WO2013172967A1

WO2013172967A1 - Carriers for improved drug delivery

Info

Publication number: WO2013172967A1
Application number: PCT/US2013/031788
Authority: WO
Inventors: Tarik M. SOLIMAN; Laura M. Hales; Howard P. Sard; Mukkanti AMERE
Original assignee: Extend Biosciences, Inc
Priority date: 2012-05-17
Filing date: 2013-03-14
Publication date: 2013-11-21
Also published as: IL235608A0; US9289507B2; US20150104469A1; KR20200077616A; US20150065420A1; US9884124B2; NZ701573A; KR102434075B1; US9173950B2; CN104302177B; AU2013263349A1; MX349035B; CA2869190A1; CN104302177A; AU2013263349B2; JP2015518825A; CA3062003C; KR102238317B1; BR112014028322A2; KR20220051197A

Abstract

The invention provides carriers that enhance the absorption, half-life or bioavailability of therapeutic compounds. The carriers comprise targeting groups that bind the Vitamin D Binding protein (DBP), conjugation groups for coupling the targeting groups to the therapeutic compounds, and optionally scaffolding moieties.

Description

CARRIERS FOR IMPROVED DRUG DELIVERY

FIELD OF THE INVENTION

The field of the invention provides the composition and general use of carriers, conjugates, fusions or formulations of therapeutic compounds for the purpose of increasing the potency, absorption, bioavailability or circulating half-life of the compounds by improving pharmacokinetic properties in vivo.

BACKGROUND OF THE INVENTION

The invention relates to improving the potency, absorption or pharmacokinetic properties of therapeutic compounds. The addition of poly(ethylene glycol) or (PEG) is a known method of increasing the half-life of some compounds by reducing kidney clearance, reducing aggregation, and diminishing potentially unwanted immune recognition (Jain, Crit. Rev. Ther. Drug Carrier Syst. 25:403-447 (2008)). The PEG is typically used at a considerably large size (20-40 kDa) to maximize the half-life in circulation. This can be accomplished by using either a single large PEG or multiple smaller PEGs attached to the compound. (Clark et al. J. Biol.

Chem. 271 :21969-21977 (1996); Fishburn, J. Pharm. Sci. 97:4167-4183 (2008)).

Absorption is a primary focus in drug development and medicinal chemistry since a drug must be absorbed before any medicinal effects can take place. A drug's pharmacokinetic profile can be affected by many factors. Additionally, the absorption properties of therapeutic compounds vary significantly from compound to compound. Some therapeutic compounds are poorly absorbed following oral or dermal administration. Other therapeutic compounds, such as most peptide- and protein-based therapeutics, cannot be administered orally. Alternate routes of administration such as intravenous, subcutaneous, or intramuscular injections are routinely used for some of compounds; however, these routes often result in slow absorption and exposure of the therapeutic compounds to enzymes that can degrade them, thus requiring much higher doses to achieve efficacy.

A number of peptides have been identified as therapeutically promising. The chemical and biological properties of peptides and proteins make them attractive candidates for use as therapeutic compounds. Peptides and proteins are naturally-occurring molecules made up of amino acids and are involved in numerous physiological processes. Peptides and proteins display a high degree of selectivity and potency, and may not suffer from potential adverse drug-drug interactions or other negative side effects. Thus peptides and proteins hold great promise as a highly diverse, highly potent, and highly selective class of therapeutic compounds with low toxicity. Peptides and proteins, however, may have short in vivo half-lives. For such peptides, this may be a few minutes. This may render them generally impractical, in their native form, for therapeutic administration. Additionally, peptides may have a short duration of action or poor bioavailability.

Fibroblast growth factor 21 (SEQ ID:2) is a protein that circulates in serum. Encoded by the FGF21 gene, it is a member of a family of atypical fibroblast growth factors (FGFs), which include FGF 19 and FGF23. It lacks the conventional FGF heparin-binding domain. FGF family members possess broad mitogenic and cell survival activities and are involved in a variety of biological processes including embryonic development, cell growth, morphogenesis, tissue repair, tumor growth and invasion. FGF21 is specifically induced by HMGCS2 activity. FGF21 stimulates glucose uptake in adipocytes but not in other cell types. This effect is additive to the activity of insulin.

In vitro studies indicate that FGF21 prefers binding to the FGFRlc/b-Klotho receptor complex over those containing other FGFR isotypes (Kliewer and Mangelsdorf, Am. J. Clin. Nutr. 91 :254S-257S (2010)). FGF21 promotes glucose uptake by adipocytes in vitro.

Administration of FGF21 to diabetic animals reduces circulating glucose levels while excess FGF21 does not induce hypoglycemia as seen with administration of excess insulin

(Kharitonenkov and Shanafelt, Curr. Opin. Investig. Drugs 10:359-364 (2009)). Therefore, FGF21 is a promissing therapeutic protein for the treatment of diabetes. FGF21 , however, was administered frequently to see therapeutic benefits in an animal model (Kharitonenkov et al, J. Clin. Invest. 115: 1627-1635 (2005)). FGF21 in its natural state has an extremely short half-life in serum (1.1 hr) making exogenous addition of FGF21 in its natural state not clinically practical as a treatment (see WO03/011213). Additionally, FGF21 exhibits poor bioavailability when injected subcutaneously. In a comparative pharmacokinetic study, lmg/kg of FGF21 was injected either intravenously (IV) or subcutaneously (SC) and the concentration of FGF21 was analyzed over time. The results showed a significant reduction in bioavailability using a subcutaneous route of administration (Cmax 73 nM) compared to the intravenous route (Cmax of 1890 nM; see Table 1 in Xu J et al, 2009. Am J Physiol Endocrinol Metab 297: El 105- El 114). The foregoing references are incorporated herein by reference in their entirety.

Ghrelin peptide (SEQ ID NO:5) is naturally secreted from the stomach in mammals into circulation to stimulate appetite and release of growth hormone. Ghrelin stimulates the release of growth hormone (GH) from the pituitary gland through the cellular receptor GHS-R and plays important roles in energy homeostasis. In addition, ghrelin acts directly on the central nervous system to decrease sympathetic nerve activity. Ghrelin receptors (GHS-Rs) are concentrated in the hypothalamus-pituitary unit. GHS-R is distributed in peripheral tissues, including the heart, lung, liver, kidney, pancreas, stomach, small and large intestines, adipose, and immune cells.

Ghrelin has been used therapeutically to increase weight and lean body mass in patients suffering from cachexia or involuntary weight loss resulting from a chronic disease such as cancer (Hiura et. al., Cancer Jan 26, 2012,

http://onlinelibrary.wiley.com/doi/10.1002/cncr.27430/abstract). Ghrelin, however, has a naturally short half-life of 11 mins in humans (Akamizu et al., Eur J Endocrinol 150:447-55 (2004)) and thus must be dosed often to see therapeutic effects.

Infliximab (Remicade®, Janssen Biotech Inc., U.S. Pat. Nos. US 5,919,452 and US 2002/0141996, incorporated herein by reference in their entirety) is a monoclonal antibody that binds tumor necrosis factor alpha (TNF-a, SEQ ID: 10) that is used to treat autoimmune diseases. Infliximab was approved by the U.S. Food and Drug Administration (FDA) for the treatment of psoriasis, Crohn's disease, ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, and ulcerative colitis. TNF-a is a chemical messenger (cytokine) and a key part of the autoimmune reaction. Infliximab is administered intravenously by a healthcare professional and is not approved for subcutaneous dosing.

SUMMARY OF THE INVENTION

The invention provides carriers that enhance the absorption, stability, half-life, duration of effect, potency, or bioavailability of therapeutic compounds. The carriers comprise targeting groups that bind the Vitamin D Binding protein (DBP), conjugation groups for coupling the targeting groups to the therapeutic compounds, and optional scaffolding moieties.

In an embodiment of the invention, the targeting group is vitamin D, a vitamin D analog, a vitamin D-related metabolite, an analog of a vitamin D related-metabolite, a peptide that binds DBP, an anti-DBP antibody, an anti-DBP antibody derivative, a nucleotide aptamer that binds DBP, or a small carbon-based molecule that binds DBP.

In another embodiment, the coupling group is an amine-reactive group, a thiol-reactive group, a maleimide group, a thiol group, an aldehyde group, an NHS-ester group, a 4- nitrophenyl ester, an acylimidazole, a haloacetyl group, an iodoacetyl group, a bromoacetyl groups, a SMCC group, a sulfo SMCC group, a carbodiimide group and bifunctional cross- linkers such as NHS-Maleimido or combinations thereof. The coupling groups of the invention can promote thiol linkages, amide linkages, oxime linkages, hydrazone linkages, thiazolidinone linkages or utilizes cycloaddition reactions (e.g. click chemistry) to couple the carrier or targeting group to a therapeutic compound.

In another embodiment, the pharmaceutical carrier further comprising a scaffold moiety, comprising poly(ethylene glycol), polylysine, polyethyleneimine, poly(propyleneglycol), a peptide, serum albumin, thioredoxin, an immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contains a reactive linker, a water-soluble polymer, a small carbon chain linker, or an additional therapeutic moiety.

In another embodiment, the scaffold moiety is between about 100 Da. and 200,000 Da. In preferred embodiments, the scaffold moiety is between about 100 Da. and 20,000 Da., 200 Da. and 15,000 Da., 300 Da. and 10,000 Da., 400 Da. and 9,000 Da., 500 Da. and 5,000 Da., 600 Da. and 2,000 Da., 1000 Da. and 200,000 Da., 5000 Da. and 100,000 Da., 10,000 Da. and 80,000 Da., 20,000 Da. and 60,000 Da., or 20,000 Da. and 40,000 Da.

The invention provides a pharmaceutical composition comprising a therapeutic compound conjugated to, fused to, or formulated with a carrier. The carrier comprises a targeting group that binds DBP and increases the absorption, bioavailability, or half-life of the therapeutic compound in circulation. The pharmaceutical compositions of the invention may comprise two or more therapeutic compounds conjugated to a single carrier. The pharmaceutical compositions of the invention may comprise two or more carriers conjugated to a therapeutic compound.

In one embodiment, the targeting group in the pharmaceutical composition is vitamin D, a vitamin D analog, a vitamin D-related metabolite, an analog of a vitamin D-related metabolite, a peptide that binds DBP, an anti-DBP antibody, an anti-DBP antibody derivative, a nucleotide aptamer that binds DBP, or a small, carbon-based molecule that binds DBP.

In another embodiment, the pharmaceutical composition further comprises a scaffold moiety. In a preferred embodiment, the scaffold moiety is poly(ethylene glycol), polylysine, polyethyleneimine, poly(propyleneglycol), a peptide, serum albumin, thioredoxin, an

immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contains a reactive linker, a water-soluble polymer, a small carbon chain linker, or an additional therapeutic compound.

The pharmaceutical compositions of the invention may comprise small molecules, chemical entities, nucleic acids, nucleic acid derivatives, peptides, peptide derivatives, naturally- occurring proteins, non-naturally-occurring proteins, peptide -nucleic acids (PNA), stapled peptides, morpholinos, phosphorodiamidate morpholinos, antisense drugs, RNA-based silencing drugs, aptamers, glycoproteins, enzymes, hormones, cytokines, interferons, growth factors, blood coagulation factors, antibodies, antibody fragments, antibody derivatives, toxin- conjugated antibodies, metabolic effectors, analgesics, antipyretics, anti-inflammatory agents, antibiotics, anti-microbial agents, anti-viral agents, anti-fungal drugs, musculoskeletal drugs, cardiovascular drugs, renal drugs, pulmonary drugs, digestive disease drugs, hematologic drugs, urologic drugs, metabolism drugs, hepatic drugs, neurological drugs, anti-diabetes drugs, anticancer drugs, drugs for treating stomach conditions, drugs for treating colon conditions, drugs for treating skin conditions, or drugs for treating lymphatic conditions.

In a preferred embodiment, the pharmaceutical composition comprises a protein having FGF21 activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:2. In another preferred embodiment, the targeting group is Vitamin D. In another preferred embodiment, the scaffold moiety is poly(ethylene glycol).

In a most preferred embodiment, the invention contemplates a pharmaceutical composition comprising a protein having FGF21 activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:2, a scaffold moiety that is poly(ethylene glycol), and a targeting group that is Vitamin D. In this embodiment, the targeting group increases the absorption, bioavailability, or the half-life of the therapeutic compound in circulation. In another most preferred embodiment, the invention contemplates a pharmaceutical composition comprising a protein having FGF21 activity and the amino acid sequence of SEQ ID NO:2.

In a preferred embodiment, the pharmaceutical composition comprises a protein having ghrelin activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:5. In another preferred embodiment, the targeting group is Vitamin D. In another preferred embodiment, the scaffold moiety is poly(ethylene glycol).

In a most preferred embodiment, the invention contemplates a pharmaceutical composition comprising a protein having ghrelin activity comprising an amino acid sequence with at least a 90%> sequence identity to SEQ ID NO:5, a scaffold moiety that is poly(ethylene glycol), and a targeting group that is Vitamin D. In this embodiment, the targeting group increases the absorption, bioavailability, or the half-life of the therapeutic compound in circulation. In another most preferred embodiment, the invention contemplates a pharmaceutical composition comprising a protein having ghrelin activity and the amino acid sequence of SEQ ID NO:5. In one embodiment, the pharmaceutical composition comprises an antibody. In a preferred embodiment, the antibody is an anti-TNF-a antibody that specifically binds a protein having an amino acid sequence of at least a 90% sequence identity to SEQ ID NO: 10. In a more preferred embodiment, the anti-TNF-α antibody specifically binds a protein having the amino acid sequence of SEQ ID NO: 10. In another preferred embodiment, the targeting group is Vitamin D. In another preferred embodiment, the scaffold moiety is poly(ethylene glycol).

In a most preferred embodiment, the invention comprises an anti-TNF-α antibody that specifically binds a protein having an amino acid sequence with at least a 90% sequence identity to SEQ ID NO: 10, a scaffold moiety that is poly(ethylene glycol), and a targeting group that is Vitamin D. In this embodiment, the targeting group increases the absorption, bioavailability, or the half-life of the therapeutic compound in circulation.

In certain embodiments, the present invention provides carriers that include those of formula I:

B— L— S— L²— L³— C

I

Wherein:

B is a targeting group selected from vitamin D, a vitamin D analog, a vitamin D-related

metabolite, an analog of a vitamin D related-metabolite, a peptide that binds DBP, an anti- DBP antibody, an anti-DBP antibody derivative, a nucleotide aptamer that binds DBP, or a small carbon-based molecule that binds DBP;

S is a scaffold moiety, comprising poly(ethylene glycol), polylysine, polyethyleneimine,

poly(propyleneglycol), a peptide, serum albumin, thioredoxin, an immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contains a reactive linker, polylactic acid, a water-soluble polymer, a small carbon chain linker, or an additional therapeutic moiety;

C is an amine -reactive group, a thiol-reactive group, a maleimide group, a thiol group, a

disulfide group, an aldehyde group, an NHS-ester group, a 4-nitrophenyl ester, an acylimidazole, a haloacetyl group, an iodoacetyl group, a bromoacetyl group, a SMCC group, a sulfo SMCC group, a carbodiimide group and bifunctional cross-linkers such as NHS-Maleimido or combinations thereof;

L¹ and L² are linkers independently selected from -(CH₂)„-, -C(0)NH-, -HNC(O)-, -C(0)0-, - OC(O)-, -0-, -S-S-, -S-, -S(O)-, -S(0)₂- and -NH-.

L³ is -(CH₂)₀-; n is an integer from 0-3; and

o is an integer from 0-3.

In certain embodiments, the present invention provides a method for producing a carrier of formula I:

B— L¹— S— L²— L³— C

I

comprising the step of reacting a compound of formula la:

B— COOH

la

with a compound of formula lb:

H₂N— S— L²— L³— C

lb

In the presence of an amide coupling agent,

Wherein B, S, C, L² and L³ are defined as above and L¹ is -C(0)NH-.

In certain other embodiments, the present invention provides a method for producing a carrier of formula I:

B— L¹— S— L²— L³— C

I

comprising the step of reacting a compound of formula la:

B— COOH

la

with a compound of formula Ic:

H₂N-S— L²-L³-COOR¹

Ic

In the presence of an amide coupling agent,

Hydrolyzing an ester to a carboxylic acid and,

Converting a carboxylic acid to an active ester,

Wherein B, S, L², L³ and n and o are defined as above,

L¹ is -C(0)NH- and,

R¹ is Ci-Cg alkyl.

The invention provides a method of treating a patient in need of a therapeutic compound, comprising administering an effective amount of one or more of the pharmaceutical compositions described herein. Exemplary therapeutic compounds include small molecules, chemical entities, nucleic acids, nucleic acid derivatives, peptides, peptide derivatives, naturally- occurring proteins, non-naturally-occurring proteins, peptide -nucleic acids (PNA), stapled peptides, morpholinos, phosphorodiamidate morpholinos, antisense drugs, RNA-based silencing drugs, aptamers, glycoproteins, enzymes, hormones, cytokines, interferons, growth factors, blood coagulation factors, antibodies, antibody fragments, antibody derivatives, toxin- conjugated antibodies, metabolic effectors, analgesics, antipyretics, anti-inflammatory agents, antibiotics, anti-microbial agents, anti-viral agents, anti-fungal drugs, musculoskeletal drugs, cardiovascular drugs, renal drugs, pulmonary drugs, digestive disease drugs, hematologic drugs, urologic drugs, metabolism drugs, hepatic drugs, neurological drugs, anti-diabetes drugs, anticancer drugs, drugs for treating stomach conditions, drugs for treating colon conditions, drugs for treating skin conditions, and drugs for treating lymphatic conditions.

In preferred methods, the therapeutic compound is a protein having FGF21 activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:2. In other preferred methods, the therapeutic compound is a protein having ghrelin activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:5. In other preferred methods, the therapeutic compound is an anti-TNF-a antibody that specifically binds a protein having at least a 90% sequence identity to SEQ ID NO: 10. In other preferred methods, the targeting group is Vitamin D or the scaffold is poly(ethylene glycol).

In other embodiments and methods, the pharmaceutical compositions of the invention are in pharmaceutically acceptable formulations. The pharmaceutical compositions may be delivered to patients by a transdermal, oral, parenteral, subcutaneous, intracutaneous, intravenous, intramuscular, intraarticular, intrasynovial, intrasternal, intrathecal, intralesional, intracranial injection, infusion, inhalation, ocular, topical, rectal, nasal, buccal, sublingual, vaginal, or implanted reservoir mode.

The invention provides the use of the disclosed pharmaceutical compositions for the manufacture of medicaments for the treatment of patients that need the medicaments.

The invention provides methods of manufacturing the pharmaceutical compositions disclosed herein comprising conjugating a targeting group and a drug into a carrier-drug compound utilizing coupling groups. The coupling groups may be amine -reactive coupling groups, maleimide coupling groups, cysteine coupling groups, aldehyde coupling groups, or thiol-reactive coupling groups. Maleimide is a useful coupling group for use in coupling to sulfhydryl groups such as on a free cysteine residue that can be site-specifically engineered into a peptide or protein in a desired position. Other coupling groups such as NHS- that target amine groups or aldehyde that can be used to site specifically attach to the N-terminus of a therapeutic compound are well known to those skilled in the art. Other more specialized coupling groups are contemplated and could be substituted by one skilled in the art.

In some methods, the targeting group is vitamin D, a vitamin D analog, a vitamin D- related metabolite, an analog of a vitamin D-related metabolite, a peptide that binds DBP, an anti-DBP antibody, an anti-DBP antibody derivative, a nucleotide aptamer that binds DBP, or a small carbon-based molecule that binds DBP.

In other embodiments, methods of manufacturing pharmaceutical compositions further comprise conjugating a scaffold moiety to the targeting group or drug. The scaffold moiety may be poly(ethylene glycol), polylysine, polyethyleneimine, poly(propyleneglycol), a peptide, serum albumin, thioredoxin, an immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contains a reactive linker, a water-soluble polymer, a small carbon chain linker, or an additional therapeutic compound.

DESCRIPTION OF THE DRAWINGS

Figure 1 : Schematic diagram showing the general structure of a carrier coupled to a drug. The carrier comprises a targeting group, a scaffold, and optionally, a coupling group.

Figure 2: Reaction scheme showing the chemical structures and syntheses used to generate a carrier, a Vitamin D3-PEG-Maleimide adduct. The carrier was generated by conjugating 1) a Vitamin D analog (the targeting group), 2) a PEG scaffold, and 3) a maleimide coupling group.

Figure 3: Bioavailability and pharmacokinetics of an FGF21 -carrier conjugate. FGF21 alone (SEQ ID NO:3) or conjugated to the Vitamin D3-PEG-Maleimide carrier were injected subcutaneously into Sprague Dawley rats at O.lmg/kg. Plasma samples were analyzed for FGF21 concentration by ELISA in duplicate and an average from 3-5 animals per time point were plotted on the semi-log plot graph.

Figure 4: Pharmacokinetics of Ghrelin-carrier conjugate. Ghrelin (SEQ ID NO:6) alone or conjugated to the Vitamin D3-PEG-Maleimide carrier were injected intravenously into Sprague Dawley rats at O.lmg/kg. Plasma samples were analyzed for Ghrelin concentration by ELISA in duplicate and an average from 3-5 animals per time point were plotted on the semi-log plot graph. Figure 5 : Reaction scheme showing the chemical structures and syntheses used to generate another carrier, a Vitamin D3-PEG-NHS adduct. The carrier was generated by conjugating 1) a Vitamin D analog (the targeting group), 2) a PEG scaffold, and 3) an NHS coupling group.

Figure 6: Bioavailability and pharmacokinetics of an infliximab-carrier conjugate.

Infliximab alone or conjugated to the Vitamin D3-PEG-NHS carrier was injected subcutaneously into Sprague Dawley rats at 1 mg/kg. Plasma samples were analyzed for infliximab

concentration by an infliximab-specific ELISA and an average from 3 animals per time point were plotted on a linear plot graph.

DETAILED DESCRIPTION OF THE INVENTION

The invention provides carrier molecules that are covalently attached to, fused to or formulated with therapeutic proteins, peptides, nucleic acids or small molecules for the purpose of improving the potency, absorption, bioavailability, circulating half-life or pharmacokinetic properties of the therapeutic compounds. In certain embodiments, the carriers comprise a targeting group, a scaffold, and a coupling group. In other embodiments, the carriers lack a scaffold, which acts, among other things, as a "spacer" between the targeting group and the therapeutic compound.

The carriers are designed to be suitable for use in humans and animals. The carriers serve the purpose of improving the pharmacokinetic properties of a biological or chemical entity that is coupled to, conjugated to, fused to, or formulated with the carrier. This occurs through the interaction of the targeting group with vitamin D binding protein (DBP), which can actively transport molecules quickly and effectively from the site of administration to the circulating plasma, thereby reducing exposure of the drug to degradative enzymes. The carriers, by binding to DBP, also improve the circulating half-life of the drug, thus increasing the potency and therapeutic efficacy of the drug by preventing kidney filtration. Methods for conjugating the carrier to therapeutic compounds described herein are known in the art. By way of example, conjugation using the coupling groups of the invention may be carried out using the

compositions and methods described in WO93/012145 (Atassi et al.) and 7,803,777 (Defrees et al.), each of which are incorporated by reference herein in their entirety.

In describing and claiming one or more embodiments of the present invention, the following terminology will be used in accordance with the definitions described below.

The term "absorption" is the movement of a drug into the bloodstream. A drug needs to be introduced via some route of administration (e.g. oral, topical or dermal) or in a specific dosage form such as a tablet, capsule or liquid. Intravenous therapy, intramuscular injection, and enteral nutrition provide less variability in absorption and bioavailability is often near 100%. The fastest route of absorption is inhalation.

An "antagonist" refers to a molecule capable of neutralizing, blocking, inhibiting, abrogating, reducing or interfering with the activities of a particular or specified protein, including its binding to one or more receptors in the case of a ligand, or binding to one or more ligands in case of a receptor. Antagonists include antibodies and antigen-binding fragments thereof, proteins, peptides, glycoproteins, glycopeptides, glycolipids, polysaccharides, oligosaccharides, nucleic acids, bioorganic molecules, peptidomimetics, pharmacological agents and their metabolites, transcriptional and translation control sequences, and the like. Antagonists also include small molecule inhibitors of proteins, hormones, or other bioactive molecules. Antagonists may be fusion proteins, receptor molecules, antisense molecules, aptamers, ribozymes, or derivatives that bind specifically to the proteins, hormones, or other bioactive molecules and thereby sequester its binding to its target.

"Antibodies" (Abs) and "immunoglobulins" (Igs) refer to glycoproteins having similar structural characteristics. While antibodies exhibit binding specificity to a specific antigen, immunoglobulins include both antibodies and other antibody-like molecules which generally lack antigen specificity. Polypeptides of the latter kind are, for example, produced at low levels by the lymph system and at increased levels by myelomas.

"Aptamers" are nucleic acid-based compounds that have been selected to bind a specific target. An example of an aptamer-based therapeutic compound can be found in WO07/035922, incorporated by reference herein in its entirety.

The term "bioavailability" refers to the fraction of an administered dose of unchanged drug that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. When a medication is administered intravenously, its bioavailability is 100%. When a medication is administered via other routes (such as orally), its bioavailability generally decreases (due to incomplete absorption and first-pass metabolism) or may vary from patient to patient. Bioavailability is an important parameter in pharmacokinetics that is considered when calculating dosages for non-intravenous routes of administration.

"Carriers" are compounds that can be conjugated to, fused to, coupled to or formulated with therapeutic compounds to improve the absorption, half-life, bioavailability,

pharmacokinetic or pharmacodynamic properties of the drugs. They comprise a targeting group, a coupling group, and optionally, a scaffold moiety.

An "effective amount" refers to an amount of therapeutic compound that is effective, at dosages and for periods of time necessary, to achieve the desired therapeutic or prophylactic result. A "therapeutically effective amount" of a therapeutic compound may vary according to factors such as the disease state, age, sex, and weight of the individual, and the ability of the antibody to elicit a desired response in the individual. A therapeutically effective amount may be measured, for example, by improved survival rate, more rapid recovery, or amelioration, improvement or elimination of symptoms, or other acceptable biomarkers or surrogate markers. A therapeutically effective amount is also one in which any toxic or detrimental effects of the therapeutic compound are outweighed by the therapeutically beneficial effects. A

"prophylactically effective amount" refers to an amount of therapeutic compound that is effective, at dosages and for periods of time necessary, to achieve the desired prophylactic result. Typically, but not necessarily, since a prophylactic dose is used in subjects prior to or at an earlier stage of disease, the prophylactically effective amount will be less than the

therapeutically effective amount.

"Half-life" is a scientific term known in the art that refers to the amount of time that elapses when half of the quantity of a test molecule is no longer detected. An in vivo half-life refers to the time elapsed when half of the test molecule is no longer detectable in circulating serum or tissues of a human or animal.

A "hormone" is a biological or chemical messenger from one cell (or group of cells) to another cell that has signaling capability. As described herein, hormones for use in the invention may be peptides, steroids, pheromones, interleukins, lymphokines, cytokines, or members of other hormone classes known in the art.

"Homologs" are bioactive molecules that are similar to a reference molecule at the nucleotide sequence, peptide sequence, functional, or structural level. Homologs may include sequence derivatives that share a certain percent identity with the reference sequence. Thus, in one embodiment, homologous or derivative sequences share at least a 70 percent sequence identity. In a preferred embodiment, homologous or derivative sequences share at least an 80 or 85 percent sequence identity. In a more preferred embodiment, homologous or derivative sequences share at least an 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, or 99 percent sequence identity. Homologous or derivative nucleic acid sequences may also be defined by their ability to remain bound to a reference nucleic acid sequence under high stringency hybridization conditions. Homologs having a structural or functional similarity to a reference molecule may be chemical derivatives of the reference molecule. Methods of detecting, generating, and screening for structural and functional homologs as well as derivatives are known in the art.

"Hybridization" generally depends on the ability of denatured DNA to reanneal when complementary strands are present in an environment below their melting temperature. The higher the degree of desired homology between the probe and hybridizable sequence, the higher the relative temperature which can be used. As a result, it follows that higher relative

temperatures would tend to make the reaction conditions more stringent, while lower

temperatures less so. For additional details and explanation of stringency of hybridization reactions, see Ausubel et al, Current Protocols in Molecular Biology, Wiley Interscience Publishers, (1995).

An "individual," "subject" or "patient" is a vertebrate. In certain embodiments, the vertebrate is a mammal. Mammals include, but are not limited to, primates (including human and non-human primates) and rodents (e.g., mice, hamsters, guinea pigs, and rats). In certain embodiments, a mammal is a human. A "control subject" refers to a healthy subject who has not been diagnosed as having a disease, dysfunction, or condition that has been identified in an individual, subject, or patient. A control subject does not suffer from any sign or symptom associated with the disease, dysfunction, or condition.

A "medicament" is an active drug that has been manufactured for the treatment of a disease, disorder, or condition.

"Morpholinos" are synthetic molecules that are non-natural variants of natural nucleic acids that utilize a phosphorodiamidate linkage, described in U.S. Patent No. 8,076,476, incorporated by reference herein in its entirety.

"Nucleic acids" are any of a group of macromolecules, either DNA, RNA, or variants thereof, that carry genetic information that may direct cellular functions. Nucleic acids may have enzyme-like activity (for instance ribozymes) or may be used to inhibit gene expression in a subject (for instance RNAi). The nucleic acids used in the inventions described herein may be single-stranded, double-stranded, linear or circular. The inventions further incorporate the use of nucleic acid variants including, but not limited to, aptamers, PNA, Morpholino, or other non- natural variants of nucleic acids. By way of example, nucleic acids useful for the invention are described in U.S. Patent No. 8,076,476, incorporated by reference herein in its entirety.

"Patient response" or "response" can be assessed using any endpoint indicating a benefit to the patient, including, without limitation, (1) inhibition, to some extent, of disease progression, including slowing down and complete arrest; (2) reduction in the number of disease episodes and/or symptoms; (3) inhibition (i.e., reduction, slowing down or complete stopping) of a disease cell infiltration into adjacent peripheral organs and/or tissues; (4) inhibition (i.e.

reduction, slowing down or complete stopping) of disease spread; (5) decrease of an

autoimmune condition; (6) favorable change in the expression of a biomarker associated with the disorder; (7) relief, to some extent, of one or more symptoms associated with a disorder; (8) increase in the length of disease-free presentation following treatment; or (9) decreased mortality at a given point of time following treatment.

As used herein, the term "peptide" is any peptide comprising two or more amino acids. The term peptide includes short peptides (e.g., peptides comprising between 2 - 14 amino acids), medium length peptides (15-50) or long chain peptides (e.g., proteins). The terms peptide, medium length peptide and protein may be used interchangeably herein. As used herein, the term "peptide" is interpreted to mean a polymer composed of amino acid residues, related naturally occurring structural variants, and synthetic non-naturally occurring analogs thereof linked via peptide bonds, related naturally-occurring structural variants, and synthetic non-naturally occurring analogs thereof. Synthetic peptides can be synthesized, for example, using an automated peptide synthesizer. Peptides can also be synthesized by other means such as by cells, bacteria, yeast or other living organisms. Peptides may contain amino acids other than the 20 gene-encoded amino acids. Peptides include those modified either by natural processes, such as processing and other post-translational modifications, but also by chemical modification techniques. Such modifications are well described in basic texts and in more detailed

monographs, and are well-known to those of skill in the art. Modifications occur anywhere in a peptide, including the peptide backbone, the amino acid side-chains, and the amino or carboxyl termini.

As used herein, a "pharmaceutically acceptable carrier" or "therapeutic effective carrier" is aqueous or nonaqueous (solid), for example alcoholic or oleaginous, or a mixture thereof, and can contain a surfactant, emollient, lubricant, stabilizer, dye, perfume, preservative, acid or base for adjustment of pH, a solvent, emulsifier, gelling agent, moisturizer, stabilizer, wetting agent, time release agent, humectant, or other component commonly included in a particular form of pharmaceutical composition. Pharmaceutically acceptable carriers are well known in the art and include, for example, aqueous solutions such as water or physiologically buffered saline or other solvents or vehicles such as glycols, glycerol, and oils such as olive oil or injectable organic esters. A pharmaceutically acceptable carrier can contain physiologically acceptable compounds that act, for example, to stabilize or to increase the absorption of specific inhibitor, for example, carbohydrates, such as glucose, sucrose or dextrans, antioxidants such as ascorbic acid or glutathione, chelating agents, low molecular weight proteins or other stabilizers or excipients.

The term "pharmacokinetics" is currently defined as the time course of the absorption, distribution, metabolism, and excretion of a therapeutic compound. Improved "pharmacokinetic properties" are defined as: improving one or more of the pharmacokinetic properties as desired for a particular therapeutic compound. Examples include but are not limited to: reducing elimination through metabolism or secretion, increasing drug absorption, increasing half-life, and/or increasing bioavailability.

"PNA" refers to peptide nucleic acids with a chemical structure similar to DNA or R A. Peptide bonds are used to link the nucleotides or nucleosides together.

"Scaffolds" are molecules to which other molecules can be covalently or or non- covalently attached or formulated. The scaffolds of the invention may act as "spacers" or "linkers" between the targeting group and the drug. Scaffolds may also contain a reactive linker or may have beneficial therapeutic properties in addition to the drug. Thus, the scaffolds of the invention may be, for example, PEG, serum albumin, thioredoxin, an immunoglobulin, a modifying group that contains a reactive linker, a water-soluble polymer, or a therapeutic compound.

"Stringency" of hybridization reactions is readily determinable by one of ordinary skill in the art, and generally is an empirical calculation dependent upon probe length, washing temperature, and salt concentration. In general, longer probes require higher temperatures for proper annealing, while shorter probes need lower temperatures.

"Stringent conditions" or "high stringency conditions", as defined herein, can be identified by those that: (1) employ low ionic strength and high temperature for washing, for example 0.015 M sodium chloride/0.0015 M sodium citrate/0.1% sodium dodecyl sulfate at 50°C; (2) employ during hybridization a denaturing agent, such as formamide, for example, 50%> (v/v) formamide with 0.1% bovine serum albumin/0.1% Ficoll/0.1% polyvinylpyrrolidone/50 mM sodium phosphate buffer at pH 6.5 with 750 mM sodium chloride, 75 mM sodium citrate at 42°C; or (3) overnight hybridization in a solution that employs 50% formamide, 5 x SSC (0.75 M NaCl, 0.075 M sodium citrate), 50 mM sodium phosphate (pH 6.8), 0.1 % sodium

pyrophosphate, 5 x Denhardt's solution, sonicated salmon sperm DNA (50 μΐ/ml), 0.1%> SDS, and 10% dextran sulfate at 42°C, with a 10 minute wash at 42°C in 0.2 x SSC (sodium chloride/sodium citrate) followed by a 10 minute high-stringency wash consisting of 0.1 x SSC containing EDTA at 55°C.

The "therapeutic compounds" disclosed herein refer to small molecules, chemical entities, nucleic acids, nucleic acid derivatives, peptides, peptide derivatives, naturally-occurring proteins, non-naturally-occurring proteins, glycoproteins, and steroids that are administered to subjects to treat a diseases or dysfunctions or to otherwise affect the health of individuals. Non- limiting examples of therapeutic compounds include polypeptides such as enzymes, hormones, cytokines, antibodies or antibody fragments, antibody derivatives, drugs that affect metabolic function, as well as organic compounds such as analgesics, antipyretics, anti-inflammatory agents, antibiotics, anti-viral compounds, anti-fungal compounds, cardiovascular drugs, drugs that affect renal function, electrolyte metabolism, drugs that act on the central nervous system, chemotherapeutic compounds, receptor agonists and receptor antagonists. Therapeutic compounds include, for example, extracellular molecules such as serum factors including, but not limited to, plasma proteins such as serum albumin, immunoglobulins, apolipoproteins or transferrin, or proteins found on the surface of erythrocytes or lymphocytes. Thus, exemplary therapeutic compounds include small molecules, chemical entities, nucleic acids, nucleic acid derivatives, peptides, peptide derivatives, naturally-occurring proteins, non-naturally-occurring proteins, peptide-nucleic acids (PNA), stapled peptides, phosphorodiamidate morpholinos, antisense drugs, RNA-based silencing drugs, aptamers, glycoproteins, enzymes, hormones, cytokines, interferons, growth factors, blood coagulation factors, antibodies, antibody fragments, antibody derivatives, toxin-conjugated antibodies, metabolic effectors, analgesics, antipyretics, anti-inflammatory agents, antibiotics, anti-microbial agents, anti-viral agents, anti-fungal drugs, musculoskeletal drugs, cardiovascular drugs, renal drugs, pulmonary drugs, digestive disease drugs, hematologic drugs, urologic drugs, metabolism drugs, hepatic drugs, neurological drugs, anti-diabetes drugs, anti-cancer drugs, drugs for treating stomach conditions, drugs for treating colon conditions, drugs for treating skin conditions, and drugs for treating lymphatic conditions. The term "therapeutic compound" as used herein has essentially the same meaning as the terms "drug" or "therapeutic agent."

As used herein, "treatment" refers to clinical intervention in an attempt to alter the natural course of the individual or cell being treated, and can be performed before or during the course of clinical pathology. Desirable effects of treatment include preventing the occurrence or recurrence of a disease or a condition or symptom thereof, alleviating a condition or symptom of the disease, diminishing any direct or indirect pathological consequences of the disease, decreasing the rate of disease progression, ameliorating or palliating the disease state, and achieving remission or improved prognosis. In some embodiments, methods and compositions of the invention are useful in attempts to delay development of a disease or disorder.

A "vitamin" is a recognized term in the art and is defined as a fat-soluble or water- soluble organic substance essential in minute amounts for normal growth and activity of the body and is obtained naturally from plant and animal foods or supplements.

"Vitamin D" is a group of fat-soluble secosteroids. Several forms (vitamers) of vitamin D exist. The two major forms are vitamin D₂ or ergocalciferol, and vitamin D3 or cholecalciferol. Vitamin D without a subscript refers to either D₂ or D3 or both. In humans, vitamin D can be ingested as cholecalciferol (vitamin D3) or ergocalciferol (vitamin D₂). Additionally, humans can synthesize it from cholesterol when sun exposure is adequate.

"Vitamin D binding protein" or "DBP" is a naturally circulating serum protein found in all mammals that, among other activities, can bind to and transport vitamin D and its analogs to sites in the liver and kidney where the vitamin is modified to its active form, and it retains vitamin D in its various forms in circulation for, on average, 30 days in humans. A DBP protein sequence is disclosed in SEQ ID NO: 7 and an exemplary nucleic acid sequence encoding the DBP protein sequence is disclosed in SEQ ID NO:8. DBP has multiple naturally-occurring isoforms. Exemplary isoforms are available in the public sequence databases (e.g. Accession Nos. NM 001204306.1, NM_001204307.1, NM_000583.3, BC036003.1, M12654.1, X03178.1, AK223458, P_001191235.1 , NP_000574.2, AAA61704.1, AAD13872.1, NP_001191236.1, AAA19662.2, 154269, P02774.1, EAX05645.1, AAH57228.1, AAA52173.1, AAB29423.1, AAD14249.1, AAD14250.1, and BAD97178.1).

The invention contemplates the use of DBP variants and homo logs that contain conservative or non-conservative amino acid substitutions that substantially retain DBP activity. DBP binding molecules or functional DBP variants may be identified using known techniques and characterized using known methods (Bouillon et al., J Bone Miner Res. 6(10): 1051-7 (1991), Teegarden et. al, Anal. Biochemistry 199(2):293-299 (1991), McLeod et al, J Biol Chem. 264(2): 1260-7 (1989), Revelle et al, J. Steroid Biochem. 22:469-474 (1985)) The foregoing references are incorporated by reference herein in their entirety.

The term "water-soluble" refers to moieties that have some detectable degree of solubility in water. Methods to detect and/or quantify water solubility are well known in the art. Exemplary water-soluble polymers include peptides, saccharides, poly(ethers), poly(amines),

poly(carboxylic acids) and the like.

The invention provides effective routes for administration of proteins, peptides, other biologies, nucleic acids, and small molecule drugs. The invention further provides effective routes of drug administration via transdermal, oral, parenteral, subcutaneous, intracutaneous, intravenous, intramuscular, intraarticular, intrasynovial, intrasternal, intrathecal, intralesional, intracranial injection, infusion, inhalation, ocular, topical, rectal, nasal, buccal, sublingual, vaginal, or implanted reservoir modes.

In addition, the inventions described herein provide compositions and methods for maintaining target binding activity, i.e. pharmacodynamics (PD), for therapeutic compounds. It further provides compositions and methods for improving the pharmacokinetic (PK) profiles of therapeutic compounds as described herein. The invention further provides compositions and methods for improved drug absorption profiles as compared to the drug absorption profiles for the drugs using the same routes of administration or different routes of administration but without the inventions described herein. The invention further provides compositions and methods for improved drug bioavailability profiles as compared to the drug bioavailability profiles for the drugs using the same routes of administration or different routes of

administration but without the inventions described herein. The invention further provides compositions and methods for improved drug half-life profiles as compared to the drug half-life profiles for the drugs using the same routes of administration or different routes of

administration but without the inventions described herein.

The invention also provides alternative routes of drug administration that are more cost- effective and favorable to the patients when compared to the drugs without the inventions described herein.

The invention provides compositions and methods for using molecules that serve as carriers that can be conjugated to, fused to, or formulated with active therapeutic compounds for the purpose of improving the absorption, half-life, bioavailability, or pharmacokinetic properties of the drugs. The carriers have the properties of binding to the body's natural DBP. One aspect of the invention provides use of the natural DBP to transport the carrier-drug complex from the site of administration to the circulating serum. Another aspect of the invention is the use of the natural DBP to retain a drug in circulation for an extended period of time. This can prevent its excretion from the body and increase the exposure of the therapeutic compound in the body to achieve a longer lasting therapeutic effect. In another aspect of the invention, a smaller dose of drug is required when conjugated to, fused to or formulated with the carrier, when compared to the unconjugated, unfused or unformulated drug. Another aspect of the invention is the use of a carrier to replace the function of a much larger PEG compound when coupled to a therapeutic compound. This can improve the pharmacokinetic profile and efficacy of the conjugated, fused or formulated compound.

The invention provides a carrier molecule that is preferably composed of one or more parts or components. In one embodiment, the carrier comprises a targeting group and a coupling group for attaching the targeting group to the therapeutic compound. In another embodiment, the carrier comprises a scaffold moiety that is linked to the targeting group and the therapeutic compound. The targeting group is vitamin D, a vitamin D analog, a vitamin D-related metabolite, a vitamin D-related metabolite analog, or another molecule that can bind to or interact with the vitamin D binding protein (DBP). In one embodiment, the targeting group is an antibody or antibody derivative, a peptide designed to bind DBP or a fragment thereof, a peptide derived from a phage display or other peptide library selected against DBP or a fragment thereof, a nucleotide aptamer that binds DBP, a small molecule designed to bind DBP or derived from a chemical library selected against DBP, or a fragment thereof.

The therapeutic compound carrier conjugates of the invention typically have about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 targeting groups individually attached to a therapeutic compound. In one embodiment, the carrier conjugate of the invention will comprise about 4 targeting groups individually attached to a therapeutic compound, or about 3 targeting groups individually attached to a therapeutic compound, or about 2 targeting groups individually attached to a therapeutic compound, or about 1 targeting group attached to a therapeutic compound. The structure of each of the targeting groups attached to the therapeutic compound may be the same or different. In a preferred embodiment, one or more targeting groups are stably attached to the therapeutic compound at the N-terminus of a therapeutic protein. In another preferred embodiment, one or more targeting groups are stably attached to the therapeutic protein at the C- terminus of a therapeutic protein. In other preferred embodiments, one or more targeting groups may be stably attached to other sites on the therapeutic protein. For example, a therapeutic compound carrier conjugate may comprise a targeting group attached to the N-terminus and additionally a targeting group attached to a lysine residue. In another embodiment, a therapeutic compound carrier conjugate has a targeting group attached to a therapeutic protein via a modification such as a sugar residue as part of a glycosylation site, or on an acylation site of a peptide or attached to a phosphorylation site or other natural or non-natural modifications that are familiar to one skilled in the art. Also contemplated are attachment sites using a combination of sites mentioned above. One preferred embodiment of the present invention comprises a targeting group that is attached to the therapeutic compound at one specific site on a therapeutic compound. In another preferred embodiment, the attachment site on a protein may be a cysteine, lysine, the N-terminus or C-terminus.

In another embodiment, the scaffold is a pharmaceutically acceptable carrier. In preferred embodiments, the scaffold is poly(ethylene glycol), polylysine, polyethyleneimine, poly(propyleneglycol), a peptide, serum albumin, thioredoxin, an immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contain a reactive linker, a water-soluble polymer, a small carbon chain linker, or an additional therapeutic moiety.

In one embodiment, water-soluble scaffold moieties have some detectable degree of solubility in water. Methods to detect and/or quantify water solubility are well known in the art. Exemplary water-soluble polymers include peptides, saccharides, poly(ethers), poly(amines), poly(carboxylic acids) and the like.

Peptides can have mixed sequences or be composed of a single amino acid, e.g., poly(lysine). An exemplary polysaccharide is poly(sialic acid). An exemplary poly(ether) is poly(ethylene glycol), e.g. m-PEG. Poly(ethyleneimine) is an exemplary polyamine, and poly(acrylic) acid is a representative poly(carboxylic acid). The polymer backbone of the water- soluble polymer can be poly(ethylene glycol) (i.e. PEG). However, it should be understood that other related polymers are also suitable for use in the practice of this invention and that the use of the term PEG or poly(ethylene glycol) is intended to be inclusive and not exclusive in this respect. The term PEG includes poly(ethylene glycol) in any of its forms, including alkoxy PEG, difunctional PEG, multiarmed PEG, forked PEG, branched PEG, pendent PEG (i.e. PEG or related polymers having one or more functional groups pendent to the polymer backbone), or PEG with degradable linkages therein. The polymer backbone can be linear or branched.

Branched polymer backbones are generally known in the art. Typically, a branched polymer has a central branch core moiety and a plurality of linear polymer chains linked to the central branch core. PEG is commonly used in branched forms that can be prepared by addition of ethylene oxide to various polyols, such as glycerol, pentaerythritol and sorbitol. The central branch moiety can also be derived from several amino acids, such as lysine. The branched poly(ethylene glycol) can be represented in general form as R(-PEG-OH)_m in which R represents the core moiety, such as glycerol or pentaerythritol, and m represents the number of arms. Multi- armed PEG molecules, such as those described in U.S. Pat. No. 5,932,462, which is incorporated by reference herein in its entirety, can also be used as the polymer backbone.

Many other polymers are also suitable for the invention. Polymer backbones that are non- peptidic and water-soluble, with from 2 to about 300 termini, are particularly useful in the invention. Examples of suitable polymers include, but are not limited to, other poly(alkylene glycols), such as poly(propylene glycol) ("PPG"), copolymers of ethylene glycol and propylene glycol and the like, poly(oxyethylated polyol), poly(olefmic alcohol), polyvinylpyrrolidone), polylysine, polyethyleneimine,poly(hydroxypropylmethacrylamide), poly(a-hydroxy acid), poly( vinyl alcohol), polyphosphazene, polyoxazoline, poly(N-acryloylmorpholine), such as described in U.S. Pat. No. 5,629,384, which is incorporated by reference herein in its entirety, and copolymers, terpolymers, and mixtures thereof. Although the molecular weight of each chain of the polymer backbone can vary, it is typically in the range of about 100 Da to about 100,000 Da.

In other embodiments, the scaffold moiety may be a peptide, serum albumin, thioredoxin, an immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contains a reactive linker, a water-soluble polymer, a small carbon chain linker, or an additional therapeutic compound. In one embodiment, the scaffold moieties are non-toxic to humans and animals. In another embodiment, the scaffolds are endogenous serum proteins. In another embodiment, the scaffold moieties are water-soluble polymers. In another embodiment, the scaffolds are non- naturally-occuring polymers. In another embodiment, the scaffolds are naturally-occurring moieties that are modified by covalent attachment to additional moieties (e.g., PEG,

poly(propylene glycol), poly(aspartate), biomolecules, therapeutic moieties, or diagnostic moieties).

The conjugation of hydrophilic polymers, such as PEG is known in the art. In its most common form, PEG is a linear polymer terminated at each end with hydroxyl groups: HO— CH₂CH₂0-(CH₂CH₂0)_n-CH₂CH₂— OH where n typically ranges from about 3 to about 4000. In a preferred embodiment, the PEG has a molecular weight distribution that is essentially homodisperse. In another preferred embodiment, the PEG is a linear polymer. In another preferred embodiment the PEG is a branched polymer.

Many end-functionalized or branched derivatives and various sizes are known in the art and commercially available. By way of example, conjugation of the PEG or PEO may be carried out using the compositions and methods described herein and in U.S. Pat. Nos. 7,803,777 (Defrees et al.) and 4,179,337 (Davis et al.), each of which are incorporated by reference herein in their entirety.

In some embodiments, smaller therapeutic compounds are paired with smaller scaffold moieties and larger therapeutic compounds are paired with larger scaffold moieties. It is contemplated, however, that smaller therapeutic compounds could be paired with a larger scaffold moiety and vice versa. Smaller therapeutic compounds are defined as having a molecular weight of IDa to lOkDa. Larger therapeutic compounds are defined as having a molecular weight of lOkDa to lOOOkDa.

The scaffolds of the present invention, for example, could have a molecular weight of 100 Daltons (Da.), 500 Da., 1000 Da., 2000 Da., 5000 Da., 10,000 Da., 15,000 Da., 20,000 Da., 30,000 Da., 40,000 Da. or 60,000 Da. In one embodiment of the invention, "small" scaffold moieties may be between about 100 Da. and 20,000 Da. In another embodiment, "large" scaffold moieties may be greater than about 20,000 Da. to about 200,000 Da. In preferred embodiments, the scaffold moiety is between about 100 Da. and 200,000 Da. In more preferred embodiments, the scaffold moiety is between about 100 Da. and 20,000 Da., 200 Da. and 15,000 Da., 300 Da. and 10,000 Da., 400 Da. and 9,000 Da., 500 Da. and 5,000 Da., 600 Da. and 2,000 Da., 1000 Da. and 200,000 Da., 20,00 Da. and 200,000 Da., 100,000 and 200,000 Da., 5000 Da. and 100,000 Da., 10,000 Da. and 80,000 Da., 20,000 Da. and 60,000 Da., or 20,000 Da. and 40,000 Da.

Another component of the carrier molecule preferably comprises a coupling group that is used to covalently attach the drug to the scaffold or the carrier. The coupling groups of the invention include an amine-reactive group, a thiol-reactive group, a maleimide group, a thiol group, an aldehyde group, an NHS-ester group, a haloacetyl group, an iodoacetyl group, a bromoacetyl groups, a SMCC group, a sulfo SMCC group, a carbodiimide group and

bifunctional cross-linkers such as NHS-Maleimido, combinations thereof, or other coupling groups familiar to persons skilled in the art. The coupling groups of the invention can promote thiol linkages, amide linkages, oxime linkages, hydrazone linkages, thiazolidinone linkages or utilizes cycloaddition reactions also called click chemistry to couple the carrier to a therapeutic compound. In another embodiment, the

composition preferably includes a combination of one or more therapeutic compounds attached to the coupling group of the scaffold molecule.

NHS groups are known to those skilled in the art as being useful for coupling to native peptides and proteins without having to engineer in a site of attachment. NHS groups allow attachment to most proteins and peptides that contain amino acids with amine groups such as a lysine residue. Utilization of NHS groups allows for flexibility in the site of carrier conjugation as protein structure and reaction time can influence the attachment site and number of carrier molecules conjugated to the therapeutic compound. By way of example, controlling the molar ratio of NHS-carrier to therapeutic compound, one skilled in the art can have some control over the number of carrier molecules attached to the therapeutic compound thus allowing for more than one carrier to be conjugated to a given therapeutic compound, if desired.

Conjugation of the carrier to a therapeutic compound is achieved by mixing a solution of the molecules together in a specific molar ratio using compatible solutions, buffers or solvents. For example, a molar ratio of 1 : 1, 2: 1, 4: 1, 5: 1, 10: 1, 20: 1, 25:1, 50: 1, 100:1, 1000: 1, or 1 :2, 1 :4, 1 :5, 1 : 10, 1 :20 1 :25, 1 :50, 1 : 100 or 1 : 1000 of carrier to therapeutic compound could be used. In certain embodiments, a molar ratio of 1 : 1, 2: 1, 4: 1, 5:1, 10: 1, 20: 1, 25: 1 or 1 :2, 1 :4, 1 :5, 1 : 10, 1 :20 1 :25, 1 :50 of carrier to therapeutic compound could be used. In preferred embodiments, a molar ratio of 1 : 1, 2: 1, 4: 1, 5: 1, 10: 1 or 1 :2, 1 :4, 1 :5, 1 : 10 of carrier to therapeutic compound could be used. By varying the ratio, this could result in different numbers of individual carriers attached to the therapeutic compound, or could help to select a specific site of attachment.

Attachment of the carriers is also pH, buffer, salt and temperature dependent and varying these parameters among other parameters can influence the site of attachment the number of carriers attached and the speed of the reaction. For example, by selecting a pH for the reaction at or below pH 6 could help selectively conjugate an aldehyde version of the carrier to the N-terminus of the therapeutic protein or peptide.

B— L¹— S— L²— L³— C

I

Wherein:

poly(propyleneglycol), a peptide, serum albumin, thioredoxin, an immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contains a reactive linker, polylactic acid, a water-soluble polymer, a small carbon chain linker, or an additional therapeutic compound;

disulfide group, an aldehyde group, an NHS-ester group, a 4-nitrophenyl ester, an acylimidazole, a haloacetyl group, an iodoacetyl group, a bromoacetyl groups, a SMCC group, a sulfo SMCC group, a carbodiimide group and bifunctional cross-linkers such as

NHS-Maleimido or combinations thereof;

L¹ and L² are linkers independently selected from -(CH₂)„-, -C(0)NH-, -HNC(O)-, -C(0)0-, -

OC(O)-, -0-, -S-S-, -S-, -S(O)-, -S(0)₂- and -NH-;

L³ is -(CH₂)₀-;

n is an integer from 0-3; and

o is an integer from 0-3.

In preferred embodiments, the present invention provides carriers that include those of formula I:

B— L¹— S— L²— L³— C

I

Wherein:

metabolite, an analog of a vitamin D related-metabolite, or a small carbon-based molecule that binds DBP;

S is a scaffold moiety, comprising poly(ethylene glycol), polylysine, poly(propyleneglycol), a peptide, serum albumin, an amino acid, a nucleic acid, a glycan, polylactic acid, a water- soluble polymer, or a small carbon chain linker;

C is a maleimide group, a thiol group, a disulfide group, an aldehyde group, an NHS-ester group, an iodoacetyl group, or a bromoacetyl group;

L¹ and L² are linkers independently selected from -(CH₂)_n-, -C(0)NH-, -HNC(O)-, -C(0)0-, - OC(O)-, -0-, -S-, and -NH-;

L³ is -(CH₂)₀-;

n is an integer from 0-3; and

o is an integer from 0-3.

In more preferred embodiments, the present invention provides carriers that include those of formula I:

B— L¹— S— L²— L³— C

I

Wherein:

B is a targeting group selected from vitamin D, a vitamin D analog, or a vitamin D-related

metabolite;

S is a scaffold moiety, comprising poly(ethylene glycol), polylysine or poly(propyleneglycol); C is a maleimide group, a disulfide group, an aldehyde group, an NHS-ester group or an iodoacetyl group;

L¹ and L² are linkers independently selected from -(CH₂)„-, -C(0)NH-, -HNC(O)-, -C(0)0- and

-OC(O)-;

L³ is -(CH₂)₀-;

n is an integer from 0-3; and

o is an integer from 0-3.

In most preferred embodiments, the present invention provides carriers that include those of formulas Ila and lib:

Ila lib

Wherein:

metabolite;

S is a scaffold moiety, comprising poly(ethylene glycol), or poly(propyleneglycol); and

C is a maleimide group, a disulfide group, an aldehyde group, an NHS-ester group or an

iodoacetyl group;

L² is -(CH₂)_n-;

L³ is -(CH₂)₀-;

n is 1 ; and

o is 2.

In certain most preferred embodiments of formula Ila, B is represented by formula III, S is poly(ethylene glycol) and ³-C is represented by formula IVa.

In certain most preferred embodiments of formula lib, B is represented by formula III, S is poly(ethylene glycol) and L²-C is represented by formula IVb.

In certain most preferred embodiment, S is between about 100 Da. and 200,000 Da. In other most preferred embodiments, the scaffold moiety is between about 100 Da. and 20,000 Da., 200 Da. and 15,000 Da., 300 Da. and 10,000 Da., 400 Da. and 9,000 Da., 500 Da. and 5,000 Da., 600 Da. and 2,000 Da., 1000 Da. and 200,000 Da., 5000 Da. and 100,000 Da., 10,000 Da. and 80,000 Da., 20,000 Da. and 60,000 Da., or 20,000 Da. and 40,000 Da.

In a specific embodiment, the present invention provides a carrier represented by formula

V.

In another specific embodiment, the present invention provides a carrier represented by formula VI.

In certain embodiments, the present invention provides a method for producing a carrier of formula I: B— L¹— S— L²— L³— C

I

comprising the step of reacting a compound of formula la:

B— COOH

la

with a compound of formula lb:

H₂N— S— L²— L³— C

lb

in the presence of an amide coupling agent,

wherein B, S, C and L² are defined as above and L¹ is -C(0)NH-.

One skilled in the art will recognize that a compound of formula lb can be used either as a free base or as a suitable salt form. Suitable salt forms include, but are not limited to TFA, HC1, HBr, MsOH, TfOH and AcOH.

Any suitable amide coupling agent may be used to form a compound of formula I.

Suitable amide coupling agents include, but are not limited to 2-chloromethylpyridinium iodide, BOP, PyBOP, HBTU, HATU, DCC, EDCI, TBTU and T3P. In certain embodiments, the amide coupling agent is used alone. In certain embodiments, the amide coupling agent is used with a co-reagent such as HOBT or DMAP. In certain embodiments, the amide coupling agent is used with a base such as triethylamine or diisopropylethylamine. In certain embodiments, the amide coupling agent is used with both a co-reagent such as HOBT or DMAP and a base such as triethylamine or diisopropylethylamine. One skilled in the art will recognize that co-reagents other than HOBT or DMAP may be used. Furthermore, one skilled in the art will recognize that bases other than triethylamine or diisopropylethylamine may be used.

In certain embodiments, the carboxylic acid component of formula la is produced by treating an ester of formula Idwith a hydrolyzing agent:

B— COOR

Id

wherein, B is defined as above and R is a Ci-C₆ branched or unbranched alkyl group.

Any suitable hydrolyzing agent can be used to prepare a compound of formula la from a compound of formula Id.

In certain other embodiments, the present invention provides a method for producing a carrier of formula Ig: O |_|

B N-S- L²-L³-C

Ig

comprising the steps of reacting a compound of formula la:

B— COOH

la

with a compound of formula Ic:

H₂N-S— L²-L³-COOR¹

Ic

in the presence of an amide coupling agent forming a compound of formula le;

Hydrolyzing an ester of formula le to a carboxylic acid of formula If; and

° H ° H

B-U-N-S— L²-L³-COOR¹ - B-U-N-S— L²-L³-COOH

le If

Converting a carboxylic acid of formula If to an active ester of formula I;

O |_|

B-U-N-S— L²-L³-COOH B L¹ S— L² L³ C

If I

wherein B, S, C, R¹, L², L³, n and o are defined as above and L¹ is -C(0)NH-.

One skilled in the art will recognize that a compound of formula Ic can be used either as a free base or as a suitable salt form. Suitable salt forms include, but are not limited to TFA, HC1, HBr, MsOH, TfOH and AcOH.

Any suitable amide coupling agent may be used to form a compound of formula le. Suitable amide coupling agents include, but are not limited to 2-chloromethylpyridinium iodide, BOP, PyBOP, HBTU, HATU, DCC, EDCI, TBTU and T3P. In certain embodiments, the amide coupling agent is used alone. In certain embodiments, the amide coupling agent is used with a co-reagent such as HOBT or DMAP. In certain embodiments, the amide coupling agent is used with a base such as triethylamine or diisopropylethylamine. In certain embodiments, the amide coupling agent is used with both a co-reagent such as HOBT or DMAP and a base such as triethylamine or diisopropylethylamine. One skilled in the art will recognize that co-reagents other than HOBT or DMAP may be used. Furthermore, one skilled in the art will recognize that bases other than triethylamine or diisopropylethylamine may be used.

In certain embodiments, the carboxylic acid component of formula la is produced by treating an ester of formula Id with a hydrolyzing agent: B— COOR

Id

Any suitable hydrolyzing agent can be used to prepare a compound of formula la from a compound of formula Id. Suitable hydrolyzing agents include, but are not limited to lithium hydroxide, sodium hydroxide and potassium hydroxide.

Any suitable hydrolyzing agent can be used to prepare a compound of formula If from a compound of formula Ie. Suitable hydrolyzing agents include, but are not limited to lithium hydroxide, sodium hydroxide and potassium hydroxide.

Any suitable leaving group can be coupled with a carboxylic acid of formula If in the presence of a suitable coupling reagent to form an active ester of formula I. Suitable leaving groups include, but are not limited to imidazole, HOBT, NHS and 4-nitrophenol. Suitable coupling reagents include, but are not limited to 2-chloromethylpyridinium iodide, BOP, PyBOP, HBTU, HATU, DCC, EDCI, TBTU and T3P.

In some embodiments, an active ester of formula I is formed from a carboxylic acid of formula If using a combination of a suitable leaving group and a coupling reagent.

In some embodiments, an active ester of formula I is formed from a carboxylic acid of formula If using a single reagent that produces a leaving group and also effects a coupling reaction. Such reagents include, but are not limited to 1 ,1 '-carbonyldiimidazole, Ν,Ν'- disuccinimidyl carbonate, 4-nitrophenyl trifluoroacetate and HBTU. In some embodiments, the single reagent is used alone. In other embodiments, the single reagent is used with an acyl transfer catalyst. Such acyl transfer catalysts include, but are not limited to DMAP and pyridine. One skilled in the art will recognize that additional acyl transfer catalysts may be used.

In a specific embodiment, the present invention provides a method for producing a carrier represented by formula V:

comprising the step of reacting a compound of formula Va:

with a compound of formula V

in the presence of an amide coupling agent. One skilled in the art will recognize that a compound of formula Vb can be used either as a free base or as a suitable salt form. Suitable salt forms include, but are not limited to TFA, HC1, HBr, MsOH, TfOH and AcOH.

Any suitable amide coupling agent may be used to form a compound of formula V. Suitable amide coupling agents include, but are not limited to 2-chloromethylpyridinium iodide, BOP, PyBOP, HBTU, HATU, DCC, EDCI, TBTU and T3P. In certain embodiments, the amide coupling agent is used alone. In certain embodiments, the amide coupling agent is used with a co-reagent such as HOBT or DMAP. In certain embodiments, the amide coupling agent is used with a base such as triethylamine or diisopropylethylamine. In certain embodiments, the amide coupling agent is used with both a co-reagent such as HOBT or DMAP and a base such as triethylamine or diisopropylethylamine. One skilled in the art will recognize that co-reagents other than HOBT or DMAP may be used. Furthermore, one skilled in the art will recognize that bases other than triethylamine or diisopropylethylamine may be used.

In a specific embodiment, the carboxylic acid component of formula Va is produced by treating a methyl ester of formula Vc with a hydrolyzing agent:

Any suitable hydrolyzing agent can be used to prepare a compound of formula Va from a compound of formula Vc. Suitable hydrolyzing agents include, but are not limited to lithium hydroxide, sodium hydroxide and potassium hydroxide.

In another specific embodiment, the present invention provides a method for producing a carrier represented by formul

comprising the steps of reacting a mpound of formula Va:

with a compound of formula Via: O

H₂N^¾f^OCH₃

Via

in the presence of an amide coupling agent forming a compound of formula VIb;

Hydrolyzing an ester of formula VIb to a carboxylic acid of formula Vic; and

Converting a carboxylic acid of formula Vic to an active ester of formula VI;

One skilled in the art will recognize that a compound of formula Via can be used either as a free base or as a suitable salt form. Suitable salt forms include, but are not limited to TFA, HC1, HBr, MsOH, TfOH and AcOH.

Any suitable amide coupling agent may be used to form a compound of formula VIb. Suitable amide coupling agents include, but are not limited to 2-chloromethylpyridinium iodide, BOP, PyBOP, HBTU, HATU, DCC, EDCI, TBTU and T3P. In certain embodiments, the amide coupling agent is used alone. In certain embodiments, the amide coupling agent is used with a co-reagent such as HOBT or DMAP. In certain embodiments, the amide coupling agent is used with a base such as triethylamine or diisopropylethylamine. In certain embodiments, the amide coupling agent is used with both a co-reagent such as HOBT or DMAP and a base such as triethylamine or diisopropylethylamine. One skilled in the art will recognize that co-reagents other than HOBT or DMAP may be used. Furthermore, one skilled in the art will recognize that bases other than triethylamine or diisopropylethylamine may be used.

Any suitable hydrolyzing agent can be used to prepare a compound of formula Vic from a compound of formula VIb. Suitable hydro lyzing agents include, but are not limited to lithium hydroxide, sodium hydroxide and potassium hydroxide.

NHS can be coupled with a carboxylic acid of formula Vic in the presence of a suitable coupling reagent to form an active ester of formula VI. Suitable coupling reagents include, but are not limited to 2-chloromethylpyridinium iodide, BOP, PyBOP, HBTU, HATU, DCC, EDCI, TBTU and T3P.

In some embodiments, an active ester of formula VI is formed from a carboxylic acid of formula Vic using a combination of NHS and a coupling reagent.

In some embodiments, an active ester of formula VI is formed from a carboxylic acid of formula Vic using a single reagent that produces a leaving group and also effects a coupling reaction. Such reagents include, but are not limited to, Ν,Ν'-disuccinimidyl carbonate. In some embodiments, the single reagent is used alone. In other embodiments, the single reagent is used with an acyl transfer catalyst. Such acyl transfer catalysts include, but are not limited to DMAP and pyridine. One skilled in the art will recognize that additional acyl transfer catalysts may be used.

If desired, therapeutic compound carrier conjugates having different molecular weights can be isolated using gel filtration chromatography and/or ion exchange chromatography. Gel filtration chromatography may be used to fractionate different therapeutic compound carrier conjugates (e.g., 1-mer, 2-mer, 3-mer, and so forth, wherein "1-mer" indicates one targeting group molecule per therapeutic compound, "2-mer" indicates two targeting groups attached to therapeutic compound, and so on) on the basis of their differing molecular weights (where the difference corresponds essentially to the average molecular weight of the targeting group).

Gel filtration columns suitable for carrying out this type of separation include Superdex and Sephadex columns available from Amersham Biosciences (Piscataway, N.J.). Selection of a particular column will depend upon the desired fractionation range desired. Elution is generally carried out using a suitable buffer, such as phosphate, acetate, or the like. The collected fractions may be analyzed by a number of different methods, for example, (i) optical density (OD) at 280 nm for protein content, (ii) bovine serum albumin (BSA) protein analysis, and (iii) sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS PAGE).

Separation of therapeutic compound carrier conjugates can also be carried out by reverse phase chromatography using a reverse phase-high performance liquid chromatography (RP- HPLC) CI 8 column (Amersham Biosciences or Vydac) or by ion exchange chromatography using an ion exchange column, e.g., a DEAE- or CM-Sepharose ion exchange column available from Amersham Biosciences. The resulting purified compositions are preferably substantially free of the non-targeting group-conjugated therapeutic compound. In addition, the compositions preferably are substantially free of all other non-covalently attached targeting groups

The invention provides compositions and methods for rendering a drug more potent by improving its pharmacokinetic properties using vitamin D or another DBP binding molecule. The natural pathway for the formation of vitamin D at the skin upon exposure to ultraviolet light relies on the interaction with DBP to bring the UV activated vitamin D into circulation where it can be utilized for cellular processes (Lips, Prog. Biophys. Molec. Biol. 92:4-8 (2006); DeLuca, Nutr. Rev. 66 (suppl. 2):S73-S78 (2008)). DBP brings vitamin D into circulation quickly and effectively. DBP also keeps active vitamin D in circulation for, on average, 30 days (Cooke, N.E., and J.G. Haddad. 1989. Endocr. Rev. 10:294-307; Haddad, J.G. et al. 1993. J. Clin. Invest. 91 :2552-2555; Haddad, J.G. 1995. J. Steroid Biochem. Molec. Biol. 53:579-582). The invention provides for the first time using DBP to more effectively deliver therapeutic compounds to the body. In one embodiment, the therapeutic compound is covalently linked or fused to a carrier. In another embodiment, the therapeutic compound is formulated with the carrier but not covalently linked. In one embodiment, the carrier interacts with DBP for the purpose of carrying the drug into the body more effectively from the site of administration. In another embodiment, the carrier keeps the drug in circulation for an extended period of time.

In one embodiment, the carrier comprises a targeting group and a coupling group for attaching the targeting group to the therapeutic compound. In another embodiment, the carrier comprises a scaffold moiety that is linked to the targeting group and the therapeutic compound. The targeting group is vitamin D, a vitamin D analog, a vitamin D-related metabolite, a vitamin D-related metabolite analog, or another molecule that can bind to or interact with the vitamin D binding protein (DBP). In one embodiment, the targeting group is an antibody or antibody derivative, a peptide designed to bind DBP or a fragment thereof, a peptide derived from a phage display or other peptide library selected against DBP or a fragment thereof, a nucleotide aptamer that binds DBP, a small molecule designed to bind DBP or derived from a chemical library selected against DBP, or a fragment thereof or moiety that can bind DBP as disclosed herein. In another embodiment, the carrier comprises DBP itself or a derivative of DBP.

Vitamin D is a group of fat-soluble secosteroids. Several forms (vitamers) of vitamin D exist. The two major forms are vitamin D₂ or ergocalciferol, and vitamin D₃ or cholecalciferol, vitamin D without a subscript refers to either D₂ or D₃ or both. In humans, vitamin D can be ingested as cholecalciferol (vitamin D₃) or ergocalciferol (vitamin D₂). Additionally, humans can synthesize it from cholesterol when sun exposure is adequate.

Vitamin D is further modified by enzymes found in various organs to a family of "vitamin D metabolites" that are also capable of binding DBP. For instance, vitamin D is converted to calcidiol (25 OH hydroxy- Vitamin D) in the liver. Part of the calcidiol is converted by the kidneys to calcitriol (1, 25 (OH)₂ dihydroxy- Vitamin D). Calcidiol is also converted to calcitriol outside of the kidneys for other purposes. Also found in the body is 24, 25(OH)₂ dihydroxy- Vitamin D. Thus, in one embodiment, the targeting group is a vitamin D metabolite.

In another embodiment, the targeting group is a "Vitamin D analog." These compounds are based on the vitamin D structure and retain partial function of vitamin D. They interact with some of the same proteins as Vitamin D (e.g. DBP and the Vitamin D receptor), albeit at varying affinities. Exemplary analogs include: OCT, a chemically synthesized analogue of

l,25(OH)₂D3 with an oxygen atom at the 22 position in the side chain (Abe et.al., FEB S Lett. 226:58-62 (1987)); Gemini vitamin D analog, l ,25-dihydroxy-20R-21(3-hydroxy-3- deuteromethyl-4,4,4-trideuterobutyl)-23-yne-26,27-hexafluoro-cholecalciferol (BXL0124) (So et al, Mol Pharmacol. 79(3):360-7 (2011)); Paricalcitol, a vitamin D₂ derived sterol lacking the carbon- 19 methylene group found in all natural vitamin D metabolites (Slatopolsky et al., Am J. Kidney Dis. 26: 852 (1995)); Doxercalciferol (l -hydroxyvitamin D₂), like alfacalcidol (l - hydroxyvitamin D₃), is a prodrug which is hydroxylated in the liver to l ,25(OH)₂D2. Unlike alfacalcidol, doxercalciferol is also 24-hydroxylated to produce l ,24(S)-(OH)₂D2 (Knutson et al., Biochem Pharmacol 53: 829 (1997)); Dihydrotachysterol₂ (DHT₂), hydroxylated in vivo to 25(OH)DHT₂ and l,25(OH)₂DHT₂ (Mclntyre et al., Kidney Int. 55: 500 (1999)). See also Erben and Musculoskel, Neuron Interact. 2(l):59-69 (2001) and Steddon et al. Nephrol. Dial.

Transplant. 16 (10): 1965-1967 (2001). The foregoing references are incorporated by reference in their entirety.

In another embodiment, the carrier further comprises a pharmaceutically acceptable scaffold moiety covalently attached to the targeting group and the therapeutic compound. The scaffold moiety of the carriers of the invention does not necessarily participate in but may contribute to the function or improve the pharmacokinetic properties of the therapeutic compound. The scaffolds of the invention do not substantially interfere with the binding of the targeting group to DBP. Likewise, the scaffolds of the invention do not substantially interfere with structure or function of the therapeutic compound. The length of the scaffold moiety is dependent upon the character of the targeting group and the therapeutic compound. One skilled in the art will recognize that various combinations of atoms provide for variable length molecules based upon known distances between various bonds (Morrison, and Boyd, Organic Chemistry, 3rd Ed, Allyn and Bacon, Inc., Boston, Mass. (1977), incorporated herein by reference). Other scaffolds contemplated by the invention include peptide linkers, protein linkers such as human serum albumin, an antibody or fragment thereof, nucleic acid linkers, small carbon chain linkers, carbon linkers with oxygen or nitrogen interspersed, also

combinations of these examples are contemplated.

In another embodiment, a peptide has been selected as the targeting group that binds DBP. Methods of screening peptide or protein libraries for DBP binding peptides are known in the art. In a preferred embodiment, a two-hybrid method of identifying DBP binding peptides is used. In another preferred embodiment, an in vitro screen for DBP binding is used. This targeting peptide can then be covalently attached to or alternatively formulated with a drug. In a preferred embodiment, a scaffold moiety is used. In another embodiment, the targeting group is an aptamer that was selected because it binds DBP. Said aptamer may then be covalently attached to or formulated with a drug either through a scaffold or fused directly to the drug.

In one embodiment, the drug is a a DNA molecule, an RNA molecule, an aptamer (single-stranded or double-stranded), DNA or RNA oligonucleotides, larger DNA molecules that are linear or circular, oligonucleotides that are used for RNA interference (RNAi), variations of DNA such as substitution of DNA / RNA hybrid molecules, synthetic DNA-like molecules such as PNA or other nucleic acid derivative molecules (see WO07/035922, incorporated by reference herein in its entirety). In another embodiment, the therapeutic compound is composed of nuclease-resistant DNA or RNA oligonucleotides. In a preferred embodiment, nuclease-resistant DNA oligonucleotides are Morpholinos, (i.e. phosphorodiamidate analogs of nucleic acids that bind to nucleic acids in a sequence-specific manner, AVI BioPharma, Bothell, WA).

In another embodiment, the drug is a small molecule or chemical entity. In another embodiment, the drug is a peptide or a derivative of a peptide such as a PNA. In another embodiment, the drug is a protein comprised of all or part of a polypeptide, whether full-length or a fragment or truncated version, whether PEGylated, glycosylated or otherwise covalently or noncovalently modified or left unmodified.

Therapeutic compounds include proteins, peptides, glycoproteins, glycopeptides, glycolipids, polysaccharides, oligosaccharides, nucleic acids, and the like. Exemplary polypeptides include growth factors, such as hepatocyte growth factors (HGF), nerve growth factors (NGF), epidermal growth factors (EGF), fibroblast growth factors including FGF21, blood coagulation factors, hormones such as growth hormones, follicle stimulating hormone (FSH), cytokines, interferons, tumor necrosis factors, enzymes, bone morphogenetic proteins, neurotrophins, and growth differentiation factors. Compositions and methods of the invention also include conjugated agonists, antagonists, or other effectors of the above-mentioned proteins, glycoproteins, small molecules, hormones, growth factors, and other molecules found within a patient or subject.

Also within the scope of the invention are therapeutic peptides. The term peptide is meant to include a string of amino acids. The amino acids in the peptides of the invention may be naturally-occurring or non-naturally-occurring. The peptides of the invention may be synthesized chemically or biologically, and can include cysteine -rich peptides, circular peptides, stapled peptides, peptides that include D- or L- amino acids and mixtures thereof,

peptidomimetics, peptide-nucleic acids (PNAs), and combinations thereof. Exemplary embodiments include AIDS vaccines, allergy vaccines, anti-inflammatory peptides, anti-integrin peptides, anti-TCR vaccines, anti-allergy peptides, anti-cancer peptides, anti-fungal peptides, anti-bacterial peptides, anti-rheumatic peptides, anti-thrombin peptides, anti-viral peptides, G Protein-Coupled Receptor (GPCR) ligands and related peptides (e.g. the Secretin family), CGRP analogues, GPCR antagonists, CMV peptides, calpain inhibitors, collagenase inhibitors, DAP inhibitors, defensins, dialytic oligopeptides, Enhancins, endorphins, endothelin antagonists, fibronectin inhibitors, gastrin antagonists, ghrelin, glucagon antagonists, gonadorelin analogs, growth factor peptides, hypothalamic hormones, pituitary hormones, peptides that control gut function and appetite, proinflammatory adipose tissue products, peptides that stimulate stem cell proliferation, proinflammatory peptides, natural products, herpes simplex vaccines, heparin binding peptides, hepatitis-B vaccines, immunomodulating peptides, influenza vaccines, LHRH antagonists, opiod peptide derivatives, MMP inhibitors, MUC-1 vaccines, malaria vaccines, melanoma vaccines, meningitis vaccines, neuropeptides, opioid peptides, osteogenic growth peptides, osteoporosis peptides, papillomavirus vaccines, prostate cancer vaccines, RGD peptides, RSV vaccines, T cell receptor peptides and the like. The invention contemplates synthetic analogs thereof which would be improved as clinical products through further modification by the methods described herein. Those skilled in the art will recognize many additional commercially important peptides that are amenable to modifications described herein to provide increased half-life, duration of action, absorption and/or bioavailability.

Also contemplated within the scope of embodiments described herein are peptides that are branched or cyclic, with or without branching. Cyclic, branched and branched circular peptides result from post-translational natural processes and are also made by suitable synthetic methods. In some embodiments, any peptide product described herein comprises a peptide analog described above that is then covalently attached to an alkyl-glycoside surfactant moiety.

Also contemplated within the scope of embodiments presented herein are peptide chains that are substituted in a suitable position by the modification of the analogs claimed herein. For example, acylation is on a linker amino acid, for example, at the ε-position of Lysine, with fatty acids such as octanoic, decanoic, dodecanoic, tetradecanoic, hexadecanoic, octadecanoic, 3- phenylpropanoic acids and the like, or with saturated or unsaturated alkyl chains (Zhang, L. and Bulaj, G. (2012) Curr Med Chem 19: 1602-1618, incorporated herein by reference in its entirety).

Also contemplated within the scope of embodiments presented herein are peptide chains that are comprised of natural and unnatural amino acids or analogs of natural amino acids. As used herein, peptide and/or protein "analogs" comprise non-natural amino acids based on natural amino acids, such as tyrosine analogs, which includes para-substituted tyrosines, ortho- substituted tyrosines, and meta-substituted tyrosines, wherein the substituent on the tyrosine comprises an acetyl group, a benzoyl group, an amino group, a hydrazine, an hydroxyamine, a thiol group, a carboxy group, a methyl group, an isopropyl group, a C2-C20 straight chain or branched hydrocarbon, a saturated or unsaturated hydrocarbon, an O-methyl group, a polyether group, a halogen, a nitro group, or the like. Examples of Tyr analogs include 2,4-dimethyl- tyrosine (Dmt), 2,4-diethyl-tyrosine, O-4-allyl-tyrosine, 4-propyl-tyrosine, Ca-methyl-tyrosine and the like. Examples of lysine analogs include ornithine (Orn), homo-lysine, Ca-methyl-lysine (CMeLys), and the like. Examples of phenylalanine analogs include, but are not limited to, meta- substituted phenylalanines, wherein the substituent comprises a methoxy group, a C1-C20 alkyl group, for example a methyl group, an allyl group, an acetyl group, or the like. Specific examples include, but are not limited to, 2,4,6-trimethyl-L-phenylalanine (Tmp), O-methyl- tyrosine, 3-(2-naphthyl)alanine (Nal(2)), 3-(l-naphthyl)alanine (Nal(l)), 3-methyl-phenylalanine, 1 ,2,3,4-tetrahydroisoquinoline-3-carboxylic acid (Tic), fluorinated phenylalanines, isopropyl- phenylalanine, p-azido-phenylalanine, p-acyl-phenylalanine, p-benzoyl-phenylalanine, p-iodo- phenylalanine, p-bromophenylalanine, p-amino- phenylalanine, and isopropyl-phenylalanine, and the like.

Also contemplated within the scope of embodiments presented herein are peptide chains containing nonstandard or unnatural amino acids known to the art, for example, C-alpha- disubstituted amino acids such as Aib, Ca-diethylglycine (Deg), aminocyclopentane-l-carboxylic acid (Ac4c), aminocyclopentane-l-carboxylic acid (Ac5c), and the like. Such amino acids frequently lead to a restrained structure, often biased toward an alpha helical structure (Kaul, R. and Balaram, P. (1999) Bioorg Med Chem 7: 105-117, incorporated herein by reference in its entirety). Additional examples of such unnatural amino acids useful in analog design are homo- arginine (Har), and the like. Substitution of reduced amide bonds in certain instances leads to improved protection from enzymatic destruction or alters receptor binding. By way of example, incorporation of a Tic-Phe dipeptide unit with a reduced amide bond between the residues (designated as Tic- F[CH2-NH]^A-Phe) reduces enzymatic degradation.

Also contemplated within the scope of embodiments presented herein are modifications at the amino or carboxyl terminus may optionally be introduced into the present peptides or proteins (Nestor, J.J., Jr. (2009) Current Medicinal Chemistry 16: 4399 - 4418). For example, the present peptides or proteins can be truncated or acylated on the N-terminus (Gourlet, P., et al. (1998) Eur J Pharmacol 354: 105-1 1 1, Gozes, I. and Furman, S. (2003) Curr Pharm Des 9: 483- 494), the contents of which is incorporated herein by reference). Other modifications to the N- terminus of peptides or proteins, such as deletions or incorporation of D-amino acids such as D- Phe also can give potent and long acting agonists or antagonists when substituted with the modifications described herein such as long chain alkyl glycosides. Such agonists and antagonists also have commercial utility and are within the scope of contemplated embodiments described herein. The foregoing references are incorported herein in their entirety.

Also contemplated within the scope of embodiments described herein are carriers covalently attached, fused to or formulated with therapeutic compound analogs, wherein the native therapeutic compound is modified by acetylation, acylation, PEGylation, ADP- ribosylation, amidation, covalent attachment of a lipid or lipid derivative, covalent attachment of phosphotidylinositol, cross-linking, cyclization, disulfide bond formation, demethylation, formation of covalent cross-link formation of cysteine, formation of pyroglutamate, formylation, gamma-carboxylation, glycosylation, GPI anchor formation, hydroxylation, iodination, methylation, myristoylation, oxidation, proteolytic processing, phosphorylation, prenylation, racemization, glycosylation, lipid attachment, sulfation, gamma-carboxylation of glutamic acid residues, hydroxylation and ADP-ribosylation, selenoylation, sulfation, transfer-RNA mediated addition of amino acids to proteins, such as arginylation, and ubiquitination. See, for instance, (Nestor, J.J., Jr. (2007) Comprehensive Medicinal Chemistry II 2: 573-601, Nestor, J.J., Jr. (2009) Current Medicinal Chemistry 16: 4399 - 4418, Creighton, T.E. (1993, Wold, F. (1983) Posttranslational Covalent Modification of Proteins 1-12, Seifter, S. and Englard, S. (1990) Methods Enzymol 182: 626-646, Rattan, S.I., et al. (1992) Ann N Y Acad Sci 663: 48-62). The foregoing reference are incorporated by reference in their entirety.

Glycosylated therapeutic peptides may be prepared using conventional Fmoc chemistry and solid phase peptide synthesis techniques, e.g., on resin, where the desired protected glycoamino acids are prepared prior to peptide synthesis and then introduced into the peptide chain at the desired position during peptide synthesis. Thus, the therapeutic peptide polymer conjugates may be conjugated in vitro. The glycosylation may occur before deprotection.

Preparation of amino acid glycosides is described in U.S. Pat. No. 5,767,254, WO 2005/097158, and Doores, K., et al., Chem. Commun., 1401-1403, 2006, which are incorporated herein by reference in their entirety. For example, alpha and beta selective glycosylations of serine and threonine residues are carried out using the Koenigs-Knorr reaction and Lemieux's in situ anomerization methodology with Schiff base intermediates. Deprotection of the Schiff base glycoside is then carried out using mildly acidic conditions or hydrogenolysis. A composition, comprising a glycosylated therapeutic peptide conjugate is made by stepwise solid phase peptide synthesis involving contacting a growing peptide chain with protected amino acids in a stepwise manner, wherein at least one of the protected amino acids is glycosylated, followed by water- soluble polymer conjugation. Such compositions may have a purity of at least 95%, at least 97%, or at least 98%>, of a single species of the glycosylated and conjugated therapeutic peptide.

Monosaccharides that may by used for introduction at one or more amino acid residues of the therapeutic peptides defined and/or disclosed herein include glucose (dextrose), fructose, galactose, and ribose. Additional monosaccharides suitable for use include glyceraldehydes, dihydroxyacetone, erythrose, threose, erythrulose, arabinose, lyxose, xylose, ribulose, xylulose, allose, altrose, mannose, N-Acetylneuraminic acid, fucose, N- Acetylgalactosamine, and N- Acetylglucosamine, as well as others. Glycosides, such as mono-, di-, and trisaccharides for use in modifying a therapeutic peptide, one or more amino acid residues of the therapeutic peptides defined and/or disclosed herein include sucrose, lactose, maltose, trehalose, melibiose, and cellobiose, among others. Trisaccharides include acarbose, raffmose, and melezitose.

In further embodiments of the invention, the therapeutic compounds defined and/or disclosed herein may be chemically coupled to biotin. The biotin/therapeutic compound can then bind to avidin.

Also within the scope of the invention are polypeptides that are antibodies. The term antibody is meant to include monoclonal antibodies, polyclonal antibodies, toxin-conjugated antibodies, humanized antibodies, antibody fragments (e.g., Fc domains), Fab fragments, single chain antibodies, bi- or multi-specific antibodies, Llama antibodies, nano-bodies, diabodies, Fv, Fab, F(ab')2, Fab', scFv, scFv-Fc, and the like. Also included in the term are antibody-fusion proteins, such as Ig chimeras. Preferred antibodies include humanized or fully human

monoclonal antibodies or fragments thereof.

The terms "antibody" and "immunoglobulin" are used interchangeably in the broadest sense and include monoclonal antibodies (e.g., full length or intact monoclonal antibodies), polyclonal antibodies, monovalent antibodies, multivalent antibodies, multispecific antibodies (e.g., bispecific antibodies so long as they exhibit the desired biological activity) and may also include certain antibody fragments (as described in greater detail herein). An antibody can be chimeric, human, humanized and/or affinity matured.

The terms "full length antibody," "intact antibody" and "whole antibody" are used herein interchangeably to refer to an antibody in its substantially intact form, not antibody fragments as defined below. The terms particularly refer to an antibody with heavy chains that contain the Fc region. "Antibody fragments" comprise a portion of an intact antibody, preferably comprising the antigen binding region thereof. Examples of antibody fragments include Fab, Fab', F(ab')2, and Fv fragments; diabodies; linear antibodies; single-chain antibody molecules; and

multispecific antibodies formed from antibody fragments. The term "monoclonal antibody" as used herein refers to an antibody obtained from a population of substantially homogeneous antibodies, i.e., the individual antibodies comprising the population are identical except for possible mutations, e.g., naturally occurring mutations, that may be present in minor amounts. Thus, the modifier "monoclonal" indicates the character of the antibody as not being a mixture of discrete antibodies. In certain embodiments, such a monoclonal antibody typically includes an antibody comprising a polypeptide sequence that binds a target, wherein the target-binding polypeptide sequence was obtained by a process that includes the selection of a single target binding polypeptide sequence from a plurality of polypeptide sequences. For example, the selection process can be the selection of a unique clone from a plurality of clones, such as a pool of hybridoma clones, phage clones, or recombinant DNA clones. It should be understood that a selected target binding sequence can be further altered, for example, to improve affinity for the target, to humanize the target binding sequence, to improve its production in cell culture, to reduce its immunogenicity in vivo, to create a multispecific antibody, etc., and that an antibody comprising the altered target binding sequence is also a monoclonal antibody of this invention. In contrast to polyclonal antibody preparations which typically include different antibodies directed against different determinants (epitopes), each monoclonal antibody of a monoclonal antibody preparation is directed against a single determinant on an antigen. In addition to their specificity, monoclonal antibody preparations are advantageous in that they are typically uncontaminated by other immunoglobulins.

Antibodies that bind specifically to an antigen have a high affinity for that antigen. Antibody affinities may be measured by a dissociation constant (Kd). In certain embodiments, an antibody provided herein has a dissociation constant (Kd) of≤ 100 nM,≤10 nM,≤1 nM,≤0.1 nM, <0.01 nM, or <0.001 nM (e.g. 10-8M or less, e.g. from 10-8 M to 10-13M, e.g., from 10-9M to 10-13 M).

In one embodiment, Kd is measured by a radiolabeled antigen binding assay (RIA) performed with the Fab version of an antibody of interest and its antigen as described by the following assay. Solution binding affinity of Fabs for antigen is measured by equilibrating Fab with a minimal concentration of (125I)-labeled antigen in the presence of a titration series of unlabeled antigen, then capturing bound antigen with an anti-Fab antibody-coated plate (see, e.g., Chen et al, J. Mol. Biol. 293:865-881 (1999)). To establish conditions for the assay, MICROTITER® multi-well plates (Thermo Scientific) are coated overnight with 5 μg/ml of a capturing anti-Fab antibody (Cappel Labs) in 50 mM sodium carbonate (pH 9.6), and subsequently blocked with 2% (w/v) bovine serum albumin in PBS for two to five hours at room temperature (approximately 23° C). In a non-adsorbent plate (Nunc #269620), 100 μΜ or 26 μΜ [125I]-antigen are mixed with serial dilutions of a Fab of interest (e.g., consistent with assessment of the anti-VEGF antibody, Fab-12, in Presta et al, Cancer Res. 57:4593-4599 (1997)). The Fab of interest is then incubated overnight; however, the incubation may continue for a longer period (e.g., about 65 hours) to ensure that equilibrium is reached. Thereafter, the mixtures are transferred to the capture plate for incubation at room temperature (e.g., for one hour). The solution is then removed and the plate washed eight times with 0.1% polysorbate 20 (TWEEN-20®) in PBS. When the plates have dried, 150 μΐ/well of scintillant (MICROSCINT- 20™; Packard) is added, and the plates are counted on a TOPCOUNT™ gamma counter (Packard) for ten minutes. Concentrations of each Fab that give less than or equal to 20% of maximal binding are chosen for use in competitive binding assays.

According to another embodiment, Kd is measured using surface plasmon resonance assays using a BIACORE®-2000 or a BIACORE®-3000 (BIAcore, Inc., Piscataway, N.J.) at 25° C. with, e.g., immobilized antigen CM5 chips at ~10 response units (RU). Briefly, carboxymethylated dextran biosensor chips (CM5, BIACORE, Inc.) are activated with N-ethyl- N'-(3-dimethylaminopropyl)-carbodiimide hydrochloride (EDC) and N-hydroxysuccinimide (NHS) according to the supplier's instructions. Antigen is diluted with 10 mM sodium acetate, pH 4.8, to 5 μg/ml (~0.2 μΜ) before injection at a flow rate of 5 μΐ/minute to achieve

approximately 10 response units (RU) of coupled protein. Following the injection of antigen, 1 M ethanolamine is injected to block unreacted groups. For kinetics measurements, two-fold serial dilutions of Fab (0.78 nM to 500 nM) are injected in PBS with 0.05% polysorbate 20 (TWEEN-20™) surfactant (PBST) at 25° C. at a flow rate of approximately 25 μΐ/min.

Association rates (kon) and dissociation rates (koff) are calculated using a simple one-to-one Langmuir binding model (BIACORE® Evaluation Software version 3.2) by simultaneously fitting the association and dissociation sensorgrams. The equilibrium dissociation constant (Kd) is calculated as the ratio koff/kon See, e.g., Chen et al, J. Mol. Biol. 293:865-881 (1999). If the on-rate exceeds 106 M-l s-1 by the surface plasmon resonance assay above, then the on-rate can be determined by using a fluorescent quenching technique that measures the increase or decrease in fluorescence emission intensity (excitation=295 nm; emission=340 nm, 16 nm bandpass) at 25°C of a 20 nM anti-antigen antibody (Fab form) in PBS, pH 7.2, in the presence of increasing concentrations of antigen as measured in a spectrometer, such as a stop-flow equipped spectrophometer (Aviv Instruments) or a 8000-series SLM-AMINCO™ spectrophotometer (ThermoSpectronic) with a stirred cuvette. Other coupling chemistries for the target antigen to the chip surface (e.g., streptavidin/biotin, hydrophobic interaction, or disulfide chemistry) are also readily available instead of the amine coupling methodology (CM5 chip) described above, as will be understood by one of ordinary skill in the art. The modifier "monoclonal" indicates the character of the antibody as being obtained from a substantially homogeneous population of antibodies, and is not to be construed as requiring production of the antibody by any particular method. For example, the monoclonal antibodies to be used in accordance with the present invention may be made by a variety of techniques, including, for example, the hybridoma method (e.g., Kohler et al, Nature, 256: 495 (1975); Harlow et al, Antibodies: A Laboratory Manual, (Cold Spring Harbor Laboratory Press, 2nd ed. 1988); Hammerling et al, in: Monoclonal Antibodies and T- Cell Hybridomas 563-681 (Elsevier, N.Y., 1981)), recombinant DNA methods (see, e.g., U.S. Patent No. 4,816,567), phage display technologies (see, e.g., Clackson et al, Nature, 352: 624-628 (1991); Marks et al, J. Mol Biol 222: 581-597 (1992); Sidhu et al, J. Mol Biol 338(2): 299-310 (2004); Lee et al, J. Mol Biol 340(5): 1073-1093 (2004); Fellouse, Proc. Natl Acad. Sci. USA 101(34): 12467- 12472 (2004); and Lee et al, J. Immunol Methods 284(1-2): 119-132(2004), and technologies for producing human or human-like antibodies in animals that have parts or all of the human immunoglobulin loci or genes encoding human immunoglobulin sequences (see, e.g.,

W098/24893; WO96/34096; W096/33735; WO91/10741; Jakobovits et al, Proc. Natl. Acad. Sci. USA 90: 2551 (1993); Jakobovits et al, Nature 362: 255-258 (1993); Bruggemann et al, Year in Immunol. 7:33 (1993); U.S. Patent Nos. 5,545,807; 5,545,806; 5,569,825; 5,625,126; 5,633,425; 5,661,016; Marks et al, Bio. Technology 10: 779-783 (1992); Lonberg et al, Nature 368: 856-859 (1994); Morrison, Nature 368: 812-813 (1994); Fishwild et al, Nature Biotechnol. 14: 845-851 (1996); Neuberger, Nature Biotechnol. 14: 826 (1996) and Lonberg and Huszar, Intern. Rev. Immunol. 13: 65-93 (1995). The above patents, publications, and references are incorporated by reference in their entirety.

"Humanized" forms of non-human (e.g., murine) antibodies are chimeric antibodies that contain minimal sequence derived from non-human immunoglobulin. In one embodiment, a humanized antibody is a human immunoglobulin (recipient antibody) in which residues from a hypervariable region of the recipient are replaced by residues from a hypervariable region of a non-human species (donor antibody) such as mouse, rat, rabbit, or nonhuman primate having the desired specificity, affinity, and/or capacity. In some instances, framework region (FR) residues of the human immunoglobulin are replaced by corresponding non-human residues. Furthermore, humanized antibodies may comprise residues that are not found in the recipient antibody or in the donor antibody. These modifications may be made to further refine antibody performance. In general, a humanized antibody will comprise substantially all of at least one, and typically two, variable domains, in which all or substantially all of the hypervariable loops correspond to those of a non-human immunoglobulin, and all or substantially all of the FRs are those of a human immunoglobulin sequence. The humanized antibody optionally will also comprise at least a portion of an immunoglobulin constant region (Fc), typically that of a human immunoglobulin. For further details, see Jones et al, Nature 321 :522-525 (1986); Riechmann et al., Nature 332:323-329 (1988); and Presta, Curr. Op. Struct. Biol. 2:593-596 (1992). See also the following review articles and references cited therein: Vaswani and Hamilton, Ann. Allergy, Asthma & Immunol. 1 : 105-115 (1998); Harris, Biochem. Soc. Transactions 23: 1035-1038 (1995); Hurle and Gross, Curr. Op. Biotech. 5:428-433 (1994). The foregoing references are incorporated by reference in their entirety.

A "human antibody" is one which comprises an amino acid sequence corresponding to that of an antibody produced by a human and/or has been made using any of the techniques for making human antibodies as disclosed herein. Such techniques include screening human-derived combinatorial libraries, such as phage display libraries (see, e.g., Marks et al., J. Mol. Biol, 222: 581-597 (1991) and Hoogenboom et al, Nucl. Acids Res., 19: 4133-4137 (1991)); using human myeloma and mouse-human heteromyeloma cell lines for the production of human monoclonal antibodies (see, e.g., Kozbor, J. Immunol, 133: 3001 (1984); Brodeur et al, Monoclonal

Antibody Production Techniques and Applications, pp. 55-93 (Marcel Dekker, Inc., New York, 1987); and Boerner et al., J. Immunol, 147: 86 (1991)); and generating monoclonal antibodies in transgenic animals (e.g., mice) that are capable of producing a full repertoire of human antibodies in the absence of endogenous immunoglobulin production (see, e.g., Jakobovits et al, Proc. Natl. Acad. Sci USA, 90: 2551 (1993); Jakobovits et al, Nature, 362: 255 (1993);

Bruggermann et al, Year in Immunol, 7: 33 (1993)). This definition of a human antibody specifically excludes a humanized antibody comprising antigen-binding residues from a non- human animal.

All known types of such antibodies are within the scope of the invention. Exemplary antibodies include those that bind to growth factors, cytokines, lymphokines, cell surface receptors, enzymes, vascular endothelial growth factors, fibroblast growth factors, and antibodies to their respective receptors. Other exemplary antibodies include monoclonal antibodies directed to receptor-IgG Fc fusion proteins, and glycoproteins. Any modified (e.g., mutated) version of any of the above listed polypeptides is also within the scope of the invention. Therapeutic compounds to be used in the invention are known in the art and are disclosed by way of example in U.S. Patent No. 7,608,681, incorporated herein by reference in its entirety. Additionally, the invention contemplates conjugates of inhibitors or antagonists of naturally- occurring or non-naturally occurring antibodies in a subject that cause autoimmune diseases or undesirable inflammatory conditions.

Some aspects of the assembly of carriers utilizes chemical methods that are well-known in the art. For example, Vitamin E-PEG is manufactured by Eastman Chemical, Biotin-PEG is manufactured by many PEG manufacturers such as Enzon, Nektar and NOF Corporation.

Methods of producing PEG molecules with some vitamins and other therapeutic compounds linked to them follows these and other chemical methods known in the art. The attachment of PEG to an oligonucleotide or related molecule occurs, for example, as the PEG2-N- hydroxysuccinimide ester coupled to the oligonucleotide through the 5' amine moiety. Several coupling methods are contemplated and include, for example, NHS coupling to amine groups such as a lysine residue on a peptide, maleimide coupling to sulfhydryl group such as on a cysteine residue, iodoacetyl coupling to a sulfhydryl group, pyridyldithiol coupling to a sulfhydryl group, hydrazide for coupling to a carbohydrate group, aldehyde for coupling to the N-terminus, or tetrafluorophenyl ester coupling that is known to react with primary or secondary amines. Other possible chemical coupling methods are known to those skilled in the art and can be substituted. By way of example, conjugation using the coupling groups of the invention may be carried out using the compositions and methods described in WO93/012145 (Atassi et al.) and also see 7,803,777 (Defrees et al), incorporated by reference herein in their entirety.

In one embodiment, carrier compounds may be covalently or noncovalently attached to the drug. In another embodiment, the carrier compounds are separate from the drugs but are mixed together at discrete concentrations so as to become formulated into functional units. Exemplary drug formulations of the invention include aqueous solutions, organic solutions, powder formulations, solid formulations and a mixed phase formulations.

Pharmaceutical compositions of this invention comprise any of the compounds of the present invention, and pharmaceutically acceptable salts thereof, with any pharmaceutically acceptable carrier, adjuvant or vehicle. Pharmaceutically acceptable carriers, adjuvants and vehicles that may be used in the pharmaceutical compositions of this invention include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, serum proteins, such as human serum albumin, buffer substances such as phosphates, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances, polyethylene glycol, sodium carboxymethylcellulose, polyacrylates, waxes, polyethylene-polyoxypropylene -block polymers, polyethylene glycol and wool fat.

Pharmaceutically acceptable salts retain the desired biological activity of the therapeutic composition without toxic side effects. Examples of such salts are (a) acid addition salts formed with inorganic acids, for example, hydrochloric acid, hydrobromic acid, sulfuric acid, phosphoric acid, nitric acid and the like/ and salts formed with organic acids such as, for example, acetic acid, trifluoroacetic acid, tartaric acid, succinic acid, maleic acid, fumaric acid, gluconic acid, citric acid, malic acid, ascorbic acid, benzoic acid, tanic acid, pamoic acid, alginic acid, polyglutamic acid, naphthalenesulfonic acid, naphthalene disulfonic acid, polygalacturonic acid and the like; (b) base addition salts or complexes formed with polyvalent metal cations such as zinc, calcium, bismuth, barium, magnesium, aluminum, copper, cobalt, nickel, cadmium, and the like; or with an organic cation formed from Ν,Ν'-dibenzylethylenediamine or

ethlenediamine; or (c) combinations of (a) and (b), e.g. a zinc tannate salt and the like.

The pharmaceutical compositions of this invention may be administered by transdermal, oral, parenteral, inhalation, ocular, topical, rectal, nasal, buccal (including sublingual), vaginal, or implanted reservoir modes. The pharmaceutical compositions of this invention may contain any conventional, non-toxic, pharmaceutically-acceptable carriers, adjuvants or vehicles. The term parenteral as used herein includes subcutaneous, intracutaneous, intravenous,

intramuscular, intraarticular, intrasynovial, intrasternal, intrathecal, intralesional, and intracranial injection or infusion techniques.

Also contemplated, in some embodiments, are pharmaceutical compositions comprising as an active ingredient, therapeutic compounds described herein, or pharmaceutically acceptable salt thereof, in a mixture with a pharmaceutically acceptable, non-toxic component. As mentioned above, such compositions may be prepared for parenteral administration, particularly in the form of liquid solutions or suspensions; for oral or buccal administration, particularly in the form of tablets or capsules; for intranasal administration, particularly in the form of powders, nasal drops, evaporating solutions or aerosols; for inhalation, particularly in the form of liquid solutions or dry powders with excipients, defined broadly; for transdermal administration, particularly in the form of a skin patch or microneedle patch; and for rectal or vaginal administration, particularly in the form of a suppository.

The compositions may conveniently be administered in unit dosage form and may be prepared by any of the methods well-known in the pharmaceutical art, for example, as described in Remington's Pharmaceutical Sciences, 17^th ed., Mack Publishing Co., Easton, PA (1985), incorporated herein by reference in its entirety. Formulations for parenteral administration may contain as excipients sterile water or saline alkylene glycols such as propylene glycol, polyalkylene glycols such as polyethylene glycol, saccharides, oils of vegetable origin, hydrogenated napthalenes, serum albumin or other nanoparticles (as used in Abraxane™, American Pharmaceutical Partners, Inc. Schaumburg, IL), and the like. For oral administration, the formulation can be enhanced by the addition of bile salts or acylcarnitines. Formulations for nasal administration may be solid or solutions in evaporating solvents such as

hydrofluorocarbons, and may contain excipients for stabilization, for example, saccharides, surfactants, submicron anhydrous alpha-lactose or dextran, or may be aqueous or oily solutions for use in the form of nasal drops or metered spray. For buccal administration, typical excipients include sugars, calcium stearate, magnesium stearate, pregelatinated starch, and the like.

Delivery of modified therapeutic compounds described herein to a subject over prolonged periods of time, for example, for periods of one week to one year, may be

accomplished by a single administration of a controlled release system containing sufficient active ingredient for the desired release period. Various controlled release systems, such as monolithic or reservoir-type microcapsules, depot implants, polymeric hydrogels, osmotic pumps, vesicles, micelles, liposomes, transdermal patches, iontophoretic devices and alternative injectable dosage forms may be utilized for this purpose. Localization at the site to which delivery of the active ingredient is desired is an additional feature of some controlled release devices, which may prove beneficial in the treatment of certain disorders.

In certain embodiments for transdermal administration, delivery across the barrier of the skin would be enhanced using electrodes (e.g. iontophoresis), electroporation, or the application of short, high-voltage electrical pulses to the skin, radiofrequencies, ultrasound (e.g.

sonophoresis), microprojections (e.g. microneedles), jet injectors, thermal ablation,

magnetophoresis, lasers, velocity, or photomechanical waves. The drug can be included in single-layer drug-in-adhesive, multi-layer drug-in-adhesive, reservoir, matrix, or vapor style patches, or could utilize patchless technology. Delivery across the barrier of the skin could also be enhanced using encapsulation, a skin lipid fluidizer, or a hollow or solid microstructured transdermal system (MTS, such as that manufactured by 3M), jet injectors. Additives to the formulation to aid in the passage of therapeutic compounds through the skin include prodrugs, chemicals, surfactants, cell penetrating peptides, permeation enhancers, encapsulation technologies, enzymes, enzyme inhibitors, gels, nanoparticles and peptide or protein chaperones.

One form of controlled-release formulation contains the therapeutic compound or its salt dispersed or encapsulated in a slowly degrading, non-toxic, non-antigenic polymer such as copoly(lactic/glycolic) acid, as described in the pioneering work of Kent et al, US Patent No. 4,675,189, incorporated by reference herein. The compounds, or their salts, may also be formulated in cholesterol or other lipid matrix pellets, or silastomer matrix implants. Additional slow release, depot implant or injectable formulations will be apparent to the skilled artisan. See, for example, Sustained and Controlled Release Drug Delivery Systems, JR Robinson ed., Marcel Dekker Inc., New York, 1978; and Controlled Release of Biologically Active Agents, RW Baker, John Wiley & Sons, New York, 1987. The foregoing are incorporated by reference in their entirety.

An additional form of controlled-release formulation comprises a solution of

biodegradable polymer, such as copoly(lactic/gly colic acid) or block copolymers of lactic acid and PEG, is a bioacceptable solvent, which is injected subcutaneous ly or intramuscularly to achieve a depot formulation. Mixing of the therapeutic compounds described herein with such a polymeric formulation is suitable to achieve very long duration of action formulations.

When formulated for nasal administration, the absorption across the nasal mucous membrane may be further enhanced by surfactants, such as, for example, glycocholic acid, cholic acid, taurocholic acid, ethocholic acid, deoxycholic acid, chenodeoxycholic acid, dehdryocholic acid, glycodeoxycholic acid, cycledextrins and the like in an amount in the range of between about 0.1 and 15 weight percent, between about 0.5 and 4 weight percent, or about 2 weight percent. An additional class of absorption enhancers reported to exhibit greater efficacy with decreased irritation is the class of alkyl maltosides, such as tetradecylmaltoside (Arnold, JJ et al, 2004, J Pharm Sci 93: 2205-13; Ahsan, F et al, 2001, Pharm Res 18: 1742046) and references therein, all of which are hereby incorporated by reference.

The pharmaceutical compositions may be in the form of a sterile injectable preparation, for example, as a sterile injectable aqueous or oleaginous suspension. This suspension may be formulated according to techniques known in the art using suitable dispersing or wetting agents (such as, for example, Tween 80) and suspending agents. The sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenterally-acceptable diluent or solvent, for example, as a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that may be employed are mannitol, water, Ringer's solution and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium. For this purpose, any bland fixed oil may be employed including synthetic mono- or diglycerides. Fatty acids, such as oleic acid and its glyceride derivatives are useful in the preparation of injectables, as are natural pharmaceutically-acceptable oils, such as olive oil or castor oil, especially in their polyoxyethylated versions. These oil solutions or suspensions may also contain a long-chain alcohol diluent or dispersant such as Ph. Helv or a similar alcohol.

The pharmaceutical compositions of this invention may be orally administered in any orally acceptable dosage form including, but not limited to, capsules, tablets, and aqueous suspensions and solutions. In the case of tablets for oral use, carriers which are commonly used include lactose and corn starch. Lubricating agents, such as magnesium stearate, are also typically added. For oral administration in a capsule form, useful diluents include lactose and dried corn starch. When aqueous suspensions are administered orally, the active ingredient is combined with emulsifying and suspending agents. If desired, certain sweetening and/or flavoring and/or coloring agents may be added.

The pharmaceutical compositions of this invention may also be administered in the form of suppositories for rectal administration. These compositions can be prepared by mixing a compound of this invention with a suitable non-irritating excipient which is solid at room temperature but liquid at the rectal temperature and therefore will melt in the rectum to release the active components. Such materials include, but are not limited to, cocoa butter, beeswax and polyethylene glycols.

Topical administration of the pharmaceutical compositions of this invention is especially useful when the desired treatment involves areas or organs readily accessible by topical application. For application topically to the skin, the pharmaceutical composition should be formulated with a suitable ointment containing the active components suspended or dissolved in a carrier. Carriers for topical administration of the compounds of this invention include, but are not limited to, mineral oil, liquid petroleum, white petroleum, propylene glycol, polyoxyethylene polyoxypropylene compound, emulsifying wax and water. Alternatively, the pharmaceutical composition can be formulated with a suitable lotion or cream containing the active compound suspended or dissolved in a carrier. Suitable carriers include, but are not limited to, mineral oil, sorbitan monostearate, polysorbate 60, cetyl esters wax, cetearyl alcohol, 2-octyldodecanol, benzyl alcohol and water. The pharmaceutical compositions of this invention may also be topically applied to the lower intestinal tract by rectal suppository formulation or in a suitable enema formulation. Topical transdermal patches are also included in this invention.

The pharmaceutical compositions of this invention may be administered by nasal aerosol or inhalation. Such compositions are prepared according to techniques well-known in the art of pharmaceutical formulation and may be prepared as solutions in saline, employing benzyl alcohol or other suitable preservatives, absorption promoters to enhance bioavailability, fluorocarbons, and/or other solubilizing or dispersing agents known in the art.

When formulated for delivery by inhalation, a number of formulations offer advantages. Adsorption of the therapeutic compound to readily dispersed solids such as diketopiperazines (for example, Technosphere particles [Pfutzner, A and Forst, T, 2005, Expert Opin Drug Deliv 2: 1097-1106] or similar structures gives a formulation that results in rapid initial uptake of the therapeutic compound. Lyophilized powders, especially glassy particles, containing the therapeutic compound and an excipient are useful for delivery to the lung with good

bioavailability, for example, see Exubera® (inhaled insulin by Pfizer and Aventis

Pharmaceuticals Inc.).

Dosage levels of between about 0.01 and about 100 mg/kg body weight per day, preferably 0.5 and about 50 mg/kg body weight per day of the active ingredient compound are useful in the prevention and treatment of disease. Typically, the pharmaceutical compositions of this invention will be administered from about 1 to about 5 times per day or alternatively, as a continuous infusion. Such administration can be used as a chronic or acute therapy. The amount of active ingredient that may be combined with the carrier materials to produce a single dosage form will vary depending upon the host treated and the particular mode of administration. A typical preparation will contain from about 5% to about 95% active compound (w/w).

Preferably, such preparations contain from about 20% to about 80% active compound.

Upon improvement of a patient's condition, a maintenance dose of a compound, composition or combination of this invention may be administered, if necessary. Subsequently, the dosage or frequency of administration, or both, may be reduced, as a function of the symptoms, to a level at which the improved condition is retained when the symptoms have been alleviated to the desired level, treatment should cease. Patients may, however, require intermittent treatment on a long-term basis upon any recurrence of disease symptoms.

As the skilled artisan will appreciate, lower or higher doses than those recited above may be required. Specific dosage and treatment regimens for any particular patient will depend upon a variety of factors, including the activity of the specific compound employed, the age, body weight, general health status, gender, diet, time of administration, rate of excretion, drug combination, the severity and course of an infection, the patient's disposition to the infection and the judgment of the treating physician.

The carrier-drug conjugate, fusion or formulation provides advantages to the drug manufacturer and the patient over the unconjugated, unfused or unformulated drug. Specifically, the carrier-drug conjugate or formulation will be a more potent and longer lasting drug requiring smaller and less frequent dosing compared to the unconjugated, unfused or unformulated drug. This translates into lowered healthcare costs and a more convenient drug administration schedule for the patient. The carrier-drug conjugate or formulation can also influence the route of injection of a drug that is normally infused by intravenous injection to now be administered via subcutaneous injection or in a transdermal delivery system. The route of administration via subcutaneous injection or transdermal delivery is most favored because they can be self- administered by patients at home. This can improve patient compliance.

In yet another aspect of the invention, the levels of DBP can be increased as part of the carrier-drug therapy. It has been reported that estrogen can increase DBP levels (Speeckaert et al., Clinica Chimica Acta 371 :33). It is contemplated here that levels of DBP can be increased by administration of estrogen for more effective delivery of carrier-drug conjugates.

In yet another aspect of the invention, it is contemplated that the carrier can be used to deliver drugs transdermally. Since DBP normally transports UV activated vitamin D at locations close to the surface of the skin, the use of a transdermal delivery system with the carrier becomes feasible.

In order that the invention described herein may be more fully understood, the following examples are set forth. It should be understood that these examples are for illustrative purposes only and are not to be construed as limiting this invention in any manner.

EXAMPLES

Example 1: Preparation of an examplary thiol-reactive carrier composed of Vitamin D₃- PEG with a maleimide reactive group

The maleimide on the carrier in this example was used to conjugate to a free cysteine on a protein or peptide in Examples 2 and 3. It is contemplated that the size of the PEG in the scaffolds of the invention are from 0.1 kDa to lOOkDa. Thus, a 2kDa PEG was selected as a scaffold for this example. The starting materials used in this example were purchased from Toronto Research Chemicals for the Vitamin D analog (compound 1) and from Creative

Pegworks for the 2kDa mPEG-maleimide (compound 4) .

According to Figure 2, (R)-methyl5-((lR,3aS,7aR,E)-4-((Z)-2-((S)-5-((tert- butyldimethylsilyl)oxy)-2-methylenecy-clohexylidene)ethylidene)-7a-methyloctahydro-lH- inden-l-yl)hexanoate (compound 1, 7.5 mg, 0.0145 mmol, 1 equiv., purchased from Toronto Research Chemicals) was dissolved in anhydrous tetrahydrofuran (0.4 mL) and flushed with nitrogen. Tetrabutylammonium fluoride (22.7 mg, 0.087 mmol, 6 equiv.) was added and the reaction was stirred at room temperature for 3 hours with monitoring by thin layer chromatography (TLC, silica gel, 30% ethyl acetate in hexanes, UV detection, phosphomolybdic acid stain). To the resulting mixture containing compound 2 was added lithium hydroxide monohydrate (4.2 mg, 0.1015 mmol, 7 equiv.), tetrahydrofuran (0.3 mL) and water (0.15 mL). The reaction was flushed with nitrogen and stirred at room temperature for 18 hours. Evaluation by TLC and mass spectroscopy (MS) indicated complete reaction with the presence of expected compound 3. The reaction mixture was diluted with ether (2 x 15 mL) and washed with 10% aqueous citric acid (30 mL), water (30 mL) and brine (30 mL). The organic layer was dried over anhydrous sodium sulfate and concentrated while maintaining the temperature below 20°C. The sample was further dried under a stream of nitrogen giving ((R)-5-((lR,3aS,7aR,E)-4-((Z)-2- ((S)-5 -hydroxy-2-methylenecyclohexylidene)ethyl-idene)-7a-methyloctahydro- 1 H-inden- 1 - yl)hexanoic acid) (compound 3, 5.3 mg, 95% yield) as a colorless gum. Rf 0.2 (silica gel, 40% EtOAc in hexanes). NMR analysis revealed the presence of about 1.14% of THF and about 0.14% of ether.

Compound 3 (5.3 mg, 0.0137 mmol, 1 equiv.), compound 4 (MAL-PEG-amine TFA salt, 21.9 mg, 0.0109 mmol, 0.8 equiv., purchased from Creative Pegworks) and 2-chloro-l- methylpyridinium iodide (8.7 mg, 0.0342 mmol, 2.5 equiv.) were dissolved in anhydrous dichloromethane (0.5 mL). Triethylamine (7.6 ί, 0.0548 mmol, 4 equiv.) was added and the reaction mixture was stirred for 3 hours at room temperature under nitrogen. The reaction was then diluted with dichloromethane (30 mL) and washed with 10% aqueous citric acid (40 mL), saturated aqueous sodium bicarbonate (30 mL) and brine (30 mL). The organic layer was dried over anhydrous sodium sulfate, filtered and concentrated while maintaining the temperature below 20°C. The sample was further dried under a stream of nitrogen to afford the target compound as a brown gum. Rf 0.6 (silica gel, 20% methanol in dichloromethane). TLC analysis (ninhydrin stain) of the isolated product indicated the absence of compound 4. 1H NMR analysis of the isolated material confirmed its identity and purity. The NMR analysis did not show an appreciable amount of methylene choloride or other solvents.

Example 2: Preparation and characterization of a modified FGF21 protein-carrier conjugate:

A modified FGF21 was conjugated to the Vitamin D3-PEG-maleimide carrier described in Example 1. As shown below, the FGF21 -carrier composition provides significantly improved pharmacokinetic properties when compared to a naturally-occuring FGF21, thereby making the carrrier-conjugated molecule an important therapeutic compound for the treatment of diabetes.

FGF21 was expressed in E. coli, purified and conjugated to the carrier as follows. A modified FGF21 was designed to incorporate a free cysteine residue near the amino-terminus of FGF21 to allow site-specific coupling of the protein to the carrier and a His₆ tag added for ease of purification. The modified FGF21 coding sequence (SEQ ID NO:4) was computationally optimized for expression in E. coli, and the gene was chemically synthesized by a contract research organization (DNA2.0 Menlo Park, CA) and cloned into the expression vector pJexpress401 that contains a T5 promoter and a kanamycin resistance gene. The plasmid was transformed into E. coli Origami2 cells (EMD Biosciences Inc.). Expression of the FGF21 from the pJexpress401 vector in the Origami strain was accomplished as follows. Luria Broth plus 1% glucose was inoculated with an overnight culture at a 1 : 100 dilution and grown to log phase where the OD600 was 0.6. Then the culture temperature was reduced from 37°C to 18°C and the culture was induced using 0.2mM IPTG and grown overnight at 18°C while shaking at 180rpm. Cells were harvested, lysed and the supernatant collected. The protein was affinity purified using immobilized metal affinity chromatography (IMAC) resin and polished by ion exchange chromatography.

Purified FGF21 protein was then buffer exchanged into lOmM Tris pH 8.0, 50mM NaCl, lmM EDTA. Conjugation to the Vitamin D3-PEG-maleimide carrier molecule (Example 1) was accomplished by mixing the thiol-reactive carrier dissolved in DMSO at lOmg/mL with the FGF21 protein containing a free cysteine (SEQ ID NO:3) at 0.5mg/mL in a molar ratio of 2: 1 carrier to protein. The conjugated protein was separated from unreacted components by ion exchange chromatography. Conjugation and purity was confirmed by SDS-PAGE. FGF21 alone and the FGF21 -carrier conjugate were then buffer exchanged to PBS and sterilized using a 0.22 micron filter for use in the animal study.

Pharmacokinetics of FGF21 (SEQ ID NO:3) or the FGF21-carrier conjugate was studied in Sprague Dawley rats. Briefly, O. lmg/kg of each molecule was injected separately into the rats by SC injection. Samples of plasma were collected at 30 mins, 60 mins, 120 mins, 240 mins, 360 mins, 24 hrs and 48 hrs. Samples were analyzed using a commercial ELISA kit validated for FGF21 (Millipore, Cat. #EZHFGF21-19K). The results show a significant difference in absorption following SC administration between the FGF21 and the FGF21 -carrier conjugate at the following time points (30, 60, 120 and 240 mins), beyond which FGF21 levels began to decline (Figure 3). These data show that the conjugation of carrier to FGF21 significantly increased the bioavailability of FGF21 following SC injection (380-fold increase, calculated by dividing the average Cmax of FGF21, 376 pg/mL from average Cmax of the FGF21 -carrier conjugate, 143526 pg/mL). The area under the curve (AUC) was also calculated as 1047980 h*pg/mL for the FGF21 -carrier conjugate and 1551 h*pg/mL for FGF21 alone. Therefore, there was a 675-fold increase in drug exposure when dividing the mean AUC of FGF21 -carrier conjugate from the mean AUC of FGF21. Together, the data demonstrates the utility of the carrier molecule in increasing the bioavailability and indicates that conjugated FGF21 has significant pharmacokinetic advantages over the native FGF21.

Example 3: Preparation and characterization of a ghrelin peptide-carrier conjugate:

In this example, conjugation of the Vitamin D₃-PEG-maleimide carrier generated in Example 1 to ghrelin imparted a significantly longer half-life on ghrelin, thereby making the conjugated molecule a potentially useful therapeutic for the treatment of cachexia, anorexia and/or frailty in the elderly.

A synthetic rat ghrelin peptide with an added C-terminal cysteine was purchased from Innovagen (Lund, Sweden, SEQ ID NO: 6). The Vitamin D₃-PEG-maleimide carrier as described in Example 1 was selected to be proportional in size to a 2-3kDa peptide so that conjugation might not significantly affect the bioactivity. Conjugation with the carrier was accomplished by mixing a thiol reactive carrier (from Example 1) dissolved in DMSO at 10 mg/mL with the ghrelin peptide containing a free cysteine at a concentration of lmg/mL in 15 mM MES pH 6.0, ImM EDTA in a molar ratio of 2: 1 carrier to peptide. The conjugated peptide was separated from unreacted components by ion exchange chromatography. Conjugation and purity was confirmed by SDS-PAGE. Rat ghrelin (rGhrelin) peptide and the rGhrelin-carrier conjugates were then buffer exchanged to PBS and filter sterilized using a 0.22 micron filter for use in the animal study.

Pharmacokinetics of rGhrelin (SEQ ID NO: 6) or the rGhrelin-carrier conjugate was studied in Sprague Dawley rats. Briefly, O. lmg/kg of each molecule was injected separately into the rats by intravenous (IV) injection. Samples of plasma were collected at 30 mins, 60 mins, 120 mins, 240 mins, 360 mins, 24 hrs and 48 hrs. Samples were analyzed using a commercial ELISA kit validated for analyzing rGhrelin from rat plasma (Millipore, Cat. #EZRGRT-91K). The results show significant differences in the pharmacokinetic profiles of rGhrelin and the rGhrelin-carrier conjugate (Figure 4). Calculation of the half-life using WinNonLin revealed a 0.37 hr half-life for rGhrelin and an 8 hr half-life for the rGhrelin-carrier conjugate, which is calculated to be a 22-fold improvement. The data demonstrate a second example of the usefulness of the carrier molecule in increasing half- life. Thus, ghrelin in a conjugated form is a useful therapeutic for the treatment of ghrelin-responsive diseases such as cachexia, anorexia and frailty in the elderly.

Example 4. Assessment of the receptor binding activity of a ghrelin peptide-carrier.

The activity of the ghrelin peptide, when conjugated to a carrier, was not adversely affected by the presence of the scaffold and targeting groups. To show this, ghrelin (SEQ ID:5) and Vitamin D3-PEG-maleimide carrier-conjugated ghrelin from Example 3 were compared for receptor binding and activation of a ghrelin receptor (agonist activity) using a cell-based receptor agonist assay as described below.

The test compounds were added to GHS-R-expressing CHO-K1 cell cultures. Ghrelin binds and activates the GHS-R receptor and intracellular calcium responses were assessed as an indicator of agonist activity. The activity was measured by a calcium flux-based assay developed by GenScript USA Inc. for the FLIPR™ (Fluorescence Imaging Plate Reader) high- throughput cellular screening instrument.

CHO-K1 cells expressing GHS-R were cultured in Ham's F12 supplemented with 10% fetal bovine serum, 500mg/mL G418 and were passaged in order to maintain optimal cell health. The cells were seeded in a 384-well black- wall, clear-bottom plate at a density of 20,000 cells per well in 20 of growth medium 18 hours prior to the assay and maintained at 37°C/5% C0₂. At the beginning of the assay, 20 of Calcium-4 loading buffer was added into the wells. The plate was incubated in the dark at 37°C for 60 minutes then at room temperature for 15 minutes. The ghrelin and ghrelin-conjugate test articles were at an initial concentration of ImM in DMSO. The test articles were serially diluted 10-fold in Hank's Buffered Saline Solution (HBSS) with 20mM HEPES buffer pH 7.4 prior to addition to the test plates. The final concentration of each test article was 5x the concentration before addition to the cells. The intracellular calcium levels in the cells were measured for 20 seconds using the FLIPR™ instrument prior to addition of the test articles. Ten μΕ of each diluted test article was added to the plate to make a final volume of 50 μί. Changes in intracellular calcium levels were measured for an additional 100 sec (21 to 120 seconds).

The average value of the 20 second reading (1 to 20 seconds) was calculated as the baseline reading and the relative fluorescent units (ARFU) intensity values were calculated with the maximal fluorescent units (21 to 120 seconds) subtracting the average value of baseline reading. Data acquisition and analyses was performed using Screen Works® (version 3.1) and exported to Excel.

The % activation of compound was calculated using the following equation:

% activation = (ARFUcompound" ARFUBackground)/( ARFUA gonist control " ARFU_Background)} * 100% activation was then plotted as a function of the log of the cumulative doses of compounds. The data represent the average of duplicate determinations. The EC50 was determined using a data analysis wizard written by GenScript.

The EC50 value of ghrelin without carrier was 88.5nM. In comparison, the carrier- conjugated ghrelin had an EC50 value of 85nM, which is nearly identical to the control peptide. Thus, the agonist activity of the peptide was preserved following conjugation of the carrier to the ghrelin peptide. Note that the assays were done in the presence of 10% serum that contains DBP. No interference in receptor binding and activation was observed for the carrier-conjugated peptide.

Example 5. Preparation of an exemplary amine-reactive carrier composed of Vitamin D₃- PEG with a NHS-reactive group

NHS-reactive groups on carriers were generated for conjugation to amine groups on proteins. A 2 kDa PEG was selected as a scaffold for this example. The starting materials used in this example were purchased from Toronto Research Chemicals for the Vitamin D analog (compound 1) and from Creative Pegworks for the 2 kDa mPEG-amino acid (compound 5).

According to Figure 5 (steps 1 and 2): (R)-Methyl-5-((lR,3aS,7aR,E)-4-((Z)-2-((S)-5- ((tert-butyldimethylsilyl)oxy)-2-methylenecy-clohexylidene)ethylidene)-7a-methyloctahydro- lH-inden-l-yl)hexanoate (compound 1, 8.2 mg, 0.0159 mmol, 1 equiv.) was dissolved in anhydrous tetrahydrofuran (THF, 0.4 mL) and the mixture was flushed with nitrogen.

Tetrabutylammonium fluoride solution (25 mg, 0.096 mmol, 6 equiv.) was added and the reaction mixture was stirred at room temperature for 3 hr with monitoring by thin layer chromatography (TLC, silica gel, 30%> ethyl acetate in hexanes, UV detection, phosphomolybdic acid stain). To the resulting mixture containing compound 2, lithium hydroxide monohydrate (4.6 mg, 0.109 mmol, 7 equiv.), THF (0.3 mL), and water (0.16 mL) were added. The reaction mixture was flushed with nitrogen and stirred at room temperature for 18 hr. Evaluation by TLC and mass spectroscopy (MS) indicated complete reaction with the presence of the expected compound 3. The reaction mixture was diluted with ether (10 mL) and washed with 10% aqueous citric acid (10 mL), water (10 mL) and brine (10 mL). The organic layer was dried over anhydrous sodium sulfate and concentrated while maintaining the temperature below 20°C. The sample was further dried under a stream of nitrogen giving ((R)-5-((lR,3aS,7aR,E)-4-((Z)-2- ((S)-5 -hydroxy-2-methylenecyclohexylidene)ethyl-indene)-7a-methyloctahydro- 1 H-inden- 1 - yl)hexanoic acid (compound 3, 6.1 mg, 99% yield) as a colorless gum. Rf 0.2 (silica gel, 40% ethyl acetate (EtOAc) in hexanes). Nuclear magnetic resonance spectroscopy (NMR) analysis revealed the presence of ~7% of ether.

According to Figure 5 (step 3): to a solution of PEG-amino acid 4 (18.5 mg, 0.0092 mmol, purchased from Creative Pegworks) in anhydrous methanol, HC1 in dioxane (4 M, 1.5 mL) was added, and the reaction mixture was heated at 70°C in a sealed tube for 20 hr. The reaction was monitored by TLC (ninhydrin stain), and upon completion of the reaction, it was concentrated on a rotavap. The residue was co-evaporated with dichloromethane (3 x 5 mL) and ether (3 x 5 mL) to a pale yellow foam, which was suspended in ether (5 mL). The liquid was decanted and the solid obtained was dried to isolate the desired product 5 (14 mg, 75%) as a pale yellow solid. Rf 0.2 (silica gel, 20% methanol (MeOH) / DCM / 0.2 % NH40H). NMR analysis did not show an appreciable amount of methylene chloride or ether.

According to Figure 5 (step 4): compound 3 (3.4 mg, 0.009 mmol, 1 equiv.), compound 6 (methyl ester PEG-amine HC1 salt, 14 mg, 0.007 mmol, 0.8 equiv.) and 2-chloro-l- methylpyridinium iodide (5.6 mg, 0.022 mmol, 2.5 equiv.) were dissolved in anhydrous dichloromethane (0.6 mL). Triethylamine (5 ί, 0.0356 mmol, 4 equiv.) was added and the reaction mixture was stirred for 3 hr at room temperature under nitrogen. The reaction was incomplete at this time, therefore an additional amount of compound 3 (1.7 mg, 0.0045 mmol) was added and the reaction was continued further 3 hr, then diluted with dichloromethane (10 mL) and washed with 10% aqueous citric acid (10 mL), saturated aqueous sodium bicarbonate (10 mL) and brine (10 mL). The organic layer was dried over anhydrous sodium sulfate, filtered and concentrated while maintaining the temperature below 20°C. The sample was purified by silica gel (2 g) flash chromatography. The column was first eluted with ethyl acetate to remove unreacted compound 3 and then with 1-10 % MeOH / dichloromethane (20 mL each). Fractions containing pure product were combined together and evaporated on a rotavap, while maintaining the temperature below 20°C. The sample was dried under a stream of nitrogen to afford compound 7 as a brown gum (10 mg, 60%). Rf 0.3 (silica gel, 5% MeOH in dichloromethane). TLC analysis (ninhydrin stain) of the isolated product indicated the absence of compound 6. 1H NMR analysis of the isolated material confirmed its identity and purity. The NMR analysis revealed the presence of 1.1% of methylene chloride. According to Figure 5 (step 5): compound 7 (10 mg, 0.0042 mmol) was dissolved in a mixture of THF (0.2 mL) and a drop of methanol. To this solution was added lithium hydroxide monohydrate solution (0.9 mg, 0.021 mmol, 5 equiv. in 0.1 mL of water). The reaction mixture was flushed with nitrogen and stirred at room temperature for 18 hr. Evaluation by TLC indicated complete reaction with the presence of compound 8. The reaction mixture was diluted with dichloromethane (10 mL) and washed with 10% aqueous citric acid (10 mL) and brine (10 mL). The organic layer was dried over anhydrous sodium sulfate and concentrated while maintaining the temperature below 20°C. The sample was further dried under a stream of nitrogen giving the desired Vitamin-D₃-PEG-acid (compound 8, 7 mg, 71% yield) as a brown gum. Rf 0.2 (silica gel, 10% MeOH / dichloromethane). NMR analysis revealed the presence of ~2% of dichloromethane.

Stock solutions were prepared: 34 g of N-hydroxysuccinimide in 1 mL of anhydrous dimethylformamide (DMF) and 61 mg of dicyclohexylcarbodiimide (DCC) in 1 mL of anhydrous dichloromethane

According to Figure 5 (step 6): to a solution of compound 8 (7 mg, 0.003 mmol, 1 equiv.) in dichloromethane (0.3 mL) was added a solution of N-hydroxysuccinimide in DMF (10 μί, 0.34 mg, 0.003 mmol) followed by a solution of DCC in dichloromethane (10 μί, 0.61 mg, 0.003 mmol) and the reaction mixture was flushed with nitrogen and stirred for 20 hr. Since the reaction was incomplete as indicated by TLC, additional amounts of N-hydroxysuccinimide in DMF (25 μί, 0.85 mg, 0.0075 mmol) and DCC in dichloromethane (25 μί, 1.53 mg, 0.0075 mmol) were added and the reaction was continued for another 20 hr. Chloroform (10 mL) was added to the reaction mixture, and it was washed with water (10 mL). The organic phase was dried over sodium sulfate and the removal of solvent provided the desired target compound Vitamin D₃ - PEG - NHS (7.0 mg, crude). 1H NMR and TLC (R_f: 0.3, 10% MeOH /

chloroform) of this material indicated the presence of desired material. Vitamin D3 - PEG - NHS carrier was then used in Example 6.

Example 6. Preparation and characterization of an antibody-carrier conjugate

The infliximab-carrier conjugate of showed increased serum concentrations and bioavailability in rats when compared to infliximab alone.

Infliximab, sold as a lyophilized powder with the appropriate salts (Hannah

Pharmaceuticals), was resuspended to a concentration of 10 mg/mL with water. The Vitamin D3 - PEG - NHS carrier was resuspended at a concentration of 10 mg/mL in DMSO. The Vitamin D3 - PEG - NHS carrier and the infliximab were then mixed at a molar ratio of 5 : 1 and 10: 1 carrier to infliximab. A therapeutic compound carrier conjugate of the invention typically has at least 1 and could be between 1-10 carrier molecules individually attached to a therapeutic compound. By using an NHS version of the carrier, more than one carrier can be attached to a therapeutic protein and this can be experimentally controlled by altering the molar ratio of carrier to target therapeutic in the reaction. In this example, a target distribution of 2-4 carriers was set as a desired parameter. By testing two different molar ratios and examining the resulting conjugates by mass spectrometry, an actual ratio was determined.

The infliximab and infliximab NHS-carrier conjugates were separated from unconjugated carrier by use of a desalting column with a 40kDa cutoff (Zeba Spin, Thermo Scientific). Mass spectrometry was used to calculate the intact mass of infliximab in the reactions. The results show that unmodified infliximab had a mass predominatly of 149 kDa. The mass of the carrier- conjugated infliximab had a mass in increasing ratios with an average attachment of the 3 kDa carrier of 2-4 carriers per antibody.

The purified 5 : 1 reaction product was then used in a rat pharmacokinetic study comparing infliximab to the infliximab-carrier conjugate administered subcutaneously (SC). The dose was 1 mg/kg in all test groups with three rats per group. Serum samples were collected pre- dosing and at various times from 5 min to 48 hrs post injection. Serum samples were then analyzed by ELISA using an ELISA kit specific for determining the levels of infliximab in serum (Promonitor™ , Progenika™). Pharmacokinetic parameters were determined using WinNonLin. The results shown in Figure 6 demonstrate a 1.5 -fold improvement in serum concentration and area under the curve (AUC) when the antibody is conjugated to the Vitamin D3 - PEG - NHS carrier when compared to the unconjugated antibody. More specifically, at the 24 hr and 48 hr time points, a concentration of 2100 ng/mL and 4800 ng/mL are observed for infliximab. In contrast, at the 24 hr and 48 hr time points, a concentration of 3200 ng/mL and 7000 ng/mL are observed for carrier conjugated-infliximab. This translates into a 50% improvement in bioavailability. The AUC calculation showed a 50% improvement (Figure 6). Thus, this example shows the utility of the carrier in improving the serum concentration and bioavailability of infliximab when compared to the unconjugated antibody. Exemplary Sequences

SEQ ID NO: l

Human FGF21 protein sequence

MDSDETGFEHSGLWVSVLAGLLLGACQAHPIPDSSPLLQFGGQVRQRYLYTDDAQQTE AHLEIREDGTVGGAADQSPESLLQLKALKPGVIQILGVKTSRFLCQRPDGALYGSLHFDP EACSFRELLLEDGYNVYQSEAHGLPLHLPGNKSPHRDPAPRGPARFLPLPGLPPALPEPP GILAPQPPDVGSSDPLSMVGPSQGRSPSYAS

SEQ ID NO:2

Mature human FGF21 protein sequence

HPIPDSSPLLQFGGQVRQRYLYTDDAQQTEAHLEIREDGTVGGAADQSPESLLQLKALK PGVIQILGVKTSRFLCQRPDGALYGSLHFDPEACSFRELLLEDGYNVYQSEAHGLPLHLP GNKSPHRDPAPRGPARFLPLPGLPPALPEPPGILAPQPPDVGSSDPLSMVGPSQGRSPSYA S

SEQ ID NO:3

Modified mature human FGF21 protein sequence (N-terminal 6-his tag, tev cleavage site, an additional 182P at the C terminus, and modifications to the following residues using the numbering of the mature human FGF21 sequence: I3C, and G170E)

MGSHHHHHHSSGENLYFQGHPCPDSSPLLQFGGQVRQRYLYTDDAQQTEAHLEIREDG TVGGAADQSPESLLQLKALKPGVIQILGVKTSRFLCQRPDGALYGSLHFDPEACSFRELL LEDGYNVYQSEAHGLPLHLPGNKSPHRDPAPRGPARFLPLPGLPPALPEPPGILAPQPPD VGSSDPLSMVEPSQGRSPSYASP

SEQ ID NO:4

Optimized coding sequence for FGF21 expression in E. coli (see amino acids SEQ ID NO:3)

ATGGGCTCACATCATCACCACCATCATAGCAGCGGAGAGAACTTGTATTTTCAGGG

ACATCCGTGCCCTGACAGCAGCCCGCTGCTGCAGTTCGGTGGTCAAGTCCGTCAGCG

TTACCTGTACACTGACGACGCGCAACAGACCGAGGCGCACCTGGAAATTCGCGAAG

ATGGTACGGTGGGTGGCGCAGCGGACCAAAGCCCGGAGTCCCTGTTGCAGCTGAAG

GCCCTGAAGCCGGGTGTCATCCAAATCCTGGGCGTTAAAACCAGCCGTTTTCTGTGC

CAACGTCCGGATGGTGCGCTGTACGGTTCCCTGCACTTCGACCCAGAGGCATGTAGC

TTTCGTGAACTGCTGCTGGAAGATGGCTATAATGTGTACCAGTCTGAGGCGCACGGT CTGCCGTTGCACTTGCCGGGTAACAAAAGCCCGCACCGCGACCCAGCACCGCGTGG TCCGGCTCGCTTCCTGCCGCTGCCGGGTCTGCCTCCGGCGCTGCCGGAGCCGCCAGG CATTCTGGCTCCGCAACCGCCGGATGTTGGCAGCAGCGATCCGCTGAGCATGGTTGA ACCGTCGCAGGGCCGCAGCCCGTCTTATGCCAGCCCGTAA

SEQ ID NO:5

Human Ghrelin protein sequence

GS(n-octanoyl-S)FLSPEHQRVQQRKESKKPPAKLQPR SEQ ID NO:6

Rat Ghrelin with added C-term cys

GS(n-octanoyl-S)FLSPEHQKAQQRKESKKPPAKLQPRC

SEQ ID NO:7

DBP protein sequence

MKRVLVLLLAVAFGHALERGRDYEK KVCKEFSHLGKEDFTSLSLVLYSRKFPSGTFEQ

VSQLVKEVVSLTEACCAEGADPDCYDTRTSALSAKSCESNSPFPVHPGTAECCTKEGLE

RKLCMAALKHQPQEFPTYVEPTNDEICEAFRKDPKEYANQFMWEYSTNYGQAPLSLLV

SYTKSYLSMVGSCCTSASPTVCFLKERLQLKHLSLLTTLSNRVCSQYAAYGEK SRLSN

LIKLAQKVPTADLEDVLPLAEDITNILSKCCESASEDCMAKELPEHTVKLCDNLSTK SK

FEDCCQEKTAMDVFVCTYFMPAAQLPELPDVELPTNKDVCDPGNTKVMDKYTFELSRR

THLPEVFLSKVLEPTLKSLGECCDVEDSTTCFNAKGPLLKKELSSFIDKGQELCADYSEN

TFTEYKKKLAERLKAKLPDATPTELAKLVNKHSDFASNCCSINSPPLYCDSEIDAELK I

L

SEQ ID NO: 8

DBP nucelotide sequence

TTTAATAATAATTCTGTGTTGCTTCTGAGATTAATAATTGATTAATTCATAGTCAGGA

ATCTTTGTAAAAAGGAAACCAATTACTTTTGGCTACCACTTTTACATGGTCACCTAC

AGGAGAGAGGAGGTGCTGCAAGACTCTCTGGTAGAAAAATGAAGAGGGTCCTGGT

ACTACTGCTTGCTGTGGCATTTGGACATGCTTTAGAGAGAGGCCGGGATTATGAAAA

GAATAAAGTCTGCAAGGAATTCTCCCATCTGGGAAAGGAGGACTTCACATCTCTGTC

ACTAGTCCTGTACAGTAGAAAATTTCCCAGTGGCACGTTTGAACAGGTCAGCCAACT TGTGAAGGAAGTTGTCTCCTTGACCGAAGCCTGCTGTGCGGAAGGGGCTGACCCTG

ACTGCTATGACACCAGGACCTCAGCACTGTCTGCCAAGTCCTGTGAAAGTAATTCTC

CATTCCCCGTTCACCCAGGCACTGCTGAGTGCTGCACCAAAGAGGGCCTGGAACGA

AAGCTCTGCATGGCTGCTCTGAAACACCAGCCACAGGAATTCCCTACCTACGTGGA

ACCCACAAATGATGAAATCTGTGAGGCGTTCAGGAAAGATCCAAAGGAATATGCTA

ATCAATTTATGTGGGAATATTCCACTAATTACGGACAAGCTCCTCTGTCACTTTTAGT

CAGTTACACCAAGAGTTATCTTTCTATGGTAGGGTCCTGCTGTACCTCTGCAAGCCC

AACTGTATGCTTTTTGAAAGAGAGACTCCAGCTTAAACATTTATCACTTCTCACCAC

TCTGTCAAATAGAGTCTGCTCACAATATGCTGCTTATGGGGAGAAGAAATCAAGGC

TCAGCAATCTCATAAAGTTAGCCCAAAAAGTGCCTACTGCTGATCTGGAGGATGTTT

TGCCACTAGCTGAAGATATTACTAACATCCTCTCCAAATGCTGTGAGTCTGCCTCTG

AAGATTGCATGGCCAAAGAGCTGCCTGAACACACAGTAAAACTCTGTGACAATTTA

TCCACAAAGAATTCTAAGTTTGAAGACTGTTGTCAAGAAAAAACAGCCATGGACGT

TTTTGTGTGCACTTACTTCATGCCAGCTGCCCAACTCCCCGAGCTTCCAGATGTAGA

GTTGCCCACAAACAAAGATGTGTGTGATCCAGGAAACACCAAAGTCATGGATAAGT

ATACATTTGAACTAAGCAGAAGGACTCATCTTCCGGAAGTATTCCTCAGTAAGGTAC

TTGAGCCAACCCTAAAAAGCCTTGGTGAATGCTGTGATGTTGAAGACTCAACTACCT

GTTTTAATGCTAAGGGCCCTCTACTAAAGAAGGAACTATCTTCTTTCATTGACAAGG

GACAAGAACTATGTGCAGATTATTCAGAAAATACATTTACTGAGTACAAGAAAAAA

CTGGCAGAGCGACTAAAAGCAAAATTGCCTGATGCCACACCCACGGAACTGGCAAA

GCTGGTTAACAAGCACTCAGACTTTGCCTCCAACTGCTGTTCCATAAACTCACCTCC

TCTTTACTGTGATTCAGAGATTGATGCTGAATTGAAGAATATCCTGTAGTCCTGAAG

CATGTTTATTAACTTTGACCAGAGTTGGAGCCACCCAGGGGAATGATCTCTGATGAC

CTAACCTAAGCAAAACCACTGAGCTTCTGGGAAGACAACTAGGATACTTTCTACTTT

TTCTAGCTACAATATCTTCATACAATGACAAGTATGATGATTTGCTATCAAAATAAA

TTGAAATATAATGCAAACCATAAAAAAAAAAAAAAAAAAAAAAA

SEQ ID NO:9

Tumor necrosis factor-alpha (TNF-a)

ATGAGCACTGAAAGCATGATCCGGGACGTGGAGCTGGCCGAGGAGGCGCTCCCCAA GAAGACAGGGGGGCCCCAGGGCTCCAGGCGGTGCTTGTTCCTCAGCCTCTTCTCCTT CCTGATCGTGGCAGGCGCCACCACGCTCTTCTGCCTGCTGCACTTTGGGGTGATCGG CCCCCAGAGGGAAGAGTTCCCCAGGGACCTCTCTCTAATCAGCCCTCTGGCCCAGGC AGTCAGATCATCTTCTCGAACCCCGAGTGACAAGCCTGTAGCCCATGTTGTAGCAAA

CCCTCAAGCTGAGGGGCAGCTCCAGTGGCTGAACCGCCGGGCCAATGCCCTCCTGG

CCAATGGCGTGGAGCTGAGAGATAACCAGTTGGTGGTGCCATCAGAGGGCCTGTAC

CTCATCTACTCCCAGGTCCTCTTCAAGGGCCAAGGCTGCCCCTCCACCCATGTGCTC

CTCACCCACACCATCAGCCGCATCGCCGTCTCCTACCAGACCAAGGTCAACCTCCTC

TCTGCCATCAAGAGCCCCTGCCAGAGGGAGACCCCAGAGGGGGCTGAGGCCAAGCC

CTGGTATGAGCCCATCTATCTGGGAGGGGTCTTCCAGCTGGAGAAGGGTGACCGAC

TCAGCGCTGAGATCAATCGGCCCGACTATCTCGACTTT

GCCGAGTCTGGGCAGGTCTACTTTGGGATCATTGCCCTGTGA

SEQ ID NO: 10

Tumor necrosis factor-alpha (TNF-a)

MSTESMIRDVELAEEALPK TGGPQGSRRCLFLSLFSFLIVAGATTLFCLLHFGVIGPQRE EFPRDLSLISPLAQAVRSSSRTPSDKPVAHVVANPQAEGQLQWLNRRANALLANGVELR DNQLVVPSEGLYLIYSQVLFKGQGCPSTHVLLTHTISRIAVSYQTKVNLLSAIKSPCQRET PEGAEAKPWYEPIYLGGVFQLEKGDRLSAEINRPDYLDFAESGQVYFGIIAL

All publications and patent documents disclosed or referred to herein are incorporated by reference in their entirety. The foregoing description has been presented only for purposes of illustration and description. This description is not intended to limit the invention to the precise form disclosed. It is intended that the scope of the invention be defined by the claims appended hereto.

Claims

WHAT IS CLAIMED:

1. A pharmaceutical carrier, comprising

(a) a targeting group that binds the Vitamin D Binding Protein (DBP), and

(b) a coupling group for conjugating said targeting group to a therapeutic compound, wherein said pharmaceutical carrier increases the absorption, half-life, potency or bioavailability of said therapeutic compound in circulation.

2. The pharmaceutical carrier of claim 1, wherein said targeting group is selected from the group consisting of vitamin D, a vitamin D analog, a vitamin D-related metabolite, an analog of a vitamin D related-metabolite, a peptide, an anti-DBP antibody, an anti-DBP antibody derivative, a nucleotide aptamer, and a small carbon-based molecule that binds DBP.

3. The pharmaceutical carrier of claim 1 further comprising a scaffold moiety, wherein said scaffold moiety is selected from the group consisting of poly(ethylene glycol), polylysine, polyethyleneimine, poly(propyleneglycol), a peptide, serum albumin, thioredoxin, an

immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contains a reactive linker, a water-soluble polymer, a small carbon chain linker, and an additional therapeutic moiety.

4. The pharmaceutical carrier of claim 1, wherein said coupling group is selected from the group consisting of an amine-reactive group, a thiol-reactive group, a maleimide group, a thiol group, an aldehyde group, an NHS-ester group, a haloacetyl group, an iodoacetyl group, a bromoacetyl groups, a SMCC group, a sulfo SMCC group, a carbodiimide group, bifunctional cross-linkers, NHS-Maleimido, and combinations thereof.

5. The pharmaceutical carrier of claim 3, wherein said scaffold moiety is between about 100 Da. and 200,000 Da.

6. The pharmaceutical carrier of claim 5, wherein said scaffold moiety is between about 100 Da. and 20,000 Da., 200 Da. and 15,000 Da., 300 Da. and 10,000 Da., 400 Da. and 9,000 Da., 500 Da. and 5,000 Da., 600 Da. and 2,000 Da., 1000 Da. and 200,000 Da., 5000 Da. and 100,000 Da., 10,000 Da. and 80,000 Da., 20,000 Da. and 60,000 Da., or 20,000 Da. and 40,000 Da.

7. A pharmaceutical composition, comprising a therapeutic compound conjugated to or formulated with a carrier, wherein said carrier comprises a targeting group that binds the

Vitamin D Binding Protein (DBP) and wherein said carrier increases the absorption,

bioavailability, or half-life of said therapeutic compound in circulation.

8. The pharmaceutical composition of claim 7, wherein said targeting group is selected from the group consisiting of vitamin D, a vitamin D analog, a vitamin D-related metabolite, an analog of a vitamin D-related metabolite, a peptide, an anti-DBP antibody, an anti-DBP antibody derivative, a nucleotide aptamer, and a small carbon-based molecule that binds DBP.

9. The pharmaceutical composition of claim 7 further comprising a scaffold moiety, wherein said scaffold moiety is selected from the group consisting of poly(ethylene glycol), polylysine, polyethyleneimine, poly(propyleneglycol), a peptide, serum albumin, thioredoxin, an

immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contain a reactive linker, a water-soluble polymer, a small carbon chain linker, and an additional therapeutic compound.

10. The pharmaceutical composition of any one of claims 7 to 9, wherein said therapeutic compound is selected from the group consisting of small molecules, chemical entities, nucleic acids, nucleic acid derivatives, peptides, peptide derivatives, naturally-occurring proteins, non- naturally-occurring proteins, peptide -nucleic acids (PNA), stapled peptides, morpholinos, phosphorodiamidate morpholinos, antisense drugs, RNA-based silencing drugs, aptamers, glycoproteins, enzymes, hormones, cytokines, interferons, growth factors, blood coagulation factors, antibodies, antibody fragments, antibody derivatives, toxin-conjugated antibodies, metabolic effectors, analgesics, antipyretics, anti-inflammatory agents, antibiotics, anti-microbial agents, anti-viral agents, anti-fungal drugs, musculoskeletal drugs, cardiovascular drugs, renal drugs, pulmonary drugs, digestive disease drugs, hematologic drugs, urologic drugs, metabolism drugs, hepatic drugs, neurological drugs, anti-diabetes drugs, anti-cancer drugs, drugs for treating stomach conditions, drugs for treating colon conditions, drugs for treating skin conditions, and drugs for treating lymphatic conditions.

11. The pharmaceutical composition of claim 10, wherein said therapeutic compound is a protein having FGF21 activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:2.

12. The pharmaceutical composition of claim 11, wherein said targeting group is Vitamin D.

13. The pharmaceutical composition of claim 11, wherein said scaffold moiety is poly(ethylene glycol).

14. A pharmaceutical composition, comprising

(a) a protein having FGF21 activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:2,

(b) a scaffold moiety that is poly(ethylene glycol), and

(c) a targeting group that is Vitamin D,

wherein said targeting group increases the absorption, bioavailability, or the half-life of said therapeutic compound in circulation.

15. The pharmaceutical composition of claim 10, wherein said therapeutic compound is a protein having ghrelin activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:5.

16. The pharmaceutical composition of claim 15, wherein said targeting group is Vitamin D.

17. The pharmaceutical composition of claim 15, wherein said scaffold moiety is poly(ethylene glycol).

18. A pharmaceutical composition, comprising

(a) a protein having ghrelin activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:5,

(b) a scaffold moiety that is poly(ethylene glycol), and

(c) a targeting group that is Vitamin D,

wherein said targeting group increases the absorption, bioavailability, or half-life of said therapeutic compound in circulation.

19. A method of treating a patient in need of a therapeutic compound, comprising administering an effective amount of the pharmaceutical composition of any one of claims 7-9.

20. The method of claim 19, wherein said therapeutic compound selected from the group consisting of small molecules, chemical entities, nucleic acids, nucleic acid derivatives, peptides, peptide derivatives, naturally-occurring proteins, non-naturally-occurring proteins, peptide- nucleic acids (PNA), stapled peptides, morpholinos, phosphorodiamidate morpholinos, antisense drugs, RNA-based silencing drugs, aptamers, glycoproteins, enzymes, hormones, cytokines, interferons, growth factors, blood coagulation factors, antibodies, antibody fragments, antibody derivatives, toxin-conjugated antibodies, metabolic effectors, analgesics, antipyretics, antiinflammatory agents, antibiotics, anti-microbial agents, anti-viral agents, anti-fungal drugs, musculoskeletal drugs, cardiovascular drugs, renal drugs, pulmonary drugs, digestive disease drugs, hematologic drugs, urologic drugs, metabolism drugs, hepatic drugs, neurological drugs, anti-diabetes drugs, anti-cancer drugs, drugs for treating stomach conditions, drugs for treating colon conditions, drugs for treating skin conditions, and drugs for treating lymphatic conditions.

21. The method of claim 20, wherein said therapeutic compound is a protein having FGF21 activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:2.

22. The method of claim 20, wherein said therapeutic compound is a protein having ghrelin activity comprising an amino acid sequence with at least a 90% sequence identity to SEQ ID NO:5.

23. The method of claim 19, wherein said targeting group is Vitamin D.

24. The method of claim 19, wherein said scaffold is poly(ethylene glycol).

25. The method of of claim 19, wherein said pharmaceutical composition is in a

pharmaceutically acceptable formulation.

26. The method of claim 19, wherein said pharmaceutical composition is delivered to said patient by a transdermal, oral, parenteral, subcutaneous, intracutaneous, intravenous,

intramuscular, intraarticular, intrasynovial, intrasternal, intrathecal, intralesional, intracranial injection, infusion, inhalation, ocular, topical, rectal, nasal, buccal, sublingual, vaginal, or implanted reservoir mode.

27. The use of the pharmaceutical composition of any one of claims 7 to 9, 14 or 18 for the manufacture of a medicament for the treatment of a patient in need of said medicament.

28. A method of manufacturing the pharmaceutical composition of any one of claims 7 to 9, 14 or 18, comprising conjugating a targeting group and a drug into a carrier-drug compound, wherein said conjugating step utilizes a coupling group.

29. The method according to claim 28, further comprising conjugating a scaffold moiety to said targeting group or said drug.

30. The method according to claim 28, wherein said coupling group is selected from the group consisting of an amine-reactive group, a thiol-reactive group, a maleimide group, a thiol group, an aldehyde group, an NHS-ester group, a haloacetyl group, an iodoacetyl group, a bromoacetyl groups, a SMCC group, a sulfo SMCC group, a carbodiimide group, bifunctional cross-linkers, NHS-Maleimido, and combinations thereof.

31. The pharmaceutical composition resulting from the method of claim 28, wherein sad composition comprises a carrier-drug compound containin a linkage selected from the group consisting of a thiol linkage, an amide linkage, an oxime linkage, a hydrazone linkage, and a thiazolidinone linkage.

32. The method according to claim 28, wherein said conjugating step is accomplished by cycloaddition reactions.

33. The method of claim 28, wherein said targeting group is selected from the group consisting of vitamin D, a vitamin D analog, a vitamin D-related metabolite, an analog of a vitamin D- related metabolite, a peptide, an anti-DBP antibody, an anti-DBP antibody derivative, a nucleotide aptamer, and a small carbon-based molecule that binds DBP.

34. The method of claim 28, wherein said scaffold moiety is selected from the group consisting of poly(ethylene glycol), polylysine, polyethyleneimine, poly(propyleneglycol), a peptide, serum albumin, thioredoxin, an immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contain a reactive linker, a water-soluble polymer, a small carbon chain linker, and an additional therapeutic moiety.

35 The pharmaceutical composition of claim 10, wherein said therapeutic compound is an antibody.

36. The pharmaceutical composition of claim 35, wherein said antibody is an anti-TNFalpha antibody that specifically binds a protein having an amino acid sequence of at least a 90% sequence identity to SEQ ID NO: 10.

37. The pharmaceutical composition of claim 36, wherein said anti-TNFalpha antibody specifically binds a protein having the amino acid sequence of SEQ ID NO: 10.

38. The pharmaceutical composition of claim 37, wherein said targeting group is Vitamin D and said scaffold moiety is poly(ethylene glycol).

39. A pharmaceutical carrier comprising a formula I:

B— L¹— S— L²— L³— C

I

Wherein:

B is a targeting group selected from vitamin D, a vitamin D analog, a vitamin D-related metabolite, an analog of a vitamin D related-metabolite, a peptide that binds DBP, an anti-DBP antibody, an anti-DBP antibody derivative, a nucleotide aptamer that binds DBP, or a small carbon-based molecule that binds DBP;

S is a scaffold moiety, comprising poly(ethylene glycol), polylysine, polyethyleneimine, poly(propyleneglycol), a peptide, serum albumin, thioredoxin, an immunoglobulin, an amino acid, a nucleic acid, a glycan, a modifying group that contains a reactive linker, polylactic acid, a water-soluble polymer, a small carbon chain linker, or an additional therapeutic moiety;

C is an amine -reactive group, a thiol-reactive group, a maleimide group, a thiol group, a disulfide group, an aldehyde group, an NHS-ester group, a 4-nitrophenyl ester, an acylimidazole, a haloacetyl group, an iodoacetyl group, a bromoacetyl groups, a SMCC group, a sulfo SMCC group, a carbodiimide group and bifunctional cross-linkers such as NHS-Maleimido or combinations thereof;

OC(O)-, -0-, -S-S-, -S-, -S(O)-, -S(0)₂- and -NH-;

L³ is -(CH₂)₀-;

n is an integer from 0-3; and

o is an integer from 0-3.

The pharmaceutical carrier of claim 39 comprising formula V:

The pharmaceutical carrier of claim 39 comprising formula VI