothioate, a phosphorodithioate, a phosphoramidothioate, a phosphoramidate, a phosphordiamidate, a methylphosphonate, an alkyl phosphotriester, and a formacetal or analog thereof. In yet another embodiment, an antisense oligonucleotide for use in the therapeutic methods disclosed herein is an alpha-anomeric oligonucleotide. An alpha-anomeric oligonucleotide forms specific double-stranded hybrids with complementary RNA in which, contrary to the usual situation, the strands run parallel to each other (Gautier et al., Nucl. Acids Res. 15:6625-6641(1987)). The oligonucleotide is a 2'-.beta.-methylribonucleotide (Inoue et al., Nucl. Acids Res. 15:6131-6148(1987)), or a chimeric RNA-DNA analogue (Inoue et al., FEBS Lett. 215:327-330(1987)).
[00084] Polynucleotides may be synthesized by standard methods known in the art, e.g. by use of an automated DNA synthesizer (such as are commercially available from Biosearch, Applied Biosystems, etc.). As examples, phosphorothioate oligonucleotides may be synthesized by the method of Stein et al., Nucl. Acids Res. 16:3209 (1988), methylphosphonate oligonucleotides can be prepared by use of controlled pore glass polymer supports (Sarin et al., Proc. Natl. Acad. Sci. USA. 85:7448-7451(1988)), etc. Polynucleotide compositions for use in the therapeutic methods disclosed herein further include catalytic RNA, or a ribozyme (See, e.g., PCT International Publication WO 90/11364, published Oct. 4, 1990; Sarver et al., Science 247: 1222-1225 (1990). The use of hammerhead ribozymes is preferred. Hammerhead ribozymes cleave mRNAs at locations dictated by flanking regions that form complementary base pairs with the target mRNA. The sole requirement is that the target mRNA have the following sequence of two bases: 5'-UG-3'. The construction and production of hammerhead ribozymes is well known in the art and is described more fully in Haseloff and Gerlach, Nature 334:585-591 (1988). Preferably, the ribozyme is engineered so that the cleavage recognition site is located near the 5' end of the target mRNA; i.e., to increase efficiency and minimize the intracellular accumulation of non-functional mRNA transcripts.
Ribozymes
[00085] As in the antisense approach, ribozymes for use in the therapeutic methods disclosed herein can be composed of modified oligonucleotides (e.g. for improved stability, targeting, etc.) and may be delivered to cells which express TLlA or DR3 in vivo. DNA constructs encoding the ribozyme may be introduced into the cell in the same manner as described above for the introduction of antisense encoding DNA. A preferred method of delivery involves using a DNA construct "encoding" the ribozyme under the control of a strong constitutive promoter, such as, for example, pol III or pol II promoter, so that transfected cells will produce sufficient quantities of the ribozyme to destroy endogenous TLlA or DR3 messages and inhibit translation. Since ribozymes unlike antisense molecules, are catalytic, a lower intracellular concentration is required for efficiency.
Aptamers
[00086] Aptamers are short oligonucleotide sequences that can be used to recognize and specifically bind almost any molecule, including cell surface proteins. The systematic evolution of ligands by exponential enrichment (SELEX) process is powerful and can be used to readily identify such aptamers. Aptamers can be made for a wide range of proteins of importance for therapy and diagnostics, such as growth factors and cell surface antigens. These oligonucleotides bind their targets with similar affinities and specificities as antibodies do (See Ulrich (2006) Handb Exp Pharmacol. 173:305-26). Macugen® is an approved aptamer therapeutic which is also the first anti-angiogenic agent approved for a common eye disorder.
Pharmaceutical Compositions
[00087] An agent described herein can be formulated as a pharmaceutical composition.
Typically, a pharmaceutical composition includes a pharmaceutically acceptable carrier. As used herein, "pharmaceutically acceptable carrier" includes any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like that are physiologically compatible.
[00088] A "pharmaceutically acceptable salt" refers to a salt that retains the desired biological activity of the parent compound and does not impart any undesired toxicological effects (see e.g., Berge, S.M., et al. (1977) J. Pharm. Sci. 66:1-19). Examples of such salts include acid addition salts and base addition salts. Acid addition salts include those derived from nontoxic inorganic acids, such as hydrochloric, nitric, phosphoric, sulfuric, hydrobromic, hydroiodic, and the like, as well as from nontoxic organic acids such as aliphatic mono- and dicarboxylic acids, phenyl-substituted alkanoic acids, hydroxy alkanoic acids, aromatic acids, aliphatic and aromatic sulfonic acids and the like. Base addition salts include those derived from alkaline earth metals, such as sodium, potassium, magnesium, calcium and the like, as well as from nontoxic organic amines, such as N,N'- dibenzylethylenediamine, N-methylglucamine, chloroprocaine, choline, diethanolamine, ethylenediamine, procaine and the like.
[00089] Agents described herein can be formulated according to standard methods.
Pharmaceutical formulation is a well-established art, and is further described in Gennaro (ed.), Remington: The Science and Practice of Pharmacy, 20th ed., Lippincott, Williams & Wilkins (2000) (ISBN: 0683306472); Ansel et al., Pharmaceutical Dosage Forms and Drug Delivery Systems, 7th Ed.., Lippincott Williams & Wilkins Publishers (1999) (ISBN: 0683305727); and Kibbe (ed.), Handbook of Pharmaceutical Excipients American Pharmaceutical Association, 3rd ed. (2000) (ISBN: 091733096X). [00090] In one embodiment, an agent (e.g., an antibody) can be formulated with excipient materials, such as sodium chloride, sodium dibasic phosphate heptahydrate, sodium monobasic phosphate, and polysorbate 80. It can be provided, for example, in a buffered solution at a concentration of about 20 mg/ml and can be stored at 2-80C. Pharmaceutical compositions may also be in a variety of other forms. These include, for example, liquid, semi-solid and solid dosage forms, such as liquid solutions (e.g., injectable and infusible solutions), dispersions or suspensions, tablets, pills, powders, liposomes and suppositories. The preferred form can depend on the intended mode of administration and therapeutic application. Typically compositions for the agents described herein are in the form of injectable or infusible solutions.
[00091] Such compositions can be administered by a parenteral mode (e.g., intravenous, subcutaneous, intraperitoneal, or intramuscular injection). The phrases "parenteral administration" and "administered parenterally" as used herein mean modes of administration other than enteral and topical administration, usually by injection, and include, without limitation, intravenous, intramuscular, intraarterial, intrathecal, intracapsular, intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal, subcutaneous, subcuticular, intraarticular, subcapsular, subarachnoid, intraspinal, epidural and intrasternal injection and infusion.
[00092] Pharmaceutical compositions typically must be sterile and stable under the conditions of manufacture and storage. A pharmaceutical composition can also be tested to insure it meets regulatory and industry standards for administration. [00093] The composition can be formulated as a solution, microemulsion, dispersion, liposome, or other ordered structure suitable to high drug concentration. Sterile injectable solutions can be prepared by incorporating an agent described herein in the required amount in an appropriate solvent with one or a combination of ingredients enumerated above, as required, followed by filtered sterilization. Generally, dispersions are prepared by incorporating an agent described herein into a sterile vehicle that contains a basic dispersion medium and the required other ingredients from those enumerated above. In the case of sterile powders for the preparation of sterile injectable solutions, the preferred methods of preparation are vacuum drying and freeze-drying that yields a powder of an agent described herein plus any additional desired ingredient from a previously sterile-filtered solution thereof. The proper fluidity of a solution can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersion and by the use of surfactants. Prolonged absorption of injectable compositions can be brought about by including in the composition an agent that delays absorption, for example, monostearate salts and gelatin.
Administration
[00094] An agent described herein (e.g., an antibody) can be administered to a subject, e.g., a human subject, by a variety of methods. For many applications, the route of administration is one of: intravenous injection or infusion, subcutaneous injection, or intramuscular injection. An antibody can be administered as a fixed dose, or in a mg/kg dose, but preferably as a fixed dose. The antibody can be administered intravenously (IV), subcutaneously (SC) or intramuscularly (IM).
[00095] Dosage regimens are adjusted to provide the desired response, e.g., a therapeutic response. For example, doses in the range of 0.1-100 mg/kg, 1 mg/kg -100 mg/kg, 0.5-20 mg/kg, .1-10 mg/kg or 1- 10 mg/kg can be administered. A particular dose may be administered more than once, e.g., at periodic intervals over a period of time (a course of treatment). For example, the dose may be administered every 2 months, every 6 weeks, monthly, biweekly, weekly, or daily, as appropriate, over a period of time to encompass at least 2 doses, 3 doses, 5 doses, 10 doses, or more.
[00096] In certain embodiments, the active agent may be prepared with a carrier that will protect the compound against rapid release, such as a controlled release formulation, including implants, and microencapsulated delivery systems. Biodegradable, biocompatible polymers can be used, such as ethylene vinyl acetate, polyanhydrides, polyglycolic acid, collagen, polyorthoesters, and polylactic acid. Many methods for the preparation of such formulations are patented or generally known. See, e.g., Sustained and Controlled Release Drug Delivery Systems, J.R. Robinson, ed., Marcel Dekker, Inc., New York, 1978. [00097] Pharmaceutical compositions can be administered with medical devices. For example, pharmaceutical compositions can be administered with a needleless hypodermic injection device, such as the devices disclosed in US Pat. Nos. 5,399,163, 5,383,851, 5,312,335, 5,064,413, 4,941,880, 4,790,824, or 4,596,556. Examples of well-known implants and modules include: US Pat. No. 4,487,603, which discloses an implantable micro-infusion pump for dispensing medication at a controlled rate; US Pat. No. 4,486,194, which discloses a therapeutic device for administering medicants through the skin; US Pat. No. 4,447,233, which discloses a medication infusion pump for delivering medication at a precise infusion rate; US Pat. No. 4,447,224, which discloses a variable flow implantable infusion apparatus for continuous drug delivery; US Pat. No. 4,439,196, which discloses an osmotic drug delivery system having multi-chamber compartments; and US Pat. No. 4,475,196, which discloses an osmotic drug delivery system. Of course, other such implants, delivery systems, and modules are also known.
[00098] Dosage unit form or "fixed dose" as used herein refers to physically discrete units suited as unitary dosages for the subjects to be treated; each unit contains a predetermined quantity of active compound calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier and optionally in association with the other agent.
[00099] A pharmaceutical composition may include a "therapeutically effective amount" of an agent described herein. A therapeutically effective amount of an agent may also vary according to factors such as the disease state, age, sex, and weight of the individual, and the ability of the compound to elicit a desired response in the individual, e.g., amelioration of at least one disorder parameter, e.g., a multiple sclerosis parameter, or amelioration of at least one symptom of the disorder, e.g., multiple sclerosis. A therapeutically effective amount is also one in which any toxic or detrimental effects of the composition is outweighed by the therapeutically beneficial effects.
Multiple Sclerosis
[000100] Multiple sclerosis (MS) is a central nervous system disease that is characterized by inflammation and loss of myelin sheaths. MS may be identified by criteria establishing a diagnosis of clinically definite MS as defined by the workshop on the diagnosis of MS (Poser et al., Ann. Neurol. 13:227, 1983). Briefly, an individual with clinically definite MS has had two attacks and clinical evidence of either two lesions or clinical evidence of one lesion and paraclinical evidence of another, separate lesion. Definite MS may also be diagnosed by evidence of two attacks and oligoclonal bands of IgG in cerebrospinal fluid or by combination of an attack, clinical evidence of two lesions and oligoclonal band of IgG in cerebrospinal fluid. The McDonald criteria can also be used to diagnose MS. (McDonald et al., 2001, Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the Diagnosis of Multiple Sclerosis, Ann Neurol 50: 121-127). The McDonald criteria include the use of MRI evidence of CNS impairment over time to be used in diagnosis of MS, in the absence of multiple clinical attacks. Effective treatment of multiple sclerosis may be evaluated in several different ways. The following parameters can be used to gauge effectiveness of treatment. Two exemplary criteria include: EDSS (extended disability status scale), and appearance of exacerbations on MRI (magnetic resonance imaging). The EDSS is a means to grade clinical impairment due to MS (Kurtzke, Neurology 33:1444, 1983). Eight functional systems are evaluated for the type and severity of neurologic impairment. Briefly, prior to treatment, patients are evaluated for impairment in the following systems: pyramidal, cerebella, brainstem, sensory, bowel and bladder, visual, cerebral, and other. Follow-ups are conducted at defined intervals. The scale ranges from O (normal) to 10 (death due to MS). A decrease of one full step indicates an effective treatment (Kurtzke, Ann. Neurol. 36:573-79, 1994).
[000101] MRI can be used to measure active lesions using gadolinium-DTPA-enhanced imaging (McDonald et al. Ann. Neurol. 36:14, 1994) or the location and extent of lesions using T2 -weighted techniques. Briefly, baseline MRIs are obtained. The same imaging plane and patient position are used for each subsequent study. Positioning and imaging sequences can be chosen to maximize lesion detection and facilitate lesion tracing. The same positioning and imaging sequences can be used on subsequent studies. The presence, location and extent of MS lesions can be determined by radiologists. Areas of lesions can be outlined and summed slice by slice for total lesion area. Three analyses may be done: evidence of new lesions, rate of appearance of active lesions, percentage change in lesion area (Paty et al., Neurology 43:665, 1993). Improvement due to therapy can be established by a statistically significant improvement in an individual patient compared to baseline or in a treated group versus a placebo group.
[000102] Exemplary symptoms associated with multiple sclerosis, which may be improved with the methods described herein, include: optic neuritis, diplopia, nystagmus, ocular dysmetria, internuclear ophthalmoplegia, movement and sound phosphenes, afferent pupillary defect, paresis, monoparesis, paraparesis, hemiparesis, quadraparesis, plegia, paraplegia, hemiplegia, tetraplegia, quadraplegia, spasticity, dysarthria, muscle atrophy, spasms, cramps, hypotonia, clonus, myoclonus, myokymia, restless leg syndrome, footdrop, dysfunctional reflexes, paraesthesia, anaesthesia, neuralgia, neuropathic and neurogenic pain, l'hermitte's, proprioceptive dysfunction, trigeminal neuralgia, ataxia, intention tremor, dysmetria, vestibular ataxia, vertigo, speech ataxia, dystonia, dysdiadochokinesia, frequent micturation, bladder spasticity, flaccid bladder, detrusor-sphincter dyssynergia, erectile dysfunction, anorgasmy, frigidity, constipation, fecal urgency, fecal incontinence, depression, cognitive dysfunction, dementia, mood swings, emotional lability, euphoria, bipolar syndrome, anxiety, aphasia, dysphasia, fatigue, uhthoff s symptom, gastroesophageal reflux, and sleeping disorders.
[000103] Each case of MS displays one of several patterns of presentation and subsequent course. Most commonly, MS first manifests itself as a series of attacks followed by complete or partial remissions as symptoms mysteriously lessen, only to return later after a period of stability. This is called relapsing-remitting (RR) MS. Primary-progressive (PP) MS is characterized by a gradual clinical decline with no distinct remissions, although there may be temporary plateaus or minor relief from symptoms. Secondary-progressive (SP) MS begins with a relapsing-remitting course followed by a later primary-progressive course. Rarely, patients may have a progressive-relapsing (PR) course in which the disease takes a progressive path punctuated by acute attacks. PP, SP, and PR are sometimes lumped together and called chronic progressive MS.
Innate Immunity
[000104] Innate immunity is the body's first, generalized line of defense against pathogens, which includes the rapid inflammation of tissues that takes place shortly after injury or infection, hindering the entrance and spread of disease. Innate immune responses are effected by a wide array of effector cells, including phagocytic cells (neutrophils, monocytes, macrophages and dendritic cells), cells that release inflammatory mediators (basophils, mast cells, and eosinophils), and natural killer cells, which are especially adept at destroying cells infected with viruses. Another component of the innate immune system is the complement system. Complement proteins are normally inactive components of the blood. However, when activated by the recognition of a pathogen, the various proteins are activated to recruit inflammatory cells, coat pathogens to make them more easily phagocytosed, and to make destructive pores in the surfaces of pathogens. Other molecular components of innate responses include cytokines such as the interferons.
[000105] Methods described herein can be used to modulate innate immunity. Reducing the innate immunity response in a subject in need thereof, e.g., a subject exhibiting a pathogenically increased innate immunity response can be achieved by administering a TLlA blocking agent described herein. Increasing the innate immunity response in a subject in need thereof, e.g., a subject exhibiting an inadequate innate immunity response, can be achieved by administering a TLlA agonist agent, e.g., an anti-DR3 agonist antibody or other agonist described herein.
[000106] All references, including patent documents, disclosed herein are incorporated by reference in their entirety.
EXAMPLES
[000107] Example 1: Role of TLlA in an animal model of multiple sclerosis [000108] TLlA deficient mice were generated and were found to be phenotypically normal, with a unaltered distribution of immune cell subsets. We investigated the role of TLlA in MOG induced EAE, an animal model for multiple sclerosis (MS). We demonstrate that TLlA-/- animals have a lower incidence of EAE, a milder disease course and a lower level of inflammatory infiltrates in the CNS then wild type animals. TLlA deficient T cells have a comparable proliferative capacity but secrete lower levels of ThI cytokines, especially IFN and GM-CSF in response to stimulation with MOG peptide. TLlA deficient T cells from MOG stimulated cultures also display a reduced level of cell surface markers and adhesion molecules characteristic of the effector T cell phenotype. These observations indicate that TLlA plays a role in the generation of MOG specific effector T cells and/or their ability to infiltrate and persist in the CNS and is a therapeutic target for treating MS. Generation of TLlA deficient mice
[000109] TLlA deficient mice were generated by replacing exon 4 of the TLlA (Tnfs/15) locus with a neomycin cassette (FIG. IA). Exon 4 encodes amino acids 103-251 of TLlA encompassing the TNF-homology domain, essential for TLlA function. Lack of TLlA expression was confirmed by RT-PCR of kidney tissues (FIG. IB) which contain high levels of TLlA mRNA. TLlA deficient mice were phenotypically normal and similar immune cell numbers and proportions were observed in the lymph nodes, spleen, thymus and bone marrow. Surface marker phenotype of lymph node cells is shown; no differences in marker expression were observed between TLlA"7" and WT animals (not shown). Decreased severity of EAE in TLlA"7' animals
[000110] To determine the role of TLlA in the pathogenesis of MOG induced EAE, TLl A"7" mice and WT controls were immunized s.c. with 200 μg of MOG3S-S5 peptide and given 50 ng of pertussis toxin i.p. on the day of immunization. In four independent experiments TLlA7" and WT animals exhibited similar timing of disease onset. However TLlA deficient mice consistently showed a significantly reduced disease severity as manifested by a lower maximal disease score as well as lower scores throughout the course of the disease (FIG. 2). Disease incidence was similar in the two groups, with a consistent though not statistically significant, trend towards lower incidence in the TLlA"7" mice. TLl A"7" mice show a reduced level of T cell infiltration into the CNS [000111] Histological examination of the spinal cords was performed to determine whether the difference in clinical symptoms between TLlA"'" and WT mice was reflected in the degree of inflammatory infiltration and demyelination in the CNS. TLlA"7' mice exhibited fewer mononuclear infiltrates and demyelination foci than wild-type control animals at day 27 post-immunization. These results indicate that the observed reduced clinical disease in the KO animals is likely due to decreased CNS inflammation and damage. Since TLlA may be involved in the generation and/or function of MOG-specific T cells during the course of EAE, the levels of T-cell infiltration were quantified by image analysis of anti-CD3 staining. TL1A";' animals had fewer CD3 positive cells per spinal cord cross- section then wild type counterparts.
[000112] Inability to survive in the CNS is a possible mechanism underlying the reduction in T cell number in TL1A'A spinal cords. TUNEL and anti-activated caspase-3 staining were carried out to assess the extent of apoptosis in TLl A";" and wild type CNS. The level of apoptosis in the wild type spinal cord was low on days 21 or 27 post-immunization. Furthermore, no increase in apoptotic cells was observed in the KO spinal cords (not shown), suggesting that T cell apoptosis is unlikely to be a major mechanism behind the observed reduction in T cell infiltration of TLlA deficient CNS.
[000113] To examine whether the reduction in T cell frequency was manifest early in disease, levels of CD4+ T cells in the CNS (spinal cord and cerebellum) were assessed by flow cytometry. CD4+ T cells start accumulating in the CNS of WT mice one or two days prior to the onset of clinical symptoms and their levels peak at day 5-7 after disease onset. We found that the percentage of CD45+CD4+ cells in the TLl A''' CNS was consistently reduced as compared to WT CNS over the course of the study (not shown). Absolute numbers of CD45+CD4+cell were also examined and showed a similar trend (not shown). These observations indicate that TLlA deficiency reduces and/or delays CD4 T cell infiltration into the CNS. The levels of CD45+CD1 Ib+ cells in the CNS were comparable in TLlA deficient and WT animals (data not shown). TLlA is not required for antigen-specific T-cell proliferation
[000114] TLlA expression on antigen presenting cells, such as macrophages has been suggested. Additionally, human recombinant soluble TLlA potentiates T cell responses under the conditions of suboptimal polyclonal stimulation in vitro. To examine whether the reduced clinical severity and T cell infiltration in TLl A'1' mice is due to impaired antigen- specific T cell expansion, we used two independent systems. The role of TLl A in priming of naϊve T cells was addressed using the OT-2 ovalbumin (OVA) specific TCR-transgenic system. CFSE-labeled naϊve CD4+ T cells from OT-2 transgenic mice were transferred into TLl A"A or WT hosts. Twenty-four hours later 3 mg OVA protein and 5 ug LPS were administered by i.p. injection. Proliferation of OT-2 T cells in the spleens of recipient animals was examined 48 hrs subsequently. The pattern of CFSE dilution was independent of the genotype of the recipient animal, demonstrating that TLlA in not required for the priming of CD4+ T cells in this system.
[000115] To further examine whether antigen-specific T cells can proliferate in the TLlA knock-out (where both the T cells and the APCs lack TLlA) we studied the MOG- specific recall response. TLlA"'" and WT animals were immunized with MOG35.55 in CFA and in vitro T cell proliferation was examined on day 10. T cell proliferation in response to MOG3S-S5 or anti-CD3 stimulation was comparable in lymph node cultures from TLl A'1' and WT mice. The results from these two experimental systems indicate that TLlA does not play a significant role in CD4 T cell proliferation during initial priming or subsequent expansion of antigen-activated T cells.
TLlA deficient T cells have an impaired cytokine response
[000116] An alteration in the pattern on cytokines secreted by CD4+ T cells in TLlA"'' mice may also lead to the observed amelioration of EAE. In the human system, treatment with soluble hTLIA has been reported to alter the pattern of cytokines secreted by activated T cells. To determine whether the absence of TLlA alters the T cell cytokine profile, MOG- specific responses were examined. TL1A";" and WT animals were immunized as above and levels of secreted cytokine from lymph node cultures were measured after 72 hrs. Consistent with the comparable proliferative response, the levels of T cell survival cytokine IL-2 were unaffected (data not shown). The levels of Th2-type cytokines IL-4 and EL-5 secreted in response to MOG3S-5S or anti-CD3 stimulation were comparable (FIG. 3D, 3E). Levels of IL- 10, IL- 13 and EL-6 were similarly unaffected (data not shown). Interestingly, TLlA"'" lymph node cultures secreted significantly lower levels of IFNγ, TNFα and GM-CSF in response to MOG stimulation as well as a lower level of IFNγ in response to anti-CD3 stimulation (FIG. 3A, B and C). These observations suggest that TLlA deficiency impairs differentiation into ThI cytokine producing effector cells, but does not appear to skew the response towards a Th2 phenotype.
T cells from TLlA deficient animals display at altered surface marker phenotype. [000117] In addition to cytokine production, differentiation into effector T cells is reflected by a coordinated change in the pattern of surface molecules after antigen stimulation; the acquired pattern indicative of T cell activation and altered migratory capacity. Several of these molecules function in the homing of effector T cells out of the primary lymphoid organs and into the target tissue and may affect the ability to TLlA deficient T cells to infiltrate into the CNS. To examine the pattern of activation marker expression, TLlA"'" and WT animals were immunized with MOG35-5S peptide in CFA and draining LN cells cultured in the presence of MOG peptide, anti-CD3 or media alone and analyzed by FACS. Forward/side scatter profiles of the CD4+ cells), with gating on the larger CD4+ cells were analysed of the activated portion of the population. It should be noted that this population is not limited to MOG-specific activated T cells and likely contains bystander activated T cells as well. TLl A";" animals showed a small but significant decrease (mean value of 24.8+1.5% WT vs. 21.8+1.03% KO for cohorts of 5 animals) in the number of activated T cells on the basis of cell size recovered after culture.
[000118] Analysis of the activated CD4+ T cell population revealed an alteration in the surface marker profile in TLlA-/- as compared to WT cultures. Most notably, TLlA deficient cultures contained a larger percentage of cells expressing high levels of CD62L, the adhesion molecule present on naϊve, lymph node resident T cells, which is downregulated with activation. TLlA-/- cultures exhibited a lower percentage of cells expressing E-selectin ligand, while the level of α4-integrin positive cells was somewhat increased in the KO. Expression of three other adhesion molecules CD44, LFA-I and P-selectin ligand was unaffected. TLlA-/- cultures also showed a significant reduction as compared to WT in the percentage of cells expressing CD25 though not in their MFI values, as well as reduction in both the percent positive and MFI values for the early activation marker CD69. The expression of two co-stimulatory TNF family receptors was also examined. While the percentage of cells positive for OX40 was slightly but significantly lower in the absence of TLlA with an accompanying reduction in MFI, the pattern of CD27 expression was markedly altered, with higher levels observed on TLlA-/- cells, resembling a naϊve phenotype. The overall alteration in surface marker profile indicates that antigen-activated TLlA-/- T cells do not acquire the full effector phenotype.
[000119] This study establishes a significant contribution of TLlA to the pathogenesis MOG-induced EAE and indicates that TLlA plays an important role in the acquisition of effector functions by T cells as evidenced by the altered pattern of secreted cytokines and surface markers.
[000120] Example 2: Role of TLlA in an animal model of UC and innate immunity [000121] TLlA deficient mice were generated and were found to be phenotypically normal; with an unaltered distribution of immune cell subsets and apparently normal organ histology including colon. We investigated the role of TLlA in the DSS (dextran sodium sulfate) model of ulcerative colitis (UC) (see Dieleman et al. (1998) CUn. Exp. Immunol 14:385-391). In this model, the colon is damaged by DSS inhibition of colonic epithelial proliferation, resulting in colonic ulcers, loss of the epithelial cell barrier and microbial activation of resident lamina propria immune cells and inflammation.
[000122] TLlA-/- animals were found to have a reduced severity of acute DSS colitis as compared to wildtype animals, as measured by reduced weight loss and clinical score (FIG. 4), as well as reduced histological score including ulcers, infiltration, goblet cell loss and crypt changes (FIG. 5). Immunohistochemical staining showed that the infiltrates associated with the ulcers included F4/80+ macrophages but not T lymphocytes (not shown). These data reveal a role for the TLlA pathway in the pathogenesis of UC and suggest that blocking TLlA can be useful to treat UC.
[000123] The ability to induce DSS colitis in RAG deficient mice which lack lymphocytes underscores the primary role of innate immune cell types and their release of proinflammatory cytokines, in the pathogenesis of this colitis. The data thus reveal a role for TLlA in promoting the innate inflammatory response. A ThI or mixed Thl/2 response may occur in more chronic stages of the inflammation.

Claims

We claim:
1. A method of treating multiple sclerosis in a subject, the method comprising administering to the subject a TLlA blocking agent selected from the group consisting of: (a) an anti-TLl A blocking antibody or antigen binding fragment thereof, (b) an anti-DR3 blocking antibody or antigen binding fragment thereof, (c) a soluble decoy DR3 polypeptide, (d) an anti-TLIA aptamer, (e) an anti-DR3 aptamer, (f) an RNAi inhibitor of TLlA, and (g) an RNAi inhibitor of DR3.
2. The method of claim 1, wherein the agent is an anti-TLIA blocking antibody or antigen binding fragment thereof.
3. The method of claim 1, wherein the agent is an anti-DR3 blocking antibody or antigen binding fragment thereof.
4. The method of claim 1, wherein the agent is a soluble decoy DR3 polypeptide.
5. The method of claim 2 or 3, wherein the agent is an antibody that is a full length IgG.
6. The method of claim 2 or 3, wherein the agent is an antigen-binding fragment.
7. The method of claim 2 or 3, wherein the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment.
8. The method of claim 2 or 3, wherein the antibody is a human, humanized or humaneered antibody.
9. The method of claim 4, wherein the polypeptide comprises a sequence which is at least 95% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
10. The method of claim 4, wherein the polypeptide comprises a sequence which is at least 96% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
11. The method of claim 4, wherein the polypeptide comprises a sequence which is at least 97% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
12. The method of claim 4, wherein the polypeptide comprises a sequence which is at least 98% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
13. The method of claim 4, wherein the polypeptide comprises amino acids 40-191 of SEQ ID NO:2 and binds TLlA.
14. The method of claim 4, 9, 10, 11, 12 or 13, wherein the polypeptide is fused to an Fc region of an Ig.
15. The method of claim 1 , 2, 3 or 4, wherein the agent is administered in combination with a second therapeutic agent for multiple sclerosis.
16. The method of claim 15, wherein the second therapeutic agent is selected from the group consisting of: beta-interferon, Copaxone, and natalizumab.
17. The method of claim 2, 3 or 4, wherein the agent is administered at a dosage between 0.1-100 mg/kg.
18. The method of claim 2, 3 or 4, wherein the agent is administered via an intravenous, subcutaneous, intrathecal or intramuscular route.
19. A method of treating ulcerative colitis (UC) in a subject, the method comprising administering to the subject a TLlA blocking agent selected from the group consisting of: (a) an anti-TLl A blocking antibody or antigen binding fragment thereof, (b) an anti-DR3 blocking antibody or antigen binding fragment thereof, (c) a soluble decoy DR3 polypeptide, (d) an anti-TLl A aptamer, (e) an anti-DR3 aptamer, (f) an RNAi inhibitor of TLlA, and (g) an RNAi inhibitor of DR3.
20. The method of claim 19, wherein the agent is an anti-TLl A blocking antibody or antigen binding fragment thereof.
21. The method of claim 19, wherein the agent is an anti-DR3 blocking antibody or antigen binding fragment thereof.
22. The method of claim 19, wherein the agent is a soluble decoy DR3 polypeptide.
23. The method of claim 20 or 21, wherein the agent is an antibody that is a full length IgG.
24. The method of claim 20 or 21 , wherein the' agent is an antigen-binding fragment.
25. The method of claim 20 or 21, wherein the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment.
26. The method of claim 20 or 21, wherein the antibody is a human, humanized or humaneered antibody.
27. The method of claim 22, wherein the polypeptide comprises a sequence which is at least 95% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
28. The method of claim 22, wherein the polypeptide comprises a sequence which is at least 96% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
29. The method of claim 22, wherein the polypeptide comprises a sequence which is at least 97% identical to amino acids 25-206 of SEQ ID NO.2 and binds TLlA.
30. The method of claim 22, wherein the polypeptide comprises a sequence which is at least 98% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
31. The method of claim 22, wherein the polypeptide comprises amino acids 40-191 of SEQ ED NO:2 and binds TLlA.
32. The method of claim 22, 27, 28, 29, 30 or 31 , wherein the polypeptide is fused to an Fc region of an Ig.
33. The method of claim 19, 20, 21 or 22, wherein the agent is administered in combination with a second therapeutic agent for UC.
34. The method of claim 33, wherein the second therapeutic agent is selected from the group consisting of: corticosteroids, aminosalicylates, and immunosuppressants.
35. The method of claim 20, 21 or 22, wherein the agent is administered at a dosage between 0.1-100 mg/kg.
36. The method of claim 20, 21 or 22, wherein the agent is administered via an intravenous, subcutaneous, intrathecal or intramuscular route.
37. A method of reducing an innate immunity response in a subject in need thereof, the method comprising administering, to the subject, an agent that blocks TLlA signaling, wherein the agent is selected from the group consisting of: (a) an anti-TLIA blocking antibody or antigen binding fragment thereof, (b) an anti-DR3 blocking antibody or antigen binding fragment thereof, (c) a soluble decoy DR3 polypeptide, (d) an anti-TLIA aptamer, (e) an anti-DR3 aptamer, (f) an RNAi inhibitor of TLlA, and (g) an RNAi inhibitor of DR3.
38. The method of claim 37, wherein the agent is an anti-TLIA blocking antibody or antigen binding fragment thereof.
39. The method of claim 37, wherein the agent is an anti-DR3 blocking antibody or antigen binding fragment thereof.
40. The method of claim 37, wherein the agent is a soluble decoy DR3 polypeptide.
41. The method of claim 38 or 39, wherein the antibody is a full length IgG.
42. The method of claim 38 or 39, wherein the agent is an antigen-binding fragment.
43. The method of claim 38 or 39, wherein the agent is a single chain antibody, Fab fragment, F(ab')2 fragment, Fd fragment, Fv fragment, or dAb fragment.
44. The method of claim 38 or 39, wherein the antibody is a human, humanized or humaneered antibody.
45. The method of claim 40, wherein the polypeptide comprises a sequence which is at least 95% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
46. The method of claim 40, wherein the polypeptide comprises a sequence which is at least 96% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
47. The method of claim 40, wherein the polypeptide comprises a sequence which is at least 97% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
48. The method of claim 40, wherein the polypeptide comprises a sequence which is at least 98% identical to amino acids 25-206 of SEQ ID NO:2 and binds TLlA.
49. The method of claim 40, wherein the polypeptide comprises amino acids 40-191 of SEQ ID NO:2 and binds TLlA.
50. The method of claim 40, 45, 46, 47, 48 or 49, wherein the polypeptide is fused to an Fc region of an Ig.
51. The method of claim 38, 39 or 40, wherein the agent is administered at a dosage between 0.1-100 mg/kg.
52. The method of claim 38, 39 or 40, wherein the agent is administered via an intravenous, subcutaneous, intrathecal or intramuscular route.
53. The method of claim 37, wherein the subject has an inflammatory disease or autoimmune disease.
54. The method of claim 37, further comprising evaluating the subject for a marker of innate immunity response.
55. A method of enhancing an innate immunity response in a subject in need thereof, the method comprising administering, to the subject, an agent that increases TLlA signaling.
56. The method of claim 55, wherein the agent is selected from the group consisting of: a soluble TLlA polypeptide, an anti-TLIA agonist antibody, and an anti-DR3 agonist antibody.
57. The method of claim 55, wherein the agent is a soluble TLlA polypeptide.
58. The method of claim 57, wherein the polypeptide comprises a sequence which is at least 95% identical to amino acids 103-251 of SEQ ID NO: 1.
59. The method of claim 57, wherein the polypeptide comprises a sequence which is at least 96% identical to amino acids 103-251 of SEQ ID NO: 1.
60. The method of claim 57, wherein the polypeptide comprises a sequence which is at least 97% identical to amino acids 103-251 of SEQ ID NO:1.
61. The method of claim 57, wherein the polypeptide comprises a sequence which is at least 98% identical to amino acids 103-251 of SEQ DD NO:1.
62. The method of claim 57 or 58, wherein the polypeptide is fused to a heterologous polypeptide.
63. The method of claim 62, wherein the heterologous polypeptide is an FC region of an Ig-
64. The method of claim 57 or 58, wherein the polypeptide is coupled to a non- polypeptide moiety.
65. The method of claim 64, wherein the non-polypeptide moiety is a chemical label or a lipid.
66. The method of claim 56 or 57, wherein the agent is administered at a dosage between 0.1-100 mg/kg.
67. The method of claim 55, 56, 57 or 58, wherein the agent is administered via an intravenous, subcutaneous, intrathecal or intramuscular route.
68. The method of claim 55, wherein the subject has a susceptibility to cancer.
69. The method of claim 55, wherein the subject has a family history of cancer.
70. The method of claim 55, wherein the subject has a genetic marker for cancer susceptibility.
71. The method of claim 55, wherein the subject has cancer.
72. The method of claim 55, wherein the subject has an opportunistic infection.
73. The method of claim 55, wherein the subject is exposed to radiation and/or one or more chemotherapeutic antiproliferative drugs.
74. The method of claim 55, wherein the subject has chronic respiratory disease or upper airways disease or chronic eye-ear-nose or throat infections.
75. The method of claim 55, wherein the subject is immunocompromised.
76. The method of claim 55, further comprising evaluating the subject for a marker of innate immunity response.
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