WO2014195803A2 - Contiguous overlapping peptides for treatment of house dust mites allergy - Google Patents
Contiguous overlapping peptides for treatment of house dust mites allergy Download PDFInfo
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- WO2014195803A2 WO2014195803A2 PCT/IB2014/001888 IB2014001888W WO2014195803A2 WO 2014195803 A2 WO2014195803 A2 WO 2014195803A2 IB 2014001888 W IB2014001888 W IB 2014001888W WO 2014195803 A2 WO2014195803 A2 WO 2014195803A2
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- C07K14/43504—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from invertebrates
- C07K14/43513—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from invertebrates from arachnidae
- C07K14/43531—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from invertebrates from arachnidae from mites
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K39/35—Allergens
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P37/00—Drugs for immunological or allergic disorders
- A61P37/08—Antiallergic agents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
- A61K2039/55505—Inorganic adjuvants
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
- A61K2039/55511—Organic adjuvants
- A61K2039/55566—Emulsions, e.g. Freund's adjuvant, MF59
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/70—Multivalent vaccine
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K2319/00—Fusion polypeptide
Definitions
- the present invention relates to contiguous overlapping peptides (COPs) derived from the Der p 1 and Der p 2 house dust mite major allergens and the use of such compounds in medicine.
- COPs contiguous overlapping peptides
- the compounds and methods of treatment of the invention are contemplated to be useful in treating house dust mite allergy and widely accelerating its treatment.
- IgE- mediated allergic disease appears to be very common particularly in industrialized countries where up to one quarter of the population is affected by allergic rhinitis [1]. Furthermore people suffering from allergic rhinitis show a lower quality of life than healthy ones [2], with only a few going into remission spontaneously.
- House Dust Mites allergy is widely distributed worldwide and about 50% of the allergic population in the US and Europe suffers from allergy to house dust mites for review see [3].
- House dust mites (HDM) belong predominantly to two species Dermatophagoides pteronyssinus, and Dermatophagoides farinae. Treatment against HDM allergy can be based on the major allergens of one of the two species since the major HDM allergens of D.
- Der p 1 shares 83% sequence identity with Der f 1 leading to highly cross-reactive human IgE antibody and T cell responses between these two species.
- preincubation of allergic patients' serum with Der f 1 has been found to prevent binding of Der p 1 to HDM IgE antibodies, even though different binding affinities were reported.
- Der p 2and Der f 2 (88% sequence identity) have been found to prevent binding of their counterparts very effectively.
- T cell proliferation was also found to be equally induced by D. pteronyssinus and D. farinae peptides. Allergens from the two species are not fully interchangeable however, since fewer peptides from Der f 1 than from Der p 1 were able to stimulate T cell proliferation for example.
- allergens have been described in HDM allergy, as found in the NCBI Nucleotide and protein databases.
- the allergens can be allocated to at least 7 groups related in sequence to known proteins, namely:
- Der p 1 variants have been described indicating some polymorphism [7].
- a BLAST search using the Swiss-Prot sequence P08176.2 revealed a number of protein sequences within the NCBI databases. Most variations were found in Der f 1 sequences and were located to 5 predominant positions, namely 123, 132, 150, 152 and 204 (coordinates referred to Swiss-Prot P08176.2).
- Polymorphism was also described using RT-PCR on a panel of sequences of the groups 1 and 2 allergens from both D. pteronys sinus and D. farinae isolated from homes in Bangkok [8]. Taken together these results indicate that the most predominant Der p 1 is the sequence referenced in Swiss-Prot P08176.2 , also identical to Der p 1.0105 [8].
- the Der p 1 protein is a cysteine protease (Peptidase of the CI superfamily) of 320 amino acids. The first 18 amino acids have properties of a signal peptide, whereas the next amino acids from R19 to E98 are present in the pro-protein and do contain a protease inhibitor domain 129. Mature Der p 1 is composed of 222 amino acids (T 99 to L320) and three crystal structures had been determined (PDB 1XKG, 2AS8 and 3F5V).
- IgE epitopes are mostly conformational and thus difficult to map.
- Monoclonal antibodies raised against either Der p 1 or Der f 1 are mostly species-specific.
- antibody 4C1 against Der f 1 binds also Der p 1 and the epitopes for the monoclonal antibody (mAb) and human IgE antibodies were found to overlap as determined by crystal structures of the complex [13].
- mAb W108 not only inhibited the binding of Der p 1 with IgE antibodies but also its cysteine proteinase activity [14].
- Three peptides were identified by LC-MS after protease digestion of the W108/Der p 1 complex (aa 209-224; 227-243 and 260-287) which did not overlap with two peptide segments of Der p 1 found to bind most directly to mAb W108 (aa 151-197 and 286-320). These results demonstrate the complexity of mapping IgE epitopes even when using monoclonal antibodies.
- Der p 2 seems to be very polymorphic with 15 described variants, including the best characterized versions Der p2.0101, 0103, 0104, 0107 and 0108 [15]. According to [8], Der p 2 showed frequent variations with clusters of amino acid substitutions, but the canonical Der p 2.0101 was not found in any of the 17 sequences. Der f 2 showed variants with clusters of substitutions similar to Der p 2 but in different amino acid positions and without any structural concordance.
- IgE epitopes include Hydrogen Exchange Nuclear Magnetic Resonance [17] and Mimotopes [18].
- Three major regions seem to be involved located on the surface of the molecule, namely N71-C78, V94-K100 and LI 11-Gl 15 (numbering according to GenBank AFJ68067.1 sequence).
- the last two regions include residues identified in the IEDB database as being part of possible IgE epitopes [7]; However, no definitive epitope mapping was proposed due to the 3D binding specificity of IgEs.
- hypoallergenic allergy vaccines The only treatment directed to the cause of IgE-mediated allergy is specific immunotherapy (SIT).
- SIT specific immunotherapy
- the treatment consists in injecting increasing doses of allergens for extended periods of time (three to five years) to induce tolerance in the allergic patient.
- a further approach consisted in providing peptides encompassing a restricted number of T-cell epitopes which were used for allergen immunotherapy of cat dander with limited efficacy [32] .
- allergens harbor a great variety of T cell epitopes partly dependent on the HLA type of the patient.
- T cell epitopes were found scattered throughout the Bet v 1 sequence, except for a short region [33].
- immunotherapy product should preferably contain the complete sequence of the allergen rather than selected T-cell epitopes.
- fragments of allergens remains attractive, based on the evidence that human IgE recognize mainly non-contiguous epitopes which may be separated by
- a method was devised to select contiguous overlapping peptides (COPs) for treatment of allergy which together form the entire amino acid sequence of an allergen, thus providing all possible T cell epitopes of the allergen, while having lowered IgE binding (US Patent 7,923,209).
- COPs contiguous overlapping peptides
- Such selected fragments show a reduced ability to reform the original tertiary structure of the allergen, if any, resulting in a reduced ability to bind IgE and therefore to elicit allergic reactions in humans.
- the present invention provides contiguous overlapping peptides (COPs) as a composition for the treatment of house dust mites' allergies.
- COPs contiguous overlapping peptides
- COPS are provided from the sequence of the two major allergens of house dust mites Der p 1 and Der p 2 which include the complete sequence of these allergens and thus provide all potential T cell epitopes, but are devoid of the three dimensional structure of the original allergen.
- the COPS may be used in methods of specific immunotherapy against house mite dust allergies and may be administered to mice and other mammals sensitized with Der pi or Der p 2 or a mix of these two allergens without eliciting anaphylactic shock. More specifically, the invention relates to a specific immunotherapy (SIT) method able to reduce allergic symptoms after a few administrations over a short period of time.
- This therapy consists of repeatedly administering specific COPs to humans suffering from allergy to house dust mites. Administration may be done by systemic, transdermal, intradermal subcutaneous, or by oral routes, or mucosal routes including sublingual and intestinal routes. Administration may in some embodiments be repeated five times over two month compared to 3 to 5 years for current SIT.
- Administered amount of active product (COPs) may reach a cumulated value equivalent in molar amount to the amount of Der p 1 and Der p 2 administered over three year of SIT treatment.
- the invention provides a composition comprising a plurality of contiguous overlapping peptide fragments (COPs) wherein the reactivity of said COPs to IgE antibodies of subjects who are allergic to house dust mites is substantially reduced or eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained.
- COPs contiguous overlapping peptide fragments
- Said combination of COPs including both the complete sequences of Der p 1 (Swiss-Prot P08176.2) and the complete sequence of Der p 2 (GenBank AFJ68067.1), said Der p 1 sequences are obtained by the addition of a first peptide starting at amino acid T99 and ending at G 168 (SEQ ID NO: 8), a second peptide starting at amino acid A164 and ending at S200 (SEQ ID NO: 12), a third peptide starting at amino acids R193 and ending at E227 (SEQ ID NO: 13), a fourth peptide starting at amino acids P220 and ending at R254 (SEQ ID NO: 14), a fifth peptide starting at amino acids R249 and ending at D282 (SEQ ID NO: 15), a sixth peptide starting at amino acids A278 and ending at L320 (SEQ ID NO: 11), said Der p 2 sequences are obtained by addition of a first peptide starting at amino acids Dl and ending at E25 (SEQ ID
- first through sixth Der p 1 peptides and first through fourth Der p 2 peptides are contemplated which are each 1-3 or 1-5 or 1-10 or 1-15 amino acids truncated or elongated from the preferred peptides of SEQ ID NOS: 8, 11-15, 18, 19, 24 and 25 such that IgE reactive three dimensional epitopes are not recreated and such that the reactivity of the peptide to IgE antibodies of subjects who are allergic to Der p 1 and/or Der p 2 is eliminated and whereby sets of peptides which overlap each other by one or more amino acids are produced such that reactivity with T lymphocytes from subjects who are allergic to house dust mites is maintained.
- the truncated or elongated COPs will be equivalent functionally to the peptides of SEQ ID NOS: 8, 11-15, 18, 19, 24 and 25 provided that they do not lead to restored IgE binding.
- SEQ ID NOS: 8 11-15, 18, 19, 24 and 25 provided that they do not lead to restored IgE binding.
- Der p 1 and Der p 2 there exists some sequence variability in the major dust mite allergens Der p 1 and Der p 2.
- Der p 2 GenBank sequence AFJ68067.1 SEQ ID NO: 28 differs by four amino acid residues from the mature protein sequence variant in Swiss Prot P49278.1 (SEQ ID NO: 29).
- the sequences vary by the substitution of a hydrophobic valine (V) for a hydrophilic lysine (L) at AA 40, the substitution of a nucleophilic serine (S) for a nucleophilic threonine (T) at AA 47, the substitution of a hydrophobic lysine (L) for a hydrophobic methionine (M) at AA 70 and the substitution of an amide asparagine (N) for an acidic residue aspartic acid (D) at AA 114.
- V hydrophobic valine
- S nucleophilic serine
- T nucleophilic threonine
- M hydrophobic methionine
- N an amide asparagine
- the invention provides COPs having 70%, 80%, 85%, 90% or 95% sequence identity to the peptides of SEQ ID NOS: 8, 11-15, 18, 19, 24 and 25 and the peptides of SEQ ID NOS: 8 and 11-15 which are elongated or truncated by 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 26 and SEQ ID NOS: 18, 19, 24 and 25 along SEQ ID NO: 27 and wherein the reactivity of such peptides to IgE antibodies of subjects allergic to house dust mites is eliminated while reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained.
- the first and second peptides of Der p 1 overlap each other by 1 to 5 amino acids.
- the second and third peptides of Der p 1 overlap each other by 1 to 8 amino acids.
- the third and fourth peptides of Der p 1 overlap each other by 1 to 8 amino acids.
- the fourth and fifth peptides of Der p 1 overlap each other by 1 to 6 amino acids.
- the fifth and sixth peptides of Der p 1 overlap each other by 1 to 5 amino acids.
- the first and second peptides of Der p 2 overlap each other by 1 to 4 amino acids.
- the second and third peptides of Der p 2 overlap each other by 1 to 21 amino acids.
- the third and fourth peptides of Der p 2 overlap each other by 1 to 5 amino acids.
- compositions comprise the combination of the peptide having SEQ ID NO: 8, the peptide having SEQ ID NO: 12, the peptide having SEQ ID NO: 13, the peptide having SEQ ID NO: 14, the peptide having SEQ ID NO: 15, the peptide having SEQ ID NO: 11, the peptide having SEQ ID NO: 18, the peptide having SEQ ID NO: 19, the peptide having SEQ ID NO: 24 and the peptide having SEQ ID NO: 25.
- Preferred COP compositions include those wherein the peptides are soluble in aqueous buffers compatible with application routes.
- the set of peptides are soluble in aqueous buffers compatible with application routes.
- AllerDM1.5, AllerDM1.52, AllerDM1.53, AllerDM1.54 and AllerDM1.5a are preferred to AllerDM1.2 due to their solubility in water.
- AllerDM1.7 is preferred to AllerDM1.3 and AllerDM1.72 as no polar aprotic solvent is needed for solubilization.
- Such peptides can be obtained by any of a variety of methods including by chemical synthesis or by recombinant means.
- compositions can be provided in dry powdered form but can also be provided in combination with an acceptable carrier or diluent.
- the compositions can further comprise an adjuvant with a preferred adjuvant being aluminum hydroxide. As such the compositions can be characterized as and used as a vaccine composition.
- the COPs and peptides of the invention can be provided together with denaturing and or chaotropic agents, comprising guanidinium chloride. Such agents function by preventing 3-dimensional structure formation in solution contribute to lower IgE binding.
- Also provided are methods of specific immunotherapy (SIT) against house dust mite allergies comprising administering to a patient in need thereof one or more allergens selected from the group consisting of a combination of COPs including both the complete sequences of Der p 1 (Swiss-Prot P08176.2) and the complete sequence of Der p 2 (GenBank AFJ68067.1), said Der p 1 sequences are obtained by the addition of a first peptide starting at amino acid T99 and ending at G168 (SEQ ID NO: 8), a second peptide starting at amino acid A164 and ending at S200 (SEQ ID NO: 12), a third peptide starting at amino acids R193 and ending at E227 (SEQ ID NO: 13), a fourth peptide starting at amino acids P220 and ending at R254 (SEQ ID NO: 14), a fifth peptide starting at amino acids R249 and ending at D282 (SEQ ID NO: 15), a sixth peptide starting at amino acids A278 and ending
- Such methods can be carried out in which the peptides are administered using intradermal injection, subcutaneous injection, intramuscular injection, intravenous injection, transdermal, intranasal, oral, sublingual, intraocular, or intrathecal techniques.
- a patient is treated with the combination of COPs including both the complete sequences of Der p 1 (Swiss-Prot P08176.2) and the complete sequence of Der p 2 (GenBank AFJ68067.1), said Der p 1 sequences are obtained by the addition of a first peptide starting at amino acid T99 and ending at G168 (SEQ ID NO: 8), a second peptide starting at amino acid A164 and ending at S200 (SEQ ID NO: 12), a third peptide starting at amino acids R193 and ending at E227 (SEQ ID NO: 13), a fourth peptide starting at amino acids P220 and ending at R254 (SEQ ID NO: 14), a fifth peptide starting at amino acids R249 and ending at D282 (SEQ ID NO: 15), a sixth peptide starting at amino acids A278 and ending at L320 (SEQ ID NO: 11), said Der p 2 sequences are obtained by addition of a first peptide starting at amino acid T99 and ending at G168
- the first and second peptides of Der p 1 overlap each other by 1 to 5 amino acids.
- the second and third peptides of Der p 1 overlap each other by 1 to 8 amino acids.
- the third and fourth peptides of Der p 1 overlap each other by 1 to 8 amino acids.
- the fourth and fifth peptides of Der p 1 overlap each other by 1 to 6 amino acids.
- the fifth and sixth peptides of Der p 1 overlap each other by 1 to 5 amino acids.
- the first and second peptides of Der p 2 overlap each other by 1 to 4 amino acids.
- the second and third peptides of Der p 2 overlap each other by 1 to 21 amino acids.
- the third and fourth peptides of Der p 2 overlap each other by 1 to 5 amino acids.
- Particularly preferred compositions comprise the combination of the peptide having SEQ ID NO: 8, the peptide having SEQ ID NO: 12, the peptide having SEQ ID NO: 13, the peptide having SEQ ID NO: 14, the peptide having SEQ ID NO: 15, the peptide having SEQ ID NO: 11, the peptide having SEQ ID NO: 18, the peptide having SEQ ID NO: 19, the peptide having SEQ ID NO: 24 and the peptide having SEQ ID NO: 25.
- the invention provides a composition comprising a plurality of peptide fragments comprising a first polypeptide consisting of the sequence from amino acids 99-104 to amino acids 157-177 of a polypeptide having 90% sequence identity to SEQ ID NO:27 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained, a second peptide consisting of the sequence from amino acids 154-174 to amino acids 190-210 of a polypeptide having 90% sequence identity to SEQ ID NO:27 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained, a third peptide consisting of the sequence from amino acids 183-203 to amino acids 217-237 of a polypeptide having 90% sequence
- compositions wherein the first and second peptides overlap each other by 1 to 5 amino acids; the second and third peptides overlap each other by 1 to 8 amino acids; the third and fourth peptides overlap each other by 1 to 8 amino acids; the fourth and fifth peptides overlap each other by 1 to 6 amino acids or the fifth and sixth peptides overlap each other by 1 to 5 amino acids.
- composition comprising a plurality of peptide fragments comprising a first polypeptide consisting of the sequence from amino acids 1-15 to amino acids 15-35 of a polypeptide having 90% sequence identity to SEQ ID NO:28 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained, a second peptide consisting of the sequence from amino acids 12-32 to amino acids 67-87 of a polypeptide having 90% sequence identity to SEQ ID NO:28 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained, a third peptide consisting of the sequence from amino acids 47-67 to amino acids 103-123 of a polypeptide having 90% sequence identity
- compositions wherein the first and second peptides overlap each other by 1 to 4 amino acids; the second and third peptides overlap each other by 1 to 21 amino acids or the third and fourth peptides overlap each other by 1 to 5 amino acids.
- composition comprising a plurality of Der pi contiguous overlapping peptide fragments comprising a first polypeptide consisting of the sequence from amino acids 99-104 to amino acids 157-177 of a polypeptide having 90% sequence identity to SEQ ID NO:27 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained, a second peptide consisting of the sequence from amino acids 154-174 to amino acids 190-210 of a polypeptide having 90% sequence identity to SEQ ID NO:27 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained, a third peptide consisting of the sequence from amino acids 183-203 to amino acids 217-237 of SEQ ID NO:27
- a patient in need of specific immunotherapy for dust mite allergy is treated with the combination of one or more Der p 1 contiguous overlapping peptides comprising a first peptide starting at amino acid T99 and ending at G 168 of a polypeptide having 90% sequence identity to (SEQ ID NO: 8), a second peptide starting at amino acid A 164 and ending at S200 of a polypeptide having 90% sequence identity to (SEQ ID NO: 12), a third peptide starting at amino acids R193 and ending at E227 of a polypeptide having 90% sequence identity to (SEQ ID NO: 13), a fourth peptide starting at amino acids P220 and ending at R254 of a polypeptide having 90% sequence identity to (SEQ ID NO: 14), a fifth peptide starting at amino acids R249 and ending at D282 of a polypeptide having 90% sequence identity to (SEQ ID NO: 15), a sixth peptide starting at amino acids A278 and ending at L320 (SEQ ID NO: 8), a
- the first and second peptides overlap each other by 1 to 5 amino acids
- the first and second peptides overlap each other by 1 to 11 amino acids
- the second and third peptides overlap each other by 1 to 8 amino acids
- the third and fourth peptides overlap each other by 1 to 8 amino acids
- the fourth and fifth peptides overlap each other by 1 to 6 amino acids
- the fifth and sixth peptides overlap each other by 1 to 5 amino acids
- the seventh and eighth peptides overlap each other by 1 to 4 amino acids
- the eighth and ninth peptides overlap each other by 1 to 21 amino acids
- the ninth and tenth peptides overlap each other by 1 to 5 amino acids.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid T99 to G 168 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 8) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 27 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 8.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid A164 and ending at S200 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 12) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 27 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 12.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid R193 and ending at E227 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 13) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 27 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 13.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid P220 and ending at R254 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 14) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 27 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 14.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid R249 and ending at D282 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 15) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 27 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 15.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid A278 and ending at L320 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 11) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 27 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 11.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid Dl and ending at E25 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 18) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 28 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 18.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid Dl and ending at E25 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 18) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 28 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 18.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid H22 and ending at K77 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 19) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 28 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 19.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid S57 and ending at Dl 13 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 24) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 28 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 24.
- Preferred peptides according to the invention include a peptide comprising the sequence from amino acid K109 and ending at D129 of a polypeptide having 90% or 95% sequence identity to (SEQ ID NO: 25) which is optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 28 wherein the reactivity of said peptide to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained with a particularly preferred peptide having the sequence consisting of that of SEQ ID NO: 25.
- the invention also provides a method of specific immunotherapy against house dust mites allergies comprising administering to a patient in need thereof one or more allergens selected from the group consisting of a first polypeptide consisting of the sequence from amino acids 99-104 to amino acids 157-177 of a polypeptide having 90% sequence identity to SEQ ID NO:27 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained, a second peptide consisting of the sequence from amino acids 154-174 to amino acids 190-210 of a polypeptide having 90% sequence identity to SEQ ID NO:27 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained, a third peptide consisting of the sequence from amino acids 183-2
- composition for conducting specific immunotherapy comprising a plurality of contiguous overlapping peptide fragments which fragments together comprise the entire amino acid sequence of a polypeptide having 90% sequence identity to Der p 2 (SEQ ID NO: 28) comprising a first polypeptide consisting of the sequence from amino acid 1 to amino acids 30-82 of a polypeptide having 90% sequence identity to SEQ ID NO:28 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained, a second peptide consisting of the sequence from amino acids 12-32 to amino acids 67-87 of a polypeptide having 90% sequence identity to SEQ ID NO:28 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained,
- composition for conducting specific immunotherapy comprising a plurality of contiguous overlapping peptide fragments which fragments together comprise the entire amino acid sequence of a polypeptide having 90% sequence identity to Der p 2 (SEQ ID NO: 28) comprising a first polypeptide consisting of the sequence from amino acid 1 to amino acids 62-82 of a polypeptide having 90% sequence identity to SEQ ID NO:28 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained, a second peptide consisting of the sequence from amino acids 47-67 to amino acids 103-123 of a polypeptide having 90% sequence identity to SEQ ID NO:28 wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is is
- composition for conducting specific immunotherapy comprising a plurality of Der p 2 contiguous overlapping peptide fragments comprising a first peptide starting at amino acid Dl and ending at A72 of (SEQ ID NO: 16), a second peptide starting at amino acid S57 and ending at Dl 13 (SEQ ID NO: 24), and a third peptide selected from the group consisting of the peptide starting at amino acid K89 and ending at D129 of (SEQ ID NO: 28) or the peptide starting at amino acid K109 and ending at D129 (SEQ ID NO: 25) wherein the peptides are optionally elongated or truncated by from 1-3, 1-5, 1-10 or 1-15 amino acids along SEQ ID NO: 28 and wherein the reactivity of said peptides to IgE antibodies of subjects who are allergic to house dust mites is eliminated while the reactivity with the T lymphocytes from subjects who are allergic to house dust mites is retained.
- composition wherein the second peptide starting at amino acid S57 and ending at Dl 13 (SEQ ID NO: 24) is neither elongated nor truncated.
- compositions of the invention may be in dry powdered form and may further comprise a pharmaceutically acceptable carrier or diluent and/or an adjuvant with aluminium hydroxide being a particularly preferred adjuvant.
- the peptides, combinations of peptides and compositions comprising the same may be administered in methods of specific immunotherapy against house dust mites allergies comprising administering to a patient in need thereof one or more allergens using intradermal injection, subcutaneous injection, intramuscular injection, intravenous injection, transdermal, intranasal, oral, sublingual, intraocular, or intrathecal techniques.
- Fig. 1 depicts the competitive binding of selected COPs to IgE from two serums (continuous and dashed line) compared to Der p 1.
- Panel A Der pi (closed symbols) vs.
- Panel B Der pi (closed symbols) vs. single peptides AllerDM1.4, 1.5 and 1.6 and 1.7 (open symbols).
- Panel C Der pi (closed symbols) vs. single peptides AllerDM1.52, 1.53 and 1.5a.
- Panel D Der pi (closed symbols) vs. single peptides AllerDM1.62, 1.63 and 1.64.
- Fig. 2 depicts the ability of Der p 2 and selected COPs to induce degranulation of "humanized” RBL cells (obtained from Dr. Vogel, Paul-Ehrlich-Institute, Langen, Germany) pre-incubated with two different human serums.
- Derp2_SetA open symbols
- Panel B Der p2 (closed symbols) vs. Derp2_SetB (open symbols).
- Panel C Der p2 (closed symbols) vs. single peptides AllerDM2.3, 2.4 and 2.5.
- Fig. 3 depicts the reduction of IgE binding resulting from the use of guanidinium chloride in competition ELISA.
- Panel A Der p 1, AllerDM1.52 and AllerDM1.62 were tested with (label G) or without 30 min pre-incubation with IM guanidinium chloride.
- Panel B Der p 2 and AllerDM2.2 were tested with or without 30 min pre-incubation with IM guanidinium chloride.
- Fig. 4 depicts the lack of IgE binding of the selected product AllerDM composed of an equimolar mix of 10 COPs. 21 serums of HDM allergic subjects from Europe and USA were tested in competition ELISA. Panel A: competition with Der pi (closed symbols) vs. AllerDM (open symbols) for Der p 1 reactivity. Panel B: competition with Der p2 (full symbols) vs. AllerDM (open symbols) for Der p 2 reactivity.
- Fig. 5 depicts the inability of the selected product AllerDM composed of an equimolar mix of 10 COPs to induce degranulation of RBL cells loaded with 18 sera from HDM allergic patients.
- Panel A Der pi (full symbols) vs. AllerDM (open symbols) induced degranulation.
- Panel B Der p2 (full symbols) vs. AllerDM (open symbols) induced degranulation.
- Figure 6 depicts the anaphylactic reactions of Balb/c mice sensitized by repeated subcutaneous injections of a mix of recombinant Der p 1 and Der p 2 allergens. 7 days after the third injection of low dose of allergens, mice were challenged with a single massive dose of allergen. Mean and standard deviation of body temperatures of a set of ten mice is shown after challenge with either AllerDM (closed circles), vehicle (PBS, open circles) or the mix Der p i / Der p 2 (closed squares).
- Figure 7 depicts the immunogenicity of AllerDM compared to Der p i / Der p 2 injections in Balb/c mice with Freund's adjuvant (panel A). AllerDM is able to induce specific IgGs recognizing the allergens Der p 1 and Der p 2 respectively up to levels comparable to immunization with the respective original allergens. AllerDM1.42, DM 2.4 and DM 2.10 contribute most to AllerDM immunogenicity, whereas individual mice do react to the other COPs present in AllerDM except for AllerDM2.9 (panel B).
- Sera of allergic patients were obtained from US and Europe (PlasmaLab International, Everett, WA, USA and Biomnis, Lyon, France) respectively) selected for positive CAP for D. pteronyssinus and clear signal over background and used to test for competition with the peptides.
- Serial dilutions of each set of COPs, namely for Der p 1 Set A, B, C or D and for Der p 2 mixes D, E or F at concentrations ranging from 10 "5 to 10 "10 M were pre-incubated with selected serums for 15 min. on ice. Serums were then incubated on nDer p 1 or nDer p 2 coated 96-well plates and residual IgE binding was determined as described above. nDer p 1 and nDer p 2 dilutions were used as control for inhibition.
- Degranulation assay was performed as described in [37].
- RBL-703/21 cells transfected with human Fc epsilon RI receptor were plated in 96-well tissue culture plates (105 cells/well) overnight. Passive sensitization of RBL-703/21 cells was carried out with sera from patients with house dust mite allergy at 1:20 overnight. Unbound antibodies were removed by washing the cell layer twice in Hanks' balanced salt solution (Gibco, Life technologies) the next day.
- Degranulation of RBL cells was induced for lh at 37°C by adding nDer pi, nDer p 2 or individual COPs and mixes at indicated concentrations diluted in Tyrode's buffer (130 mM NaCl, 5 mM KC1, 1.4 mM CaC12, 1 mM MgC12, 5.6 mM glucose, 10 mM HEPES pH7.4, 0.1% BSA).
- ⁇ -hexosaminidase activity was analyzed by incubating 30 ⁇ of cell supernatant with 50 ⁇ of 1.3mg/ml 4-Nitrophenyl N-acetyl-P-D-glucosaminide (Sigma) in citrate buffer (0.1M, pH 4.5) for 1 h at 37°C. The reaction was stopped by addition of 100 ⁇ glycine buffer (0.2M glycine, 0.2M NaCl, pH 10.7) and optical densities (OD) were measured at 405 nm.
- mice were sensitized by repeated injections of low doses ( ⁇ g) of an allergen mix of equimolar Der p 1 and Der p 2 by 3 subcutaneous injections at 14 days interval. Mice were challenged with high doses of either mix of Der p 1 and Der p 2
- a second set (Derpl_Set B) was devised taking into account potential IgE binding regions from the literature and tested for IgE binding by competition ELISA.
- Derpl_Set B a mix of AllerDM1.4, 1.5, 1.6, 1.7, respectively SEQ ID 4, 5, 6 and 7 showed residual IgE reactivity, a.
- AllerDM1.4 and 1.7 showed no detectable IgE binding, whereas AllerDM1.5 and 1.6 were found to be responsible for the reactivity previously observed with AllerDM1.2 and 1.3 or complete Derpl_Set B.
- AllerDM1.5 included two cysteines which might reform a disulfide bridge and recreate an IgE epitope. Thus, the C-terminal cysteine was removed, leading to AllerDM1.52 (SEQ ID 9) which unfortunately still bound IgE. For AllerDM1.6, shortening the C-terminal part had also no influence on IgE binding (AllerDM1.62, SEQ ID 10). Since the N-terminal end of AllerDM1.52 and the C-terminal end of AllerDM1.62 were modified, alternative peptides to AllerDM1.4 and 1.7 had to be devised in order to provide sufficient overlaps to ensure the presence of possible T cell terminal epitopes. AllerDM1.42 and 1.72 received 4 and 3 additional amino acids in the overlapping region (SEQ ID 8 and 11 respectively). The candidate Derpl_Set C including AllerDM1.52 and 1.62 showing residual IgE binding was thus discarded.
- the first set of COPs was derived from previous patent application WO2004- 081028(A2) (Der p 2 isotype P49278.1) (SEQ ID 29) and contained two peptides of equal length AllerDM2.1 and 2.2 (SEQ ID 16 and 17).
- This set of COPs (Derp2_SetA) showed low but detectable IgE binding in competition ELISA and AllerDM2.2 was found to bind IgE in direct ELISA.
- Derp2_SetB composed of AllerDM2.3, 2.4 and 2.5 (SEQ ID 18, 19 and 20) was devised in order to prevent disulfide bridges responsible for two short loops known to play a role in the maintenance of the 3D structure of Der p 2.
- AllerDM2.9 (SEQ ID 25) had to be synthesized starting at K109, in order to include the complete Der p 2 sequence.
- Derp2_SetD AllerDM2.3, 2.4, 2.10 and 2.9
- the final set of COPs issued from Der p 2 thus includes four peptides, namely AllerDM2.3, 2.4, 2.10 and 2.9 (SEQ ID 18, 19, 24 and 25 respectively).
- Controls using either Der p 1 or Der p 2 natural allergens showed expected competition in the range of 10 - " 7' to 1( ⁇ -9 ⁇ . Reduced IgE binding allows to consider administering a higher dose of COPs in human compared to traditional SIT treatments.
- AllerDM a preferred product composed of ten COPs to be called AllerDM will contain a combination of soluble peptides derived from both Der p 1 and Der p 2 proteins.
- the preferred product candidate will be composed of SEQ ID: 8, SEQ ID NO: 12, SEQ ID NO: 13, SEQ ID NO: 14, SEQ ID NO: 15, SEQ ID NO: 11, SEQ ID NO: 18, SEQ ID NO: 19, SEQ ID NO: 24 and SEQ ID NO: 25.
- a further improvement of the invention includes splitting COPs in parts with improved purification and solubility properties.
- homologs of the COPs AllerDM 1.42 to 1.72 and AllerDM2.3 to 2.10 by amino acid changes within each peptide to produce homologs thereof wherein the reactivity of the homologs to IgE antibodies of patients who are allergic to HDM is eliminated while that with the T lymphocytes is still retained.
- homologs of the COPs by shifting the limits of the COPs within the house dust mites allergens Der p 1 and Der p 2. Such homologs will result in products with equivalent profiles of non-detectable IgE binding and T lymphocyte activity.
- mice were sensitized by repeated subcutaneous injections of a mix of Der p 1 and Der p 2 allergens ( ⁇ g/ml). 7 days after the last injection mice were challenged with a single massive dose of allergens (Der p 1 and Der p 2 at 30 ⁇ g/ml) or AUerDM (30 ⁇ g/ml). Anaphylactic shock in mice has been associated with body temperature drop. Controls and AUerDM challenges resulted in essentially no temperature drop, whereas the mix Der p i / Der p 2 induced a marked decrease in rectal temperature (Figure 6). These results show that AllerDM differs from its parent allergens by a lack of challenging activity, indicating that AllerDM does not trigger an anaphylactic shock in Der p i / Der p 2 sensitized mice.
- homologs of the AllerDM 1.42 to DM2.10 COPs by amino acid changes within each peptide to produce homologs thereof wherein the reactivity of the homologs to IgE antibodies of patients who are allergic to house dust mite allergens is eliminated while that with the T lymphocytes is still retained.
- homologs of the COPs by shifting the limits of the COPs within the house dust mite allergens Der p 1 and Der p 2. Such homologs will result in products with equivalent profiles of non- detectable IgE binding and T lymphocyte activity. Such products will present the same potential for safety and efficacy in human as AllerDM and can be considered as equivalent in terms of chances for treatment, unless shown otherwise.
- Suitable homologs characterized by no reactivity to anti house dust mite IgE antibodies while maintaining reactivity to T lymphocytes may be identified by the methods described herein. Also contemplated are sets of COPs with reduced or eliminated IgE reactivity which retain T lymphocyte reactivity but which are also soluble and/or which show improved synthesis and purification.
- Bet v 1142-156 is the dominant T-cell epitope of the major birch pollen allergen and important for cross-reactivity with Bet v 1-related food allergens. J Allergy Clin Immunol. 2005;116:213-9.
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AU2014276484A AU2014276484B2 (en) | 2013-06-06 | 2014-06-06 | Contiguous overlapping peptides for treatment of house dust mites allergy |
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BR112015030644A BR112015030644A2 (en) | 2013-06-06 | 2014-06-06 | COMPOSITIONS OF CONTINUOUSLY OVERLAPING PEPTIDES, AS WELL AS PEPTIDES AND THEIR USE IN THE TREATMENT OF ALLERGY TO HOUSEDUST MITE |
CA2914037A CA2914037A1 (en) | 2013-06-06 | 2014-06-06 | Contiguous overlapping peptides for treatment of house dust mites allergy |
EP14792563.0A EP3003366B1 (en) | 2013-06-06 | 2014-06-06 | Contiguous overlapping peptides for treatment of house dust mites allergy |
RU2015155874A RU2015155874A (en) | 2013-06-06 | 2014-06-06 | ADJUSTABLE OVERLAPPING PEPTIDES FOR THE TREATMENT OF AN ALLERGY CAUSED BY DOMESTIC MITS |
ES14792563T ES2828448T3 (en) | 2013-06-06 | 2014-06-06 | Contiguous Overlapping Peptides for the Treatment of House Dust Mite Allergy |
JP2016517701A JP6300907B2 (en) | 2013-06-06 | 2014-06-06 | Consecutive overlapping peptides for the treatment of house dust mite allergy |
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NL2014882A (en) * | 2015-05-29 | 2016-12-08 | Citeq B V | Allergy-specific immunotherapy compositions for use in the treatment of house-dust mite allergy. |
WO2019216394A1 (en) | 2018-05-11 | 2019-11-14 | アステラス製薬株式会社 | Nucleic acid for treating mite allergy |
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US10166286B2 (en) | 2015-02-20 | 2019-01-01 | The Board Of Trustees Of The Leland Stanford Junior University | Mixed allergen compositions and methods for using the same |
IL253976B2 (en) | 2015-02-20 | 2024-09-01 | Univ Leland Stanford Junior | Mixed allergen compositions and methods for using the same |
US10143742B2 (en) | 2015-02-20 | 2018-12-04 | The Board Of Trustees Of The Leland Stanford Junior University | Mixed allergen compositions and methods for using the same |
US11452774B2 (en) | 2015-02-20 | 2022-09-27 | The Board Of Trustees Of The Leland Stanford Junior University | Mixed allergen compositions and methods for using the same |
US10149904B2 (en) | 2015-02-20 | 2018-12-11 | The Board Of Trusteees Of The Leland Stanford Junior University | Mixed allergen compositions and methods for using the same |
CN108265056B (en) * | 2016-12-31 | 2019-08-30 | 江苏众红生物工程创药研究院有限公司 | A kind of 1 allergoid albumen of recombination dermatophagoides pteronyssinus and its preparation method and application |
CN108265057B (en) * | 2016-12-31 | 2019-10-18 | 江苏众红生物工程创药研究院有限公司 | A kind of 2 allergoid albumen of recombination dermatophagoides pteronyssinus and its preparation method and application |
KR20200029539A (en) | 2017-07-18 | 2020-03-18 | 비포어 브랜즈, 인크. | Method for preparing a mixed allergen composition |
EP3831401A4 (en) * | 2018-06-22 | 2022-04-20 | Zonhon Biopharma Institute, Inc. | Recombinant dust mite allergen protein drug mixture and use thereof |
SG11202108043PA (en) | 2019-01-23 | 2021-08-30 | Before Brands Inc | Methods for making mixed allergen compositions |
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EP0623168B1 (en) * | 1991-10-16 | 2009-09-30 | Merck Patent GmbH | T cell epitopes of the major allergens from dermatophagoides (house dust mite) |
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US9005627B2 (en) * | 2011-06-27 | 2015-04-14 | Anergis S.A. | Contiguous overlapping peptides for treatment of ragweed pollen allergy |
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Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
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NL2014882A (en) * | 2015-05-29 | 2016-12-08 | Citeq B V | Allergy-specific immunotherapy compositions for use in the treatment of house-dust mite allergy. |
WO2016193126A1 (en) | 2015-05-29 | 2016-12-08 | Citeq B.V. | Allergy-specific immunotherapy compositions for use in the treatment of house-dust mite allergy |
WO2019216394A1 (en) | 2018-05-11 | 2019-11-14 | アステラス製薬株式会社 | Nucleic acid for treating mite allergy |
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EP3003366B1 (en) | 2020-08-05 |
JP2018058856A (en) | 2018-04-12 |
AU2014276484A1 (en) | 2015-12-03 |
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CN105307679A (en) | 2016-02-03 |
RU2015155874A (en) | 2017-07-14 |
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US20150050301A1 (en) | 2015-02-19 |
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ES2828448T3 (en) | 2021-05-26 |
WO2014195803A3 (en) | 2015-05-28 |
JP6640818B2 (en) | 2020-02-05 |
BR112015030644A2 (en) | 2017-08-29 |
AU2014276484B2 (en) | 2018-01-25 |
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