WO2014118481A1 - Mutants du facteur x - Google Patents

Mutants du facteur x Download PDF

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Publication number
WO2014118481A1
WO2014118481A1 PCT/FR2014/050191 FR2014050191W WO2014118481A1 WO 2014118481 A1 WO2014118481 A1 WO 2014118481A1 FR 2014050191 W FR2014050191 W FR 2014050191W WO 2014118481 A1 WO2014118481 A1 WO 2014118481A1
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WIPO (PCT)
Prior art keywords
seq
sequence
factor
thrombin
mutation
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PCT/FR2014/050191
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English (en)
French (fr)
Inventor
Jean-Luc Plantier
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LFB SA
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LFB SA
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Publication date
Priority to DK14708609.4T priority Critical patent/DK2951297T3/en
Priority to ES14708609.4T priority patent/ES2636162T3/es
Priority to MX2015009867A priority patent/MX2015009867A/es
Priority to EP14708609.4A priority patent/EP2951297B1/fr
Priority to CN201480007229.6A priority patent/CN104995297B/zh
Priority to KR1020157024083A priority patent/KR101942619B1/ko
Priority to AU2014210986A priority patent/AU2014210986A1/en
Priority to JP2015555777A priority patent/JP2016506945A/ja
Application filed by LFB SA filed Critical LFB SA
Priority to CA2900010A priority patent/CA2900010A1/en
Priority to US14/765,073 priority patent/US10364424B2/en
Publication of WO2014118481A1 publication Critical patent/WO2014118481A1/fr
Priority to IL239889A priority patent/IL239889A0/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N9/00—Enzymes; Proenzymes; Compositions thereof; Processes for preparing, activating, inhibiting, separating or purifying enzymes
    • C12N9/14—Hydrolases (3)
    • C12N9/48—Hydrolases (3) acting on peptide bonds (3.4)
    • C12N9/50—Proteinases, e.g. Endopeptidases (3.4.21-3.4.25)
    • C12N9/64—Proteinases, e.g. Endopeptidases (3.4.21-3.4.25) derived from animal tissue
    • C12N9/6421—Proteinases, e.g. Endopeptidases (3.4.21-3.4.25) derived from animal tissue from mammals
    • C12N9/6424—Serine endopeptidases (3.4.21)
    • C12N9/6432—Coagulation factor Xa (3.4.21.6)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/43—Enzymes; Proenzymes; Derivatives thereof
    • A61K38/46—Hydrolases (3)
    • A61K38/48—Hydrolases (3) acting on peptide bonds (3.4)
    • A61K38/482—Serine endopeptidases (3.4.21)
    • A61K38/4846—Factor VII (3.4.21.21); Factor IX (3.4.21.22); Factor Xa (3.4.21.6); Factor XI (3.4.21.27); Factor XII (3.4.21.38)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
    • A61P7/02—Antithrombotic agents; Anticoagulants; Platelet aggregation inhibitors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
    • A61P7/04—Antihaemorrhagics; Procoagulants; Haemostatic agents; Antifibrinolytic agents
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12Y—ENZYMES
    • C12Y304/00—Hydrolases acting on peptide bonds, i.e. peptidases (3.4)
    • C12Y304/21—Serine endopeptidases (3.4.21)
    • C12Y304/21006—Coagulation factor Xa (3.4.21.6)

Definitions

  • the present invention relates to factor X mutants, and their use for the treatment of blood coagulation disorders.
  • Factor X is a protein found in the blood. This protein plays an important role in the coagulation cascade. Blood clotting is a complex process that prevents the flow of blood through damaged vessels. As soon as a vessel is broken, the elements responsible for coagulation interact with each other to form a plug, the platelet nail, where the vessel is broken. Coagulation factors are required to hold the platelet nail in place and stabilize the clot.
  • Step 1 The blood vessel is damaged.
  • Step 2 The blood vessel contracts to restrict blood supply to the injured area.
  • Step 3 Platelets adhere to the subendothelial space exposed during vessel injury and to the walls of the stimulated blood vessels. Platelets spread out, this is called platelet adhesion. These spread platelets release substances that activate other nearby platelets to agglomerate at the lesion site to form the platelet nail. This is called platelet aggregation.
  • Step 4 The surface of the activated platelets thus constitutes a surface on which blood coagulation can take place.
  • Coagulation proteins circulating in the blood (including factor X) are activated on the surface of platelets and form a fibrin clot.
  • coagulation proteins i.e., factors I, II, V, VIII, IX, X, XI, XII and XIII, as well as von Willebrand factor
  • Factor X in activated form (Xa) intervenes more particularly in the activation of prothrombin (factor II) in thrombin (factor Ha), in particular when it is complexed with activated c-factor V to form the prothrombinase complex.
  • This factor is an essential element in the coagulation cascade.
  • Factor X deficiency is extremely rare. Its transmission is autosomal recessive, and its prevalence is 1: 1,000,000.
  • factor X-specific mutants also called X variant factors
  • thrombin X variant factors
  • these factor X mutants can be activated by thrombin, and allow efficient coagulation, even in the absence of factor VIII and / or factor IX and / or endogenous factor X.
  • Activation peptide cleavage sites generated in these variant X factors may also be targets of other coagulation proteases, such as factor VIIIa, factor IXa, factor Xa, factor Xla, factor Xlla, or kallikrein.
  • a modification of the factor X activation peptide can lead to an additional modification of its pharmacological properties, different from the only recognition by thrombin.
  • This modification may give the variant factor X an improvement in specific activity, stability, or resistance to proteases, or an increase in pharmacokinetics.
  • the presence of additional glycosylations and phosphorylations, or on the contrary the absence of these modifications relative to the wild-type molecule may be caused by the modifications introduced into the activation peptide.
  • the present invention therefore relates to a protein comprising a mutated sequence of SEQ ID NO: 1, said mutated sequence of SEQ ID NO: 1 comprising at least one A, A ', B, C or C mutation, in which:
  • mutation A consists in the substitution of amino acids 43 to 52 of the sequence SEQ ID NO: 1 by a sequence chosen from DFLAEGLTPR, KATN * ATLSPR and KATXATLSPR,
  • mutation A consists of the substitution of amino acids 47 to 52 of the sequence SEQ ID NO: 1 by a sequence chosen from TSKLTR, FNDFTR, LSSMTR, PPSLTR and LSCGQR,
  • mutation B consists of the insertion of a sequence chosen from DFLAEGLTPR, KATN * ATLSPR, KATXATLSPR, TSKLTR, FNDFTR, LSSMTR, PPSLTR and LSCGQR, between amino acids 52 and 53 of the sequence SEQ ID NO: 1,
  • mutation C consists in the insertion of a sequence chosen from DFLAEGLTPR, KATN * ATLSPR and KATXATLSPR, between amino acids 52 and 53 of the sequence SEQ ID NO: 1, and in the deletion of amino acids 4 to 13 of the sequence SEQ ID NO: 1, mutation C consists of the insertion of a sequence selected from TSKLTR, FNDFTR, LSSMTR, PPSLTR and LSCGQR, between amino acids 52 and 53 of the sequence SEQ ID NO: 1, and in the deletion of amino acids 4 to 9 of the sequence SEQ ID NO: 1,
  • N * is an optionally glycosylated asparagine.
  • Another subject of the invention is a polynucleotide encoding said protein.
  • Another subject of the invention is an expression vector comprising said polynucleotide.
  • Another subject of the invention is a host cell comprising said expression vector or said polynucleotide.
  • said protein may be used for the treatment of blood coagulation disorders, in particular hemorrhagic disorders, such as hemophilia A, B and C (factor XI deficiency), factor X deficiency or even coagulation requirements. urgency to substitute for the Vlla Factor.
  • hemorrhagic disorders such as hemophilia A, B and C (factor XI deficiency), factor X deficiency or even coagulation requirements. urgency to substitute for the Vlla Factor.
  • said protein can be used in combination with other hemostatic molecules, such as factor VIIa and / or fibrinogen, or even in combination with procoagulant compounds (platelet transfusion, procoagulant mixture such as FEIBA, Kaskadil, Kanokad, etc.), which can enhance the effectiveness of treatment.
  • protein and “polypeptide” are used interchangeably herein and refer to an amino acid sequence having more than 100 amino acids.
  • protein includes amino acid sequences having between 100 and 1000 amino acids, preferably between 120 and 500 amino acids.
  • the present invention relates to a protein comprising a mutated sequence of SEQ ID NO: 1, said mutated sequence of SEQ ID NO: 1 comprising at least one A, A ', B, C or C mutation, wherein:
  • mutation A consists in the substitution of amino acids 43 to 52 of the sequence SEQ ID NO: 1 by a sequence chosen from DFLAEGLTPR, KATN * ATLSPR and KATXATLSPR, mutation A 'consists of the substitution of amino acids 47 to 52 of the sequence SEQ ID NO: 1 by a sequence chosen from TSKLTR, FNDFTR, LSSMTR, PPSLTR and LSCGQR,
  • mutation B consists of the insertion of a sequence chosen from DFLAEGLTPR, KATN * ATLSPR, KATXATLSPR, TSKLTR, FNDFTR, LSSMTR, PPSLTR and LSCGQR, between amino acids 52 and 53 of the sequence SEQ ID NO: 1,
  • mutation C consists in the insertion of a sequence chosen from DFLAEGLTPR, KATN * ATLSPR and KATXATLSPR, between amino acids 52 and 53 of the sequence SEQ ID NO: 1, and in the deletion of amino acids 4 to 13 of the sequence SEQ ID NO: 1, mutation C consists in the insertion of a sequence selected from TSKLTR, FNDFTR, LSSMTR, PPSLTR and LSCGQR, between amino acids 52 and 53 of the sequence SEQ ID NO: 1, and in the deletion of amino acids 4 to 9 of the sequence SEQ ID NO: 1,
  • N * is an optionally glycosylated asparagine.
  • said protein comprises, preferably consists of the sequence SEQ ID NO: 7, with at least one mutation A, A ', B, C or C as described above.
  • the sequence SEQ ID NO: 7 (500 amino acids) comprises the entire sequence SEQ ID NO: 1 (306 amino acids). More particularly, the sequence SEQ ID NO: 7 comprises, in the N- to C-terminal direction, a signal peptide and a propeptide (40 amino acids in total), the sequence SEQ ID NO: 5, the sequence SEQ ID NO: 1, then a tag (amino acids at position 489 to 500, a length of 12 amino acids), ie the HPC4 tag.
  • the sequence SEQ ID NO: 103 corresponds to the sequence SEQ ID NO: 7 without signal peptide and without propeptide.
  • Said protein according to the invention is a mutated factor X which is effective in the treatment of coagulation disorders.
  • Factor X also called Stuart-Prower factor, is encoded by the F10 gene and refers to serine protease EC3.4.21.6.
  • Factor X is composed of a heavy chain, 306 amino acids, and a light chain, 139 amino acids.
  • Factor X is a 488 amino acid protein consisting of a signal peptide, a propeptide, and light and heavy chains. Human X factor can be found in UniProtKB under accession number P00742. Its native structure is illustrated in FIG.
  • the protein is translated as a prepropeptide. After cleavage of the signal peptide, the propeptide is finally cleaved, resulting in a light chain and a heavy chain (142 and 306 amino acids respectively) (zymogen). Following the onset of coagulation, the heavy chain is finally activated by cleavage of the activation peptide, to contain only 254 amino amino acids (the first 52 amino acids are cleaved during treatment): it is the heavy chain of the factor Xa (SEQ ID NO: 6).
  • the human factor X prepropeptide corresponds to SEQ ID NO: 4.
  • the heavy chain corresponds to SEQ ID NO: 1
  • the light chain corresponds to SEQ ID NO: 5.
  • the heavy chain activation peptide corresponds to SEQ ID NO: 3, and includes 52 amino acids.
  • SEQ ID NO: 2 is identical to amino acids 1 to 182 of SEQ ID NO: 4.
  • SEQ ID NO: 1 is identical to amino acids 183 to 488 of SEQ ID NO: 4.
  • the factor Xa heavy chain corresponds to SEQ ID NO: 1, in which the peptide SEQ ID NO: 3 was cleaved.
  • the proteins according to the invention comprise mutated factor X proteins, in zymogen form, comprising, depending on the constructions, an activation peptide:
  • the protein according to the invention may be a protein comprising a mutated sequence of SEQ ID NO: 1, said mutated sequence of SEQ ID NO: 1 comprising at least one A mutation, in which mutation A consists of the substitution of amino acids.
  • the protein comprises the sequence SEQ ID NO: 7 with at least one mutation A.
  • the mutated protein comprises a sequence selected from SEQ ID NO: 9, SEQ ID NO: 10 and SEQ ID NO: 11.
  • the protein according to the invention may be a protein comprising a mutated sequence of SEQ ID NO: 1, said mutated sequence of SEQ ID NO: 1 comprising at least one A 'mutation, in which the A' mutation consists of the substitution of the acids Amines 47 to 52 of the sequence SEQ ID NO: 1 by a sequence selected from TSKLTR, FNDFTR, LSSMTR, PPSLTR and LSCGQR.
  • the protein comprises the sequence SEQ ID NO: 7 with at least one A 'mutation.
  • the mutated protein comprises a sequence selected from SEQ ID NO: 12, SEQ ID NO: 13, SEQ ID NO: 14, SEQ ID NO: 15 and SEQ ID NO: 16.
  • the protein according to the invention may be a protein comprising a mutated sequence of SEQ ID NO: 1, said mutated sequence of SEQ ID NO: 1 comprising at least one B mutation, in which the B mutation consists of the insertion of a sequence selected from DFLAEGLTPR, KATN * ATLSPR, KATXATLSPR, TSKLTR, FNDFTR, LSSMTR, PPSLTR and LSCGQR, between amino acids 52 and 53 of the sequence SEQ ID NO: 1, where N * is an optionally glycosylated asparagine.
  • the protein comprises the sequence SEQ ID NO: 7 with at least one B mutation.
  • the mutated protein comprises a sequence selected from SEQ ID NO: 18, SEQ ID NO: 19, SEQ ID NO: 20, SEQ ID NO: 21, SEQ ID NO: 22, SEQ ID NO: 23, SEQ ID NO: 24 and SEQ ID NO: 25.
  • the protein according to the invention may be a protein comprising a mutated sequence of SEQ ID NO: 1, said mutated sequence of SEQ ID NO: 1 comprising at least one C mutation, in which the C mutation consists of the insertion of a sequence chosen from DFLAEGLTPR, KATN * ATLSPR and KATXATLSPR, between amino acids 52 and 53 of the sequence SEQ ID NO: 1, and at the deletion of amino acids 4 to 13 of the sequence SEQ ID NO: 1, where N * is an asparagine possibly glycosylated.
  • the protein comprises the sequence SEQ ID NO: 7 with at least one mutation C.
  • the mutated protein comprises a sequence selected from SEQ ID NO: 27, SEQ ID NO: 28 and SEQ ID NO: 29.
  • the protein according to the invention may be a protein comprising a mutated sequence of SEQ ID NO: 1, said mutated sequence of SEQ ID NO: 1 comprising at least one C mutation, in which the C mutation consists of the insertion of a sequence chosen from TSKLTR, FNDFTR, LSSMTR, PPSLTR and LSCGQR, between amino acids 52 and 53 of the sequence SEQ ID NO: 1, and at the deletion of amino acids 4 to 9 of the sequence SEQ ID NO: 1.
  • the protein comprises the sequence SEQ ID NO: 7 with at least one C mutation.
  • the mutated protein comprises a sequence selected from SEQ ID NO: 30, SEQ ID NO: 31, SEQ ID NO: 32, SEQ ID NO: 33 and SEQ ID NO: 34.
  • the protein according to the invention comprises, preferably consists of, a sequence chosen from SEQ ID NO: 9 to 16, 18 to 25, 27 to 34, 105 to 112, 114 to 121 and 123 to 130.
  • FX-IIa mutant of SEQ ID NO: 7 comprising a mutation A: insertion of the thrombin cleavage consensus site
  • FX-PAR1 mutant of SEQ ID NO: 7 comprising a mutation A: insertion of the modified thrombin cleavage site on the PARI receptor
  • FX-PAR1M (mutant of SEQ ID NO: 7 comprising a mutation A: insertion of the modified thrombin cleavage site on the PARI receptor without a site of
  • FX-FXIal (mutant of SEQ ID NO: 7 comprising a mutation A ': insertion of cleavage site 1 of FXIa on the
  • FX-FXIa2 (mutant of SEQ ID NO: 7 comprising a mutation A ': insertion of cleavage site 2 of FXIa on the
  • FX-Kall mutant of SEQ ID NO: 7 comprising a mutation A ': insertion of cleavage site 1 of kallikrein on FXII
  • FX-Kal2 mutant of SEQ ID NO: 7 comprising a mutation A ': insertion of cleavage site 2 of kallikrein on FXII
  • FX-Kal3 mutant of SEQ ID NO: 7 comprising mutation A ': insertion of cleavage site 3 of kallikrein on FXII
  • FX-IIa mutant of SEQ ID NO: 7 comprising a B mutation: insertion of the thrombin cleavage consensus site
  • FX-PAR1 mutant of SEQ ID NO: 7 comprising a B mutation: insertion of the modified thrombin cleavage site on the PARI receptor
  • FX-PAR1M (mutant of SEQ ID NO: 7 comprising mutation B: insertion of the modified thrombin cleavage site on the PARI receptor without
  • FX-FXIal (mutant of SEQ ID NO: 7 comprising mutation B: insertion of cleavage site 1 of FXIa on the
  • FX-FXIa2 mutant of SEQ ID NO: 7 comprising mutation B: insertion of cleavage site 2 of FXIa on the
  • FX-Kall mutant of SEQ ID NO: 7 comprising mutation B: insertion of cleavage site 1 of kallikrein on FXII
  • FX-Kal2 mutant of SEQ ID NO: 7 comprising mutation B: insertion of cleavage site 2 of kallikrein on FXII
  • FX-Kal3 mutant of SEQ ID NO: 7 comprising mutation B: insertion of cleavage site 3 of kallikrein on FXII
  • FX-IIa mutant of SEQ ID NO: 7 comprising a C mutation: insertion of the thrombin cleavage consensus site
  • FX-PAR1 mutant of SEQ ID NO: 7 comprising a C mutation: insertion of the modified thrombin cleavage site on the PARI receptor
  • FX-PAR1M (mutant of SEQ ID NO: 7 comprising a C mutation: insertion of the modified thrombin cleavage site on the PARI receptor without a site of
  • FX-FXIal (mutant of SEQ ID NO: 7 comprising a mutation C: insertion of cleavage site 1 of FXIa on the
  • FX-FXIa2 (mutant of SEQ ID NO: 7 comprising a mutation C: insertion of cleavage site 2 of FXIa on the
  • FX-Kall mutant of SEQ ID NO: 7 comprising a C mutation: insertion of cleavage site 1 of kallikrein on FXII
  • FX-Kal2 mutant of SEQ ID NO: 7 comprising a C mutation: insertion of cleavage site 2 of kallikrein on FXII
  • FX-Kal3 mutant of SEQ ID NO: 7 comprising a C mutation: insertion of the cleavage site 3 of kallikrein on FXII
  • the present invention also relates to a protein complex comprising:
  • proteins being bound together by a disulfide bridge.
  • nucleic acid (polynucleotide) coding for said protein.
  • nucleic acid is chosen from the sequences SEQ ID NO: 77 to 84, 86 to 93, 95 to 102, 133 to 140, 142 to 149 and 151 to 158.
  • the expression vectors suitable for use according to the invention may comprise at least one expression control element operably linked to the nucleic acid sequence.
  • the expression control elements are inserted into the vector and make it possible to regulate the expression of the nucleic acid sequence.
  • expression control elements include lac systems, lambda phage promoter, yeast promoters or viral promoters.
  • Other operational elements may be incorporated, such as a leader sequence, termination codons, polyadenylation signals and sequences necessary for transcription and subsequent translation of the nucleic acid sequence into the host system.
  • the expression vector should contain the additional elements necessary for the subsequent transfer and replication of the expression vector containing the nucleic acid sequence in the host system. Such vectors are easily constructed using conventional or commercially available methods.
  • Another subject of the invention is a recombinant cell comprising an expression vector as described above, or a polynucleotide as described above.
  • examples of host cells that can be used are eukaryotic cells, such as animal, plant, insect and yeast cells; and prokaryotic cells, such as E. coli.
  • the means by which the vector carrying the gene can be introduced into the cells include microinjection, electroporation, transduction or transfection using DEAE-dextran, lipofection, calcium phosphate or other procedures. known to those skilled in the art.
  • eukaryotic expression vectors that function in eukaryotic cells are used.
  • vectors examples include viral vectors such as retroviruses, adenovirus, herpes virus, vaccinia virus, variola virus, poliovirus, lentivirus, bacterial expression vectors or plasmids such as pcDNA5.
  • viral vectors such as retroviruses, adenovirus, herpes virus, vaccinia virus, variola virus, poliovirus, lentivirus, bacterial expression vectors or plasmids such as pcDNA5.
  • Preferred eukaryotic cell lines include COS cells, CHO cells, HEK cells, BHK cells, PerC6 cells, HeLa cells, NIH / 3T3 cells, 293 (ATCC # CRL1573), T2 cells, dendritic cells. or monocytes.
  • the protein according to the invention can be produced in the milk of transgenic animals.
  • the expression of a DNA sequence containing a gene coding for the protein according to the invention is controlled by a mammalian casein promoter or a mammalian whey promoter, said promoter not controlling naturally the transcription of said gene, and the DNA sequence further containing a secretion sequence of the protein.
  • the secretion sequence comprises a secretion signal interposed between the gene and the promoter.
  • the transgenic animal used is capable not only of producing the desired protein, but also of transmitting this ability to its offspring.
  • the secretion of the protein in the milk facilitates purification and avoids the use of blood products.
  • the animal can thus be chosen from the goat, the rabbit, the sheep or the cow.
  • the protein according to the invention can be used as a medicament. Therefore, the protein according to the invention can be introduced into a pharmaceutical composition.
  • the protein according to the invention can be used for the treatment of coagulation disorders, in particular hemorrhagic disorders.
  • the pharmaceutical composition of the invention may be combined with pharmaceutically acceptable excipients, and optionally extended release matrices, such as biodegradable polymers, to form a therapeutic composition.
  • the pharmaceutical composition of the present invention may be administered orally, sublingually, subcutaneously, intramuscularly, intravenously, intraarterially, intrathecally, intraocularly, intracerebrally, transdermally, locally or rectally.
  • the active ingredient, alone or in combination with another active ingredient can then be administered in unit dosage form, in admixture with conventional pharmaceutical carriers.
  • Unit dosage forms include oral forms such as tablets, capsules, powders, granules and oral solutions or suspensions, sublingual and oral forms of administration, aerosols, subcutaneous implants, transdermal, topical, intraperitoneal, intramuscular, intravenous, subcutaneous, intrathecal, intranasal administration forms and rectal administration forms.
  • the pharmaceutical composition contains a pharmaceutically acceptable carrier for a formulation that can be injected.
  • a pharmaceutically acceptable carrier for a formulation that can be injected.
  • It may be in particular isotonic, sterile, saline solutions (with monosodium or disodium phosphate, sodium chloride, potassium chloride, calcium or magnesium chloride and the like, or mixtures of such salts), or freeze-dried compositions which, when adding sterilized water or physiological saline as appropriate, allow the constitution of injectable solutions.
  • Dosage forms suitable for injectable use include sterile aqueous solutions or dispersions, oily formulations, including sesame oil, peanut oil, and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions.
  • the form must be sterile and must be fluid to the extent that it must be injected by syringe. It must be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of microorganisms, such as bacteria and fungi.
  • the dispersions according to the invention can be prepared in glycerol, liquid polyethylene glycols or mixtures thereof, or in oils. Under normal conditions of storage and use, these preparations contain a preservative to prevent the growth of microorganisms.
  • the pharmaceutically acceptable carrier may be a solvent or dispersion medium containing, for example, water, ethanol, a polyol (eg, glycerine, propylene glycol, polyethylene glycol, and the like), suitable mixtures of these, and / or vegetable oils.
  • a surfactant such as lecithin.
  • Prevention of the action of microorganisms can be caused by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid or thimerosal. In many cases, it will be preferable to include isotonic agents, for example, sugars or sodium chloride.
  • Prolonged absorption of the injectable compositions may be caused by the use in the compositions of agents delaying absorption, for example, aluminum monostearate or gelatin.
  • Sterile injectable solutions are prepared by incorporating the active ingredients in the required amount in the appropriate solvent with several of the other ingredients listed above, if appropriate, followed by sterilization by filtration.
  • the dispersions are prepared by incorporating the various sterilized active ingredients into a sterile vehicle that contains the basic dispersion medium and the other required ingredients from those enumerated above.
  • the preferred methods of preparation are vacuum drying and lyophilization.
  • the solutions will be administered in a manner compatible with the dosage formulation and in a therapeutically effective amount.
  • the formulations are easily administered in a variety of dosage forms, such as the injectable solutions described above, but drug release capsules and the like can also be used.
  • parenteral administration in an aqueous solution for example, the solution should be suitably buffered and the liquid diluent rendered isotonic with sufficient saline or glucose.
  • aqueous solutions are particularly suitable for intravenous, intramuscular, subcutaneous and intraperitoneal administration.
  • sterile aqueous media that can be used are known to those skilled in the art.
  • a dose may be dissolved in 1 ml of isotonic NaCl solution and then added to 1000 ml of appropriate liquid, or injected at the proposed site of the infusion. Certain dosage variations will necessarily occur depending on the condition of the subject being treated.
  • the pharmaceutical composition of the invention can be formulated in a therapeutic mixture comprising about 0.0001 to 1.0 milligrams, about 0.001 to 0.1 milligrams, about 0.1 to 1.0 milligrams, or about 10 milligrams per dose or more. Multiple doses may also be administered.
  • the level of therapeutically effective dose specific for a particular patient will depend on a variety of factors, including the disorder being treated and the severity of the disease, the activity of the specific compound employed, the specific composition used, the age, the body weight, general health, sex and diet of the patient, the time of administration, the route of administration, the rate of excretion of the specific compound used, the duration of treatment, or the drugs used in parallel.
  • Figure legend Figure 1 Structure of native human X factor.
  • Family 1 includes mutants comprising mutations A or A '.
  • Family 3 groups mutants comprising mutation C or C.
  • Figure 3 Level of expression of variant factors produced in CHO.
  • the 3 families of FX were expressed following transfection in CHO.
  • the supernatants at day 7 were analyzed in triplicate with the Zymutest FX kit (Hyphen).
  • the concentrations (g / ml) are indicated on the ordinate. Standard deviations are shown above the histograms.
  • Family 1 gray bar; family 2, black bar; family 3, white bar.
  • Figure 4 Level of expression of X factors and variants produced in HEK.
  • Figure 5 Chronometric activity of X factors and variants produced in CHO in factor X deficient plasma.
  • the 3 families of FX were expressed following transfection in CHO-S.
  • the supernatants at day 7 were analyzed at least in duplicate by a TP test on STAR automaton (Stago).
  • the clotting times allowed a specific activity (in ⁇ g / ml) to be calculated and then converted to percent of the wild-type recombinant factor X activity. These values are presented on the ordinate. Standard deviations are shown above the histograms. Family 1, gray bar; family 2, black bar; family 3, white bar. * FX-Kal2 family 3, not made.
  • Figure 6 Activity of family X variant X factors produced in CHO after activation by the RVV-X fraction.
  • FX variants of family 1 were expressed following transfection in CHO-S.
  • the supernatants at day 7 were incubated at two concentrations of FX (at least in duplicate) in the presence of the RVV-X fraction of the venom of the Russell's viper.
  • the appearance of FXa was measured following the hydrolysis of pNAPEP 1025 substrate at 405 nM.
  • Initial transformation rates (mUDO / min / nM) were compared to that of FX-WT, set at 100%. The average value at two concentrations is established and presented on the ordinate. Standard deviations are shown above the histograms.
  • Figure 7 Thrombinograms obtained from the addition of FX or its variants of family 2 in a factor VIII deficient plasma pool following activation by tissue factor (1 ⁇ M).
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FVIII deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml FVIII are represented by the symbols ⁇ and ⁇ respectively.
  • the wild-type FX and variant symbols are: FX-WT ( ⁇ ), FX-control + (O), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in the line full), FX-FIXal (*), FX-FIXa2 (X with dotted line), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • Factor X or its variants were used at 5 ⁇ g / ml except for FX-Kal2 and 3 which for technical reasons were used at 3.5 and 1.65 ⁇ g / ml respectively.
  • Figure 8 Thrombograms obtained from the addition of FX or its variants of family 2 in a factor VIII deficient plasma pool following activation with cephalin.
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FVIII deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml of FVIII are represented by the symbols ⁇ and ⁇ respectively.
  • the wild-type FX and variant symbols are: FX-WT ( ⁇ ), FX-control + (O), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in the line full), FX-FIXal (*), FX-FIXa2 (X with dotted line), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • Factor X or its variants have been used at 5 ⁇ g / ml except for FX-Kal2 and 3 which for technical reasons were used at 3.5 and 1.65 ⁇ g / ml respectively.
  • Figure 9 Velocities of thrombograms obtained from the addition of FX or its variants of family 2 in a factor VIII deficient plasma pool, following activation by tissue factor or partial thromboplastin.
  • the velocity values (in nM / min of thrombin generated) from FIGS. 7 and 8 are presented. Note that FX-Kal2 and 3 (*) were used at 3.5 and 1.65 ⁇ g / ml respectively instead of 5 ⁇ g / ml for other FX and variants.
  • White bars values obtained by tissue factor activation (1 ⁇ M); Black bars values obtained by a partial thromboplastin activation.
  • Figure 10 Thrombograms obtained from the addition of FX or its variants of family 2 in a factor IX deficient plasma pool following activation by tissue factor (1 ⁇ M).
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FVIII deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml of FVIII are represented by the symbols ⁇ and ⁇ respectively.
  • the wild-type FX and variant symbols are: FX-WT ( ⁇ ), FX-control + (O), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in the line full), FX-FIXal (*), FX-FIXa2 (X with dotted line), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol). ).
  • Factor X or its variants were used at 5 ⁇ g / ml except for FX-Kal2 and 3 which for technical reasons were used at 3.5 and 1.65 ⁇ g / ml respectively.
  • Figure 11 Thrombograms obtained from the addition of FX or its variants of family 2 in a factor IX deficient plasma pool following activation with cephalin.
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FVIII deficient by (O).
  • the curves corresponding to deficient plasma overloaded with FVIII 1 U / ml or 0.1 U / ml are represented by the symbols ⁇ and ⁇ respectively.
  • the wild-type FX and variant symbols are: FX-WT ( ⁇ ), FX-control + (O), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in the line full), FX-FIXal (*), FX-FIXa2 (X with dotted line), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • Factor X or its variants were used at 5 ⁇ g / ml except for FX-Kal2 and 3 which for technical reasons were used at 3.5 and 1.65 ⁇ g / ml respectively.
  • Figure 12 Velocities of thrombograms obtained from the addition of FX or its variants of family 2 in a factor IX deficient plasma pool, following activation by tissue factor (1 ⁇ M) or partial thromboplastin .
  • the velocity values (in nM / min of thrombin generated) from FIGS. 10 and 11 are presented. Note that FX-Kal2 and 3 (*) were used at 3.5 and 1.65 ⁇ g / ml respectively instead of 5 ⁇ g / ml for other FX and variants. The results are presented in logarithmic scale. For more legibility, the values below 1 nM / min of thrombin generated are not represented (+). White bars, values obtained by tissue factor activation (1 ⁇ M); Black bars values obtained by a partial thromboplastin activation.
  • Figure 13 Thrombin activation of FX-WT and variants of family 2.
  • the activation of FX-WT and some of its variants of family 2 was carried out in the presence of thrombin (10 nM) in Hepes buffer containing of the Pefachrome FXa 8595 substrate.
  • the appearance of the paranitroanilide released by the generated FXa was monitored at 405 nm over time.
  • Figure 14 Thrombograms obtained from the addition of FX or its family 1 variants in a factor VIII deficient plasma pool following activation by tissue factor
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FVIII deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml of FVIII are represented by the symbols ⁇ and ⁇ respectively.
  • the wild-type FX and variant symbols are: FX-WT ( ⁇ ), FX-control + (O), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in the line full), FX-FIXal (*), FX-FIXa2 (X with dotted line), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • Factor X or its variants were used at 7.5 ⁇ g / ml except for FX-Kal3 which for technical reasons was used at 1.65 ⁇ ⁇ ⁇ .
  • FIG. 15 Thrombograms obtained from the addition of FX or its variants of family 1 in a factor VIII deficient plasma pool following activation by cephalin
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FVIII deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml of FVIII are represented by the symbols ⁇ and ⁇ respectively.
  • the wild-type FX and variant symbols are: FX-WT ( ⁇ ), FX-control + (), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in solid lines ), FX-FIXal (*), FX-FIXa2 (X with dotted curve), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • the velocity values (in nM / min of thrombin generated) from FIGS. 14 and 15 are presented. Note that FX-Kal3 (*) was used at 1.65 ⁇ g / ml instead of 7.5 ⁇ g / ml for other FX and variants.
  • the value of the FX-WT is the average of the two experiments. For more legibility, the values below 1 nM / min of thrombin generated are not represented (+).
  • White bars values obtained by tissue factor activation (1 ⁇ M); Black bars, values obtained by a partial thromboplastin activation.
  • Figure 17 Thrombinograms obtained from the addition of FX or its variants of family 1 in a factor IX deficient plasma pool following activation by tissue factor
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FIX deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml of FIX are represented by the symbols ⁇ and ⁇ respectively.
  • the wild-type FX and variant symbols are: FX-WT ( ⁇ ), FX-control + (), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in solid lines ), FX-FIXal (*), FX-FIXa2 (X with dotted curve), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • Factor X or its variants were used at 7.5 g ml except for FX-Kal3 which for technical reasons was used at 1.65 ⁇ g / ml.
  • Figure 18 Thrombograms obtained from the addition of FX or its variants of family 1 in a factor IX deficient plasma pool following activation by cephalin
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FIX deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml of FIX are represented by the symbols ⁇ and ⁇ respectively.
  • FX-WT ( ⁇ ), FX-control + (O), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in the line full), FX-FIXal (*), FX-FIXa2 (X with dotted line), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • Factor X or its variants were used at 7.5 ⁇ g / ml except for FX-Kal3 which for technical reasons was used at 1.65 ⁇ g / ml.
  • Figure 19 Velocities of thrombograms obtained from the addition of FX or its variants of family 1 in a factor IX deficient plasma pool following activation by tissue factor (1 ⁇ M) or partial thromboplastin
  • the velocity values (in nM / min of thrombin generated) from FIGS. 17 and 18 are presented. Note that FX-Kal3 (*) was used at 1.65 ⁇ g / ml instead of 7.5 ⁇ g / ml for other FX and variants.
  • the value of the FX-WT is the average of the two experiments. For more legibility, the values below 1 nM / min of thrombin generated are not represented (+).
  • White bars values obtained by tissue factor activation (1 ⁇ M); Black bars values obtained by a partial thromboplastin activation.
  • Figure 20 Thrombograms obtained from the addition of FX or its variants of family 3 in a factor VIII deficient plasma pool following activation by tissue factor
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FVIII deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml of FVIII are represented by the symbols ⁇ and ⁇ respectively.
  • the symbols representing the wild-type FXs and the variants are the following: FX-WT ( ⁇ and -), FX-control + (), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in solid line), FX-FIXal (*), FX-FIXa2 (X with dotted curve), FX- Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FVIII deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml of FVIII are represented by the symbols ⁇ and ⁇ respectively.
  • the symbols representing the wild-type FXs and the variants are the following: FX-WT ( ⁇ and -), FX-control + (O), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in solid lines), FX-FIXal (*), FX-FIXa2 (X with dotted line), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • Factor X or its variants were used at 7.5 ⁇ g / ml except for FX-Kal3 which for technical reasons was used at 1.65 ⁇ g / ml.
  • Figure 22 Velocities of thrombograms obtained from the addition of FX or its variants of family 3 in a factor VIII deficient plasma pool, following activation by tissue factor (1 ⁇ M) or thromboplastin
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FIX deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml of FIX are represented by the symbols ⁇ and ⁇ respectively.
  • the wild-type FX and variant symbols are: FX-WT ( ⁇ ), FX-control + (O), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in the line full), FX-FIXal (*), FX-FIXa2 (X with dotted line), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • Factor X or its variants were used at 7.5 ⁇ g / ml except for FX-Kal3 which for technical reasons was used at 1.65 ⁇ g / ml.
  • Figure 24 Thrombograms obtained from the addition of FX or its variants of family 3 in a factor IX deficient plasma pool following activation by cephalin
  • the normal plasma pool sample is represented by the black curve ( ⁇ ) and the FIX deficient by (O).
  • the curves corresponding to the deficient plasma overloaded with 1 U / ml or 0.1 U / ml of FIX are represented by the symbols ⁇ and ⁇ respectively.
  • the wild-type FX and variant symbols are: FX-WT ( ⁇ ), FX-control + (), FX-IIa ( ⁇ ), FX-PAR1 ( ⁇ ), FX-PAR1M (X in solid lines ), FX-FIXal (*), FX-FIXa2 (X with dotted curve), FX-Kall (), FX-Kal2 () and FX-Kal3 (solid line without symbol).
  • Factor X or its variants were used at 7.5 ⁇ g / ml except for FX-Kal3 which for technical reasons was used at 1.65 ⁇ g / ml.
  • Figure 25 Velocities of thrombograms obtained from the addition of FX or its variants of family 3 in a factor IX deficient plasma pool, following activation by tissue factor (1 ⁇ M) or partial thromboplastin
  • the velocity values (in nM / min of thrombin generated) from FIGS. 23 and 24 are presented. Note that FX-Kal3 (*) was used at 1.65 ⁇ g / ml instead of 7.5 ⁇ g / ml for other FX and variants.
  • the value of the FX-WT is the average of the two experiments. White bars, values obtained by tissue factor activation (1 ⁇ M); Black bars, values obtained by a partial thromboplastin activation.
  • the nucleotide and protein sequences of the different constructs are provided in the sequence listing, and are summarized in the table of the description.
  • the wild-type FX molecule is called FX-WT (SEQ ID NO: 7), it corresponds to a human FX whose nucleotide sequence has been optimized. This molecule will serve as a control for the three families of mutated molecules.
  • the mutated molecules are named according to the cleavage site placed upstream of the heavy chain.
  • FX-control + corresponds to the thrombin recognition site on fibrinogen, or fibrinopeptide A.
  • the mutated molecules according to the invention are respectively called FX-IIa (thrombin cleavage consensus site), FX-PAR1 (modified site of thrombin cleavage on PARI receptor), FX-PAR1M (modified site of thrombin cleavage on PARI receptor without glycosylation site), FX-FXIal (cleavage site 1 of FXIa on FIX), FX-FXIa2 ( cleavage site 2 of FXIa on FIX), FX-Kall (cleavage site 1 of Kallikrein on FXII), FX-Kal2 (cleavage site 2 of Kallikreine on FXII) and FX-Kal3 (cleavage site 3 of Kallikrein on the FX
  • each of these sites is present in a different environment (family), namely:
  • mutant B or in the family 2 which consists of inserting the same sequences upstream of the cleavage site of the activation peptide (mutation B); or - Or in the family 3 which consists of the insertion of these sequences upstream of the cleavage site of the activation peptide, coupled to the deletion of a portion of the activation peptide (mutation C or C).
  • proteins of sequence SEQ ID NO: 9 to 16 correspond to the sequence SEQ ID NO: 7, in which an A or A 'mutation has been inserted. These proteins belong to family 1.
  • the proteins of sequence SEQ ID NO: 18 to 25 correspond to the sequence SEQ ID NO: 7, in which a B mutation has been inserted. These proteins belong to family 2.
  • proteins of sequence SEQ ID NO: 27 to 34 correspond to the sequence SEQ ID NO: 7, in which a C or C mutation has been inserted. These proteins belong to family 3.
  • sequences SEQ ID NO: 8, 17 and 26 correspond to an FX-control +, and are comparative.
  • sequences specific for each variant are introduced by assembly PCR or Infusion, using primers judiciously designed to allow the insertion and / or the deletion of nucleotide sequences, within a synthetic nucleotide sequence encoding the FX. optimized for expression in Homo sapiens (SEQ ID NO: 35).
  • the cloning vector pUC57 containing the synthetic gene optimized for expression in Homo sapiens and prepared by Genescript is digested as the expression vector pCEP4 (Life Technologies) by the enzymes BamHI and HindIII.
  • the insert corresponding to the FX gene (FXWT4HSgs) and the pCEP4 digested vector are purified by Nucleospin extract II (Clonetech Laboratories) before being ligated together with T4 ligase.
  • the ligation product is used to transform Top 10 bacteria (Life Technologies).
  • the presence of the insert in the bacterial colonies is determined by digestion of the plasmid with the BamHI and HindIII enzymes and passage of the agarose gel digest to detect a band of 1519 bp.
  • the cDNA is verified by sequencing using the CMVs1 primers (5 '-GGG ACTTTCCTACTTGGC AGT- 3 'SEQ ID NO: 36) and SV40-3'UTR (5'-TTCACTGCATTCTAGTTGTGGT-3' SEQ ID NO: 37).
  • the cDNA of the FXWT4HS sequence is amplified by PCR (kapa Hifi, Biosystem) with the 5'FXWT and 3'FX-SwaI primers.
  • the 1551 bp PCR product is purified by Nucleospin extract before being digested with the NheI and SwaI enzymes, as is the OptiCHO destination vector. They are again purified on Nucleospin extract after digestion.
  • the insert and the vector are ligated together with the T4 ligase before the ligation product is integrated into Top 10 competent bacteria. After bacterial amplification in the presence of ampicillin, bacterial colonies are collected on a petri dish and screened by PCR for the search for a 296 bp amplicon with the 5'efla and 3FX primers, sign of the presence of the insert encoding the FX in the OptiCHO vector. The PCR screening is completed by screening the purified vectors by enzymatic digestion with Nhe I and SwaI enzymes to look for an 1538 bp fragment on an agarose gel.
  • the vector OptiCHO-FXWT4HS is sequenced with the primers:
  • 5'efla 5'-GTGGAGACTGAAGTTAGGCCAG-3 '(SEQ ID NO: 38)
  • the preparation of the inserts encoding the cDNAs of the variants of the family 1 is carried out according to Table 1 using assembly and ligation PCRs or by the Infusion technique using the primers listed in Table 2.
  • the matrix used for the PCR1s and 2 is the vector OptiCHO-FXWT4HS.
  • PCR products are treated with DpnI to digest parental DNA.
  • the amplicons of interest are purified by Nucleospin extract.
  • the purified PCR amplicons 1 and 2 were used as the template and assembled by assembly PCR according to Table 1.
  • the amplicons of the purified PCR3s as well as the vector digested with NheI and SwaI are ligated to the T4 ligase.
  • 5'FXlh 66 5'-CCTCCC AGCCTGACC AGG ATCGTGGG AGGAC AGGAGTGC AAGGA-3 '
  • 3FXF3 72 5'-CCAGGTAATGCTATCAGCCACTGACCTTTTGCGCCTCTC-3 '
  • the purified amplicons of PCRs 1 and 2 were generated by PCR according to the conditions of Table 3.
  • the purified amplicons of PCRs 1 and 2 are assembled by Infusion with the vector previously digested with NheI and SwaI and purified by nucleospin extract.
  • the final vector is inserted by bacterial transformation in Top 10 bacteria. After bacterial amplification in the presence of ampicillin, bacterial colonies are collected on a petri dish and screened by PCR for the search for a 296 bp amplicon with the 5'efla and 3FX primers, sign of the presence of the insert coding the FX in the OptiCHO vector.
  • the vectors OptiCHO-FX WTFla to OptiCHO-FX WTFli are sequenced with the primers:
  • the preparation of the inserts encoding the cDNAs of the variants of the family 2 is carried out according to Table 4 by the PCR technique and assembly by infusion using the primers listed in Table 2.
  • the template used for PCR1 and 2 is the OptiCHO vector. -FXWT4HS.
  • PCR products are treated with DpnI to digest parental DNA.
  • the amplicons are purified by nucleospin extract.
  • the purified amplicons of PCRs 1 and 2 are assembled by Infusion with the OptiCHO vector previously digested with NheI and SwaI and purified by nucleospin extract.
  • the final vector is inserted by bacterial transformation in Top 10 bacteria. After bacterial amplification in the presence of ampicillin, bacterial colonies are collected on a petri dish and screened by PCR for the search for a 296 bp amplicon with the 5'efla and 3FX primers, sign of the presence of the insert coding the FX in the OptiCHO vector.
  • the vectors OptiCHO-FX WTF2a to OptiCHO-FX WTF2i are sequenced with the primers:
  • the family 3 contains deletions in the activation peptide which must be prepared before the enzymatic cleavage sites can be inserted therein.
  • two intermediate vectors are prepared OptiCHO FXWT F3AD for the variants of the family 3 F3a to F3d and OptiCHO FXWT F3EI for the variants of the family 3 F3e to F3i.
  • the inserts of the intermediate vectors are constructed by assembly PCR according to Table 5 using the OptiCHO FXWT4HS-gs vector for template and the 5'FXWT, 3'FX-SwaI, 3FXF3, 5FXF3, 3FXF3bis, 5FXF3bis primers listed in the table. 2.
  • the products of the assembly PCRs are purified by Nucleospin extract before being digested, like the destination vector OptiCHO, by the enzymes NheI and Swal. They are again purified on Nucleospin extract after digestion.
  • the insert and the vector are ligated together with the T4 ligase before the ligation product is integrated into Top 10 competent bacteria. After bacterial amplification in the presence of ampicillin, bacterial colonies are collected on a petri dish and screened by PCR for the search for a 296 bp amplicon with the 5'efla and 3FX primers sign for the presence of the insert encoding the variant FX in the OptiCHO vector.
  • OptiCHO FXWT F3AD and OptiCHO FXWT F3EI are sequenced with the primers:
  • the preparation of the cDNA inserts of the 3-series variants is performed according to Table 6 by assembly PCR using the primers listed in Table 2.
  • the template used for the PCR1 and 2 is the vector OptiCHO FXWT F3AD for variants of family 3, F3a to F3d and OptiCHO FXWT F3EI for variants of family 3 F3e to F3i.
  • the amplicons are purified by nucleospin extract.
  • the purified amplicons of PCRs 1 and 2 are assembled by assembly PCR with the OptiCHO vector previously digested with NheI and SwaI and purified by nucleospin extract.
  • the products of the assembly PCRs are purified by Nucleospin extract before being digested, just like the destination vector OptiCHO, by the enzymes NheI and SwaI. They are again purified on Nucleospin extract after digestion.
  • the insert and the vector are ligated together with the T4 ligase before the ligation product is integrated into Top 10 competent bacteria. After bacterial amplification in the presence of ampicillin, bacterial colonies are collected on a petri dish and screened by PCR for the search for a 296 bp amplicon with the 5'efla and 3FX primers, sign of the presence of the insert encoding the variant FX in the OptiCHO vector.
  • the final vectors of the family 3 are sequenced with the primers:
  • Transfection medium of CHO-S cells Opti-Pro SFM (Gibco).
  • Transfection medium of HEK cells Opti-MEM (Gibco).
  • Wild type factor X and its variants are produced in CHO-S or HEK-293-Freestyle eukaryotic cells (Invitrogen) in transient expression.
  • the CHO-S cells are cultured in ProCH04 medium and the HEK 293F cells in F17 medium, supplemented respectively with 4 mM and 8 mM L-glutamine.
  • the 2 cell lines are cultured under conditions agitated at 135 rpm in a controlled atmosphere (8% CO 2 ) at 37 ° C.
  • the cells are seeded at a density of 7 ⁇ 10 5 cells / ml.
  • the DNA (20-30 ⁇ g) and 30 ⁇ g of transfection agent (AT) are pre-incubated separately in Opti-Pro for CHO-S and Opti-MEM for HEK 293F. for 5 minutes then mixed and incubated for 20 minutes to allow formation of the DNA / AT complex. The whole is added to a cell preparation of 1.10 6 cells / ml in a volume of 30 ml.
  • VKOR vitamin K epoxide-reductase
  • the 2 vectors are added at different ratios to obtain a total amount of DNA of 20-30 ⁇ g.
  • the enzyme VKOR allows active FX production in HEK by optimizing gamma-carboxylation.
  • vitamin K1 (5 ⁇ g / ml) is added to the medium.
  • the transfection rates are evaluated the day after transfection with a control plasmid expressing GFP (Green Fluorescent Protein).
  • GFP Green Fluorescent Protein
  • Factor X concentration is measured by commercial Zymutest Factor X ELISA (HYPHEN BioMed) following the manufacturer's recommendations. Concentrations are measured in triplicate using antigen values located in the linear detection zone of the assay. To ensure that the introduced mutations do not disturb the measurement of the concentration, the FX are deposited in identical quantities and revealed by immunoblotting with a polyclonal antibody different from that used in ELISA (Polyclonal anti-human FX antibody (CRYOPEP cat n ° PAHFX-S) or staining after SDS-PAGE (data not shown).
  • a polyclonal antibody Polyclonal anti-human FX antibody (CRYOPEP cat n ° PAHFX-S) or staining after SDS-PAGE (data not shown).
  • the concentrations of variant X (FX) factors present in supernatants of CHO-S cells transfected with the cDNAs encoding families 1-3 were measured by the commercial Zymutest Factor X ELISA (FIG. 3). As expected, the supernatants of non-transfected CHO cells (control) do not contain FX. Transfection with the vectors coding for the different FX makes it possible to obtain levels ranging from 0.5 to 3.06 ⁇ g / ml. There is no major difference in the FX expression of different families. At most, the FX-IIa family 3 is expressed 2. IX more strongly (2.64 ⁇ g / ml) than that of family 1 (1.26 ⁇ g / ml).
  • factor X in a higher concentration than wild-type factor X: these are the FX-IIa (family 3) and the FX-PAR1 (family 1 and 3) constructs.
  • the FX-Kal3 seems to decrease FX production.
  • the concentrations of variant X factors present in the supernatants of the HEK293S cells transfected with the cDNAs coding for families 1 to 3 were measured by the commercial Zymutest Factor X ELISA (FIG. 4). As expected, the supernatants of non-transfected (control) HEK293S cells do not contain FX.
  • the molecules of family 1 were produced at a rate close to that of FX-WT (from 0.14 to 1.64 ⁇ g / ml). Only the FX-PAR1 molecule is produced at a higher rate. The FX-Kal3 molecule remains the least produced molecule.
  • Family 2 was similarly produced for all constructs with expression values of 1.79 to 2.54 ⁇ g / ml except for the FX-Kal3 construct produced at a lower level (0.66 ⁇ g / ml).
  • Family 3 was produced at lower levels of 0.2 to 1.2 ⁇ g / ml.
  • the chronometric activity of FX variants produced by CHO-S cells was measured using a STAR (Stago) automaton in the presence of FX-deficient plasma.
  • FX deficient plasma, neoplastin and Owren-Koller buffer come from Stago (Asbecks, France).
  • the concentrated culture supernatant is diluted 1/10 in Owren-Koller buffer before being added to the FX deficient plasma.
  • the mixture is incubated 240 seconds at 37 ° C and the prothrombin time (TP) is triggered by the addition of 100 ⁇ of neoplastin.
  • the coagulation times (in sec) are transformed into specific activity of the FX.
  • Concentrated supernatants from different transfections in CHO were evaluated for their ability to compensate for factor X deficiency.
  • the supernatants were incubated in FX-deficient plasma and a TP test was performed.
  • the coagulation times (in sec) were transformed into specific activity (AS, in second per ⁇ g of protein) and then the percentage of specific activity relative to the wild-type FX was calculated (FIG.
  • the results are consistent between the different families. This result indicates that behavioral differences come mainly from cleavage sites and not from the way they are cloned.
  • the constructs can be classified in three categories: a first category whose AS is similar to that of the FX-WT (contains the FX-control +), a second category whose AS is diminished compared to that of the control (contains FX -IIa, FX-PAR1, FX-PAR1M and FX-Kal3) and a third category whose activity in absence of FX is greater than that of the FX-WT (contains FX-FXIal and 2, FX-Kall and 2). It should be noted that the FX-Kal2 construction of family 3 could not be analyzed for technical reasons (* on the graph).
  • Activation of FX variants produced by CHO-S cells was measured following incubation of culture supernatants in the presence of the anti-factor X fraction of venom of the Russell's viper (RVV-X).
  • the activated control factor X, the venom fraction X (RVV-X) and the pNAPEP 1025 substrate come from Haematologic Technologies (Cryopep adjoin, France).
  • Activation was studied at 37 ° C in the following buffer: 25 mM HEPES, pH 7.4, 0.175 M NaCl, 5 mM CaCl 2 , 5 mg / ml BSA.
  • concentrations of 0 to 100 nM FX a concentration of 200 mU / ml of RVV-X was used.
  • the reaction is stopped in 50 mM Tris buffer, pH 8.8, 0.475 M NaCl, 9 mM EDTA.
  • the amount of FXa generated is monitored by measuring the rate of hydrolysis of the pNAPEP 1025 (250 ⁇ ) substrate at 405 nm.
  • CHO supernatants expressing the family 1 variants were incubated with RVV-X.
  • the generation of FXa was measured following this treatment from different concentrations of FX.
  • the presence of FXa is quantified by the rate of appearance of the pNAPEP 1025 product in solution (in mUDO / min). This generation is a reflection of the recognition and cleavage of FX by the RVV-X as well as the FXa's ability to recognize the FX substrate.
  • the average rate of occurrence is made for the different initial FX concentrations and this value is reduced as a percentage of the FX-WT value.
  • the analysis of the family 1 shows in part similar results with the results obtained in TP, in particular for the FX-control +, FX-IIa, FX-Kall, FX-Kal2 and FX-Kal3 (FIG. 6).
  • the FX-XIal and 2 molecules show activity but this time not superior to the FX-WT.
  • the FX-PAR1 and FX-PAR1M molecules show a significant and higher activity than that observed in TP.
  • EXAMPLE 6 Measurement in Thrombin Generation Time (TGT) of the Procoagulant Capacity of Variant X Factors of Family 2: Activation of the Extrinsic Coagulation Pathway (FT lpM / PL 4 ⁇ ) in FVIII-deficient Plasma
  • Thrombin calibrator, PPP reagent low, CK-Perst, Fluca Kit (Fluo-buffer + Fluo- substrate), PNP and FIX-deficient plasma come from Stago (Asbecks, France).
  • FX-deficient plasma is from Cryopep (Montpellier, France).
  • FVIII deficient plasma is from Siemens Healthcare (Marburg, Germany).
  • Human FX Cat No. HCX-0050
  • Human FXa Cat No. HCXA-0060
  • the recombinant human factor VIII control comes from Baxter (Recombinate) (Maurepas, France).
  • the thrombin generation test consists in activating coagulation ex vivo either with a mixture of tissue factor and phospholipids (activation of the extrinsic pathway), or with the aid of cephalin (activation of the intrinsic pathway). and then measuring the thrombin concentration generated over time.
  • the thrombin generation tests are performed on 80 ⁇ l of a plasma pool optionally containing cell supernatants or controls, in the presence of 20 ⁇ l of PPP reagent (Stago) containing finally 1 ⁇ M of Tissue Factor (FT) and 4 ⁇ l of phospholipids (PL).
  • PPP reagent Stago
  • FT Tissue Factor
  • PL phospholipids
  • Different plasmas can be used, normal, deficient in factor X, deficient in factor VIII or deficient in factor IX.
  • the reaction is started by adding 20 ⁇ ⁇ of Fluca-kit (substrate + CaCl 2) which constitutes the start of the measurement of the onset of thrombin.
  • the supernatants were concentrated about 20 times on VivaSpin20-30 kDa Sartorius at 2500g for at least 1h until the desired concentration was achieved.
  • Plasmas Unicalibrator, as well as plasmas deficient in FVIII reconstituted by 0, 0.1 or 1 U / ml are used as controls.
  • the FVIII deficient plasma gives the weakest signal, corresponding to the background noise of the experiment.
  • the Unicalibrator plasma provides a weaker signal than the FVIII deficient plasma reconstituted by FVIII concentrations (0.1 or 1 U / ml).
  • the reconstitution of an FVIII deficient plasma by the FX-WT does not make it possible to generate sufficient quantities of thrombin. This reconstitution is only slightly stronger than deficient plasma alone ( Figure 7, Table 7).
  • Table 7 Kinetic parameters derived from thrombograms obtained from the addition of FX or its variants of family 2 in a factor VIII deficient plasma pool following activation by tissue factor (1 ⁇ M)
  • the kinetic parameters of the thrombograms of Figure 7 are presented in the table.
  • mutants making it possible to generate the largest amounts of thrombin in the absence of FVIII are in the order FX-PAR1, FX-FXIal, FX-IIa and FX-Kall.
  • EXAMPLE 7 Measurement in Thrombin Generation Time (TGT) of the procoagulant capacity of variant X factors: intrinsic pathway of coagulation (cephalin alone) in FVIII-deficient plasma
  • the thrombin generation tests are carried out on 80 ⁇ l of a normal plasma pool optionally containing cell supernatants and controls in the presence of 20 ⁇ l of cephalin (CK-Perst reconstituted with 1 ml of distilled H 2 0) and 20 ⁇ ⁇ Fluca-kit (substrate + CaCl 2). Plasmas used are normal plasma and Factor VIII deficient plasma. 2 - Results
  • the kinetic parameters of the thrombograms of Figure 8 are shown in the table.
  • family 2 shows, as expected, that the wild-type FX is the least active FX molecule showing a low residual activity (3.4 nM / s). All other molecules show an ability to generate larger thrombin (Table 8).
  • the FX-IIa molecule makes it possible to obtain a signal comprised between the values obtained for 0.1 and 1 U / ml of FVIII (78.2 nM / s) very effectively correcting the FVIII deficiency.
  • FX mutants have the ability to restore coagulation in the absence of FVIII following ⁇ activation of plasma by tissue factor and partial thromboplastin.
  • EXAMPLE 8 Measurement in Thrombin Generation Time (TGT) of the Procoagulant Capacity of Variant X Factors of Family 2: Activation of the Extrinsic Coagulation Pathway (FT lpM / PL 4 ⁇ ) in FIX-deficient Plasma
  • the thrombin generation tests are performed on 80 ⁇ l of a normal plasma pool optionally containing cell supernatants and controls in the presence of 1 ⁇ M of Tissue Factor (FT) and 4 ⁇ l of phospholipids (PL) and 20 ⁇ L. fluca-kit (substrate + CaCl 2 ).
  • the plasmas used are either normal or deficient in factor IX.
  • Example 6 The supernatants used in Example 6 were analyzed in TGT after activation by tissue factor using as controls a normal plasma (Unicalibrator) or a FIX deficient plasma reconstituted with 0, 0.1 or 1 U / ml plasma FIX ( Figure 10, Table 9).
  • FIX-deficient plasma is negative (it does not allow Ha generation) and its reconstitution with FIX allows it to generate large amounts of thrombin. There is, however, no quantitative difference between the two concentrations of FIX used, suggesting that they both make it possible to form a maximum amount of Ha (Table 9).
  • the kinetic parameters of the thrombograms of Figure 10 are shown in the table.
  • EXAMPLE 9 Measurement in Thrombin Generation Time (TGT) of the Procoagulant Capacity of Variant X Factors of Family 2: Activation of the Intracellular Pathway of Coagulation (Cephalin) to FIX-deficient Plasma
  • the thrombin generation tests are carried out on 80 ⁇ l of a normal plasma pool optionally containing cell supernatants and controls in the presence of cephalin (CK-Perst reconstituted with 1 ml of distilled H 2 0) and 20 ⁇ l. ⁇ Fluca-kit (substrate + CaCl 2). The plasmas used are either normal or deficient in factor IX. 2 - Results
  • Example 6 The supernatants used in Example 6 were analyzed in TGT after activation by cephalin using, as controls, a normal plasma (Unicalibrator) and a plasma deficient in FIX reconstituted with 0, 0.1 or 1 U / ml of plasma FIX (FIG. 11, Table 10).
  • FIX-deficient plasma is negative (it does not allow Ha generation) and its reconstitution with FIX allows it to generate large amounts of thrombin. However, there is no quantitative difference between the two FIX concentrations used, suggesting that they form a maximum amount of Ha (Table 10).
  • the kinetic parameters of the thrombograms of Figure 11 are shown in the table.
  • Activation of FX variants produced by HEK cells in the presence of Vitamin K epoxide reductase was measured following incubation of culture supernatants in the presence of thrombin.
  • the activated control factor X, the thrombin and the Pefachrome FXa8595 substrate come from Haematologic Technologies (Cryopep Jardin, France).
  • the phospholipids come from Diagnostica Stago (Asieres, France).
  • Activation was studied at 37 ° C in the following buffer: 25 mM HEPES, pH 7.4, 0.175 M NaCl, 5 mM CaCl 2 , 5 mg / ml BSA. At concentrations of 42.5 and 85 nM FX, a concentration of 10 nM thrombin and 4 ⁇ l phospholipids was used. After 1 hour of incubation at 37 ° C., the amount of FXa generated is monitored by measuring the hydrolysis rate of the Pefachrome FXa8595 substrate (250 ⁇ l) at 405 nm.
  • FX-Ha and FX-control + are capable of being activated by thrombin and releasing FXa.
  • FX-IIa is more effectively activated than FX-control +.
  • EXAMPLE 11 Measurement in Thrombin Generation Time (TGT) of the Procoagulant Capacity of X-Variant Factors of Family 1: Extrinsic Coagulation Pathway (FT lpM / PL 4 ⁇ ) in FVIII-deficient Plasma
  • the thrombin generation tests are performed on 80 ⁇ l of a plasma pool optionally containing cell supernatants or controls, in the presence of 20 ⁇ l of PPP reagent (Stago) containing finally 1 ⁇ M of Tissue Factor (FT) and 4 ⁇ l of phospholipids (PL). Different plasmas are used, normal and deficient in factor VIII.
  • PPP reagent Stago
  • FT Tissue Factor
  • PL phospholipids
  • the reaction is started by adding 20 ⁇ ⁇ of Fluca-kit (substrate + CaCl 2) which constitutes the start of the measurement of the onset of thrombin.
  • Fluca-kit substrate + CaCl 2
  • the appearance of fluorescence is measured on a Fluoroskan Ascent fluorimeter (ThermoLabsystems) at an excitation wavelength of 390 nm and at an emission length of 460 nm.
  • Thrombinograms curves representing the fluorescence intensity as a function of time
  • are then analyzed using the Thrombinoscope TM software which converts the fluorescence value into nM thrombin by comparative calculation. 2 - Results
  • the supernatants of the family 1 resulting from a transfection of HEK293F cells in the presence of VKOR were analyzed in TGT after activation by tissue factor using the controls already described.
  • the controls normal plasma, FVIII deficient plasma reconstituted or not with recombinant FVIII
  • the FX-WT gives a moderate signal but higher than the expected one (figures 14 and 16, table 11). Its average velocity (59 nM / min) is however exceeded by those of several mutants including FX-FXIal / 2, FX-Kall / 2 and FX-control + and FX-Ha which have a velocity of at least 130% that of control.
  • the kinetic parameters of the thrombograms of Figure 14 are shown in the table.
  • EXAMPLE 12 Measurement in Thrombin Generation Time (TGT) of the Procoagulant Capacity of Variant X Factors of Family 1: Intrinsic Coagulation Pathway (Cephalin Alone) in FVIII-deficient Plasma
  • the thrombin generation tests are performed on 80 ⁇ l of a plasma pool optionally containing the cell supernatants and the controls in the presence of 20 ⁇ l of cephalin (CK-Perst reconstituted with 1 ml of distilled H 2 0) and of 20 ⁇ ⁇ Fluca-kit (substrate + CaCl 2). Plasmas used are normal plasma and Factor VIII deficient plasma. 2 - Results
  • the supernatants of the family 1 resulting from a transfection of HEK293F cells in the presence of VKOR were analyzed in TGT after activation by cephalin using the controls already described.
  • the controls behave in an expected manner, the FVIII deficient plasma is negative (it does not allow Ha generation) and an efficiency gradient is found by increasing the dose of FVIII ( Figure 15, Table 12).
  • FX supplementation (2 trials were performed) did not produce significant amounts of thrombin (velocities of 6.06 and 7.65 nM / min).
  • the mutants FX-IIa, FX-FXIal and 2 and FX-control + of the family 1 make it possible to generate significantly greater amounts of thrombin of at least 3.5X than that of the control ( Figures 15 and 16, Table 12).
  • Table 12 Kinetic Parameters Resulting from Thrombinograms Obtained from the Addition of FX or its Family 1 Variants in a Factor VIII-deficient Plasma Pool Following Cephalin Activation
  • the kinetic parameters of the thrombograms of Figure 15 are presented in the table.
  • EXAMPLE 13 Measurement in Thrombin Generation Time (TGT) of the Procoagulant Capacity of Variant X Factors of Family 1: Extrinsic Coagulation Pathway (FT lpM / PL 4 ⁇ ) in FIX-1-deficient Plasma - Experimental Protocol
  • the thrombin generation tests are carried out on 80 ⁇ l of a plasma pool optionally containing cell supernatants and controls in the presence of 20 ⁇ l of PPP reagent (Stago) containing in the end 1 ⁇ M of Tissue Factor (FT) and 4 ⁇ M of ⁇ of phospholipids (PL) and 20 ⁇ ⁇ fluca-kit (substrate + CaCl 2 ).
  • the plasmas used are a normal plasma and a factor IX deficient plasma.
  • the supernatants of the family 1 from a transfection of HEK293F cells in the presence of VKOR were analyzed in FIX-deficient plasma TGT after activation by tissue factor using the controls already described.
  • the controls normal plasma, FIX-deficient plasma reconstituted or not with plasma FIX (at 10 or 100%) behave in an expected manner, whereas the FX-WT gives a moderate but higher signal than expected (FIG. Table 13), but its average velocity (23 nM / min) is exceeded by all mutants except the FX-PAR1, including FX-FXIal / 2, FX-Kal2 / 3 and FX-control + and FX- IIa which have a velocity of at least 150% that of the control.
  • Table 13 Kinetic parameters derived from thrombograms obtained from the addition of FX or its family 1 variants in a factor IX deficient plasma pool following activation by tissue factor
  • the kinetic parameters of the thrombograms of Figure 17 are shown in the table.
  • EXAMPLE 14 Measurement in Thrombin Generation Time (TGT) of the Procoagulant Capacity of Variant X Factors of Family 1: Intrinsic Pathway of Coagulation (Cephalin) in FIX-1-deficient Plasma - Experimental Protocol
  • the thrombin generation tests are performed on 80 ⁇ l of a plasma pool optionally containing the cell supernatants and the controls in the presence of 20 ⁇ l of cephalin (CK-Perst reconstituted with 1 ml of distilled H 2 0) and of 20 ⁇ ⁇ Fluca-kit (substrate + CaCl 2).
  • the plasmas used are a normal plasma and a factor IX deficient plasma.
  • the supernatants of the family 1 resulting from a transfection of HEK293F cells in the presence of VKOR were analyzed in TGT after activation by cephalin using the controls already described.
  • the controls behave in an expected manner, the FIX-deficient plasma is negative (it does not allow generation of Ha) and a gradient of efficiency is found by increasing the dose of FIX ( Figure 18, Table 14).
  • FX supplementation (2 trials were performed) did not produce significant amounts of thrombin (velocities of 1.24 and 1.53 nM / min).
  • the mutants FX-IIa, FX-FXIal and 2 and FX-control + of the family 1 make it possible to generate significantly greater amounts of thrombin of at least 4.7 X than that of the 55X control (FIGS. 18 and 19; 14).
  • Table 14 Kinetic Parameters from Thrombinograms Obtained from the Addition of FX or its Family 1 Variants in a Factor IX-deficient Plasma Pool Following Cephalin Activation
  • the kinetic parameters of the thrombograms of Figure 18 are shown in the table.
  • EXAMPLE 15 Measurement in Thrombin Generation Time (TGT) of the Procoagulant Capacity of Variant X Factors of Family 3: Extrinsic Coagulation Pathway (FT lpM / PL 4 ⁇ ) in FVIII-deficient Plasma 1 - Experimental Protocol
  • the thrombin generation tests are performed on 80 ⁇ l of a plasma pool optionally containing cell supernatants or controls, in the presence of 20 ⁇ l of PPP reagent (Stago) containing finally 1 ⁇ M of Tissue Factor (FT) and 4 ⁇ l of phospholipids (PL). Different plasmas are used, normal and deficient in factor VIII.
  • PPP reagent Stago
  • FT Tissue Factor
  • PL phospholipids
  • the reaction is started by adding 20 ⁇ ⁇ of Fluca-kit (substrate + CaCl 2) which constitutes the start of the measurement of the onset of thrombin.
  • Fluca-kit substrate + CaCl 2
  • the appearance of fluorescence is measured on a Fluoroskan Ascent fluorimeter (ThermoLabsystems) at an excitation wavelength of 390 nm and at an emission length of 460 nm.
  • Thrombinograms curves representing the fluorescence intensity as a function of time
  • are then analyzed using the Thrombinoscope TM software which converts the fluorescence value into nM thrombin by comparative calculation. 2 - Results
  • the supernatants of the family 3 resulting from a transfection of HEK293F cells in the presence of VKOR were analyzed in TGT after activation by tissue factor using the controls already described.
  • the controls normal plasma, FVIII deficient plasma reconstituted or not with recombinant FVIII
  • the FX-WT gives a moderate signal but greater than the expected one (figures 20 and 21, table 15).
  • Table 15 Kinetic parameters derived from thrombograms obtained from the addition of FX or its family 3 variants in a factor VIII deficient plasma pool following activation by tissue factor
  • the kinetic parameters of the thrombograms of Figure 20 are presented in the table.
  • EXAMPLE 14 Measurement in Thrombin Generation Time (TGT) of the Procoagulant Capacity of Variant X Factors of Family 3: Intrinsic Pathway of Coagulation (Cephalin Alone) in FVIII-deficient Plasma 1 - Experimental Protocol
  • the reagents, the automaton and the experimental protocol are identical to those described in example 6.
  • the thrombin generation tests are carried out on 80 ⁇ l of a plasma pool optionally containing the cell supernatants and the controls in the presence of 20 ⁇ cephalin (CK-Perst reconstituted with 1 mL of distilled H 2 0) and 20 ⁇ ⁇ Fluca-kit (substrate + CaCl 2). Plasmas used are normal plasma and Factor VIII deficient plasma.
  • the controls behave in an expected manner, the FVIII deficient plasma is negative (it does not allow Ha generation) and an efficiency gradient is found by increasing the dose of FVIII ( Figure 21, Table 16).
  • FX supplementation (2 trials were performed) did not produce significant amounts of thrombin (velocities of 6.06 and 7.65 nM / min).
  • FX-IIa, FX-FXIal and 2 and FX-control + mutants of family 3 make it possible to generate significant amounts of thrombin with velocities greater than 26 nM, ie at least 3.8X faster than FX-WT ( Figure 23, Table 16).
  • the kinetic parameters of the thrombograms of Figure 23 are shown in the table.
  • EXAMPLE 15 Measurement in Thrombin Generation Time (TGT) of the Procoagulant Capacity of Variant X Factors of Family 3: Extrinsic Coagulation Pathway (FT lpM / PL 4 ⁇ ) in FIX-1-deficient Plasma - Experimental Protocol
  • the thrombin generation tests are carried out on 80 ⁇ l of a plasma pool optionally containing cell supernatants and controls in the presence of 20 ⁇ l of PPP reagent (Stago) containing in the end 1 ⁇ M of Tissue Factor (FT) and 4 ⁇ M of ⁇ of phospholipids (PL) and 20 ⁇ ⁇ fluca-kit (substrate + CaCl 2 ).
  • the plasmas used are a normal plasma and a factor IX deficient plasma.
  • the supernatants of the family 3 resulting from a transfection of HEK293F cells in the presence of VKOR were analyzed in TGT after activation by tissue factor using the controls already described.
  • the controls behave in an expected manner, the FIX-deficient plasma is negative (it does not allow Ha generation) and an efficiency gradient is found by increasing the dose of FIX ( Figure 23, Table 17).
  • FX supplementation (2 trials were performed) did not produce significant amounts of thrombin (mean velocity 23 nM / min).
  • all the mutants except FX-PAR1M of the family 3 make it possible to generate significant quantities of thrombin with velocities greater than 33 nM, that is at least 140% faster than the FX-WT (FIG. 23, table 17).
  • Table 17 Kinetic parameters derived from thrombinograms obtained from the addition of FX or its family 3 variants in a factor IX deficient plasma pool following activation by tissue factor
  • the kinetic parameters of the thrombograms of Figure 23 are shown in the table.
  • EXAMPLE 16 Measurement in Thrombin Generation Time (TGT) of Procoagulant Capability of Variant X Factors of Family 3: Intrinsic Coagulation Pathway (Cephalin) in FIX-1-deficient Plasma - Experimental Protocol
  • the reagents, the automaton and the experimental protocol are identical to those described in example 6.
  • the thrombin generation tests are performed on 80 ⁇ l of a normal plasma pool optionally containing the cell supernatants and the controls in the presence 20 ⁇ cephalin (CK-Perst reconstituted with 1 mL of distilled H 2 0) and 20 ⁇ ⁇ Fluca-kit (substrate + CaCl 2).
  • the plasmas used are a normal plasma and a factor IX deficient plasma.
  • the controls behave in an expected manner, the FIX-deficient plasma is negative (it does not allow generation of Ha) and an efficiency gradient is found by increasing the FXI dose ( Figure 24, Table 18).
  • FX supplementation (2 trials were performed) did not produce significant amounts of thrombin (velocities of 1.24 and 1.53 nM / min).
  • the mutants FX-IIa, FX-FXIal and 2, FX-Kal 2 and 3, and FX-control + of the family 1 make it possible to generate significantly greater amounts of thrombin of at least 3.4X than that of the control. 52X ( Figures 24 and 25, Table 18).
  • all mutants except FX-PARI mutants M and FX-Kal2 are more active than FX-WT.
  • Table 18 Kinetic parameters derived from thrombinograms obtained from the addition of FX or its variants of family 3 in a factor IX deficient plasma pool following activation by the thromboplastin
  • the kinetic parameters of the thrombograms of Figure 24 are shown in the table.

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FR3077296A1 (fr) * 2018-02-01 2019-08-02 Laboratoire Francais Du Fractionnement Et Des Biotechnologies Dimeres de variants du facteur x

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FR3001729B1 (fr) * 2013-02-04 2015-03-06 Lab Francais Du Fractionnement Mutants du facteur x
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FR3050992A1 (fr) * 2016-05-06 2017-11-10 Lab Francais Du Fractionnement Mutants du facteur x
FR3077296A1 (fr) * 2018-02-01 2019-08-02 Laboratoire Francais Du Fractionnement Et Des Biotechnologies Dimeres de variants du facteur x
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