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Definitions

• Tissue macrophages play major roles in host defense against pathogen invasion and in homeostasis of immunity. Plasticity is a hallmark of macrophages. Residing in a microenvironment full of signals from host cells and microbial, macrophages can be activated to display pro-inflammatory (Ml) phenotype or anti-inflammatory (M2) phenotypes.
• Ml pro-inflammatory
• M2 anti-inflammatory
• macrophages Aberrant differentiation and activation of macrophages play major roles in pathogenesis of inflammation.
• IBD patients for example, there is an increase of mucosal CD 14+ macrophages, which display a Ml pro-inflammatory phenotype.
• macrophages Due to its central executor role of both innate and adaptive immunity, macrophages have been viewed as an ideal target to control autoimmune and inflammatory disorders.
• how macrophage plasticity is regulated remains incompletely understood, and the cell intrinsic factor that can be manipulated to modulate macrophage function remains largely unknown.
• a method of treating an inflammatory disorder in a subject comprising administering to a subject in need thereof a nucleic acid molecule for inhibiting the expression of Hom-1.
• the nucleic acid molecule is an RNAi agent or an antisense oligonucleotide.
• the nucleic acid molecule can be administered topically, orally, rectally, nasally, intravenously, intraarticularly, conjunctivally, intracranially, intraperitoneally, intrapleurally, intramuscularly, intrathecally, or subcutaneously.
• the nucleic acid molecule is administered naked.
• compositions for treating an inflammatory disorder comprising a nucleic acid molecule for inhibiting the expression of Hom-1 and a pharmaceutically acceptable carrier.
• the nucleic acid molecule is a morpholino oligonucleotide having the sequence of SEQ ID NO: 3, 4, 5, or 6.
• the composition can be formulated for topical, oral, rectal, nasal, intravenous, intraarticular, conjunctival, intracranial, intraperitoneal, intrapleural, intramuscular, intrathecal, or subcutaneous route of administration.
• the nucleic acid molecule e.g., a morpholino oligonucleotide having the sequence of SEQ ID NO: 3, 4, 5, or 6
• a method of identifying a therapeutic for an inflammatory disorder includes contacting an inflamed tissue sample with a test therapeutic; and detecting the expression level of Hom-1 in the tissue sample. If the expression level is lower than or equal to a control level, the test therapeutic is a candidate therapeutic for the inflammatory disorder.
• a method of selecting a therapeutic for an inflammatory disorder in a subject in need thereof comprising contacting an inflamed tissue sample obtained from the subject with a therapeutic; detecting a lower or same expression level of Hom-1 in the tissue sample as compared to a control level; and administering the therapeutic to the subject.
• contemplated herein is a method of monitoring the efficacy of a therapeutic for an inflammatory disorder in a subject in need thereof, comprising detecting the expression level of Hom-1 in an inflamed tissue sample obtained from the subject after the subject has been administered with the therapeutic; comparing the detected level with a control level; and making a treatment decision based on the comparison, wherein, if the detected level is higher than the control level, continue to administer the therapeutic or a different therapeutic to the subject.
• a method of treating an inflammatory disorder in a subject in need thereof includes providing a modified macrophage, monocyte, or dendritic cell that has been treated with a Horn- 1 inhibitor or contains an expression construct for expressing a Horn- 1 inhibitor, wherein the modified macrophage, monocyte, or dendritic cell expresses a lower level of Horn- 1 as compared with a control level; and administering an effective amount of the modified macrophage, monocyte, or dendritic cell to the subject.
• the method includes, prior to the providing step, detecting a higher expression of Hom-1 than a control level in an inflamed tissue sample obtained from the subject.
• Hom-1 a human homeobox transcriptional factor, is an antagonist of the canonical Wnt signaling.
• a nucleic acid sequence of Hom-1 (SEQ ID NO: 1) and the amino acid sequence it encodes (SEQ ID NO: 2) are shown below: acctggccgc catgcgcctc tcctccccc cacctcgtgg cccgcagcag ctctccagcttggctccgt ggactggctc tcccagagca gctgctcagg gccgacccac acccccaggc c ctgccctgggg agcctcccctgactt ctccctgggg agcctcccctgctgactt ctccctgggg agcctccctgctgcctgtgcccaggcca gacatccggc
• Described herein is a method of treating an inflammatory disorder in a subject in need thereof by administering to the subject a Hom-1 inhibitor, e.g., a nucleic acid molecule for inhibiting the expression of Hom-1.
• a Hom-1 inhibitor e.g., a nucleic acid molecule for inhibiting the expression of Hom-1.
• the nucleic acid molecule can be an RNAi agent or an antisense oligonucelotide.
• the nucleic acid molecule is a morpholino oligonucleotide.
• a morpholino oligonucleotide has the standard DNA bases (A, C, G, T) but the bases are bound to morpholine rings and linked through phosphorodiamidate groups.
• An anti-Horn- 1 morpholino oligonucleotide can have a sequence selected from
• RNAi agent refers to an RNA (or analog thereof), having sufficient sequence complementarity to a target RNA to direct RNA interference.
• an interfering RNA (“iRNA”) is a double stranded short-interfering RNA (siRNA) or short hairpin RNA (shRNA) that results in catalytic degradation of specific mRNAs.
• An antisense oligonucleotide is typically a single-stranded DNA, RNA, or an analog thereof that has a sequence that can bind to a target nucleic acid molecule.
• the anti-Horn- 1 nucleic acid molecule can be administered to the subject via any route of administration, e.g., topical, oral, rectal, nasal, intravenous, intraarticular, conjunctival, intracranial, intraperitoneal, intrapleural, intramuscular, intrathecal, or subcutaneous route of administration.
• the route can be selected based on the site of inflammation.
• a pharmaceutical composition containing an anti-Horn- 1 nucleic acid molecule can be formulated for any route of administration, e.g., as an injectable solution, pill, capsule, eye drop, spray, inhaler, topical cream or gel, or aerosol).
• the anti-Horn- 1 nucleic acid molecule is administered naked.
• no delivery vehicles such as liposomes or viral vectors are used with the nucleic acid molecule.
• the subject Prior to the administration of any Hom-1 inhibitor to a subject, the subject can be tested to determine whether he or she has an elevated expression level of Hom- 1 and/or an elevated expression level of an inflammatory cytokine as compared to a control level.
• the expression level is detected in an inflamed tissue sample obtained from the subject.
• a subject with an increased expression level of Hom-1 can be treated with a Hom-1 inhibitor.
• a control level can be a level representative of the Hom-1 expression level in a non-inflamed tissue or subjects without inflammatory disorders, or a level found in a non- inflamed tissue in the subject to be treated.
• a “subject” refers to a human and a non-human animal.
• Treating” or “treatment” refers to administration of a compound or agent to a subject, who has a disorder, with the purpose to cure, alleviate, relieve, remedy, delay the onset of, or ameliorate the disorder, the symptom of the disorder, the disease state secondary to the disorder, or the predisposition toward the disorder.
• An “effective amount” refers to an amount of the compound that is capable of producing a medically desirable result in a treated subject.
• the treatment method can be performed alone or in conjunction with other drugs or therapy.
• Also described herein is a screening method of identifying a therapeutic for an inflammatory disorder.
• the method includes contacting an inflamed tissue sample with a test therapeutic and detecting the expression level of Horn- 1 in the tissue sample. If the expression level is lower than or equal to a control level, the test therapeutic is a candidate therapeutic for the inflammatory disorder.
• a method of selecting a therapeutic for an inflammatory disorder in a subject in need thereof includes contacting an inflamed tissue sample obtained from the subject with a therapeutic, detecting a lower or same expression level of Hom-1 in the tissue sample as compare to a control level, and administering the therapeutic to the subject.
• the method includes detecting the expression level of Hom-1 in an inflamed tissue sample obtained from the subject after the therapeutic is administered to the subject, comparing the detected level with a control level, and making a treatment decision based on the comparison. If the detected level is lower than the control level, it indicates that the therapeutic is effective for treating inflammation in the subject. If the detected level is the same as or higher than the control level, a decision can be made to continue giving the same therapeutic or to try a different therapeutic.
• the therapeutic or test therapeutic can be a protein, peptide, peptidomimetic, peptoid, cell, antibody or fragment thereof, small molecule compound, nucleic acid molecule, or a plant extract.
• the therapeutic or test therapeutic can be a steroid, nonsteroidal anti-inflammatory drug, or immuno-suppressant.
• control level can be a level representative of the expression level of Hom-1 in a non-inflamed tissue. It can also be the expression level of Hom-1 in the inflamed tissue sample before it was contacted with a therapeutic or test therapeutic. A skilled person would be able to determine suitable control levels.
• a method of treating an inflammatory disorder using modified macrophages, monocytes, or dendritic cells includes providing modified macrophages, monocytes, or dendritic cells that have been treated with a Hom-1 inhibitor or contain an expression construct for expressing a Hom-1 inhibitor.
• the modified macrophages, monocytes, or dendritic cells express a lower level of Hom-1 as compared with a control level.
• An effective amount of the modified macrophages, monocytes, or dendritic cells are administered to a subject with an inflammatory disorder.
• the Hom-1 inhibitor can be a protein, peptide, peptidomimetic, peptoid, cell, antibody or fragment thereof, small molecule compound, nucleic acid molecule, or a plant extract.
• the inhibitor is an RNAi agent or an antisense oligonucleotide (e.g., a morpholino oligonucleotide).
• the expression level of Hom-1 in a sample e.g., an inflamed tissue sample
• a control level can be a level representative of the level in a non-inflamed tissue or the level detected in a non-inflamed tissue sample obtained from the subject to be treated. Again, a skilled practitioner would be able to determine a suitable control level.
• Hom-1 expression level can be determined at either the mRNA level or at the protein level. Methods of measuring mRNA levels and protein levels are well known in the art.
• detecting the expression level of Hom-1 as an indicator of inflammation e.g., the presence or degree of inflammation
• detecting the expression and/or secretion of a pro-inflammatory cytokine, the expression and/or secretion of an anti-inflammatory cytokine, the expression of a marker of Ml or M2 macrophages, the expression of a marker of DC differentiation and activation can also be used to measure inflammation.
• An inflammatory disorder is characterized by a local or systemic, acute, or chronic inflammation.
• Inflammatory disorders include, but are not limited to, inflammatory dermatoses (e.g., dermatitis, psoriasis, eczema, atopic dermatitis, allergic contact dermatitis, urticaria, necrotizing vasculitis, cutaneous vasculitis, hypersensitivity vasculitis, eosinophilic myositis, polymyositis, dermatomyositis, or eosinophilic fasciitis), inflammatory bowel diseases (e.g., Crohn's disease and ulcerative colitis), acute respiratory distress syndrome, fulminant hepatitis, pancreatitis, hypersensitivity lung diseases (e.g., hypersensitivity pneumonitis, eosinophilic pneumonia, delayed-type hypersensitivity, interstitial lung disease or ILD, idiopathic pulmonary fibrosis, and ILD associated with rhe
• erythematosus myasthenia gravis, juvenile onset diabetes, glomerulonephritis, autoimmune throiditis, ankylosing spondylitis, systemic sclerosis, multiple sclerosis, primary lateral sclerosis, amyotrophic lateral sclerosis, anaphylaxia, systemic anaphylaxia, hypersensitivity responses, systemic inflammatory conditions, drug allergies, insect sting allergies, allograft rejection, graft-versus-host disease, Sjogren's syndrome, human immunodeficiency, a virus infection, atherosclerosis, hypertension, diabetes, and chronic renal diseases, ocular inflammatory diseases, uveitis and conjunctivitis, neuritis.
• the expression level of Hom-1 in a sample e.g., a tissue, cell or bodily fluid sample obtained from a subject suspected of having an inflammatory disorder can also be used as a diagnostic tool.
• Macrophages are key regulators of both innate and adaptive immunity. How macrophage plasticity is regulated by cell intrinsic factors is incompletely understood.
• the data described below demonstrate that the human homeobox transcription factor, Hom-1, plays a pivotal role in directing macrophage polarization towards the Ml phenotype.
• Hom-1 expression is aberrantly elevated in tissue macrophages isolated from inflamed mucosa of IBD patients.
• Using an en bloc culture model we showed that knockdown of Hom-1 expression in tissue macrophages by morpholigo oligonucleotides can abate tissue inflammation and protect viability of mucosal epithelial cells.
• our data suggest that Hom-1 can serve as a novel target to manage inflammatory disorders.
• Hom-1 expression is up-regulated in macrophages isolated from inflamed gastrointestinal mucosa
• Ml surface markers such as CD40, CD80, and CD86 as well as the expression and secretion of Ml pro-inflammatory cytokines were elevated in macrophages isolate from inflamed mucosa.
• ROS reactive oxygen species
• NO Nitric oxide
• Hom-1 regulates mucosal macrophage plasticity and polarizes mucosal macrophage towards Ml phenotype
• Plasticity is a hall mark of macrophages.
• macrophages display spectrums of phenotypes, ranging from the classic pro-inflammatory Ml phenotype to a variety of M2 phenotypes with distinguished features.
• Corticosteroids have been used extensively to manage inflammatory disorders and have been shown to induce M2 phenotype of macrophages.
• Hom-1 plays a role in regulating mucosal macrophage plasticity.
• Hom-1 -regulated macropahges can be targeted to abate tissue inflammation.
• UC ulcerative colitis
• inflammatory cytokines such as TNFa, ⁇ and Nitrate was significantly elevated in the culture of inflamed tissues.
• MO anti-Horn- 1 morpholino oligonucleotides
• Hom-1 MO To further explore the effect of Hom-1 MO on tissue inflammation, we examined the concentrations of TNFa during the incubation of en bloc tissue with Hom-1, using ELISA assay. We found that Hom-1 MO reduced the amount of TNFa in the cultures in a dosage dependent manner. To further explore the effects of Hom-1 MO on the secretion of other pro-inflammatory cytokines, we examined the effects of Hom-1 MO on the secretion of IL1 and Nitrate and found that, similar to the TNFa, Hom- 1 MO exerts strong inhibition of these proinflammatory cytokines in the en bloc culture systems. As the ex-vivo en bloc culture may reflect the tissue microenvironment in vivo, our data suggested that Hom-1 MO can target tissue macrophages to abate tissue inflammation. Hom-1 MO rescue viability of epithelial cells in inflamed tissue inflammation
• Apoptosis of epithelial cells which causes mucosal ulceration, is a hallmark of IBD. Tissue inflammation has been thought to be the major trigger of apoptosis of mucosal epithelial cells.
• en bloc tissue culture we found that there was a greater rate of apoptosis of mucosal epithelial cells in tissues isolated from inflamed mucosa in comparison to the apoptotic rate of epithelial cells in normal control tissue.
• Hom- 1 MO was added to the en bloc tissue culture, we found that Hom-1 MO but not the control MO exerted strong inhibitory effects on apoptosis of epithelial cells in tissue culture.
• PBMC Peripheral blood mononuclear cells
• PBMC Peripheral blood mononuclear cells
• CD14 + monocytes were purified from PBMCs using anti-CD 14-coated microbeads (Miltenyi Biotec). The purity of freshly isolated CD14 + monocytes was more than 95% as analyzed by flow cytometry.
• Monocytes were cultured in 12- well plates at lxlO 6 cells/ml with RPMI 1640 medium containing 10% fetal bovine serum (FBS).
• FBS fetal bovine serum
• M-CSF, GM-CSF, and IL3 were purchased from PeproTech and used at the final concentration of lOOng/ml. Cytokines were added to cultures every 2 or 3 days.
• Human primary monocytes were transfected using the Human Monocyte
• Nucleofector Kit (Lonza) according to the manufacturer's instructions. Briefly, 5xl0 6 monocytes were resuspended into 100 ⁇ nucleofector solution with 0.5 nmol of either Hom- 1 siRNA (forward: 5'-UUCAGAAUCGCCGCAUGAAACACAAACGG-3' (SEQ ID NO: 7); reverse: 5'-CCGUUUGUGUUUCAUGCGGCGAUUCUGAA-3' (SEQ ID NO: 8)) or non- effective GFP siRNA (forward: 5'-UGACCACCCUGACCUACGGCGUGCAGUGC-3'
• nucleofector II Device (SEQ ID NO: 9); 5'-reverse: GCACUGCACGCCGUAGGUCAGGGUGGUCA-3' (SEQ ID NO: 10)) before electroporation with nucleofector II Device (Lonza).
• Cells were then immediately removed from the device and incubated overnight with 1ml pre-warmed Human Monocyte Nucleofector Medium containing 2mM glutamine and 10% FBS. Cells were then resuspended into complete RPMI medium and treated with appropriate cytokines to induce differentiation into macrophages.
• macrophages derived from monocytes were transfected with Human Macrophage Nucleofector Kit (Lonza) following the manufacturer' s instructions.
• Phenotypic analysis of monocytes/macrophages was performed using flow cytometry after immunolabeling of cells with fluorescence dye conjugated antibodies.
• the following antibodies were used: PE-conjugated anti-CD71, CDl lb, CDl lc, CD16, CD64, CD80, CD86, HLA-DR, CD14, TLR4, ILl- ⁇ and TNF-a, and FITC-conjugated anti-CD40, CD36 (eBioscience); FITC-conjugated anti-mannose receptor (MR), and unconjugated mouse anti- MCSFR (R&D Systems). Isotope control labeling was performed in parallel. Antibodies were diluted as recommended by the supplier.
• First-Strand Synthesis System Invitrogen
• GAPDH was used as an internal control.
• the ROS level in activated macrophages was detected with Image-iT® LIVE Green Reactive Oxygen Species Detection Kit (Invitrogen) basically following the manufacturer's instructions except that the results were analyzed by both fluorescence microscope and flow cytometry.
• the NO level was determined by Griess Reagent Kit for Nitrite Determination (Invitrogen) following the protocol provided by the manufacturer.

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