WO2012023623A2 - Agent pour le traitement du syndrome de hunter - Google Patents
Agent pour le traitement du syndrome de hunter Download PDFInfo
- Publication number
- WO2012023623A2 WO2012023623A2 PCT/JP2011/068815 JP2011068815W WO2012023623A2 WO 2012023623 A2 WO2012023623 A2 WO 2012023623A2 JP 2011068815 W JP2011068815 W JP 2011068815W WO 2012023623 A2 WO2012023623 A2 WO 2012023623A2
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- brain
- administered
- hi2s
- sulfatase
- therapeutic agent
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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
- A61K38/43—Enzymes; Proenzymes; Derivatives thereof
- A61K38/46—Hydrolases (3)
- A61K38/465—Hydrolases (3) acting on ester bonds (3.1), e.g. lipases, ribonucleases
-
- 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
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P3/00—Drugs for disorders of the metabolism
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
-
- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12Y—ENZYMES
- C12Y301/00—Hydrolases acting on ester bonds (3.1)
- C12Y301/06—Sulfuric ester hydrolases (3.1.6)
- C12Y301/06013—Iduronate-2-sulfatase (3.1.6.13)
Definitions
- the present invention relates to a therapeutic agent for Hunter syndrome, and more particularly to a therapeutic agent containing human iduronic acid 2-sulfatase for preventing progression of brain damage associated with Hunter syndrome.
- Hunter syndrome is a genetic disease caused by a gene mutation of iduronic acid 2-sulfatase (I2S), and is a kind of lysosomal disease.
- I2S has an activity of hydrolyzing the sulfate ester bond of heparan sulfate and dermatan sulfate belonging to glycosaminoglycan.
- mutations in the enzyme cause abnormal metabolism of the substrates heparan sulfate and dermatan sulfate, and these incomplete degradation products accumulate in systemic tissues, resulting in skeletal abnormalities and cardiac enlargement.
- Hunter syndrome includes a severe type (IIA type) with a relatively short clinical course and a rapid progression, and a mild type (IIB type) with a very long course.
- the two types, severe (type IIA) and mild (type IIB) are caused by differences in the mutation type of the I2S gene.
- the former has a poor prognosis and dies by the age of 15-16. It was already known in the 1970s that the activity of I2S was low in Hunter syndrome patients, and it was expected that this disease was due to a congenital deficiency of I2S.
- Non-patent Document 1 The existence of the I2S gene on the X chromosome has long been predicted because the disease is inherited, but in 1990, a group of Hopwood et al. Of Women's and Children's Hospital in Australia purchased the enzyme. We succeeded in isolating the encoded gene, and proved again that the mutation of this enzyme is the cause of Hunter's syndrome (Non-patent Document 1). As mentioned above, since Hunter syndrome was expected to be caused by I2S deficiency, therapy by supplementation of this enzyme for Hunter syndrome patients was started in the 1970s, and transplantation of macrophages expressing this enzyme was started. (Non-Patent Document 2) and supplementation of this enzyme by instillation of normal serum (Non-Patent Document 3) have been attempted for patients.
- the dosage is 0.5 mg / kg body weight once a week by intravenous infusion. It has become. Hunter syndrome may be associated with intellectual disability, and severe brain disorders such as brain atrophy and hydrocephalus may be observed.
- I2S which is a high molecular weight protein, can hardly reach the brain due to the blood-brain barrier when administered intravenously. Therefore, the intravenous administration of I2S has a problem that an effective treatment for a brain disorder of a Hunter syndrome patient cannot be expected.
- Patent Document 1 A method of administering human ⁇ -L-iduronidase into the medullary cavity of a patient with Hurler's syndrome (mucopolysaccharidosis type I) in order to cope with a brain disorder associated with lysosomal disease (Patent Document 1), a patient with Niemann-Pick disease A method of administering human acid sphingomyelinase into the ventricle (Patent Document 2) has been reported. However, there are no reports on specific ways of dealing with brain damage in Hunter syndrome patients. Special table 2007-504166 Special table 2009-525963 Wilson PJ et al. Proc Natl Acad Sci USA (1990) 87, 8531-5. Dean MF et al. , J Clin Invest. (1979) 63, 138-45 Brown FR 3rd et al. , Am J Med Genet. (1982) 13, 309-18
- an object of the present invention is to provide a method of supplying human iduronic acid 2-sulfatase (hI2S) into a patient's brain in order to prevent progression of brain damage in a patient with Hunter syndrome.
- hI2S human iduronic acid 2-sulfatase
- the present inventors have found that by administering hI2S into the ventricle of the knockout mouse lacking the I2S gene, the I2S activity in the brain can be increased and maintained. completed. That is, the present invention provides the following.
- a therapeutic agent for Hunter syndrome comprising human iduronic acid 2-sulfatase as an active ingredient, which is administered into the human ventricle.
- the therapeutic agent according to (1) above wherein the Hunter syndrome is accompanied by a brain disorder.
- the therapeutic agent according to (1) or (2) which is administered using an indwelling cannula, an indwelling catheter, or an indwelling needle.
- I2S activity in the brain can be increased and maintained, and heparan sulfate and dermatan sulfate accumulated in the brain can be decomposed and eliminated.
- human iduronic acid 2-sulfatase means not only wild-type human iduronic acid 2-sulfatase but also one or more amino acids constituting human iduronic acid 2-sulfatase as long as it has biological activity. Also included are analogs of human iduronic acid 2-sulfatase with residues substituted, deleted, or inserted. hI2S is also synonymous. Human iduronic acid 2-sulfatase (hI2S) can be produced using genetic recombination techniques. For example, hI2S is produced in a culture solution or in a host cell by incorporating a gene encoding hI2S into an expression vector and culturing the transformed host cell.
- a patient with Hunter syndrome to be treated is not particularly limited, but is particularly a patient with a brain disorder. Brain disorders include intellectual disability, brain atrophy, hydrocephalus and the like.
- the scalp is incised, then a hole is made in the skull, and a long injection needle, such as a catalan needle, is inserted into the hole and administered into the ventricle.
- a long injection needle such as a catalan needle
- an indwelling needle, a cannula for indwelling, or an indwelling catheter can be installed in the hole, and can be administered into the ventricle at a desired timing through them.
- the amount of human iduronic acid 2-sulfatase administered into the ventricle is preferably 10 to 800 ⁇ g / kg body weight, more preferably 100 to 800 ⁇ g / kg body weight, still more preferably 100 to 600 ⁇ g / kg. It is weight.
- the administration interval is preferably every 3 weeks to 2 months, more preferably 3 weeks.
- the dosing interval can be adjusted as appropriate once every 2 weeks to 6 months according to the patient's symptoms.
- the therapeutic agent of the present invention can be supplied to a medical institution as a lyophilized product or as an aqueous liquid.
- human iduronic acid 2-sulfatase dissolved in a solution containing a stabilizer, a buffer, and an isotonic agent can be supplied as a preparation sealed in a vial or a syringe.
- a preparation enclosed in a syringe is generally called a prefilled syringe preparation.
- the concentration of human iduronic acid 2-sulfatase contained in the aqueous solution is preferably 1 to 4 mg / mL, more preferably 2 to 3 mg / mL.
- the stabilizer contained in the aqueous liquid is not particularly limited as long as it is pharmaceutically acceptable, but a nonionic surfactant can be preferably used.
- a nonionic surfactant polysorbate, poloxamer, etc. can be used alone or in combination.
- Polysorbate 20 and polysorbate 80 are particularly suitable as the polysorbate, and poloxamer 188 (polyoxyethylene (160) polyoxypropylene (30) glycol) is particularly suitable as the poloxamer.
- the concentration of the nonionic surfactant contained in the aqueous liquid is preferably 0.01 to 1 mg / mL, more preferably 0.01 to 0.5 mg / mL, More preferably, it is 0.5 mg / mL.
- the buffer contained in the aqueous liquid is not particularly limited as long as it is pharmaceutically acceptable, but a phosphate buffer is preferable, and a sodium phosphate buffer is particularly preferable.
- the concentration of sodium phosphate is preferably 0.01 to 0.04M.
- the pH of the aqueous liquid preparation adjusted with a buffer is preferably 5.5 to 7.2.
- the isotonic agent contained in the aqueous solution is not particularly limited as long as it is pharmaceutically acceptable, but sodium chloride and mannitol can be used preferably alone or in combination.
- the therapeutic agent of the present invention can improve convenience in a medical institution by distributing it as a kit preparation packaged together with a dedicated injection needle used for its administration, for example, a cattelan needle.
- hI2S was prepared by referring to a well-known method for culturing CHO cells transformed with the hI2S gene (US Pat. No. 5,932,211).
- a 21-week-old male mouse was placed in an anesthesia bottle filled with diethyl ether and anesthetized by inhalation, and then 200-300 ⁇ L of Nembutal injection solution (Dainippon Pharmaceutical) diluted 10-fold was added to the mouse using a 30-gauge needle. It was administered subcutaneously and completely anesthetized.
- a brain fixing tool which is an accessory member of the brain stereotaxic apparatus (Narumo Scientific Instruments Laboratory, Type SR-5)
- the mouse was fixed to the brain stereotaxic apparatus.
- the hair of the mouse head was cut off with a scissors to expose the scalp.
- the scalp was disinfected with isodine, and in the presence of an enlarged loupe, the scalp was incised with a scissors to expose the intersection of coronary and sagittal sutures (Bregma).
- a hole with a diameter of 0.5 mm was drilled in the skull at a position 3 mm deep and 2 mm left from the pegma using a catalan needle 18G (Terumo Corporation), and this was used as an access point.
- 20 ⁇ g (67 ⁇ L) of hI2S was administered to a position 3 mm deep from the access point over about 30 seconds.
- a microsyringe for Ito microsyringe 10 ⁇ L: model number ITS MS-NG10, Ito Seisakusho Co., Ltd.
- an injection needle for compatible needle Ito microsyringe 30G 20 mm 22 degrees, Ito Seisakusho Co., Ltd.
- the needle was fixed for 1 minute, then slowly pulled out 1.5 mm, where it was fixed for another 1 minute, and then slowly and completely removed.
- 6.7 ⁇ L of physiological saline was administered to the control group in the same manner. After disinfecting the incision with isodine, the scalp was pasted together with an instantaneous adhesive (Aron Alpha A, Daiichi Sankyo).
- mice Prior to administration of hI2S, mice were weighed and the dose of hI2S per kg body weight was calculated.
- the dose of hI2S was the average of 3 animals in the hI2S administration group, the first time (at 21 weeks of age) 698.7 ⁇ g / kg body weight, the second time (at 24 weeks of age) 661.2 ⁇ g / kg body weight, the third time ( 27 weeks old) was 681.8 ⁇ g / kg body weight, and the fourth time (30 weeks old) was 6452 ⁇ g / kg body weight.
- mice Three weeks after the final administration (33 weeks of age), the mouse was dissected and the tissue was removed. The mouse was placed in an anesthesia bottle filled with diethyl ether and inhaled and anesthetized. Then, the chest of the mouse was incised to cut the right atrial appendage, and then a winged needle (Terumo winged needle 27G X 1/2, Terumo) was inserted into the right ventricle. ) And 1 XD-PBS (-) (Wako Pure Chemical Industries) was slowly refluxed using a 50 mL syringe (Terumo syringe 50 mL, Terumo).
- the brain, eyes, lungs, heart, liver, kidney, spleen and testis were removed. After removal, the brain was divided into anterior cerebrum, posterior cerebrum and cerebellum. Each tissue was weighed and then enclosed in a sample tube and stored in liquid nitrogen. [Measurement of human iduronic acid 2-sulfatase activity] Frozen organs were thawed, 20 mg each was weighed and placed in a 1.5 mL sampling tube.
- the amount of liquid containing 15 ⁇ g of protein was calculated for each supernatant, and the amount of liquid was collected in 0.2 mL tubes.
- a substrate solution (1.25 mM 4-methylbelliferyl- ⁇ -L-iduronide-2-sulfate (MU- ⁇ Idu-2S, Moscerdam Substrates)
- a substrate buffer 0.1 M Na-acetate / acetic acid buffer, 10 mM.
- Pi / Ci Bafa (0.4M Na 2 HPO 4, 0.2M C 6 H 5 Na 3 O 7 .2H 2 O, 0.02% (w / v) NaN 3 (pH4.5)) and 40 ⁇ L is added Further, 10 ⁇ L of LEBT (bovine testis-derived purified lysosomal enzyme, Moscerdam Substrates) was added and stirred, and the mixture was allowed to stand at 37 ° C. for 24 hours for reaction (second reaction). After standing, the entire amount of the reaction solution was transferred to an RIA tube (RIA tube 3, Hirose Sangyo), and a stop buffer (0.5 M NaHCO 3 / Na 2 CO 3 buffer, 0.025% Triton X-100 (pH 10) was added thereto.
- LEBT bovine testis-derived purified lysosomal enzyme, Moscerdam Substrates
- the hI2S administration group When comparing the iduronic acid 2-sulfatase activity in the brain between the hI2S administration group and the control group administered with physiological saline, the hI2S administration group is about 60 times more in the cerebellum than the control group, and about 500 in the forebrain and hindbrain. The activity was ⁇ 1000 times. Since the measurement of enzyme activity is performed 3 weeks after the last administration of the enzyme, this result shows that hI2S administered into the ventricle continues its enzyme activity in the brain for more than 3 weeks after administration. Show.
- the enzyme activity of can be maintained equal to or higher than that of the wild type.
- the administration schedule of hI2S administered every 3 weeks in the amount of 600 to 700 ⁇ g / kg body weight per application is also applied to humans as it is it can.
- the enzyme activity in the forebrain and hindbrain is three times that of the wild type in the hI2S administration group, and it is sufficient that the enzyme activity in the brain rises to the wild type level in order for hI2S to exert a therapeutic effect. In view of this, even if the dose per administration is about 10 to 600 ⁇ g / kg body weight, a sufficient therapeutic effect can be obtained.
- the administration interval can be 3 weeks or more, for example, every 1 to 2 months.
- the enzyme activity of the hI2S administration group is approximately 0.7 to 1.7 times that of the wild type, and by administering hI2S into the ventricle , HI2S was found to be efficiently taken up by other organs. This indicates that the intraventricular administration of hI2S is extremely excellent as a means for systemically administering hI2S to patients with Hunter syndrome.
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Abstract
La présente invention concerne un procédé pour distribuer de l'iduronate-2-sulfatase humaine dans le cerveau d'un patient afin de prévenir la progression d'une lésion cérébrale chez des patients ayant le syndrome de Hunter. Le procédé est caractérisé en ce qu'un agent de traitement contenant de l'iduronate-2-sulfatase humaine est administré dans le cerveau d'un patient ayant le syndrome de Hunter.
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Cited By (10)
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EP2593131A2 (fr) * | 2010-06-25 | 2013-05-22 | Shire Human Genetic Therapies, Inc. | Procédés et compositions pour la délivrance au snc d'iduronate-2-sulfatase |
US9220677B2 (en) | 2010-06-25 | 2015-12-29 | Shire Human Genetic Therapies, Inc. | Methods and compositions for CNS delivery of iduronate-2-sulfatase |
US9283181B2 (en) | 2010-06-25 | 2016-03-15 | Shire Human Genetic Therapies, Inc. | CNS delivery of therapeutic agents |
US9320711B2 (en) | 2010-06-25 | 2016-04-26 | Shire Human Genetic Therapies, Inc. | Methods and compositions for CNS delivery of heparan N-sulfatase |
US9770410B2 (en) | 2010-06-25 | 2017-09-26 | Shire Human Genetic Therapies, Inc. | Methods and compositions for CNS delivery of arylsulfatase A |
KR20190097067A (ko) | 2016-12-26 | 2019-08-20 | 쿄와 기린 가부시키가이샤 | 미엘린 올리고덴드로사이트 당단백질에 결합하는 항체 |
WO2020004490A1 (fr) | 2018-06-26 | 2020-01-02 | 協和キリン株式会社 | Anticorps se liant au protéoglycane-5 à chondroïtine sulfate |
WO2020004492A1 (fr) | 2018-06-26 | 2020-01-02 | 協和キリン株式会社 | Anticorps se liant à la molécule d'adhésion cellulaire 3 |
US10660944B2 (en) | 2011-12-23 | 2020-05-26 | Shire Human Genetic Therapies, Inc. | Stable formulations for CNS delivery of arylsulfatase A |
US12121569B2 (en) | 2022-01-18 | 2024-10-22 | Takeda Pharmaceutical Company Limited | Methods and compositions for CNS delivery of iduronate-2-sulfatase |
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US9994641B2 (en) | 2013-12-25 | 2018-06-12 | Jcr Pharmaceuticals Co., Ltd. | Anti-human transferrin receptor antibody that passes through blood-brain barrier |
JP6914193B2 (ja) | 2015-06-24 | 2021-08-04 | Jcrファーマ株式会社 | Bdnfを含む融合蛋白質 |
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US11873337B2 (en) | 2018-06-26 | 2024-01-16 | Kyowa Kirin Co., Ltd. | Antibody binding to cell adhesion molecule 3 |
US11965035B2 (en) | 2018-06-26 | 2024-04-23 | Kyowa Kirin Co., Ltd. | Antibody binding to chondroitin sulfate proteoglycan 5 |
US12121569B2 (en) | 2022-01-18 | 2024-10-22 | Takeda Pharmaceutical Company Limited | Methods and compositions for CNS delivery of iduronate-2-sulfatase |
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