WO2019204912A1 - Blood-brain barrier transmigrating therapeutic compounds and uses thereof - Google Patents

Blood-brain barrier transmigrating therapeutic compounds and uses thereof Download PDF

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Publication number
WO2019204912A1
WO2019204912A1 PCT/CA2019/050499 CA2019050499W WO2019204912A1 WO 2019204912 A1 WO2019204912 A1 WO 2019204912A1 CA 2019050499 W CA2019050499 W CA 2019050499W WO 2019204912 A1 WO2019204912 A1 WO 2019204912A1
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seq
compound
sequence
ids
antibody
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PCT/CA2019/050499
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French (fr)
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Hung Fang
Danica Stanimirovic
Arsalan HAQQANI
Will COSTAIN
Greg Hussack
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National Research Council Of Canada
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Priority to CA3098162A priority Critical patent/CA3098162A1/en
Priority to US17/050,075 priority patent/US20210253715A1/en
Priority to EP19792686.8A priority patent/EP3784701A4/en
Publication of WO2019204912A1 publication Critical patent/WO2019204912A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/68—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment
    • A61K47/6835—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment the modifying agent being an antibody or an immunoglobulin bearing at least one antigen-binding site
    • A61K47/6843—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment the modifying agent being an antibody or an immunoglobulin bearing at least one antigen-binding site the antibody targeting a material from animals or humans
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P21/00—Drugs for disorders of the muscular or neuromuscular system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • 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
    • C07K14/76—Albumins
    • C07K14/765—Serum albumin, e.g. HSA
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/2863—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against receptors for growth factors, growth regulators
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    • C12N9/00—Enzymes; Proenzymes; Compositions thereof; Processes for preparing, activating, inhibiting, separating or purifying enzymes
    • C12N9/14—Hydrolases (3)
    • C12N9/16—Hydrolases (3) acting on ester bonds (3.1)
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    • C12N9/00—Enzymes; Proenzymes; Compositions thereof; Processes for preparing, activating, inhibiting, separating or purifying enzymes
    • C12N9/14—Hydrolases (3)
    • C12N9/24—Hydrolases (3) acting on glycosyl compounds (3.2)
    • C12N9/2402—Hydrolases (3) acting on glycosyl compounds (3.2) hydrolysing O- and S- glycosyl compounds (3.2.1)
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    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12Y—ENZYMES
    • C12Y301/00—Hydrolases acting on ester bonds (3.1)
    • C12Y301/06—Sulfuric ester hydrolases (3.1.6)
    • C12Y301/06013—Iduronate-2-sulfatase (3.1.6.13)
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12Y—ENZYMES
    • C12Y302/00—Hydrolases acting on glycosyl compounds, i.e. glycosylases (3.2)
    • C12Y302/01—Glycosidases, i.e. enzymes hydrolysing O- and S-glycosyl compounds (3.2.1)
    • C12Y302/01045—Glucosylceramidase (3.2.1.45), i.e. beta-glucocerebrosidase
    • 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
    • A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/10—Immunoglobulins specific features characterized by their source of isolation or production
    • C07K2317/14—Specific host cells or culture conditions, e.g. components, pH or temperature
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/20—Immunoglobulins specific features characterized by taxonomic origin
    • C07K2317/21—Immunoglobulins specific features characterized by taxonomic origin from primates, e.g. man
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/30—Immunoglobulins specific features characterized by aspects of specificity or valency
    • C07K2317/33—Crossreactivity, e.g. for species or epitope, or lack of said crossreactivity
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/40—Immunoglobulins specific features characterized by post-translational modification
    • C07K2317/41—Glycosylation, sialylation, or fucosylation
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
    • C07K2317/56—Immunoglobulins specific features characterized by immunoglobulin fragments variable (Fv) region, i.e. VH and/or VL
    • C07K2317/569—Single domain, e.g. dAb, sdAb, VHH, VNAR or nanobody®
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/90—Immunoglobulins specific features characterized by (pharmaco)kinetic aspects or by stability of the immunoglobulin
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/90—Immunoglobulins specific features characterized by (pharmaco)kinetic aspects or by stability of the immunoglobulin
    • C07K2317/92—Affinity (KD), association rate (Ka), dissociation rate (Kd) or EC50 value
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2319/00—Fusion polypeptide
    • C07K2319/01—Fusion polypeptide containing a localisation/targetting motif
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2319/00—Fusion polypeptide
    • C07K2319/20—Fusion polypeptide containing a tag with affinity for a non-protein ligand
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2319/00—Fusion polypeptide
    • C07K2319/31—Fusion polypeptide fusions, other than Fc, for prolonged plasma life, e.g. albumin
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2319/00—Fusion polypeptide
    • C07K2319/33—Fusion polypeptide fusions for targeting to specific cell types, e.g. tissue specific targeting, targeting of a bacterial subspecies

Definitions

  • the present invention relates to enabling blood-brain barrier (BBB) transmigration of proteins or functional fragments thereof involved in lysosomal storage disease (LSD).
  • the present invention relates to enabling blood-brain barrier (BBB) transmigration of proteins or functional fragments thereof involved in a-synucleinopathies using a BBB-transmigrating antibody or fragment thereof, and uses thereof.
  • the present invention describes a fusion protein comprising of IGF1 R3H5 and IDS (iduronate-2-sulfatase) or GCase (acid beta- glucosidase or glucocerebrosidase), and uses thereof.
  • Lysosomal storage diseases are a group of approximately 50 rare inherited metabolic disorders that result from defects in lysosomal function. LSDs are usually a consequence of deficiency of a single enzyme required for the metabolism of lipids, glycoproteins and mucopolysaccharides. Individually, LSDs occur with incidences of less than 1 :100,000; however, as a group the incidence is about 1 :5,000 - 1 :10,000. Most of these disorders are autosomal recessively inherited such as Gaucher’s disease and Niemann-Pick disease, type C; however a few are X-linked recessively inherited, such as Fabry disease and Hunter syndrome (MPS II). Disease is caused by excessive accumulation of non-processed material in cells and tissues resulting in gross abnormalities in development and mental retardation when the CNS is affected.
  • MDS II X-linked recessively inherited, such as Fabry disease and Hunter syndrome
  • ERT bone marrow transplantation and enzyme replacement therapy
  • BBB central nervous system
  • Peptides, antibodies and proteins have to be‘ferried’ across the BBB using ‘carriers’ that recognize BBB receptors that undergo receptor-mediated transcytosis or other forms of vesicular transport through brain endothelial cells.
  • Antibodies against such receptors have been developed as Trojan horses’ to deliver biologies across the BBB.
  • Enzyme replacement therapy with IDS is used to treat peripheral symptoms in mucopolysaccharidosis type II (MPS II; also known as Hunter syndrome) patients.
  • MPS II mucopolysaccharidosis type II
  • ERT with recombinant glucocerebrosidase is used to treat peripheral symptoms in Gaucher patients.
  • Creating a fusion protein consisting of a Trojan horse’ antibody that crosses the BBB and a payload (such as IDS or GCase) is expected to enable ERT in the brain.
  • An example is a fusion protein consisting of the Insulin receptor antibody (IgG) expressed in fusion with 2 molecules of IDS at its C-terminus end (developed by Armagen). This fusion protein has a MW of ⁇ 300 kDa and demonstrates side effects due to insulin receptor engagement (hypoglycemia).
  • the fusion molecule is not optimized for lysosomal targeting in cells and neurons.
  • BBB blood-brain barrier
  • LSD lysosomal storage disease
  • BBB blood-brain barrier
  • the antibody or fragment thereof may bind TMEM30A or IGF 1 R.
  • the antibody or fragment thereof may comprises
  • CDR complementarity determining region
  • CDR complementarity determining region
  • CDR 1 complementarity determining region (CDR) 1 sequence GRTIDNYA (SEQ ID NO:1 1); CDR2 sequence IDWGDGGX, where X is A or T (SEQ ID NO: 12), where X is A or T; and CDR3 sequence AMARQSRVNLDVARYDY (SEQ ID NO: 13).
  • the antibody or fragment thereof may comprise an amino acid sequence selected from the group consisting of:
  • the antibody or fragment thereof may be a single chain Fab (scFab), a single chain Fv (scFv), or a single domain antibody (sdAb).
  • scFab single chain Fab
  • scFv single chain Fv
  • sdAb single domain antibody
  • the polypeptide related to the treatment of LSD, or for the treatment of a-synucleinopathy may be selected from the group consisting of Type I sulfatases, a glucosidase or a glucocerebrosidase.
  • the polypeptide related to the treatment of LSD, or for the treatment of a-synucleinopathy may be iduronate-2-sulfatase (IDS) (SEQ ID NO:24), acid-beta-glucosidase (GCase) (SEQ ID NO:68), acid-beta-glucosidase mut1 (GCase-mut1) (SEQ ID NO:26).
  • IDS iduronate-2-sulfatase
  • GCase acid-beta-glucosidase
  • GCase-mut1 acid-beta-glucosidase mut1
  • the antibody or fragment thereof may be linked to the polypeptide.
  • the antibody or fragment thereof may be linked to the polypeptide with a linker sequence.
  • the linker sequence in any one of SEQ ID NO: 30, 31 , 32, 33, 34, 35, 36, 37, 39, 41 , 42, 43, 44, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58. 59, 60, 61 , 62, 64, 65, or 70 may be (GGGGS) n , wherein n > 1 , or any suitable linker.
  • the compound may be glycosylated.
  • the polypeptide related to the treatment of LSD, or for the treatment of a-synucleinopathy may be glycosylated polypeptide.
  • the glycosylated polypeptide may be glycosylated with one or more N-glycans.
  • the N-glycans of the glycosylated polypeptide may contain one or more mannose 6-phosphate residues.
  • the glycosylated polypeptide may contain monophosphorylated N-glycans, bi-phosphorylated N-glycans or a combination thereof.
  • the compound may further comprise human serum albumin (HSA) (SEQ ID NO:67), human serum albumin K573P (HSA(K573P)) (SEQ ID NO:28), or an albumin targeting moiety.
  • HSA human serum albumin
  • HSA(K573P) human serum albumin K573P
  • SEQ ID NO:28 human serum albumin targeting moiety.
  • the albumin targeting moiety may be an antibody or a fragment thereof capable of targeting albumin.
  • the albumin targeting moiety may be a single domain antibody (sdAb) comprising:
  • the compound may be any one of the following compounds:
  • a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7), CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO: 24); and human serum albumin (HSA) (SEQ ID NO:67) or human serum albumin K573P (HSA(K573P)) (SEQ ID NO:28);
  • IGF1 R3H5 - IDS - HSA(K573P) (SEQ ID NO:35);
  • IGF1 R3H5 - IDS - R28 SEQ ID NO:36
  • IGF1 R3H5 - IDS - M79 (SEQ ID NO:37).
  • composition comprising the compound of the present invention and a pharmaceutically acceptable diluent, carrier, or excipient.
  • a compound of the present invention or a composition of the present invention for the treatment of LSD in the brain in a subject in need thereof.
  • a compound of the present invention or a composition of the present invention for the treatment of a-synucleinopathy in the brain in a subject in need thereof.
  • a method of delivering a polypeptide related to LSD across the BBB comprising administering the compound according to the present invention or a composition according to the present invention to a subject in need thereof.
  • a method of delivering a polypeptide related to a-synucleinopathy across the BBB comprising administering the compound according to the present invention or a composition according to the present invention to a subject in need thereof.
  • the administering may be intravenous (iv), subcutaneous (sc), or intramuscular (im).
  • the compound may be for use intravenously (iv), subcutaneously (sc), or intramuscularly (im).
  • the LSD may be a sphingolipidose, a mucopolysaccharidoses, a glycoproteinose, an oligosaccharidose, a glycogenose, a lipidose or a neuronal ceroid lipofuscinoses.
  • the a-synucleinopathy may be Parkinson Disease (PD), dementia with Lewy Bodies or Multiple System Atrophy (MSA).
  • PD Parkinson Disease
  • MSA Multiple System Atrophy
  • nucleic acid vector comprising a nucleotide sequence encoding a compound of the present invention.
  • a cell comprising the nucleic acid vector of the present invention for expressing the compound of the present invention.
  • FIGURE 1 depicts the arrangement of some of the constructs utilized herein.
  • BBB VHH indicates BBB penetrating single domain antibodies (IGF1 R3H5 or IGF1 R5H2 or FC5).
  • anti- Alb indicates anti albumin single domain antibodies (R28 VHH or M79 VHH) or Alb1 or Alb8.
  • FIGURE 2 shows (A) a coomassie-stained SDS-PAGE of IGF1 R3H5-IDS. (B) shows an HPLC-SEC chromatogram of IGR1 R3H5-IDS. The purity of the product is typically > 90%.
  • FIGURE 3 shows (A) immunoblot analysis of IGF1 R3H5-IDS using anti-IDS and anti-His. (B) Samples loaded are described in the table legend below.
  • FIGURE 4 shows the results of an N-glycan analysis with results presented as percentage area under the peak for each N-glycan structure detected using DSA-FACE.
  • FIGURE 5 shows the binding kinetics of (A) uncapped and (B, C and D) capped IGF1 R3H5- IDS to human IGF1 R using surface plasmon resonance.
  • the capped and uncapped forms give essentially identical rate constants and affinities.
  • the observed K D values are concentration dependent, indicating a matrix effect that reduces K D values at high concentrations.
  • FIGURE 6 shows that the in vitro BBB permeability (P A PP) of uncapped IDS-C1 (IDS) is comparable to the non-permeable negative control protein (A20.1).
  • the BBB carrier IGF1 R3-VHH is highly permeable.
  • the fusion proteins (capped and uncapped IGF1 R3H5-IDS) exhibited permeability that is comparable to that of IGF1 R3-VHH.
  • FIGURE 7 shows that the construct consisting of an IGF1 R5H2 carrier fused to monomeric Fc (monoFc) (Ying et al., 2012) and IDS exhibits good in vitro BBB permeability, exceeding that of the FC5-VHH.
  • FIGURE 8 shows that IGF1 R5H2-monoFc-IDS exhibits permeability in an in vitro human BBB model that is comparable to the rat BBB model.
  • FIGURE 9 shows that IGF1 R5H2 reduces trapping of IDS in brain endothelial cells.
  • the amounts of IGF1 R5H2-monoFc-IDS were significantly lower compared to IDS-C1.
  • IGF1 R5-VHH was not detected in the SV-ARBEC cells.
  • FIGURE 10 shows IGF1 R3H5-IDS-HSA exhibits in vitro BBB permeability that is comparable to IGF1 R3H5-IDS.
  • FIGURE 11 shows that IGF1 R5H2 significantly increase the in vitro BBB permeability of constructs containing, IDS and anti-albumin domains in rat SV-ARBEC cells.
  • the figure also shows the effect of domain arrangement and mouse serum on IGF1 R5H2-mediated BBB permeability. > indicates values exceeding the upper limit of quantitation were set to 250.
  • FIGURE 12 shows that FC5 significantly increases in vitro BBB permeability of capped or uncapped IDS in rat SV-ARBEC cells.
  • FIGURE 13 shows that IGF1 R3H5 and IGF1 R5H2 significantly increase the in vitro BBB permeability of IDS and IDS-HSA in rat SV-ARBEC cells.
  • FIGURE 14 shows that IGF1 R3H5 increases the in vitro BBB permeability of GCase in rat SV- ARBEC cells.
  • FIGURE 15 shows that IGFR1 R5H2-monoFc-IDS is not degraded following in vitro transcytosis in rat SV-ARBEC cells.
  • A is an anti-IDS western blot showing the detection of IGF1 R5H2-monoFc-IDS (XT) and IDS-C1 (XU) in the bottom chambers of the in vitro BBB assay, and
  • B is a quantitation of the western blot in panel (A).
  • FIGURE 16 shows protein concentrations of IDS-C1 , IGF1 R3H5-IDS, IGF1 R3H5-IDS-HSA, IGF1 R3H5-IDS-R28 and IGF1 R3H5-IDS-M79 in rat serum following single bolus iv injections of equimolar doses of the test articles.
  • A Levels were determined by MRM and
  • B by IDS activity of I DS-C1 and IGF1 R3H5-IDS only.
  • FIGURE 17 shows the results of a WinNonlin analysis of in vivo serum PK data in rats for IDS- C1 , IGF1 R3H5-IDS, IGF 1 R3H5-IDS-HSA, IGF1 R3H5-IDS-R28 and IGF1 R3H5-IDS-M79.
  • FIGURE 18 shows protein concentrations of IDS-C1 and IGF1 R3H5-IDS-HSA in cynomolgus monkey ( Macaca fascicularis) serum following single bolus iv injections of equimolar doses of the test articles. Levels were determined by MRM.
  • FIGURE 19 shows protein concentrations of IDS-C1 , IGF1 R3H5-IDS, IGF1 R3H5-IDS-HSA and IGF1 R3H5-IDS-R28 in rat CSF following single bolus iv injections of equimolar doses of the test articles.
  • FIGURE 20 shows the results of a Prism analysis of in vivo serum and CSF PK data in rats for IDS-C1 , IGF1 R3H5-IDS, IGF 1 R3H5-IDS-HSA, IGF1 R3H5-IDS-R28, and IDS-R28.
  • the analysis shows that IGF1 R3H5 increases brain exposure of IDS by increasing the AUC ratio.
  • the data also demonstrates that HSA or R28 increases total brain exposure (CSF AUC) by increasing the serum half-life.
  • CSF AUC total brain exposure
  • the data also shows that the serum PK of IGF1 R3H5-IDS-R28 was extended relative to IDS-R28.
  • FIGURE 21 shows protein concentrations of IDS-C1 , IGF1 R3H5-IDS, IGF1 R3H5-IDS-HSA and IGF1 R3H5-IDS-R28 in rat whole brain homogenates following single bolus iv injections of equimolar doses of the test articles. * not detected; # not determined.
  • FIGURE 22 shows protein concentrations of IDS-C1 , IGF1 R3H5-IDS and IGF1 R3H5-IDS-R28 in rat brain parenchyma and vessels following single bolus iv injections of equimolar doses of the test articles. * not detected; # not determined.
  • FIGURE 23 shows protein concentrations of IDS-C1 , A20.1 VHH, IGF 1 R3H5-IDS-HSA and A20.1 hFc1X7 (SEQ ID NO:69) in (A) whole rat brain 1 , 4 and 24 hours and (B) rat brain parenchyma and vessels 4 hours post-treatment following single bolus iv injections of equimolar doses of the test articles. * not detected.
  • a compound comprising an antibody or a fragment thereof operable to transmigrate the blood-brain barrier (BBB), and a polypeptide related to the treatment of lysosomal storage disease (LSD).
  • BBB blood-brain barrier
  • LSD lysosomal storage disease
  • a compound comprising an antibody or a fragment thereof operable to transmigrate the blood-brain barrier (BBB), and a polypeptide related to the treatment of a-synucleinopathy.
  • BBB blood-brain barrier
  • polypeptide refers to enzymes, proteins, or functional fragments thereof, that are related to the treatment of LSD, a-synucleinopathy, or both.
  • the present invention provides isolated or purified fusion proteins comprising an antibody or fragment thereof and a polypeptide related to LSD, related to a-synucleinopathy, or both, wherein the antibody or fragment specifically binds to an Insulin-Like Growth Factor 1 Receptor (IGF1 R) epitope or a TMEM30A epitope, and wherein the antibody or fragment thereof is operable to transmigrate the blood-brain barrier, along with a polypeptide related to the treatment of LSD, to the treatment of a-synucleinopathy, or both.
  • IGF1 R Insulin-Like Growth Factor 1 Receptor
  • the antibody or fragment thereof as described herein is capable of transmigration across the blood brain barrier.
  • the brain is separated from the rest of the body by a specialized endothelial tissue known as the blood-brain barrier (BBB).
  • BBB blood-brain barrier
  • the endothelial cells of the BBB are connected by tight junctions and efficiently prevent many therapeutic compounds from entering the brain.
  • one specific feature of the BBB is the existence of enzymatic barrier(s) and high level(s) of expression of ATP-dependent transporters on the abluminal (brain) side of the BBB, including P-glycoprotein (Gottesman and Pastan, 1993; Watanabe et al., 1995), which actively transport various molecules from the brain into the blood stream (Samuels et al., 1993). Only small ( ⁇ 500 Daltons) and hydrophobic (Pardridge, 1995) molecules can more readily cross the BBB.
  • the ability of the antibody or fragment thereof as described above to specifically bind the surface receptor, internalize into brain endothelial cells, and undergo transcytosis across the BBB by evading lysosomal degradation is useful in the neurological field.
  • immunoglobulin refers to a protein constructed from paired heavy and light polypeptide chains; various Ig isotypes exist, including IgA, IgD, IgE, IgG, and IgM.
  • each chain fold folds into a number of distinct globular domains joined by more linear polypeptide sequences.
  • V L variable
  • C L constant
  • C H constant
  • C H constant
  • Fv antigen binding region
  • the light and heavy chain variable regions are responsible for binding the target antigen and can therefore show significant sequence diversity between antibodies.
  • the constant regions show less sequence diversity, and are responsible for binding a number of natural proteins to elicit important biochemical events.
  • the variable region of an antibody contains the antigenbinding determinants of the molecule, and thus determines the specificity of an antibody for its target antigen.
  • the majority of sequence variability occurs in six hypervariable regions, three each per variable heavy (V H ) and light (V L ) chain; the hypervariable regions combine to form the antigen-binding site, and contribute to binding and recognition of an antigenic determinant.
  • the specificity and affinity of an antibody for its antigen is determined by the structure of the hypervariable regions, as well as their size, shape, and chemistry of the surface they present to the antigen.
  • Various schemes exist for identification of the regions of hypervariability the two most common being those of Kabat and of Chothia and Lesk.
  • Kabat et al. (1991) define the “complementarity-determining regions” (CDR) based on sequence variability at the antigen-binding regions of the V H and V L domains.
  • CDR complementarity-determining regions
  • Chothia and Lesk (1987) define the “hypervariable loops” (H or L) based on the location of the structural loop regions in the V H and Vi_ domains.
  • CDR and hypervariable loop regions that are adjacent or overlapping, those of skill in the antibody art often utilize the terms“CDR” and “hypervariable loop” interchangeably, and they may be so used herein.
  • the CDR/loops are identified herein according to the Kabat scheme (i.e. CDR1 , 2 and 3, for each variable region).
  • an“antibody fragment” as referred to herein may include any suitable antigen-binding antibody fragment, or simply, antigen-binding fragment known in the art.
  • the antibody fragment may be a naturally-occurring antibody fragment, or may be obtained by manipulation of a naturally- occurring antibody or by using recombinant methods.
  • an antibody fragment may include, but is not limited to an Fv, single-chain Fv (scFv; a molecule consisting of V L and V H connected with a peptide linker), Fab, F(ab’) 2 , single-domain antibody (sdAb; a fragment composed of a single V L or V H ), and multivalent presentations of any of these.
  • Antibody fragments such as those just described may require linker sequences, disulfide bonds, or other types of covalent bond to link different portions of the fragments; those of skill in the art will be familiar with the requirements of the different types of fragments and various approaches for their construction.
  • the antibody fragment may be an sdAb derived from naturally- occurring sources. Heavy chain antibodies of camelid origin (Hamers-Casterman et al., 1993) lack light chains and thus their antigen binding sites consist of one domain, termed V H H . sdAb have also been observed in shark and are termed VNAR (Nuttall et al., 2003).
  • sdAb may be engineered based on human Ig heavy and light chain sequences (Jespers et al., 2004; To et al., 2005).
  • the term“sdAb” includes those sdAb directly isolated from V H , V H H, VL, or VNAR reservoir of any origin through phage display or other technologies, sdAb derived from the aforementioned sdAb, recombinantly produced sdAb, as well as those sdAb generated through further modification of such sdAb by humanization, affinity maturation, stabilization, solubilization, camelization, or other methods of antibody engineering.
  • homologues, derivatives, or fragments that retain the antigen-binding function and specificity of the sdAb.
  • SdAb possess desirable properties for antibody molecules, such as high thermostability, high detergent resistance, relatively high resistance to proteases (Dumoulin et al., 2002) and high production yield (Arbabi Ghahroudi et al., 1997); they can also be engineered to have very high affinity by isolation from an immune library (Li et al., 2009) or by in vitro affinity maturation (Davies and Riechmann, 1996). Further modifications to increase stability, such as the introduction of non-canonical disulfide bonds (Hussack et al., 201 1 a, 201 1 b; Kim et al., 2012), may also be brought to the sdAb.
  • An sdAb comprises a single immunoglobulin domain that retains the immunoglobulin fold; most notably, only three CDR/hypervariable loops form the antigen-binding site.
  • not all CDR may be required for binding the antigen.
  • one, two, or three of the CDR may contribute to binding and recognition of the antigen by the sdAb of the present invention.
  • the CDR of the sdAb or variable domain are referred to herein as CDR1 , CDR2, and CDR3.
  • the present invention further encompasses an antibody or fragment that is "humanized” using any suitable method known in the art, for example, but not limited to CDR grafting and veneering.
  • Humanization of an antibody or antibody fragment comprises replacing an amino acid in the sequence with its human counterpart, as found in the human consensus sequence, without loss of antigen-binding ability or specificity; this approach reduces immunogenicity of the antibody or fragment thereof when introduced into human subjects.
  • one or more than one of the CDR defined herein may be fused or grafted to a human variable region (V H , or V L ), to other human antibody (IgA, IgD, IgE, IgG, and IgM), to other human antibody fragment framework regions (Fv, scFv, Fab) or to other proteins of similar size and nature onto which CDR can be grafted (Nicaise et al., 2004).
  • V H human variable region
  • V L human antibody
  • IgA, IgD, IgE, IgG, and IgM human antibody fragment framework regions
  • Fv, scFv, Fab human antibody fragment framework regions
  • the conformation of the one or more than one hypervariable loop(s) is likely preserved, and the affinity and specificity of the sdAb for its target (i.e., IGF1 R) is likely minimally affected.
  • CDR grafting is known in the art and is described in at least the following: US Patent No. 6180370, US Patent No. 5693761 , US Patent No. 6054297, US Patent No. 5859205, and European Patent No. 626390.
  • Veneering also referred to in the art as "variable region resurfacing", involves humanizing solvent-exposed positions of the antibody or fragment; thus, buried non- humanized residues, which may be important for CDR conformation, are preserved while the potential for immunological reaction against solvent-exposed regions is minimized.
  • Veneering is known in the art and is described in at least the following: US Patent No. 5869619, US Patent No. 5766886, US Patent No. 5821 123, and European Patent No. 519596. Persons of skill in the art would also be amply familiar with methods of preparing such humanized antibody fragments and humanizing amino acid positions.
  • the antibody or fragment thereof of the present invention may also comprise additional sequences to aid in expression, detection or purification of a recombinant antibody or fragment thereof. Any such sequences or tags known to those of skill in the art may be used.
  • the antibody or fragment thereof may comprise a targeting or signal sequence (for example, but not limited to ompA), a detection/purification tag (for example, but not limited to c-Myc, His5, or His6), or a combination thereof.
  • the additional sequence may be a biotin recognition site such as that described by Cronan et al. in WO 95/04069 or Voges et al. in WO/2004/076670.
  • linker sequences may be used in conjunction with the antibody or fragment thereof, the polypeptide related to treatment of lysosomal storage disease (LSD) or treatment of a-synucleinopathies, the additional sequences or tags, or may serve as a detection/purification tag.
  • LSD lysosomal storage disease
  • additional sequences or tags or may serve as a detection/purification tag.
  • linker sequences is intended to mean short peptide sequences that occur between protein domains. Linker sequences are often composed of flexible residues like glycine and serine so that the adjacent protein domains are free to move relative to one another.
  • the linker sequence can be any linker sequence known in the art that would allow for the antibody and polypeptide of a compound, of the present invention to be operably linked for the desired function.
  • the linker may be any sequence in the art (either a natural or synthetic linker) that allows for an operable fusion comprising an antibody or fragment linked to a polypeptide.
  • the linker sequence may be a linker sequence L such as (GGGGS) n , wherein n equal to or greater than 1 , or from about 1 to about 5, or from about 1 to 15, or n may be any number of linker that would allow for the operability of the compound of the present invention.
  • the linker may be an amino acid sequence, for example, an amino acid sequence that comprises about 3 to about 40 amino acids, or about 5 to about 40 amino acids, or about 10 to about 40 amino acids, or about 15 to about 40 amino acids, or about 20 to about 40 amino acids, or about 25 to about 40 amino acids, or about 30 to about 40 amino acids, or about 35 to about 40 amino acids, or about 3 to about 35 amino acids, or about 5 to about 35 amino acids, or about 10 to about 35 amino acids, or about 15 to about 35 amino acids, or about 20 to about 35 amino acids, or about 25 to about 35 amino acids, or about 30 to about 35 amino acids, or about 3 to about 30 amino acids, or about 5 to about 30 amino acids, or about 10 to about 30 amino acids, or about 15 to about 30 amino acids, or about 20 to about 30 amino acids, or about 25 to about 30 amino acids, or about 3 to about 25 amino acids, or about 5 to about 25 amino acids, or about 10 to about 25 amino acids, or about 15 to about 25 amino acids, or about 20 to about 25 amino acids, or about
  • the antibody or fragment thereof of the present invention may also be in a multivalent display format, also referred to herein as multivalent presentation.
  • Multimerization may be achieved by any suitable method known in the art. For example, and without wishing to be limiting in any manner, multimerization may be achieved using self-assembly molecules such as those described in Zhang et al. (2004a, 2004b) and W02003/046560, where pentabodies are produced by expressing a fusion protein comprising the antibody or fragment thereof of the present invention and the pentamerization domain of the B-subunit of an AB5 toxin family (Merritt and Hoi, 1995).
  • a multimer may also be formed using the multimerization domains described by Zhu et al.
  • antibody form is a fusion of the antibody or fragment of the present invention with a coiled-coil peptide resulting in a multimeric molecule (Zhu et al., 2010).
  • Other forms of multivalent display are also encompassed by the present invention.
  • the antibody or fragment thereof may be presented as a dimer, a trimer, or any other suitable oligomer.
  • Fc domains may be selected from various classes including, but not limited to, IgG, IgM, or various subclasses including, but not limited to lgG1 , lgG2, etc.
  • multivalent display formats may encompass chimeric or humanized formats of antibodies and V h H of the present invention linked to an Fc domain, or bi- or tri-specific antibody fusions with two or three antibodies and VHH recognizing unique epitopes.
  • Such antibodies are easy to engineer and to produce, can greatly extend the serum half-life of sdAb, and may be excellent tumor imaging reagents (Bell et al., 2010).
  • the Fc domain in the multimeric complex as just described may be any suitable Fc fragment known in the art.
  • the Fc fragment may be from any suitable source; for example, the Fc may be of mouse or human origin.
  • the Fc may be the mouse Fc2b fragment or human Fc1 fragment (Bell et al., 2010; Iqbal et al., 2010).
  • the antibody or fragment thereof may be fused to the N-terminus or C-terminus of the Fc fragment.
  • Each subunit of the multimers described above may comprise the same or different antibodies or fragments thereof of the present invention, which may have the same or different specificity.
  • the multimerization domains may be linked to the antibody or antibody fragment using a linker sequence, as required.
  • the linker sequence can be any linker known in the art that would allow for the compound of the present invention to be prepared and be operable for the desired function.
  • such a linker sequence should be of sufficient length and appropriate composition to provide flexible attachment of the two molecules, but should not hamper the antigen-binding properties of the antibody.
  • the isolated or purified antibody or fragment thereof operable to transmigrate the BBB may be an antibody or fragment thereof which comprises:
  • CDR complementarity determining region
  • GFKITHYTMG SEQ ID NO:1
  • X 2 sequence • a complementarity determining region (CDR) 1 sequence EYPSNFYA (SEQ ID NO:6); CDR2 sequence VSRDGLTT (SEQ ID NO:7); and CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8); or
  • CDR complementarity determining region
  • the antibody or fragment thereof comprises an amino acid sequence selected from the group consisting of:
  • a substantially identical sequence may comprise one or more conservative amino acid mutations. It is known in the art that one or more conservative amino acid mutations to a reference sequence may yield a mutant peptide with no substantial change in physiological, chemical, physico-chemical or functional properties compared to the reference sequence; in such a case, the reference and mutant sequences would be considered “substantially identical” polypeptides.
  • a conservative amino acid substitution is defined herein as the substitution of an amino acid residue for another amino acid residue with similar chemical properties (e.g. size, charge, or polarity). These conservative amino acid mutations may be made to the framework regions of the sdAb while maintaining the CDR sequences listed above and the overall structure of the CDR of the antibody or fragment; thus the specificity and binding of the antibody are maintained.
  • a conservative mutation may be an amino acid substitution.
  • Such a conservative amino acid substitution may substitute a basic, neutral, hydrophobic, or acidic amino acid for another of the same group.
  • basic amino acid it is meant hydrophilic amino acids having a side chain pK value of greater than 7, which are typically positively charged at physiological pH.
  • Basic amino acids include histidine (His or H), arginine (Arg or R), and lysine (Lys or K).
  • neutral amino acid also“polar amino acid”
  • hydrophilic amino acids having a side chain that is uncharged at physiological pH, but which has at least one bond in which the pair of electrons shared in common by two atoms is held more closely by one of the atoms.
  • Polar amino acids include serine (Ser or S), threonine (Thr or T), cysteine (Cys or C), tyrosine (Tyr or Y), asparagine (Asn or N), and glutamine (Gin or Q).
  • hydrophobic amino acid (also“non-polar amino acid”) is meant to include amino acids exhibiting a hydrophobicity of greater than zero according to the normalized consensus hydrophobicity scale of Eisenberg (1984). Hydrophobic amino acids include proline (Pro or P), isoleucine (lie or I), phenylalanine (Phe or F), valine (Val or V), leucine (Leu or L), tryptophan (Trp or W), methionine (Met or M), alanine (Ala or A), and glycine (Gly or G). “Acidic amino acid” refers to hydrophilic amino acids having a side chain pK value of less than 7, which are typically negatively charged at physiological pH. Acidic amino acids include glutamate (Glu or E), and aspartate (Asp or D).
  • Sequence identity is used to evaluate the similarity of two sequences; it is determined by calculating the percent of residues that are the same when the two sequences are aligned for maximum correspondence between residue positions. Any known method may be used to calculate sequence identity; for example, computer software is available to calculate sequence identity. Without wishing to be limiting, sequence identity can be calculated by software such as NCBI BLAST2 service maintained by the Swiss Institute of Bioinformatics (and as found at ca.expasy.org/tools/blast/), BLAST-P, Blast-N, or FASTA-N, or any other appropriate software that is known in the art.
  • the substantially identical sequences of the present invention may be at least 90% identical; in another example, the substantially identical sequences may be at least 90, 91 , 92, 93, 94, 95, 96, 97, 98, 99, or 100% identical, or any percentage therebetween, at the amino acid level to sequences described herein. Importantly, the substantially identical sequences retain the activity and specificity of the reference sequence. In a non-limiting embodiment, the difference in sequence identity may be due to conservative amino acid mutation(s). In a non-limiting example, the present invention may be directed to an antibody or fragment thereof comprising a sequence at least 95%, 98%, or 99% identical to that of the antibodies described herein.
  • the present invention provides a compound comprising an antibody or fragment thereof that transmigrates the blood brain barrier (BBB).
  • An antibody or fragment of the present invention may bind to, for example, transmembrane protein 30A (TMEM30A), as described in WO 2007/036021 , or to an Insulin-Like Growth Factor 1 Receptor (IGF1 R) epitope, or isoforms, variants, portions, or fragments thereof.
  • TMEM30A transmembrane protein 30A
  • IGF1 R Insulin-Like Growth Factor 1 Receptor
  • the compound of the present invention comprises a polypeptide related to the treatment of LSDs.
  • the compound of the present invention comprises a polypeptide related to the treatment of a-synucleinopathies.
  • the compound of the present invention comprises a polypeptide related to the treatment of both LSD and a-synucleinopathies.
  • Non-limiting examples of such polypeptides include polypeptides that are operable for the treatment of, without wishing to be limiting, sphingolipidoses, mucopolysaccharidoses, glycoproteinoses/oligosaccharidoses, glycogenosis (e.g. type II), lipodoses or neuronal ceroid lipofuscinoses.
  • such polypeptides may be selected from the group consisting of Type I sulfatases or a glucosidase.
  • the peptide related to the treatment of LSD may be iduronate-2-sulfatase (IDS):
  • LMP LMP, referred to herein as IDS (SEQ ID NO: 24), or sequences substantially identical thereto.
  • the peptide related to the treatment of LSD, to the treatment of a-synucleinopathy, or both may be acid-beta-glucosidase (GCase)
  • NRSSKDVPLTIKDPAVGFLETISPGYSIHTYLWRRQ referred to herein as GCaseMutl
  • GCasemutl differs from wild-type human GCase in that it lacks the first 39 amino acids (signal peptide) and has 2 amino acid substitutions.
  • the compounds of the present invention and/or the polypeptide related to the treatment of LSD, to the treatment of a-synucleinopathy, or both may be hyperglycosylated and hyperphosphorylated to increase cellular uptake into neurons and its lysosomal localization. Therefore, according to another embodiment, the compound of the present invention, and particularly the polypeptide related to the treatment of LSD, to the treatment of a- synucleinopathy, or both may be a glycosylated polypeptide. In embodiments, the glycosylated polypeptide may be glycosylated with one or more N-glycans.
  • the glycosylated polypeptide may further be a phosphorylated polypeptide, and for example, the phosphorylation may be a mannose-6-phosphate.
  • the mannose-6-phosphate may be attached to an N-glycan.
  • the glycosylated and phosphorylated polypeptide may contain monophosphorylated or bisphosphorylated N- glycans, or a combination thereof.
  • the compounds may be expressed in yeast expression systems that synthesize high levels of phosphorylated N-glycans, such as those described in WO201 1061629, and the strain Yarrowia lipolytica strain OXYY5632 mentioned below.
  • the compounds of the present invention may also comprise elements to improve the half-life of the compounds in serum.
  • the compounds of the present invention may further comprise human serum albumin (HSA).
  • HSA(K573P) SEQ ID NO:28.
  • HSA(K573P) differs from mature wild-type human HSA in that it has the K573P substitution.
  • the elements to improve the half-life of the compounds in serum may be an albumin targeting moiety.
  • albumin targeting moiety is intended to mean any compound that can bind to serum albumin and particularly to human serum albumin.
  • the albumin targeting moiety may be an anti-albumin or anti-HSA antibody or a fragment thereof.
  • the albumin targeting moiety may be any suitable material. According to an embodiment, for example and without wishing to be limiting in any manner, the albumin targeting moiety may be
  • the compounds of the present invention may comprise
  • a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7); CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO:24), and an albumin targeting moiety comprising CDR1 sequence GSTFSSSS (SEQ ID NO:20), CDR2 sequence ITSGGST (SEQ ID NO:21), and CDR3 sequence NVAGRNWVPISRYSPGPY (SEQ ID NO:22);
  • IGF1 R3H5 - IDS - HSA(K573P) (SEQ ID NO: 35);
  • IGF1 R3H5 - IDS - R28 SEQ ID NO: 36
  • IGF1 R3H5 - IDS - M79 (SEQ ID NO: 37).
  • the present invention also encompasses a composition comprising one or more than one of the compound as described herein.
  • the composition may comprise a single compound as described above, or may be a mixture of compounds.
  • the compound may have the same specificity, or may differ in their specificities; for example, and without wishing to be limiting in any manner, the composition may comprise antibodies or fragments thereof specific to IGF1 R (same or different epitope).
  • the composition may also comprise a pharmaceutically acceptable diluent, excipient, or carrier.
  • the diluent, excipient, or carrier may be any suitable diluent, excipient, or carrier known in the art, and must be compatible with other ingredients in the composition, with the method of delivery of the composition, and is not deleterious to the recipient of the composition.
  • the composition may be in any suitable form; for example, the composition may be provided in suspension form, powder form (for example, but not limited to lyophilized or encapsulated), capsule or tablet form.
  • the carrier when the composition is provided in suspension form, may comprise water, saline, a suitable buffer, or additives to improve solubility and/or stability; reconstitution to produce the suspension is effected in a buffer at a suitable pH to ensure the viability of the compound of the present invention.
  • Dry powders may also include additives to improve stability and/or carriers to increase bulk/volume; for example, and without wishing to be limiting, the dry powder composition may comprise sucrose or trehalose.
  • the composition may be so formulated as to deliver the compound of the present invention to the gastrointestinal tract of the subject.
  • the composition may comprise encapsulation, time-release, or other suitable technologies for delivery of the compound of the present invention. It would be within the competency of a person of skill in the art to prepare suitable compositions comprising the present compounds.
  • the present invention further provides a method of transporting a molecule of interest across the blood-brain barrier.
  • Such methods also encompass methods of treating a lysosomal storage disease (LSD), treating a-synucleinopathy, or both across the blood-brain barrier, comprising administering the compound according to the present invention or a composition according to the present invention to a subject in need thereof.
  • LSD lysosomal storage disease
  • This also includes use of the compound or of a composition of the present invention related to the treatment of LSD, treating a-synucleinopathy, or both in the brain in a subject in need thereof
  • the method comprises administering the compounds as described herein to a subject; the antibody part or fragment thereof transmigrates the blood-brain barrier.
  • the molecule may be any desired molecule, including the cargo molecules as previously described, related to the treatment of LSD, the treatment of a-synucleinopathy, or both; the molecule may be“linked” to the antibody or fragment thereof using any suitable method, including, but not limited to conjugation or expression in a fusion protein.
  • the administration may be by any suitable method, for example parenteral administration, including but not limited to intravenous (iv), subcutaneous (sc), and intramuscular (im) administration.
  • the antibody or fragment thereof of the present invention “ferries” the molecule of interest across the BBB to its brain target.
  • the invention also encompasses a method of quantifying an amount of a cargo molecule delivered across the BBB of a subject, wherein the cargo molecule is linked to one or more than one isolated or purified antibody or fragment thereof as described herein, the method comprising a) collecting cerebrospinal fluid (CSF) from the subject; and b) using targeted proteomics methods to quantify the amount of the cargo molecule linked to one or more than one antibody or fragment thereof in the CSF.
  • CSF cerebrospinal fluid
  • the cargo molecule may be any desired molecule, including the cargo molecules, as previously described; the isolated compound of the present invention transmigrates the blood- brain barrier; and the molecule may be“linked” to the antibody or fragment thereof using any suitable method, including, but not limited to conjugation or expression in a fusion protein, as previously described.
  • the CSF is collected from a subject using any suitable method known in the art.
  • the amount of CSF required for the targeted proteomics method in step b) may be between about 1 to 10 pL; for example, the amount of CSF required may be about 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0, 9.5, or 10 pL, or any amount there between, or any range defined by the amount just described.
  • the compound of the present invention may have been administered to the subject prior to collection of the CSF. A suitable delay between administration and delivery of the antibody or fragment linked to the cargo molecule across the BBB may be required.
  • the delay may be at least 30 minutes following administration of the antibody or fragment linked to the cargo molecule; for example and without wishing to be limiting in any manner, the delay may be at least 30 minutes, 1 hour, 1.5 hour, 2 hours, 2.5 hours, 3 hours, 3.5 hours, 4 hours, 4.5 hours, or 5 hours.
  • the targeted proteomics methods used to quantify the amount of the one or more than one antibody or fragment thereof linked to the cargo molecule may be any suitable method known in the art.
  • the targeted proteomics method may be a mass spectrometry method, such as but not limited to multiple reaction monitoring using an isotopically labeled internal standard (MRM-ILIS; see for example (Haqqani et al., 2013)).
  • MRM is advantageous in that it allows for rapid, sensitive, and specific quantification of unlabeled targeted analytes (for example, a compound as described herein) in a biological sample.
  • the multiplexing capability of the assay may allow for quantification of both the antibody or fragment thereof and the cargo molecule.
  • the invention also encompasses nucleic acid vectors comprising a nucleotide sequence encoding a compound of the present invention, as well as cells comprising the nucleic acid vector, for expressing the compound of the present invention, and cells for expressing the compound of the present invention.
  • a recombinant fusion protein comprising an IGF1 R3H5 sdAb domain, an IDS domain and C- terminal affinity purification tags (shown in Figure 1 ; see also amino acids SEQ ID NO:30) was prepared.
  • the fusion protein comprised a 17 amino acid N-terminal signal peptide, the 127 amino acid IGF1 R3H5 sdAb domain (SEQ ID NO:43), a 25 amino acid linker sequence, the 525 amino acid mature human IDS sequence (SEQ ID NO:24) and a 16 amino acid HIS-strep tag sequence.
  • the protein is produced in a 10 L fermentation of the IGF1 R3H5-IDS expressing Yarrowia lipolytica strain OXYY5632.
  • Yarrowia lipolytica strain OXYY5632 co-expresses IGF1 R3H5-IDS and Bos Taurus formylglycine generating enzyme (FGE) to produce catalytically active IDS. Furthermore, the strain is glycol-engineered to obtain glycoproteins with high levels of phosphorylated N-glycans. The fermentation and subsequent harvest step were performed, after which the clarified medium containing the target protein IGF1 R3H5-IDS was subjected to different chromatography steps to yield the pure product.
  • FGE Taurus formylglycine generating enzyme
  • the purification protocol consisted of a Ni-IMAC capturing step to remove most of the contaminants, followed by an enzymatic treatment with Jack Bean a-mannosidase (JBMan) at pH 4.5 to uncap the shielded Man-6-P and further trim terminal a-linked mannose residues from the protein-linked N-glycans.
  • JBMan Jack Bean a-mannosidase
  • a second Ni-IMAC step was included for JBMan removal.
  • the final samples were formulated by diafiltration in 20 mM sodium phosphate + 137 mM NaCI, pH 6.2.
  • the same production and purification method is applied for all other compounds or other recombinant proteins referred to within the following examples. Only in the case of the IGF1 R3H5-IDS- HSA(K573P) fusion construct, an extra polishing step needed to be developed to reach the same level of purity as for the other variants.
  • IGF1 R3H5-IDS SDS-PAGE analysis.
  • a sample of purified IGF1 R3H5-IDS compound was prepared with reducing agent, heat-denatured at 95°C and loaded at a concentration of 1 pg and 2 pg on a NuPAGE Novex 4-12% Bis-Tris gel (1.5 mm thick, 15-well), run with MOPS-SDS running buffer. Following electrophoresis, the gel was stained for 1 hour in InstantBlue staining solution and de-stained with water until background decolorization. The gel was scanned using scanning software (Odyssey) ( Figure 2A). IGF1 R3H5-IDS corresponds to a ⁇ 90 kDa band, when taking the presence of N-glycans into account. The obtained band pattern was consistent with the expectations.
  • Immunodetection of IDS consisted of a 2 h-incubation with rabbit anti-elaprase polyclonal antibody (in-house batch 0X010) and a subsequent 30 min-incubation with goat anti-rabbit IgG, IRdye (680 nm) conjugated antibody (Sigma). Immunodetection of the His-tag was performed in a similar manner, but with THETM His Tag mouse monoclonal antibody (Genscript) and goat anti-mouse IgG, IRdye (800 nm) conjugated antibody. The membrane was then scanned using the Odyssey software.
  • Immunodetection with anti-IDS antibody shows a main band at ⁇ 90 kDa, corresponding to the full-length IGF1 R3H5-IDS construct.
  • Immunodetection with anti-His antibody ( Figure 3A, right panel) reveals a main band at ⁇ 90 kDa, confirming the integrity of the C-terminal end of IGF1 R3H5-IDS.
  • an aggregate at ⁇ 200 kDa and the protein band at ⁇ 75 kDa (2 bands) can also be seen in lane 2 and 4, corresponding to the highest loaded concentration of the construct.
  • the extra bands in lane 4 at 75, 100, 150 and 250 kDa are due to overflow of the marker to the adjacent lane.
  • N-qlvcan analysis To evaluate the uncapping process and to analyze the N-glycan profile of uncapped IGF1 R3H5-IDS, the N-glycans are released with PNGaseF, labeled with APTS and subsequently analyzed via capillary electrophoresis. From the obtained profile, the surface area of peaks representing relevant N-glycan structures was calculated to determine the peak ratios and thus the corresponding N-glycan distribution (Figure 4). The N-glycan distribution of the uncapped IGF1 R3H5-IDS gives a 48%/52% ratio of bi- and monophosphorylated N- glycans (Figure 4: 2 bottom rows).
  • SPR analysis Surface Plasmon Resonance (SPR) analysis was performed to determine the affinity of the IGF1 R3H5-IDS construct towards human IGF1 R (hIGRI R).
  • the SPR analysis was performed on a Biacore T200 (GE Healthcare) under the following conditions.
  • hIGFI R was immobilized on a CM4 chip at high density (FC1 - ethanoloamine blocked; FC3 - 2,500 RUs of hIGFI R). A variable concentration of the flowing molecule was used, with contact and dissociations times of 300 and 400 s, respectively.
  • the assay was performed at 25°C with a flow rate of 40 pL/min and the chip was regenerated in 10 mM glycine (pH 5.5).
  • Figures 5A and 5B show that the uncapped and capped versions of IGF1 R3H5-IDS (20 nM) exhibit rate constants and affinities that are essentially identical. Strong binding to immobilized h-IGF1 R (on the CM4 chip) was observed for both capped and uncapped IGF1 R3H5-IDS constructs.
  • matrix effects build-up of charge
  • K D of ⁇ 70 nM.
  • the IGF1 R3H5-IDS construct retains its ability to bind to the target receptor IGF1 R.
  • the samples are diluted in transport buffer (TB; 5 mM MgCI 2 , 10 mM HEPES in Hanks’ balanced salt solution (HBSS), pH 7.4) and added (1 :1) to the top chamber containing SV-ARBEC media with 5% fetal bovine serum (FBS).
  • transport buffer 5 mM MgCI 2 , 10 mM HEPES in Hanks’ balanced salt solution (HBSS), pH 7.4
  • FBS fetal bovine serum
  • the bottom chamber contains TB.
  • SFTB sulfate-free transport buffer
  • the apparent permeability coefficient P app was calculated as described previously (Artursson and Karlsson, 1991).
  • a human BBB model was created using brain endothelial cells derived from amniotic fluid induced pluripotent stem cells (AF- iPSC-BEC). Except for the origin of the cell line, this model is essentially the same as the SV- ARVBEC model. Details pertaining to the production of AF-iPSC-BEC are found in CA2970173, to Ribecco-Lutkiewicz et al. (2016).
  • VHH or VHH-Fc fusion proteins in vitro BBB transport or body fluid samples containing these proteins, were reduced, alkylated, and trypsin digested using previously described protocol (Haqqani et al., 2008a, 2013).
  • ILIS isotopically labeled internal standard
  • isotopically heavy versions of the peptides that contained heavy C-terminal K (+8 Da) were synthesized from a commercial source (New England Peptide LLC, Gardner, MA, USA) (Lin et al., 2013).
  • Each protein was first analyzed by nanoLC-MS/MS [nanoAcquity UPLC (Waters, Milford, MA, USA) coupled to LTQ XL ETD MS (ThermoFisher, Waltham, MA, USA)] using data-dependent acquisition to identify all ionizable peptides, and the 3-5 most intense fragment ions were chosen.
  • An initial SRM assay was developed to monitor these fragments at attomole amounts of the digest. Fragments that showed reproducible intensity ratios at low amounts ( ⁇ 100- 300 amol; Pearson r 2 >0.95) were considered stable and were chosen for the final SRM assay.
  • FIG. 6 shows that permeability (PAPP) of uncapped IDS-C1 (which comprises a C-terminal
  • HIS-Strep tag HIS-Strep tag
  • IGF1 R5H2-monoFc-IDS enhanced the in vitro transcytosis of IDS across the rat BBB ( Figure 7): IGF1 R5H2-monoFc-IDS was shown to exhibit a marked increase in permeability relative to the negative control (A20.1) and comparable to the VHH alone.
  • this construct was capable of effecting transcytosis in a human BBB model, thereby confirming its cross- reactivity between rat and human endothelial cells (Figure 8). Further analysis of the rat brain endothelial cells used in the assay depicted in Figure 7 indicated that the uncapped IDS-C1 was taken up by the endothelial cells, but did not undergo transcytosis ( Figure 9). Furthermore, endothelial cell retention of the IGF1 R5H2-monoFc-IDS construct was consistent with the positive control FC5-VHH.
  • Figure 1 1 confirmed that IGF1 R5H2 bearing constructs exhibit elevated BBB permeability, with IGF1 R5H2-IDS-2 exhibiting permeability that is comparable to IGF1 R5H2 VHH and hFc1X7-IGF1 R5H2 (SEQ ID:70). Furthermore, constructs containing ALB1 or HSA(K573P) were equally permeable. The effect of domain (IGF1 R5H2, ALB1 , IDS) arrangement was also assessed. While interpretation of the data is limited by the presence of values that exceeded the upper limit of quantitation, it is apparent that alterations in domain arrangement did not produce marked reductions in permeability.
  • FIG. 12 summarizes the permeability of the FC5-containing constructs relative to the non-transcytosing negative control (A20.1) and IDS- C1. The figure shows that the permeability of uncapped IDS-C1 was greater than A20.1 , but significantly lower than the transcytosing VHH FC5 and the FC5-IDS fusions.
  • FIG 13 summarizes the permeability of the constructs containing IGF1 R-binding VHHs relative to the non-transcytosing negative control (A20.1) and IDS-C1.
  • the figure shows that the permeability of IDS constructs containing IGF1 R-binding VHHs was consistently and significantly greater than uncapped IDS-C1.
  • Figure 14 shows that the relative permeability of IGF1 R3H5-GCase (SEQ ID NO:32) was significantly greater than GCase.
  • Biodistribution CSF and brain collection. All animals were purchased from Charles River Laboratories International, Inc. (Wilmington, MA, USA). Animals were housed in groups of three in a 12 h light-dark cycle at a temperature of 24°C, a relative humidity of 50 ⁇ 5%, and were allowed free access to food and water. All animal procedures were approved by the NRC’s Animal Care Committee and were in compliance with the Canadian Council of Animal Care guidelines. Male Wistar rats aged 8-10 weeks (weight range, 230-250 g) were used for sample collection. CSF and brain were collected to assess the biodistribution of the test sample. The animals were provided analgesia (sustained release buprenorphine, 1.2 mg/kg) before the first CSF collection.
  • analgesia sustained release buprenorphine, 1.2 mg/kg
  • Rats were anaesthetized with 3% isoflurane and placed in a stereotaxic frame with the head rotated downward at a 45° angle. A midline incision was made beginning at the occipital crest and extending caudally about 2 cm on the back of the neck. The superficial neck muscles and underlying layers of muscle covering the cisterna magna were separated along the midline by blunt dissection. The neck muscles were retracted in order to expose the dura mater. A 27G butterfly needle with tubing attached to 1 mL syringe was inserted with the bevel of the needle faced up and the angle of insertion was parallel with the dura membrane.
  • the CSF sample was ejected into a glass sample vial and the vial was immediately placed on dry ice; the frozen sample was subsequently transferred to a -80°C freezer until further analysis.
  • the wound was then closed and a blood sample was collected from the tail vein, according to Fluttert et al. (2000).
  • the rat was then returned to its home cage and housed in the recovery room until the next CSF collection. For subsequent CSF and blood collections, the rat was anaesthetized and the sutures removed. The muscles covering the cisterna magna were gently separated and the dura mater exposed.
  • CSF sampling was then performed as described above. Approximately 15-20 pL of CSF can be collected at each time point. For the terminal CSF collection, approximately 50-100 pL of CSF can be collected and blood is collected by heart puncture. Finally, euthanasia is performed by cervical dislocation under deep isoflurane anesthesia.
  • Brain homogenization and processing Prior to MRM analysis the entire right hemisphere was weighed while frozen and the middle third was extracted and weighed (typically ⁇ 0.16 g). The remaining tissue was stored at -80°C. The brain tissue was then homogenized in 1.0 mL ice- cold homogenization buffer (50 mM Tris-HCI, pH 8, 150 mM NaCI, 1.0% sodium deoxycholate (Sigma), and 1X protease inhibitor cocktail (Sigma)) using a Wheaton Dounce homogenizer (10-12 strokes with a Glas-Col drill (model# 099C K54) at 60% speed, at 4°C) until pieces of tissue are no longer detectable.
  • a Wheaton Dounce homogenizer 10-12 strokes with a Glas-Col drill (model# 099C K54) at 60% speed, at 4°C
  • the 20 pg aliquot was made up to 12.5 pL with 25 mM ABC and 12.5 pL of 10% sodium deoxycholate (DOC; Sigma) was added to give a concentration of 5% DOC.
  • DOC sodium deoxycholate
  • the samples were then vortexed and briefly centrifuged prior to the addition of 2.5 pL freshly prepared 10X DL-dithiothreitol (DTT; Sigma) to provide a concentration of 5 mM DTT.
  • the samples were vortexed and centrifuged briefly and then incubated at 95°C for 10 minutes.
  • the samples were then cooled, and briefly centrifuged prior to the addition of 2.75 pL 10X iodoacetamide (Sigma) for a concentration of 10 mM.
  • the samples were vortexed and centrifuged prior to incubation at room temp for 30 minutes in the dark.
  • the samples were then diluted to 125.0 pL with 25 mM ABC.
  • a 2.0 pL (1.0 pg) aliquot of trypsin (Promega) was then added to each sample, which were then mixed gently and briefly centrifuged prior to incubation in a Multitherm Incubator/Chiller unit (model H5000) at 37°C for 12 hours and at 4°C thereafter.
  • the samples were then stored at -80°C until MRM analysis was conducted.
  • the DOC Prior to MRM analysis, the DOC was precipitated by adding 15 pL AAF buffer (54% acetic acid, 150 mM ammonium acetate, 10% formic acid) to a 1 15 pL aliquot of the digested sample. The samples were then centrifuged at 50,400 x g for 10 min at 4°C, and 60 pL of the supernatant was transferred to a fresh vial. MRM analysis was performed using 20 pL of the supernatant.
  • AAF buffer 40% acetic acid, 150 mM ammonium acetate, 10% formic acid
  • brain homogenates of the left hemisphere were subjected to a vessel depletion protocol to obtain brain parenchyma and brain vessel fractions.
  • the tissues were homogenized as above and sequential filtration through 100 pm and 20 pm nylon Nitex mesh filters (pluriSelect, Leipzig, Germany) was performed to obtain the brain fractions. Concentrations of test substances were determined in the vessel-depleted parenchymal fractions and the vessel fractions using SRM as above.
  • Serum and CSF pharmacokinetics At several post-injection timepoints, blood was collected, and serum was prepared to determine serum half-life. Blood samples were taken from the lateral tail vein at 5, 10, 15 and 30 min and 1 , 2, 4, 6, 8, and 24 h post administration. Samples were centrifuged (15 min at 15,000 rpm; room temperature) and serum was stored at -80°C until analysis. Serum half-life was determined by plotting serum concentration (in mM) versus time and performing non-linear curve fitting using the one-phase and two-phase decay models. In both models, the plateau value was set to zero and the best fit (one-phase vs. two-phase) was determined by performing an F test on the sum of squares. Area under the curve (AUC) data was also calculated for serum using GraphPad Prism.
  • nanoLC/MS/MS The protein levels of the test samples in ex vivo samples (serum, cerebrospinal fluid (CSF), and brain) were quantified using targeted nanoflow liquid chromatography tandem mass spectrometry (nanoLC MS/MS). Pure VHH or fusion proteins and body fluid samples containing these proteins are reduced, alkylated, and trypsin digested (Haqqani et al., 2008b, 2013).
  • isotopically labeled internal standard (ILIS)-based quantification isotopically heavy versions of a peptide that contains heavy C-terminal K (+8 Da) is synthesized from a commercial source (New England Peptide LLC, Gardner, MA, USA).
  • ILIS for an alternative protein e.g., FC5 or hFc
  • FC5 or hFc an alternative protein
  • SRM selected reaction monitoring
  • Fragments showing reproducible intensity ratios at low amounts are considered stable and are chosen for the final SRM assay.
  • Blood contamination of CSF samples is evaluated by in-reaction monitoring of rat albumin levels using a nanoLC-SRM method. Measurement of CSF protein concentration is used as a rapid quantitative and nonspecific method for identifying serum contaminated samples. Typical protein concentration of CSF is 0.2-0.4 mg/mL in rat. Protein concentrations >0.4 mg/mL are considered to be likely contaminated with blood.
  • the albumin blood-CSF ratio is determined by multiple SRM analysis of CSF and the corresponding serum sample. Ratios less than 1500- fold are considered contaminated with blood and are excluded from further analyses.
  • Figure 16A shows protein concentrations of IDS-C1 , IGF1 R3H5-IDS, IGF1 R3H5-IDS-
  • the constructs containing albumin binding VHH domains (IGF1 R3H5-IDS-M79 and IGF1 R3H5-IDS-R28) exhibited reduced serum clearance and increased serum ti /2 values.
  • the serum clearance of IGF1 R3H5-IDS-M79 and IGF1 R3H5-IDS-R28 were less than that observed for IGF1 R3H5-IDS-HSA(K573P).
  • the serum aL /2 values of IGF1 R3H5-IDS-M79 and IGF1 R3H5-IDS-R28 were 1.51- and 1.61 -fold longer than for IGF1 R3H5-IDS-HSA(K573P).
  • the anti-albumin containing constructs exhibited serum PK values that were consistent with the HSA containing construct.
  • serum half-life extension was realized using two distinct strategies.
  • Figure 19 compares protein concentrations of IDS-C1 , IGF1 R3H5-IDS, IGF1 R3H5-IDS- HSA(K573P) and IGF1 R3H5-IDS-R28 in rat CSF following single bolus iv injections of equimolar doses of the test articles. It can be seen that the peak CSF concentrations of IGF1 R3H5-IDS, IGF1 R3H5-IDS-HSA(K573P) and IGF1 R3H5-IDS-R28 are very similar, which is likely the result of the similar dosing levels employed.
  • IGF1 R3H5-IDS-HSA(K573P) levels in CSF at 8 hr post-administration were comparable to the peak observed levels (Figure 19).
  • the IGF1 R3H5-IDS- HSA(K573P) and IGF1 R3H5-IDS-R28 constructs exhibited distinctly prolonged CSF PK profiles, resulting in 42.4- and 52.4-fold increases, respectively, in the observed AUC compared to IDS-C1 ( Figure 20).
  • IGF1 R3H5 Considering the unexpected serum PK extension observed with the inclusion of IGF1 R3H5 ( Figure 17, Figure 20), it appears that IGF1 R3H5 and R28 act through an unpredicted mechanism to synergistically extend the serum PK of IDS-C1 .
  • IGF1 R3H5-IDS Whole brain levels of IDS-C1 (1 , 4 & 8 hours), IGF1 R3H5-IDS (1 , 4, 8 & 24 hours), IGF1 R3H5- IDS-HSA(K573P) (4 & 24 hours) and IGF1 R3H5-IDS-R28 (4 & 24 hours only) were quantified and Figure 21 shows the test sample levels in rat brain over a 24-hour period. Brain levels of IGF1 R3H5-IDS were substantially greater than IDS-C1 at 1 and 4 hours, with IDS-C1 not detected at 8 hours.
  • FIG. 22 shows an analysis of IDS-C1 , IGF1 R3H5-IDS and IGF1 R3H5-IDS-R28 in brain parenchyma and brain vessels.
  • Figure 21 shows that IDS-C1 was detected in whole brain at 1 and 4 hours post-administration. However, IDS-C1 was below the detection limits in brain parenchyma and vessel samples from the same animals ( Figure 22).
  • IGF1 R3H5-IDS was detected in whole brain ( Figure 21) and brain parenchyma at 1 and 4 hours. Furthermore, IGF1 R3H5-IDS was not detected in the vessel fractions. In comparison, IGF1 R3H5-IDS-R28 was detected in whole brain ( Figure 21) as well as in brain parenchyma and vessels ( Figure 22). Importantly, the IGF1 R3H5-IDS and IGF1 R3H5-IDS-R28 levels in brain parenchyma were much greater than in brain vessels. This indicates that retention of IGF1 R3H5-IDS and IGF1 R3H5-IDS-R28 in the vessel component is likely to be limited and that delivery to the parenchyma is achieved.
  • Figure 23 shows protein concentrations of IDS-C1 and IGF1 R3H5-IDS-HSA(K573P) in rat brain parenchyma and vessels following single bolus iv injections of equimolar doses of the test articles.
  • Figure 23A confirms that IDS-C1 is detectable in whole brain at 1 and 4 hours, but not at 24 hours.
  • the figure also demonstrates IGF1 R3H5-IDS-HSA(K573P) levels were much greater than IDS-C1 and the non-BBB crossing controls (A20.1 VHH and A20.1 hFc1X7).
  • Figure 23B demonstrates that IDS-C1 and A20.1 hFc1X7 are not detectable in brain parenchyma at 4 hours, while IDS- C1 is present at low levels in brain vessels at 4 hours.
  • IGF1 R3H5-IDS-HSA was found in the brain parenchyma and was not observed to be trapped in brain vessels.
  • the low level of brain vessel“trapping” in the in vivo studies is consistent with observations in the in vitro BBB models ( Figure 9).
  • Pentabody-mediated antigen delivery induces antigen-specific mucosal immune response. Mol. Immunol. 46: 1718-1726.

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Abstract

The present invention relates to a compound comprising an antibody or a fragment thereof operable to transmigrate across the blood-brain barrier (BBB), and a polypeptide related to the treatment of lysosomal storage disease (LSD), for the treatment of α-synucleinopathies, or both. The present invention also relates to pharmaceutical compositions and methods for 5 treating LSDs, treating, α-synucleinopathies, or both.

Description

BLOOD-BRAIN BARRIER TRANSMIGRATING THERAPEUTIC COMPOUNDS AND USES THEREOF
CROSS-REFERENCE TO RELATED APPLICATIONS
This application claims priority of US provisional patent application 62/661 ,869 filed April 24, 2018, the specification of which is hereby incorporated by reference.
FIELD OF THE INVENTION
The present invention relates to enabling blood-brain barrier (BBB) transmigration of proteins or functional fragments thereof involved in lysosomal storage disease (LSD). The present invention relates to enabling blood-brain barrier (BBB) transmigration of proteins or functional fragments thereof involved in a-synucleinopathies using a BBB-transmigrating antibody or fragment thereof, and uses thereof. More specifically, the present invention describes a fusion protein comprising of IGF1 R3H5 and IDS (iduronate-2-sulfatase) or GCase (acid beta- glucosidase or glucocerebrosidase), and uses thereof.
BACKGROUND OF THE INVENTION
Lysosomal storage diseases (LSDs) are a group of approximately 50 rare inherited metabolic disorders that result from defects in lysosomal function. LSDs are usually a consequence of deficiency of a single enzyme required for the metabolism of lipids, glycoproteins and mucopolysaccharides. Individually, LSDs occur with incidences of less than 1 :100,000; however, as a group the incidence is about 1 :5,000 - 1 :10,000. Most of these disorders are autosomal recessively inherited such as Gaucher’s disease and Niemann-Pick disease, type C; however a few are X-linked recessively inherited, such as Fabry disease and Hunter syndrome (MPS II). Disease is caused by excessive accumulation of non-processed material in cells and tissues resulting in gross abnormalities in development and mental retardation when the CNS is affected.
There are no cures for lysosomal storage diseases and treatment is mostly symptomatic, although bone marrow transplantation and enzyme replacement therapy (ERT) have been tried with some success. ERT (injection of recombinantly produced active enzyme that is affected by the disease) has been successful in treating peripheral symptoms (by improving enzyme activity in peripheral tissues such as liver and heart) but is ineffective for treating central (brain) symptoms, because enzymes cannot cross the BBB after systemic injection and thus cannot reach neuronal tissues. Lysosomal enzymes are known to contribute to the pathology of certain complex neurodegenerative diseases, including Parkinson’s disease (PD), Multiple Systems Atrophy (MSA) and Dementia with Lewy Bodies (DLB). In particular there is an abundance of reports implicating glucocerebrosidase in the above mentioned synucleinopathies (Mitsui et al., 2015; Balestrino and Schapira, 2018), which arise from the accumulation of abnormal aggregates of a-synuclein (Puschmann et al., 2012). The involvement of glucocerebrosidase in synucleinopathies is supported by the observed increase in the incidence of PD and MSA in Gaucher’s patients, as well as the contribution of glucocerebrosidase to MPTP-induced parkinsonism (Yun et al., 2018) and the promotion of toxic assemblies of a-synuclein (Zunke et al., 2017).
While the characteristics of the BBB protect the brain from pathogens and toxins, they equally prevent the entry of most therapeutics. In fact, less than 5% of small molecule therapeutics and virtually none of the larger therapeutics can cross the BBB in pharmacologically relevant concentrations (i.e., sufficient to engage a central nervous system (CNS) target and elicit a pharmacologic/therapeutic response) unless they are specifically‘ferried’, that is, coupled to a transporter molecule. Due to the lack of effective‘carriers’ to transport molecules across the BBB, numerous drugs against neurodegenerative diseases have been‘shelved’ or eliminated from further development as they cannot be delivered to the brain in sufficient amounts.
Peptides, antibodies and proteins (such as enzymes) have to be‘ferried’ across the BBB using ‘carriers’ that recognize BBB receptors that undergo receptor-mediated transcytosis or other forms of vesicular transport through brain endothelial cells. Antibodies against such receptors have been developed as Trojan horses’ to deliver biologies across the BBB.
Enzyme replacement therapy with IDS (iduronate-2-sulfatase) is used to treat peripheral symptoms in mucopolysaccharidosis type II (MPS II; also known as Hunter syndrome) patients. Likewise, ERT with recombinant glucocerebrosidase is used to treat peripheral symptoms in Gaucher patients. Creating a fusion protein consisting of a Trojan horse’ antibody that crosses the BBB and a payload (such as IDS or GCase) is expected to enable ERT in the brain. An example is a fusion protein consisting of the Insulin receptor antibody (IgG) expressed in fusion with 2 molecules of IDS at its C-terminus end (developed by Armagen). This fusion protein has a MW of ~300 kDa and demonstrates side effects due to insulin receptor engagement (hypoglycemia). Furthermore, the fusion molecule is not optimized for lysosomal targeting in cells and neurons.
Therefore, there is a need for additional therapeutics for enzyme or protein replacement therapy of LSDs that mitigate the disadvantages of current therapies. There is also a need for or additional therapeutics for enzyme or protein replacement therapy of a-synucleinopathies that mitigate the disadvantages of current therapies.
SUMMARY OF THE INVENTION
According to an embodiment, there is provided a compound comprising
an antibody or a fragment thereof operable to transmigrate the blood-brain barrier (BBB), and
a polypeptide related to the treatment of lysosomal storage disease (LSD).
According to another embodiment, there is provided a compound comprising
an antibody or a fragment thereof operable to transmigrate the blood-brain barrier (BBB), and
a polypeptide related to the treatment of a-synucleinopathies.
The antibody or fragment thereof may bind TMEM30A or IGF 1 R.
The antibody or fragment thereof may comprises
a complementarity determining region (CDR) 1 sequence GFKITHYTMG (SEQ ID NO:1); CDR2 sequence RITWGGX1X2TX3YSNSVKG, where XT is D or K, X2 is N or D, sequence GSTSTAX4PLRVDY, where X4
Figure imgf000005_0001
a complementarity determining region (CDR) 1 sequence EYPSNFYA (SEQ ID NO:6); CDR2 sequence VSRDGLTT (SEQ ID NO:7); and CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8); or
a complementarity determining region (CDR) 1 sequence GRTIDNYA (SEQ ID NO:1 1); CDR2 sequence IDWGDGGX, where X is A or T (SEQ ID NO: 12), where X is A or T; and CDR3 sequence AMARQSRVNLDVARYDY (SEQ ID NO: 13).
The antibody or fragment thereof may comprise an amino acid sequence selected from the group consisting of:
• X1VQLVESGGGLVQPGGSLRLSCAASGFKITHYTMGWX2RQAPGKX3X4EX5VS
RITWGGDNTFYSNSVKGRFTISRDNSKNTX6YLQMNSLRAEDTAVYYCAAGST
STATPLRVDYWGQGTLVTVSS (SEQ ID NO:5), wherein X^D or E, X2=F or V, XB=E or G, X4=R or L, X5=F or W, and X6=L or V;
• X1VX2LX3ESGGGLVQX4GGSLRLSCX5ASEYPSNFYAMSWX6RQAPGKX7X8EX 9VXioGVSRDGLTTLYADSVKGRFTXiiSRDNXi2KNTXi3Xi4LQMNSXi5Xi6AEDT AVYYCAIVITGVWNKVDVNSRSYHYWGQGTX17VTVSS (SEQ ID NO:9), wherein Xi is E or Q; X2 is K or Q; X3 is V or E; X4 is A or P; X5 is V or A; X6 is F or V; X7 is E or G; Xg is R or L; Xg is F or W; X10 is A or S; Xu is M or I; X12 is A or S; X13 is V or L; X14 is D or Y; X15 is V or L; Xi6 is K or R; and X17 is Q or L; and
• X^LXgESGGGLVQXiGGSLRLSCAASGRTIDNYAMAWXsRQAPGKXgXzEXe VX9TIDWGDGGX10RYANSVKGRFTISRDNX11KX12TX13YLQMNXMLX15X16EDT AVYX17CAMARQSRVNLDVARYDYWGQGTX18VTVSS (SEQ ID NO:14), wherein X-i is E or Q; X2 is K or Q; X3 is V or E; X is A or P; X5 is V or S; X6 is D or G; X7 is L or R; Xs is F or W; Xg is A or S; X10 is A or T; Xu is A or S; X12 is G or N; X13 is M or L; Xi is N or R; X15 is E or R; Xi6 is P or A; Xi7 is S or Y; and X18 is Q or L;
or a sequence substantially identical thereto operable to transmigrate across the BBB.
The antibody or fragment thereof may be a single chain Fab (scFab), a single chain Fv (scFv), or a single domain antibody (sdAb).
The polypeptide related to the treatment of LSD, or for the treatment of a-synucleinopathy may be selected from the group consisting of Type I sulfatases, a glucosidase or a glucocerebrosidase.
The polypeptide related to the treatment of LSD, or for the treatment of a-synucleinopathy may be iduronate-2-sulfatase (IDS) (SEQ ID NO:24), acid-beta-glucosidase (GCase) (SEQ ID NO:68), acid-beta-glucosidase mut1 (GCase-mut1) (SEQ ID NO:26).
The antibody or fragment thereof may be linked to the polypeptide.
The antibody or fragment thereof may be linked to the polypeptide with a linker sequence.
The linker sequence in any one of SEQ ID NO: 30, 31 , 32, 33, 34, 35, 36, 37, 39, 41 , 42, 43, 44, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58. 59, 60, 61 , 62, 64, 65, or 70 may be (GGGGS)n , wherein n > 1 , or any suitable linker.
The compound may be glycosylated.
The polypeptide related to the treatment of LSD, or for the treatment of a-synucleinopathy may be glycosylated polypeptide.
The glycosylated polypeptide may be glycosylated with one or more N-glycans. The N-glycans of the glycosylated polypeptide may contain one or more mannose 6-phosphate residues.
The glycosylated polypeptide may contain monophosphorylated N-glycans, bi-phosphorylated N-glycans or a combination thereof.
The compound may further comprise human serum albumin (HSA) (SEQ ID NO:67), human serum albumin K573P (HSA(K573P)) (SEQ ID NO:28), or an albumin targeting moiety.
The albumin targeting moiety may be an antibody or a fragment thereof capable of targeting albumin.
The albumin targeting moiety may be a single domain antibody (sdAb) comprising:
• a CDR1 sequence G RTF I AY A (SEQ ID NO: 16), CDR2 sequence ITNFAGGTT (SEQ ID NO: 17), and CDR3 sequence AADRSAQTMRQVRPVLPY (SEQ ID NO:18);
• a CDR1 sequence GSTFSSSS (SEQ ID NO:20), CDR2 sequence ITSGGST (SEQ ID NO:21), and CDR3 sequence NVAGRNWVPISRYSPGPY (SEQ ID NO:22);
• an amino acid sequence
QVQLVESGGGLVQAGGSLRLSCVASGRTFIAYAMGWFRQAPGKEREFVAAITNF AGGTTYYADSVKGRFTISRDNAKTTVYLQMNSLKPEDTALYYCAADRSAQTMRQV RPVLPYWGQGTQVTVSS (SEQ ID NO:19); or
• an amino acid sequence
QVKLEESGGGLVQAGGSLKLSCAASGSTFSSSSVGWYRQAPGQQRELVAAITSG GSTNTADSVKGRFTMSRDNAKNTVYLQMRDLKPEDTAVYYCNVAGRNWVPISRY SPGPYWGQGTQVTVSS (SEQ ID NO: 23).
The compound may be any one of the following compounds:
1) a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7), CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO: 24); and human serum albumin (HSA) (SEQ ID NO:67) or human serum albumin K573P (HSA(K573P)) (SEQ ID NO:28);
2) a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7), a CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO:24), and a CDR1 sequence G RTF I AY A (SEQ ID NO:16), CDR2 sequence ITNFAGGTT (SEQ ID NO: 17), and CDR3 sequence AAD RSAQTM RQ VRPVLPY (SEQ ID NO: 18);
3) a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7); CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO:24), and a CDR1 sequence GSTFSSSS (SEQ ID NO:20), CDR2 sequence ITSGGST (SEQ ID NO:21), and CDR3 sequence NVAGRNWVPISRYSPGPY (SEQ ID NO:22);
4) IGF1 R3H5 - IDS - HSA(K573P) (SEQ ID NO:35);
5) IGF1 R3H5 - IDS - R28 (SEQ ID NO:36); and
6) IGF1 R3H5 - IDS - M79 (SEQ ID NO:37).
According to another embodiment, there is provided a composition comprising the compound of the present invention and a pharmaceutically acceptable diluent, carrier, or excipient.
According to another embodiment, there is provided a compound of the present invention or a composition of the present invention, for the treatment of LSD in the brain in a subject in need thereof.
According to another embodiment, there is provided a compound of the present invention or a composition of the present invention, for the treatment of a-synucleinopathy in the brain in a subject in need thereof.
According to another embodiment, there is provided a method of delivering a polypeptide related to LSD across the BBB, comprising administering the compound according to the present invention or a composition according to the present invention to a subject in need thereof.
According to another embodiment, there is provided a method of delivering a polypeptide related to a-synucleinopathy across the BBB, comprising administering the compound according to the present invention or a composition according to the present invention to a subject in need thereof.
The administering may be intravenous (iv), subcutaneous (sc), or intramuscular (im).
According to another embodiment, there is provided a use of the compound according to the present invention or a composition according to the present invention related to the treatment of LSD in the brain in a subject in need thereof. According to another embodiment, there is provided a use of the compound according to the present invention or a composition according to the present invention related to the treatment of a-synucleinopathy in the brain in a subject in need thereof.
The compound may be for use intravenously (iv), subcutaneously (sc), or intramuscularly (im).
The LSD may be a sphingolipidose, a mucopolysaccharidoses, a glycoproteinose, an oligosaccharidose, a glycogenose, a lipidose or a neuronal ceroid lipofuscinoses.
The a-synucleinopathy may be Parkinson Disease (PD), dementia with Lewy Bodies or Multiple System Atrophy (MSA).
According to another embodiment, there is provided a nucleic acid vector comprising a nucleotide sequence encoding a compound of the present invention.
According to another embodiment, there is provided a cell comprising the nucleic acid vector of the present invention for expressing the compound of the present invention.
According to another embodiment, there is provided a cell for expressing the compound of the present invention.
BRIEF DESCRIPTION OF THE DRAWINGS
These and other features of the invention will now be described by way of example, with reference to the appended drawings, wherein:
FIGURE 1 depicts the arrangement of some of the constructs utilized herein. “BBB VHH” indicates BBB penetrating single domain antibodies (IGF1 R3H5 or IGF1 R5H2 or FC5).“anti- Alb” indicates anti albumin single domain antibodies (R28 VHH or M79 VHH) or Alb1 or Alb8.
FIGURE 2 shows (A) a coomassie-stained SDS-PAGE of IGF1 R3H5-IDS. (B) shows an HPLC-SEC chromatogram of IGR1 R3H5-IDS. The purity of the product is typically > 90%.
FIGURE 3 shows (A) immunoblot analysis of IGF1 R3H5-IDS using anti-IDS and anti-His. (B) Samples loaded are described in the table legend below.
FIGURE 4 shows the results of an N-glycan analysis with results presented as percentage area under the peak for each N-glycan structure detected using DSA-FACE.
FIGURE 5 shows the binding kinetics of (A) uncapped and (B, C and D) capped IGF1 R3H5- IDS to human IGF1 R using surface plasmon resonance. The capped and uncapped forms give essentially identical rate constants and affinities. The observed KD values are concentration dependent, indicating a matrix effect that reduces KD values at high concentrations.
FIGURE 6 shows that the in vitro BBB permeability (PAPP) of uncapped IDS-C1 (IDS) is comparable to the non-permeable negative control protein (A20.1). In contrast, the BBB carrier IGF1 R3-VHH is highly permeable. The fusion proteins (capped and uncapped IGF1 R3H5-IDS) exhibited permeability that is comparable to that of IGF1 R3-VHH.
FIGURE 7 shows that the construct consisting of an IGF1 R5H2 carrier fused to monomeric Fc (monoFc) (Ying et al., 2012) and IDS exhibits good in vitro BBB permeability, exceeding that of the FC5-VHH.
FIGURE 8 shows that IGF1 R5H2-monoFc-IDS exhibits permeability in an in vitro human BBB model that is comparable to the rat BBB model.
FIGURE 9 shows that IGF1 R5H2 reduces trapping of IDS in brain endothelial cells. The amounts of IGF1 R5H2-monoFc-IDS were significantly lower compared to IDS-C1. Similarly, IGF1 R5-VHH was not detected in the SV-ARBEC cells.
FIGURE 10 shows IGF1 R3H5-IDS-HSA exhibits in vitro BBB permeability that is comparable to IGF1 R3H5-IDS.
FIGURE 11 shows that IGF1 R5H2 significantly increase the in vitro BBB permeability of constructs containing, IDS and anti-albumin domains in rat SV-ARBEC cells. The figure also shows the effect of domain arrangement and mouse serum on IGF1 R5H2-mediated BBB permeability. > indicates values exceeding the upper limit of quantitation were set to 250.
FIGURE 12 shows that FC5 significantly increases in vitro BBB permeability of capped or uncapped IDS in rat SV-ARBEC cells.
FIGURE 13 shows that IGF1 R3H5 and IGF1 R5H2 significantly increase the in vitro BBB permeability of IDS and IDS-HSA in rat SV-ARBEC cells.
FIGURE 14 shows that IGF1 R3H5 increases the in vitro BBB permeability of GCase in rat SV- ARBEC cells.
FIGURE 15 shows that IGFR1 R5H2-monoFc-IDS is not degraded following in vitro transcytosis in rat SV-ARBEC cells. (A) is an anti-IDS western blot showing the detection of IGF1 R5H2-monoFc-IDS (XT) and IDS-C1 (XU) in the bottom chambers of the in vitro BBB assay, and (B) is a quantitation of the western blot in panel (A). FIGURE 16 shows protein concentrations of IDS-C1 , IGF1 R3H5-IDS, IGF1 R3H5-IDS-HSA, IGF1 R3H5-IDS-R28 and IGF1 R3H5-IDS-M79 in rat serum following single bolus iv injections of equimolar doses of the test articles. (A) Levels were determined by MRM and (B) by IDS activity of I DS-C1 and IGF1 R3H5-IDS only.
FIGURE 17 shows the results of a WinNonlin analysis of in vivo serum PK data in rats for IDS- C1 , IGF1 R3H5-IDS, IGF 1 R3H5-IDS-HSA, IGF1 R3H5-IDS-R28 and IGF1 R3H5-IDS-M79.
FIGURE 18 shows protein concentrations of IDS-C1 and IGF1 R3H5-IDS-HSA in cynomolgus monkey ( Macaca fascicularis) serum following single bolus iv injections of equimolar doses of the test articles. Levels were determined by MRM.
FIGURE 19 shows protein concentrations of IDS-C1 , IGF1 R3H5-IDS, IGF1 R3H5-IDS-HSA and IGF1 R3H5-IDS-R28 in rat CSF following single bolus iv injections of equimolar doses of the test articles.
FIGURE 20 shows the results of a Prism analysis of in vivo serum and CSF PK data in rats for IDS-C1 , IGF1 R3H5-IDS, IGF 1 R3H5-IDS-HSA, IGF1 R3H5-IDS-R28, and IDS-R28. The analysis shows that IGF1 R3H5 increases brain exposure of IDS by increasing the AUC ratio. The data also demonstrates that HSA or R28 increases total brain exposure (CSF AUC) by increasing the serum half-life. The data also shows that the serum PK of IGF1 R3H5-IDS-R28 was extended relative to IDS-R28.
FIGURE 21 shows protein concentrations of IDS-C1 , IGF1 R3H5-IDS, IGF1 R3H5-IDS-HSA and IGF1 R3H5-IDS-R28 in rat whole brain homogenates following single bolus iv injections of equimolar doses of the test articles. * not detected; # not determined.
FIGURE 22 shows protein concentrations of IDS-C1 , IGF1 R3H5-IDS and IGF1 R3H5-IDS-R28 in rat brain parenchyma and vessels following single bolus iv injections of equimolar doses of the test articles. * not detected; # not determined.
FIGURE 23 shows protein concentrations of IDS-C1 , A20.1 VHH, IGF 1 R3H5-IDS-HSA and A20.1 hFc1X7 (SEQ ID NO:69) in (A) whole rat brain 1 , 4 and 24 hours and (B) rat brain parenchyma and vessels 4 hours post-treatment following single bolus iv injections of equimolar doses of the test articles. * not detected. DETAILED DESCRIPTION OF THE INVENTION
In a first embodiment, there is disclosed a compound comprising an antibody or a fragment thereof operable to transmigrate the blood-brain barrier (BBB), and a polypeptide related to the treatment of lysosomal storage disease (LSD).
In another embodiment, there is disclosed a compound comprising an antibody or a fragment thereof operable to transmigrate the blood-brain barrier (BBB), and a polypeptide related to the treatment of a-synucleinopathy.
As used herein the term“polypeptide” refers to enzymes, proteins, or functional fragments thereof, that are related to the treatment of LSD, a-synucleinopathy, or both.
The present invention provides isolated or purified fusion proteins comprising an antibody or fragment thereof and a polypeptide related to LSD, related to a-synucleinopathy, or both, wherein the antibody or fragment specifically binds to an Insulin-Like Growth Factor 1 Receptor (IGF1 R) epitope or a TMEM30A epitope, and wherein the antibody or fragment thereof is operable to transmigrate the blood-brain barrier, along with a polypeptide related to the treatment of LSD, to the treatment of a-synucleinopathy, or both.
The antibody or fragment thereof as described herein is capable of transmigration across the blood brain barrier. The brain is separated from the rest of the body by a specialized endothelial tissue known as the blood-brain barrier (BBB). The endothelial cells of the BBB are connected by tight junctions and efficiently prevent many therapeutic compounds from entering the brain. In addition to low rates of vesicular transport, one specific feature of the BBB is the existence of enzymatic barrier(s) and high level(s) of expression of ATP-dependent transporters on the abluminal (brain) side of the BBB, including P-glycoprotein (Gottesman and Pastan, 1993; Watanabe et al., 1995), which actively transport various molecules from the brain into the blood stream (Samuels et al., 1993). Only small (<500 Daltons) and hydrophobic (Pardridge, 1995) molecules can more readily cross the BBB. Thus, the ability of the antibody or fragment thereof as described above to specifically bind the surface receptor, internalize into brain endothelial cells, and undergo transcytosis across the BBB by evading lysosomal degradation is useful in the neurological field.
The term“antibody”, also referred to in the art as“immunoglobulin” (Ig), as used herein refers to a protein constructed from paired heavy and light polypeptide chains; various Ig isotypes exist, including IgA, IgD, IgE, IgG, and IgM. When an antibody is correctly folded, each chain folds into a number of distinct globular domains joined by more linear polypeptide sequences. For example, the immunoglobulin light chain folds into a variable (VL) and a constant (CL) domain, while the heavy chain folds into a variable (VH) and three constant (CH, CH2, CH3) domains. Interaction of the heavy and light chain variable domains (VH and VL) results in the formation of an antigen binding region (Fv). Each domain has a well-established structure familiar to those of skill in the art.
The light and heavy chain variable regions are responsible for binding the target antigen and can therefore show significant sequence diversity between antibodies. The constant regions show less sequence diversity, and are responsible for binding a number of natural proteins to elicit important biochemical events. The variable region of an antibody contains the antigenbinding determinants of the molecule, and thus determines the specificity of an antibody for its target antigen. The majority of sequence variability occurs in six hypervariable regions, three each per variable heavy (VH) and light (VL) chain; the hypervariable regions combine to form the antigen-binding site, and contribute to binding and recognition of an antigenic determinant. The specificity and affinity of an antibody for its antigen is determined by the structure of the hypervariable regions, as well as their size, shape, and chemistry of the surface they present to the antigen. Various schemes exist for identification of the regions of hypervariability, the two most common being those of Kabat and of Chothia and Lesk. Kabat et al. (1991) define the “complementarity-determining regions” (CDR) based on sequence variability at the antigen-binding regions of the VH and VL domains. Chothia and Lesk (1987) define the “hypervariable loops” (H or L) based on the location of the structural loop regions in the VH and Vi_ domains. These individual schemes define CDR and hypervariable loop regions that are adjacent or overlapping, those of skill in the antibody art often utilize the terms“CDR” and “hypervariable loop” interchangeably, and they may be so used herein. The CDR/loops are identified herein according to the Kabat scheme (i.e. CDR1 , 2 and 3, for each variable region).
An“antibody fragment” as referred to herein may include any suitable antigen-binding antibody fragment, or simply, antigen-binding fragment known in the art. The antibody fragment may be a naturally-occurring antibody fragment, or may be obtained by manipulation of a naturally- occurring antibody or by using recombinant methods. For example, an antibody fragment may include, but is not limited to an Fv, single-chain Fv (scFv; a molecule consisting of VL and VH connected with a peptide linker), Fab, F(ab’)2, single-domain antibody (sdAb; a fragment composed of a single VL or VH), and multivalent presentations of any of these. Antibody fragments such as those just described may require linker sequences, disulfide bonds, or other types of covalent bond to link different portions of the fragments; those of skill in the art will be familiar with the requirements of the different types of fragments and various approaches for their construction. In a non-limiting example, the antibody fragment may be an sdAb derived from naturally- occurring sources. Heavy chain antibodies of camelid origin (Hamers-Casterman et al., 1993) lack light chains and thus their antigen binding sites consist of one domain, termed VHH . sdAb have also been observed in shark and are termed VNAR (Nuttall et al., 2003). Other sdAb may be engineered based on human Ig heavy and light chain sequences (Jespers et al., 2004; To et al., 2005). As used herein, the term“sdAb” includes those sdAb directly isolated from VH, VHH, VL, or VNAR reservoir of any origin through phage display or other technologies, sdAb derived from the aforementioned sdAb, recombinantly produced sdAb, as well as those sdAb generated through further modification of such sdAb by humanization, affinity maturation, stabilization, solubilization, camelization, or other methods of antibody engineering. Also encompassed by the present invention are homologues, derivatives, or fragments that retain the antigen-binding function and specificity of the sdAb.
SdAb possess desirable properties for antibody molecules, such as high thermostability, high detergent resistance, relatively high resistance to proteases (Dumoulin et al., 2002) and high production yield (Arbabi Ghahroudi et al., 1997); they can also be engineered to have very high affinity by isolation from an immune library (Li et al., 2009) or by in vitro affinity maturation (Davies and Riechmann, 1996). Further modifications to increase stability, such as the introduction of non-canonical disulfide bonds (Hussack et al., 201 1 a, 201 1 b; Kim et al., 2012), may also be brought to the sdAb.
A person of skill in the art would be well-acquainted with the structure of a single-domain antibody (see, for example, 3DWT, 2P42 in Protein Data Bank). An sdAb comprises a single immunoglobulin domain that retains the immunoglobulin fold; most notably, only three CDR/hypervariable loops form the antigen-binding site. However, and as would be understood by those of skill in the art, not all CDR may be required for binding the antigen. For example, and without wishing to be limiting, one, two, or three of the CDR may contribute to binding and recognition of the antigen by the sdAb of the present invention. The CDR of the sdAb or variable domain are referred to herein as CDR1 , CDR2, and CDR3.
The present invention further encompasses an antibody or fragment that is "humanized" using any suitable method known in the art, for example, but not limited to CDR grafting and veneering. Humanization of an antibody or antibody fragment comprises replacing an amino acid in the sequence with its human counterpart, as found in the human consensus sequence, without loss of antigen-binding ability or specificity; this approach reduces immunogenicity of the antibody or fragment thereof when introduced into human subjects. In the process of CDR grafting, one or more than one of the CDR defined herein may be fused or grafted to a human variable region (VH, or VL), to other human antibody (IgA, IgD, IgE, IgG, and IgM), to other human antibody fragment framework regions (Fv, scFv, Fab) or to other proteins of similar size and nature onto which CDR can be grafted (Nicaise et al., 2004). In such a case, the conformation of the one or more than one hypervariable loop(s) is likely preserved, and the affinity and specificity of the sdAb for its target (i.e., IGF1 R) is likely minimally affected. CDR grafting is known in the art and is described in at least the following: US Patent No. 6180370, US Patent No. 5693761 , US Patent No. 6054297, US Patent No. 5859205, and European Patent No. 626390. Veneering, also referred to in the art as "variable region resurfacing", involves humanizing solvent-exposed positions of the antibody or fragment; thus, buried non- humanized residues, which may be important for CDR conformation, are preserved while the potential for immunological reaction against solvent-exposed regions is minimized. Veneering is known in the art and is described in at least the following: US Patent No. 5869619, US Patent No. 5766886, US Patent No. 5821 123, and European Patent No. 519596. Persons of skill in the art would also be amply familiar with methods of preparing such humanized antibody fragments and humanizing amino acid positions.
The antibody or fragment thereof of the present invention may also comprise additional sequences to aid in expression, detection or purification of a recombinant antibody or fragment thereof. Any such sequences or tags known to those of skill in the art may be used. For example, and without wishing to be limiting, the antibody or fragment thereof may comprise a targeting or signal sequence (for example, but not limited to ompA), a detection/purification tag (for example, but not limited to c-Myc, His5, or His6), or a combination thereof. In another example, the additional sequence may be a biotin recognition site such as that described by Cronan et al. in WO 95/04069 or Voges et al. in WO/2004/076670.
As is also known to those of skill in the art, linker sequences may be used in conjunction with the antibody or fragment thereof, the polypeptide related to treatment of lysosomal storage disease (LSD) or treatment of a-synucleinopathies, the additional sequences or tags, or may serve as a detection/purification tag. As used herein, the term“linker sequences” is intended to mean short peptide sequences that occur between protein domains. Linker sequences are often composed of flexible residues like glycine and serine so that the adjacent protein domains are free to move relative to one another. The linker sequence can be any linker sequence known in the art that would allow for the antibody and polypeptide of a compound, of the present invention to be operably linked for the desired function. The linker may be any sequence in the art (either a natural or synthetic linker) that allows for an operable fusion comprising an antibody or fragment linked to a polypeptide. For example, the linker sequence may be a linker sequence L such as (GGGGS)n, wherein n equal to or greater than 1 , or from about 1 to about 5, or from about 1 to 15, or n may be any number of linker that would allow for the operability of the compound of the present invention. In another example, the linker may be an amino acid sequence, for example, an amino acid sequence that comprises about 3 to about 40 amino acids, or about 5 to about 40 amino acids, or about 10 to about 40 amino acids, or about 15 to about 40 amino acids, or about 20 to about 40 amino acids, or about 25 to about 40 amino acids, or about 30 to about 40 amino acids, or about 35 to about 40 amino acids, or about 3 to about 35 amino acids, or about 5 to about 35 amino acids, or about 10 to about 35 amino acids, or about 15 to about 35 amino acids, or about 20 to about 35 amino acids, or about 25 to about 35 amino acids, or about 30 to about 35 amino acids, or about 3 to about 30 amino acids, or about 5 to about 30 amino acids, or about 10 to about 30 amino acids, or about 15 to about 30 amino acids, or about 20 to about 30 amino acids, or about 25 to about 30 amino acids, or about 3 to about 25 amino acids, or about 5 to about 25 amino acids, or about 10 to about 25 amino acids, or about 15 to about 25 amino acids, or about 20 to about 25 amino acids, or about 3 to about 20 amino acids, or about 5 to about 20 amino acids, or about 10 to about 20 amino acids, or about 15 to about 20 amino acids, or about 3 to about 15 amino acids, or about 5 to about 15 amino acids, or about 10 to about 15 amino acids, or about 15 to about 20 amino acids, or about 3 to about 10 amino acids, or about 5 to about 10 amino acids, or about 3 to about 5 amino acids, or about 3, 5, 10, 15, 20, 25, 30, 35, or 40 amino acids.
The antibody or fragment thereof of the present invention may also be in a multivalent display format, also referred to herein as multivalent presentation. Multimerization may be achieved by any suitable method known in the art. For example, and without wishing to be limiting in any manner, multimerization may be achieved using self-assembly molecules such as those described in Zhang et al. (2004a, 2004b) and W02003/046560, where pentabodies are produced by expressing a fusion protein comprising the antibody or fragment thereof of the present invention and the pentamerization domain of the B-subunit of an AB5 toxin family (Merritt and Hoi, 1995). A multimer may also be formed using the multimerization domains described by Zhu et al. (2010); this form, referred to herein as a "combody" form, is a fusion of the antibody or fragment of the present invention with a coiled-coil peptide resulting in a multimeric molecule (Zhu et al., 2010). Other forms of multivalent display are also encompassed by the present invention. For example, and without wishing to be limiting, the antibody or fragment thereof may be presented as a dimer, a trimer, or any other suitable oligomer. This may be achieved by methods known in the art, for example direct linking connection (Nielsen et al., 2000), c-jun/Fos interaction (De Kruif and Logtenberg, 1996), "Knob into holes" interaction (Ridgway et al., 1996). Another method known in the art for multimerization is to dimerize the antibody or fragment thereof using an Fc domain, for example, but not limited to human Fc domains. The Fc domains may be selected from various classes including, but not limited to, IgG, IgM, or various subclasses including, but not limited to lgG1 , lgG2, etc. In this approach, the Fc gene is inserted into a vector along with the sdAb gene to generate a sdAb-Fc fusion protein (Bell et al., 2010; Iqbal et al., 2010); the fusion protein is recombinantly expressed, then purified. For example, and without wishing to be limiting in any manner, multivalent display formats may encompass chimeric or humanized formats of antibodies and VhH of the present invention linked to an Fc domain, or bi- or tri-specific antibody fusions with two or three antibodies and VHH recognizing unique epitopes. Such antibodies are easy to engineer and to produce, can greatly extend the serum half-life of sdAb, and may be excellent tumor imaging reagents (Bell et al., 2010).
The Fc domain in the multimeric complex as just described may be any suitable Fc fragment known in the art. The Fc fragment may be from any suitable source; for example, the Fc may be of mouse or human origin. In a specific, non-limiting example, the Fc may be the mouse Fc2b fragment or human Fc1 fragment (Bell et al., 2010; Iqbal et al., 2010). The antibody or fragment thereof may be fused to the N-terminus or C-terminus of the Fc fragment.
Each subunit of the multimers described above may comprise the same or different antibodies or fragments thereof of the present invention, which may have the same or different specificity. Additionally, the multimerization domains may be linked to the antibody or antibody fragment using a linker sequence, as required. As defined above, the linker sequence can be any linker known in the art that would allow for the compound of the present invention to be prepared and be operable for the desired function. For example, such a linker sequence should be of sufficient length and appropriate composition to provide flexible attachment of the two molecules, but should not hamper the antigen-binding properties of the antibody.
For example, and without wishing to be limiting in any manner, the isolated or purified antibody or fragment thereof operable to transmigrate the BBB may be an antibody or fragment thereof which comprises:
• a complementarity determining region (CDR) 1 sequence GFKITHYTMG (SEQ ID NO:1); CDR2 sequence RITWGGX1X2TX3YSNSVKG, where XT is D or K, X2 sequence
Figure imgf000017_0001
• a complementarity determining region (CDR) 1 sequence EYPSNFYA (SEQ ID NO:6); CDR2 sequence VSRDGLTT (SEQ ID NO:7); and CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8); or
• a complementarity determining region (CDR) 1 sequence GRTIDNYA (SEQ ID NO: 1 1 ) ; CDR2 sequence IDWGDGGX (SEQ ID NO:12), where X is A or T; and CDR3 sequence AMARQSRVNLDVARYDY (SEQ ID NO:13).
According to an embodiment, the antibody or fragment thereof comprises an amino acid sequence selected from the group consisting of:
• X1VQLVESGGGLVQPGGSLRLSCAASGFKITHYTMGWX2RQAPGKX3X4EX5VS
RITWGGDNTFYSNSVKGRFTISRDNSKNTX6YLQMNSLRAEDTAVYYCAAGST
STATPLRVDYWGQGTLVTVSS (SEQ ID NO:5), wherein X^D or E, X2=F or V, XB=E or G, X4=R or L, X5=F or W, and X6=L or V;
• X1VX2LX3ESGGGLVQX4GGSLRLSCX5ASEYPSNFYAMSWX6RQAPGKX7X8EX 9VXioGVSRDGLTTLYADSVKGRFTXiiSRDNXi2KNTXi3Xi4LQMNSXi5Xi6AEDT AVYYCAIVITGVWNKVDVNSRSYHYWGQGTX17VTVSS (SEQ ID NO:9), wherein X-i is E or Q; X2 is K or Q; X3 is V or E; X4 is A or P; X5 is V or A; X6 is F or V; X7 is E or G; Xg is R or L; Xg is F or W; X10 is A or S; Xu is M or I; Xi2 is A or S; X-13 is V or L; Xi is D or Y; X15 is V or L; Xi6 is K or R; and Xi7 is Q or L; and
• X1VX2LX3ESGGGLVQX4GGSLRLSCAASGRTIDNYAMAWX5RQAPGKX6X7EX8 VX9TIDWGDGGXioRYANSVKGRFTISRDNXiiKXi2TXi3YLQMNXi4LXi5Xi6EDT AVYX17CAMARQSRVNLDVARYDYWGQGTX18VTVSS (SEQ ID NO:14), wherein X1 is E or Q; X2 is K or Q; X3 is V or E; X is A or P; X5 is V or S; X6 is D or G; X7 is L or R; Xg is F or W; Xg is A or S; X10 is A or T; Xu is A or S; Xi2 is G or N; X13 is M or L; Xi is N or R; X15 is E or R; Xi6 is P or A; Xi7 is S or Y; and Xi8 is Q or L;
or a sequence substantially identical thereto operable to transmigrate across the blood-brain barrier BBB.
A substantially identical sequence may comprise one or more conservative amino acid mutations. It is known in the art that one or more conservative amino acid mutations to a reference sequence may yield a mutant peptide with no substantial change in physiological, chemical, physico-chemical or functional properties compared to the reference sequence; in such a case, the reference and mutant sequences would be considered “substantially identical” polypeptides. A conservative amino acid substitution is defined herein as the substitution of an amino acid residue for another amino acid residue with similar chemical properties (e.g. size, charge, or polarity). These conservative amino acid mutations may be made to the framework regions of the sdAb while maintaining the CDR sequences listed above and the overall structure of the CDR of the antibody or fragment; thus the specificity and binding of the antibody are maintained.
In a non-limiting example, a conservative mutation may be an amino acid substitution. Such a conservative amino acid substitution may substitute a basic, neutral, hydrophobic, or acidic amino acid for another of the same group. By the term “basic amino acid” it is meant hydrophilic amino acids having a side chain pK value of greater than 7, which are typically positively charged at physiological pH. Basic amino acids include histidine (His or H), arginine (Arg or R), and lysine (Lys or K). By the term“neutral amino acid” (also“polar amino acid”), it is meant hydrophilic amino acids having a side chain that is uncharged at physiological pH, but which has at least one bond in which the pair of electrons shared in common by two atoms is held more closely by one of the atoms. Polar amino acids include serine (Ser or S), threonine (Thr or T), cysteine (Cys or C), tyrosine (Tyr or Y), asparagine (Asn or N), and glutamine (Gin or Q). The term“hydrophobic amino acid” (also“non-polar amino acid”) is meant to include amino acids exhibiting a hydrophobicity of greater than zero according to the normalized consensus hydrophobicity scale of Eisenberg (1984). Hydrophobic amino acids include proline (Pro or P), isoleucine (lie or I), phenylalanine (Phe or F), valine (Val or V), leucine (Leu or L), tryptophan (Trp or W), methionine (Met or M), alanine (Ala or A), and glycine (Gly or G). “Acidic amino acid” refers to hydrophilic amino acids having a side chain pK value of less than 7, which are typically negatively charged at physiological pH. Acidic amino acids include glutamate (Glu or E), and aspartate (Asp or D).
Sequence identity is used to evaluate the similarity of two sequences; it is determined by calculating the percent of residues that are the same when the two sequences are aligned for maximum correspondence between residue positions. Any known method may be used to calculate sequence identity; for example, computer software is available to calculate sequence identity. Without wishing to be limiting, sequence identity can be calculated by software such as NCBI BLAST2 service maintained by the Swiss Institute of Bioinformatics (and as found at ca.expasy.org/tools/blast/), BLAST-P, Blast-N, or FASTA-N, or any other appropriate software that is known in the art.
The substantially identical sequences of the present invention may be at least 90% identical; in another example, the substantially identical sequences may be at least 90, 91 , 92, 93, 94, 95, 96, 97, 98, 99, or 100% identical, or any percentage therebetween, at the amino acid level to sequences described herein. Importantly, the substantially identical sequences retain the activity and specificity of the reference sequence. In a non-limiting embodiment, the difference in sequence identity may be due to conservative amino acid mutation(s). In a non-limiting example, the present invention may be directed to an antibody or fragment thereof comprising a sequence at least 95%, 98%, or 99% identical to that of the antibodies described herein.
The present invention provides a compound comprising an antibody or fragment thereof that transmigrates the blood brain barrier (BBB). An antibody or fragment of the present invention may bind to, for example, transmembrane protein 30A (TMEM30A), as described in WO 2007/036021 , or to an Insulin-Like Growth Factor 1 Receptor (IGF1 R) epitope, or isoforms, variants, portions, or fragments thereof.
According to an embodiment, the compound of the present invention comprises a polypeptide related to the treatment of LSDs. According to an embodiment, the compound of the present invention comprises a polypeptide related to the treatment of a-synucleinopathies. According to another embodiment, the compound of the present invention comprises a polypeptide related to the treatment of both LSD and a-synucleinopathies. Non-limiting examples of such polypeptides include polypeptides that are operable for the treatment of, without wishing to be limiting, sphingolipidoses, mucopolysaccharidoses, glycoproteinoses/oligosaccharidoses, glycogenosis (e.g. type II), lipodoses or neuronal ceroid lipofuscinoses. In embodiments, such polypeptides may be selected from the group consisting of Type I sulfatases or a glucosidase.
According to embodiments, for example and without wishing to be limiting in any manner, the peptide related to the treatment of LSD may be iduronate-2-sulfatase (IDS):
SETQANSTTDALNVLLIIVDDLRPSLGCYGDKLVRSPNIDQLASHSLLFQNAFAQQAVC
APSRVSFLTGRRPDTTRLYDFNSYWRVHAGNFSTIPQYFKENGYVTMSVGKVFHPGI
SSNHTDDSPYSWSFPPYHPSSEKYENTKTCRGPDGELHANLLCPVDVLDVPEGTLPD
KQSTEQAIQLLEKMKTSASPFFLAVGYHKPHIPFRYPKEFQKLYPLENITLAPDPEVPD
GLPPVAYNPWMDIRQREDVQALNISVPYGPIPVDFQRKIRQSYFASVSYLDTQVGRLL
SALDDLQLANSTIIAFTSDHGWALGEHGEWAKYSNFDVATHVPLIFYVPGRTASLPEA
GEKLFPYLDPFDSASQLMEPGRQSMDLVELVSLFPTLAGLAGLQVPPRCPVPSFHVE
LCREGKNLLKHFRFRDLEEDPYLPGNPRELIAYSQYPRPSDIPQWNSDKPSLKDIKIMG
YSIRTIDYRYTVWVGFNPDEFLANFSDIHAGELYFVDSDPLQDHNMYNDSQGGDLFQL
LMP, referred to herein as IDS (SEQ ID NO: 24), or sequences substantially identical thereto. According to another embodiment, for example and without wishing to be limiting in any manner, the peptide related to the treatment of LSD, to the treatment of a-synucleinopathy, or both, may be acid-beta-glucosidase (GCase)
ARPCIPKSFGYSSWCVCNATYCDSFDPPTFPALGTFSRYESTRSGRRMELSMGPIQ
ANHTGTGLLLTLQPEQKFQKVKGFGGAMTDAAALNILALSPPAQNLLLKSYFSEEGIGY
NIIRVPMASCDFSIRTYTYADTPDDFQLLNFSLPEEDTKLKIPLIHRALQLAQRPVSLLAS
PWTSPTWLKTNGAVNGKGSLKGQPGDIYHQTWARYFVKFLDAYAEHKLQFWAVTAE
NEPSAGLLSGYPFQCLGFTPEHQRDFIARDLGPTLANSTHHNVRLLMLDDQRLLLPH
WAKWLTDPEAAKYVHGIAVHWYLDFLAPAA/ATLGETHRLFPNTMLFASEACVGSKF
WEQSVRLGSWDRGMQYSHSIITNLLYHWGWTDWNLALNPEGGPNWVRNFVDSPII
VDITKDTFYKQPMFYHLGHFSKFIPEGSQRVGLVASQKNDLDAVALMHPDGSAWWL
NRSSKDVPLTIKDPAVGFLETISPGYSIHTYLWRRQ, referred to herein as GCaseMutl
(SEQ ID NO: 26), or sequences substantially identical thereto.
GCasemutl differs from wild-type human GCase in that it lacks the first 39 amino acids (signal peptide) and has 2 amino acid substitutions.
The compounds of the present invention and/or the polypeptide related to the treatment of LSD, to the treatment of a-synucleinopathy, or both may be hyperglycosylated and hyperphosphorylated to increase cellular uptake into neurons and its lysosomal localization. Therefore, according to another embodiment, the compound of the present invention, and particularly the polypeptide related to the treatment of LSD, to the treatment of a- synucleinopathy, or both may be a glycosylated polypeptide. In embodiments, the glycosylated polypeptide may be glycosylated with one or more N-glycans. According to another embodiment, the glycosylated polypeptide may further be a phosphorylated polypeptide, and for example, the phosphorylation may be a mannose-6-phosphate. In embodiments, the mannose-6-phosphate may be attached to an N-glycan. Also, for example the glycosylated and phosphorylated polypeptide may contain monophosphorylated or bisphosphorylated N- glycans, or a combination thereof.
To generate the glycosylated or glycosylated and phosphorylated compounds and/or the polypeptide related to the treatment of LSD, to the treatment of a-synucleinopathy, or both, of the present invention, the compounds may be expressed in yeast expression systems that synthesize high levels of phosphorylated N-glycans, such as those described in WO201 1061629, and the strain Yarrowia lipolytica strain OXYY5632 mentioned below. According to another embodiment, the compounds of the present invention may also comprise elements to improve the half-life of the compounds in serum. According to an embodiment, for example and without wishing to be limiting in any manner, the compounds of the present invention may further comprise human serum albumin (HSA).
DAHKSEVAHRFKDLGEENFKALVLIAFAQYLQQCPFEDHVKLVNEVTEFAKTCVADES
AENCDKSLHTLFGDKLCTVATLRETYGEMADCCAKQEPERNECFLQHKDDNPNLPRL
VRPEVDVMCTAFHDNEETFLKKYLYEIARRHPYFYAPELLFFAKRYKAAFTECCQAAD
KAACLLPKLDELRDEGKASSAKQRLKCASLQKFGERAFKAWAVARLSQRFPKAEFAE
VSKLVTDLTKVHTECCHGDLLECADDRADLAKYICENQDSISSKLKECCEKPLLEKSHC
IAEVENDEMPADLPSLAADFVESKDVCKNYAEAKDVFLGMFLYEYARRHPDYSWLLL
RLAKTYETTLEKCCAAADPHECYAKVFDEFKPLVEEPQNLIKQNCELFEQLGEYKFQN
ALLVRYTKKVPQVSTPTLVEVSRNLGKVGSKCCKHPEAKRMPCAEDYLSWLNQLCV
LHEKTPVSDRVTKCCTESLVNRRPCFSALEVDETYVPKEFNAETFTFHADICTLSEKER
QIKKQTALVELVKHKPKATKEQLKAVMDDFAAFVEKCCKADDKETCFAEEGPKLVAAS
QAALGL, referred to herein as HSA(K573P) (SEQ ID NO:28).
HSA(K573P) differs from mature wild-type human HSA in that it has the K573P substitution.
According to another embodiment, the elements to improve the half-life of the compounds in serum may be an albumin targeting moiety. As used herein, the term “albumin targeting moiety” is intended to mean any compound that can bind to serum albumin and particularly to human serum albumin. For example, the albumin targeting moiety may be an anti-albumin or anti-HSA antibody or a fragment thereof.
According to an embodiment, for example and without wishing to be limiting in any manner, the albumin targeting moiety may be
• a CDR1 sequence G RTF I AY A (SEQ ID NO: 16); a CDR2 sequence ITNFAGGTT (SEQ ID NO: 17); and a CDR3 sequence AADRSAQTMRQVRPVLPY (SEQ ID NO:18);
• a CDR1 sequence GSTFSSSS (SEQ ID NO:20); a CDR2 sequence ITSGGST (SEQ ID NO:21); and a CDR3 sequence NVAGRNWVPISRYSPGPY (SEQ ID NO:22); or
• an amino acid sequence
QVQLVESGGGLVQAGGSLRLSCVASGRTFIAYAMGWFRQAPGKEREFVAAITNF AGGTTYYADSVKGRFTISRDNAKTTVYLQMNSLKPEDTALYYCAADRSAQTMRQV RPVLPYWGQGTQVTVSS (SEQ ID NO:19); or • an amino acid sequence
QVKLEESGGGLVQAGGSLKLSCAASGSTFSSSSVGWYRQAPGQQRELVAAITSG GSTNTADSVKGRFTMSRDNAKNTVYLQMRDLKPEDTAVYYCNVAGRNWVPISRY SPGPYWGQGTQVTVSS (SEQ ID NO:23).
According to another embodiment, for example and without wishing to be limiting in any manner, the compounds of the present invention may comprise
1) a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7), CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO: 24), and human serum albumin (HSA) (SEQ ID NO:67);
2) a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7), a CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO:24), and an albumin targeting moiety comprising CDR1 sequence GRTFIAYA (SEQ ID NO: 16), CDR2 sequence ITNFAGGTT (SEQ ID NO: 17), and CDR3 sequence AADRSAQTMRQVRPVLPY (SEQ ID NO:18);
3) a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7); CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO:24), and an albumin targeting moiety comprising CDR1 sequence GSTFSSSS (SEQ ID NO:20), CDR2 sequence ITSGGST (SEQ ID NO:21), and CDR3 sequence NVAGRNWVPISRYSPGPY (SEQ ID NO:22);
4) IGF1 R3H5 - IDS - HSA(K573P) (SEQ ID NO: 35);
5) IGF1 R3H5 - IDS - R28 (SEQ ID NO: 36); and
6) IGF1 R3H5 - IDS - M79 (SEQ ID NO: 37).
The present invention also encompasses a composition comprising one or more than one of the compound as described herein. The composition may comprise a single compound as described above, or may be a mixture of compounds. Furthermore, in a composition comprising a mixture of compounds of the present invention, the compound may have the same specificity, or may differ in their specificities; for example, and without wishing to be limiting in any manner, the composition may comprise antibodies or fragments thereof specific to IGF1 R (same or different epitope). The composition may also comprise a pharmaceutically acceptable diluent, excipient, or carrier. The diluent, excipient, or carrier may be any suitable diluent, excipient, or carrier known in the art, and must be compatible with other ingredients in the composition, with the method of delivery of the composition, and is not deleterious to the recipient of the composition. The composition may be in any suitable form; for example, the composition may be provided in suspension form, powder form (for example, but not limited to lyophilized or encapsulated), capsule or tablet form. For example, and without wishing to be limiting, when the composition is provided in suspension form, the carrier may comprise water, saline, a suitable buffer, or additives to improve solubility and/or stability; reconstitution to produce the suspension is effected in a buffer at a suitable pH to ensure the viability of the compound of the present invention. Dry powders may also include additives to improve stability and/or carriers to increase bulk/volume; for example, and without wishing to be limiting, the dry powder composition may comprise sucrose or trehalose. In a specific, non-limiting example, the composition may be so formulated as to deliver the compound of the present invention to the gastrointestinal tract of the subject. Thus, the composition may comprise encapsulation, time-release, or other suitable technologies for delivery of the compound of the present invention. It would be within the competency of a person of skill in the art to prepare suitable compositions comprising the present compounds.
The present invention further provides a method of transporting a molecule of interest across the blood-brain barrier. Such methods also encompass methods of treating a lysosomal storage disease (LSD), treating a-synucleinopathy, or both across the blood-brain barrier, comprising administering the compound according to the present invention or a composition according to the present invention to a subject in need thereof. This also includes use of the compound or of a composition of the present invention related to the treatment of LSD, treating a-synucleinopathy, or both in the brain in a subject in need thereof
The method comprises administering the compounds as described herein to a subject; the antibody part or fragment thereof transmigrates the blood-brain barrier. The molecule may be any desired molecule, including the cargo molecules as previously described, related to the treatment of LSD, the treatment of a-synucleinopathy, or both; the molecule may be“linked” to the antibody or fragment thereof using any suitable method, including, but not limited to conjugation or expression in a fusion protein. The administration may be by any suitable method, for example parenteral administration, including but not limited to intravenous (iv), subcutaneous (sc), and intramuscular (im) administration. In this method, the antibody or fragment thereof of the present invention“ferries” the molecule of interest across the BBB to its brain target. The invention also encompasses a method of quantifying an amount of a cargo molecule delivered across the BBB of a subject, wherein the cargo molecule is linked to one or more than one isolated or purified antibody or fragment thereof as described herein, the method comprising a) collecting cerebrospinal fluid (CSF) from the subject; and b) using targeted proteomics methods to quantify the amount of the cargo molecule linked to one or more than one antibody or fragment thereof in the CSF.
The cargo molecule may be any desired molecule, including the cargo molecules, as previously described; the isolated compound of the present invention transmigrates the blood- brain barrier; and the molecule may be“linked” to the antibody or fragment thereof using any suitable method, including, but not limited to conjugation or expression in a fusion protein, as previously described. In the above method, the CSF is collected from a subject using any suitable method known in the art. The amount of CSF required for the targeted proteomics method in step b) may be between about 1 to 10 pL; for example, the amount of CSF required may be about 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0, 9.5, or 10 pL, or any amount there between, or any range defined by the amount just described. The compound of the present invention may have been administered to the subject prior to collection of the CSF. A suitable delay between administration and delivery of the antibody or fragment linked to the cargo molecule across the BBB may be required. The delay may be at least 30 minutes following administration of the antibody or fragment linked to the cargo molecule; for example and without wishing to be limiting in any manner, the delay may be at least 30 minutes, 1 hour, 1.5 hour, 2 hours, 2.5 hours, 3 hours, 3.5 hours, 4 hours, 4.5 hours, or 5 hours. The targeted proteomics methods used to quantify the amount of the one or more than one antibody or fragment thereof linked to the cargo molecule may be any suitable method known in the art. For example and without wishing to be limiting, the targeted proteomics method may be a mass spectrometry method, such as but not limited to multiple reaction monitoring using an isotopically labeled internal standard (MRM-ILIS; see for example (Haqqani et al., 2013)). MRM is advantageous in that it allows for rapid, sensitive, and specific quantification of unlabeled targeted analytes (for example, a compound as described herein) in a biological sample. The multiplexing capability of the assay may allow for quantification of both the antibody or fragment thereof and the cargo molecule.
The invention also encompasses nucleic acid vectors comprising a nucleotide sequence encoding a compound of the present invention, as well as cells comprising the nucleic acid vector, for expressing the compound of the present invention, and cells for expressing the compound of the present invention.
The present invention will be further illustrated in the following examples. However, it is to be understood that these examples are for illustrative purposes only and should not be used to limit the scope of the present invention in any manner.
EXAMPLE 1
Production. Purification and Characterization of recombinant IGF1 R3H5-IDS
A recombinant fusion protein comprising an IGF1 R3H5 sdAb domain, an IDS domain and C- terminal affinity purification tags (shown in Figure 1 ; see also amino acids SEQ ID NO:30) was prepared. The fusion protein comprised a 17 amino acid N-terminal signal peptide, the 127 amino acid IGF1 R3H5 sdAb domain (SEQ ID NO:43), a 25 amino acid linker sequence, the 525 amino acid mature human IDS sequence (SEQ ID NO:24) and a 16 amino acid HIS-strep tag sequence. The protein is produced in a 10 L fermentation of the IGF1 R3H5-IDS expressing Yarrowia lipolytica strain OXYY5632. Yarrowia lipolytica strain OXYY5632 co-expresses IGF1 R3H5-IDS and Bos Taurus formylglycine generating enzyme (FGE) to produce catalytically active IDS. Furthermore, the strain is glycol-engineered to obtain glycoproteins with high levels of phosphorylated N-glycans. The fermentation and subsequent harvest step were performed, after which the clarified medium containing the target protein IGF1 R3H5-IDS was subjected to different chromatography steps to yield the pure product. The purification protocol consisted of a Ni-IMAC capturing step to remove most of the contaminants, followed by an enzymatic treatment with Jack Bean a-mannosidase (JBMan) at pH 4.5 to uncap the shielded Man-6-P and further trim terminal a-linked mannose residues from the protein-linked N-glycans. A second Ni-IMAC step was included for JBMan removal. The final samples were formulated by diafiltration in 20 mM sodium phosphate + 137 mM NaCI, pH 6.2. The same production and purification method is applied for all other compounds or other recombinant proteins referred to within the following examples. Only in the case of the IGF1 R3H5-IDS- HSA(K573P) fusion construct, an extra polishing step needed to be developed to reach the same level of purity as for the other variants.
Purity analysis.
SDS-PAGE analysis. A sample of purified IGF1 R3H5-IDS compound was prepared with reducing agent, heat-denatured at 95°C and loaded at a concentration of 1 pg and 2 pg on a NuPAGE Novex 4-12% Bis-Tris gel (1.5 mm thick, 15-well), run with MOPS-SDS running buffer. Following electrophoresis, the gel was stained for 1 hour in InstantBlue staining solution and de-stained with water until background decolorization. The gel was scanned using scanning software (Odyssey) (Figure 2A). IGF1 R3H5-IDS corresponds to a ~90 kDa band, when taking the presence of N-glycans into account. The obtained band pattern was consistent with the expectations.
HPLC-SEC analysis. A size exclusion chromatography method was used to measure aggregates and degradation products of IDS fusion proteins. All chromatograms of uncapped IGF1 R3H5-IDS demonstrate a broad, asymmetric main peak due to the presence of a prominent species eluting earlier than the main apex and forming a shoulder, which is believed to be an N-glycan variant. The apex of the species eluting before the main peak is even more discernible in (Figure 2B), which represents an HPLC-SEC purity analysis of two consecutive injections of undiluted IGF1 R3H5-IDS.
Western blot analysis. Samples of purified uncapped IGF1 R3H5-IDS (here referred as P454 and P453) were prepared with a reducing agent, heat-denatured at 95°C and loaded at 100 and 500 ng on a NuPAGE Novex 4-12% Bis-Tris Gel (1.5-mm thick, 10-well), and run with MOPS-SDS running buffer. After electrophoresis, an overnight transfer with transfer buffer on a nitrocellulose membrane (~16 h; constant current 50 mA) was performed. Immunodetection of IDS consisted of a 2 h-incubation with rabbit anti-elaprase polyclonal antibody (in-house batch 0X010) and a subsequent 30 min-incubation with goat anti-rabbit IgG, IRdye (680 nm) conjugated antibody (Sigma). Immunodetection of the His-tag was performed in a similar manner, but with THE™ His Tag mouse monoclonal antibody (Genscript) and goat anti-mouse IgG, IRdye (800 nm) conjugated antibody. The membrane was then scanned using the Odyssey software. Immunodetection with anti-IDS antibody (Figure 3A, left panel) shows a main band at ~90 kDa, corresponding to the full-length IGF1 R3H5-IDS construct. Immunodetection with anti-His antibody (Figure 3A, right panel) reveals a main band at ~90 kDa, confirming the integrity of the C-terminal end of IGF1 R3H5-IDS. In addition to this band, an aggregate at ~200 kDa and the protein band at ~75 kDa (2 bands) can also be seen in lane 2 and 4, corresponding to the highest loaded concentration of the construct. The extra bands in lane 4 at 75, 100, 150 and 250 kDa are due to overflow of the marker to the adjacent lane.
N-qlvcan analysis. To evaluate the uncapping process and to analyze the N-glycan profile of uncapped IGF1 R3H5-IDS, the N-glycans are released with PNGaseF, labeled with APTS and subsequently analyzed via capillary electrophoresis. From the obtained profile, the surface area of peaks representing relevant N-glycan structures was calculated to determine the peak ratios and thus the corresponding N-glycan distribution (Figure 4). The N-glycan distribution of the uncapped IGF1 R3H5-IDS gives a 48%/52% ratio of bi- and monophosphorylated N- glycans (Figure 4: 2 bottom rows). The calculation, not taking the neutral N-glycans into account, allows us to conclude that no bi-phosphorylated N-glycans are lost (e.g. if a contaminating phosphatase or endoglycosidase activity would be present) during the uncapping and downstream purification process. During the JBMan treatment these structures are trimmed down to smaller mannose structures which are harder to detect with this electrophoresis method. Therefore, neutral N-glycans are only calculated for a capped sample.
SPR analysis. Surface Plasmon Resonance (SPR) analysis was performed to determine the affinity of the IGF1 R3H5-IDS construct towards human IGF1 R (hIGRI R). The SPR analysis was performed on a Biacore T200 (GE Healthcare) under the following conditions. hIGFI R was immobilized on a CM4 chip at high density (FC1 - ethanoloamine blocked; FC3 - 2,500 RUs of hIGFI R). A variable concentration of the flowing molecule was used, with contact and dissociations times of 300 and 400 s, respectively. The assay was performed at 25°C with a flow rate of 40 pL/min and the chip was regenerated in 10 mM glycine (pH 5.5). Figures 5A and 5B show that the uncapped and capped versions of IGF1 R3H5-IDS (20 nM) exhibit rate constants and affinities that are essentially identical. Strong binding to immobilized h-IGF1 R (on the CM4 chip) was observed for both capped and uncapped IGF1 R3H5-IDS constructs. Figure 5C shows that 2.5 nM IGF 1 R3H5-IDS exhibits binding characteristics that are similar to the parental VHH: at these low concentrations (2.5 nM), IGF1 R3H5-IDS gave a KD of approximately 7 nM and on- and off-rates similar to the parental VHH IGF1 R3H5 [ka = 3.34E+05 (1/Ms), kd = 2.51 E-03 (1/s), KD = 7.50E-09 (M)]. However, at 50 nM (Figure 5D), matrix effects (build-up of charge) reduced the on-rate of IGF1 R3H5-IDS, consequently resulting in inaccurate affinity values ( KD of ~70 nM). In summary, the IGF1 R3H5-IDS construct retains its ability to bind to the target receptor IGF1 R.
EXAMPLE 2
In vitro BBB transcvtosis of IGF1 R3H5-IDS and similar test compounds
In vitro BBB transcvtosis in rat brain endothelial cells. SV-ARBECs were seeded at 80,000 cells/membrane on rat-tail collagen-coated 0.83 cm2 Falcon cell inserts, 1 pm pore size, in 1 mL SV-ARBEC feeding medium without phenol red. The model characterization is described in detail in Garberg et al. (2005). For cell growth and maintenance prior to the assays, the wells of a 12-well tissue culture plate (i.e., bottom chamber) contained 2 mL of 50:50 (v/v) mixtures of SV-ARBEC medium without phenol red and rat astrocyte-conditioned medium. The model was used when Pe[sucrose] was between 0.4 and 0.6 (x10-3) cm/min. Transport experiments were performed exactly as described in Haqqani et al. (2013) by adding a mixture of the test compounds in equimolar concentrations to the top chamber and by collecting 100 pL aliquots (with subsequent replacement with 100 mI_ of transport buffer) from the bottom chamber at 90 min for simultaneous quantification of all test compounds using the multiplexed selected reaction monitoring (SRM) method. The samples are diluted in transport buffer (TB; 5 mM MgCI2, 10 mM HEPES in Hanks’ balanced salt solution (HBSS), pH 7.4) and added (1 :1) to the top chamber containing SV-ARBEC media with 5% fetal bovine serum (FBS). For assays where samples were assessed by SRM, the bottom chamber contains TB. For assays where the samples were assessed for IDS activity, the bottom chamber contains sulfate-free transport buffer (SFTB; 5 mM MgCI2, 10 mM HEPES in sulfate-free HBSS, pH 7.4). The apparent permeability coefficient Papp was calculated as described previously (Artursson and Karlsson, 1991).
In vitro BBB transcvtosis in human brain endothelial cells. A human BBB model was created using brain endothelial cells derived from amniotic fluid induced pluripotent stem cells (AF- iPSC-BEC). Except for the origin of the cell line, this model is essentially the same as the SV- ARVBEC model. Details pertaining to the production of AF-iPSC-BEC are found in CA2970173, to Ribecco-Lutkiewicz et al. (2018).
nanoLC/MS/MS. Pure VHH or VHH-Fc fusion proteins, in vitro BBB transport or body fluid samples containing these proteins, were reduced, alkylated, and trypsin digested using previously described protocol (Haqqani et al., 2008a, 2013). For isotopically labeled internal standard (ILIS)-based quantification, isotopically heavy versions of the peptides that contained heavy C-terminal K (+8 Da) were synthesized from a commercial source (New England Peptide LLC, Gardner, MA, USA) (Lin et al., 2013). Each protein was first analyzed by nanoLC-MS/MS [nanoAcquity UPLC (Waters, Milford, MA, USA) coupled to LTQ XL ETD MS (ThermoFisher, Waltham, MA, USA)] using data-dependent acquisition to identify all ionizable peptides, and the 3-5 most intense fragment ions were chosen. An initial SRM assay was developed to monitor these fragments at attomole amounts of the digest. Fragments that showed reproducible intensity ratios at low amounts (~100- 300 amol; Pearson r2 >0.95) were considered stable and were chosen for the final SRM assay.
Figure 6 shows that permeability (PAPP) of uncapped IDS-C1 (which comprises a C-terminal
HIS-Strep tag) was not different from the negative control (A20.1 - a VHH that targets a bacterial toxin protein and is used here as a negative control for BBB crossing), whereas the permeability of the IGF1 R3H5-IDS constructs was comparable to the positive control IGF1 R3-
VHH and far exceeded that of uncapped IDS-C1 and A20.1. The BBB transcytosing positive controls (IGF1 R3-VHH) exhibited permeability consistent with historical values (IGF1 R5-VHH,
~200; IGF1 R3-VHH, ~250). Figure 6 also shows no difference in the permeability of the capped and uncapped fusion proteins. Lastly, the permeability of these fusion proteins (~ 150) was sufficient to justify evaluation in an in vivo transport assay. In another demonstration, IGF1 R5H2-monoFc-IDS (SEQ ID NO:65) enhanced the in vitro transcytosis of IDS across the rat BBB (Figure 7): IGF1 R5H2-monoFc-IDS was shown to exhibit a marked increase in permeability relative to the negative control (A20.1) and comparable to the VHH alone. Furthermore, this construct was capable of effecting transcytosis in a human BBB model, thereby confirming its cross- reactivity between rat and human endothelial cells (Figure 8). Further analysis of the rat brain endothelial cells used in the assay depicted in Figure 7 indicated that the uncapped IDS-C1 was taken up by the endothelial cells, but did not undergo transcytosis (Figure 9). Furthermore, endothelial cell retention of the IGF1 R5H2-monoFc-IDS construct was consistent with the positive control FC5-VHH. In another demonstration, permeability of FC5-IDS and IGF1 R3H5-IDS-HSA(K573P) were compared to that of IGF1 R3H5-IDS (Figure 10). The figure shows that permeability of VHH alone (FC5 or IGF1 R3) is markedly increased relative to the negative control (A20.1) and IDS-C1. Additionally, permeability of IDS was enhanced by fusion with FC5 or IGF1 R3H5. Lastly, permeability of a fusion protein containing human serum albumin (IGFR13H5-IDS-HSA(K573P)) was virtually identical to the construct lacking HSA. Figure 1 1 confirmed that IGF1 R5H2 bearing constructs exhibit elevated BBB permeability, with IGF1 R5H2-IDS-2 exhibiting permeability that is comparable to IGF1 R5H2 VHH and hFc1X7-IGF1 R5H2 (SEQ ID:70). Furthermore, constructs containing ALB1 or HSA(K573P) were equally permeable. The effect of domain (IGF1 R5H2, ALB1 , IDS) arrangement was also assessed. While interpretation of the data is limited by the presence of values that exceeded the upper limit of quantitation, it is apparent that alterations in domain arrangement did not produce marked reductions in permeability. However, the presence of mouse serum albumin (MSA; 5 mM) in the upper chamber did reduce the permeability of the IGF1 R5H2-ALB1-IDS construct. This indicates that binding of MSA by the anti-albumin domain (ALB1) reduced its availability for IGF1 R-mediated transcytosis, an effect that would be expected to be observed in vivo. Figure 12 summarizes the permeability of the FC5-containing constructs relative to the non-transcytosing negative control (A20.1) and IDS- C1. The figure shows that the permeability of uncapped IDS-C1 was greater than A20.1 , but significantly lower than the transcytosing VHH FC5 and the FC5-IDS fusions. Figure 13 summarizes the permeability of the constructs containing IGF1 R-binding VHHs relative to the non-transcytosing negative control (A20.1) and IDS-C1. The figure shows that the permeability of IDS constructs containing IGF1 R-binding VHHs was consistently and significantly greater than uncapped IDS-C1. Figure 14 shows that the relative permeability of IGF1 R3H5-GCase (SEQ ID NO:32) was significantly greater than GCase.
Western blot analysis of in vitro BBB transcytosis in rat brain endothelial cells. An assessment of transcytosis was attempted by evaluating protein levels using western blotting (anti-IDS) of SDS-PAGE gels. Prior to SDS-PAGE, the samples from bottom chamber (500 pL) were concentrated using Amicon Ultra spin columns (10 K cut-off). Immunoreactivity was quantified using FluorChem E analysis (Figure 15). Analysis of the blot indicated that transport of IGF1 R5H2-monoFc-IDS was significantly greater than IDS-C1 (Figure 15), although the protein amount varies among replicates. Additionally, no evidence for degradation or protein cleavage of the samples was observed in either the bottom or top (not shown) chambers.
EXAMPLE 3
In vivo PK/PD analysis of IGF1 R3H5-IDS and similar test compounds in rats and nonhuman primates
Biodistribution: CSF and brain collection. All animals were purchased from Charles River Laboratories International, Inc. (Wilmington, MA, USA). Animals were housed in groups of three in a 12 h light-dark cycle at a temperature of 24°C, a relative humidity of 50 ± 5%, and were allowed free access to food and water. All animal procedures were approved by the NRC’s Animal Care Committee and were in compliance with the Canadian Council of Animal Care guidelines. Male Wistar rats aged 8-10 weeks (weight range, 230-250 g) were used for sample collection. CSF and brain were collected to assess the biodistribution of the test sample. The animals were provided analgesia (sustained release buprenorphine, 1.2 mg/kg) before the first CSF collection. Rats were anaesthetized with 3% isoflurane and placed in a stereotaxic frame with the head rotated downward at a 45° angle. A midline incision was made beginning at the occipital crest and extending caudally about 2 cm on the back of the neck. The superficial neck muscles and underlying layers of muscle covering the cisterna magna were separated along the midline by blunt dissection. The neck muscles were retracted in order to expose the dura mater. A 27G butterfly needle with tubing attached to 1 mL syringe was inserted with the bevel of the needle faced up and the angle of insertion was parallel with the dura membrane. One hand was used to gently retract the syringe plunger and aspirate the CSF (~ 15-20 pL) while the other hand firmly held the needle in its original position. The CSF sample was ejected into a glass sample vial and the vial was immediately placed on dry ice; the frozen sample was subsequently transferred to a -80°C freezer until further analysis. The wound was then closed and a blood sample was collected from the tail vein, according to Fluttert et al. (2000). The rat was then returned to its home cage and housed in the recovery room until the next CSF collection. For subsequent CSF and blood collections, the rat was anaesthetized and the sutures removed. The muscles covering the cisterna magna were gently separated and the dura mater exposed. CSF sampling was then performed as described above. Approximately 15-20 pL of CSF can be collected at each time point. For the terminal CSF collection, approximately 50-100 pL of CSF can be collected and blood is collected by heart puncture. Finally, euthanasia is performed by cervical dislocation under deep isoflurane anesthesia.
Brain homogenization and processing. Prior to MRM analysis the entire right hemisphere was weighed while frozen and the middle third was extracted and weighed (typically ~0.16 g). The remaining tissue was stored at -80°C. The brain tissue was then homogenized in 1.0 mL ice- cold homogenization buffer (50 mM Tris-HCI, pH 8, 150 mM NaCI, 1.0% sodium deoxycholate (Sigma), and 1X protease inhibitor cocktail (Sigma)) using a Wheaton Dounce homogenizer (10-12 strokes with a Glas-Col drill (model# 099C K54) at 60% speed, at 4°C) until pieces of tissue are no longer detectable. Samples were sonicated (Fisher, Model 300 Sonic Dismembrator) on ice with three 10 s bursts at 30%, and insoluble material was removed by centrifugation (20,000 g for 10 min at 4°C). The supernatants were then transferred to new tubes on ice. Protein concentrations were then determined using the Bradford method with a standard curve based on bovine serum albumin (BSA Quick Start Standard; BioRad). A 5.0 pi- aliquot of the brain extract was diluted 1 :5 in 25 mM ammonium bicarbonate (ABC; Sigma), and a volume corresponding to 20 pg was transferred to a new tube. The 20 pg aliquot was made up to 12.5 pL with 25 mM ABC and 12.5 pL of 10% sodium deoxycholate (DOC; Sigma) was added to give a concentration of 5% DOC. The samples were then vortexed and briefly centrifuged prior to the addition of 2.5 pL freshly prepared 10X DL-dithiothreitol (DTT; Sigma) to provide a concentration of 5 mM DTT. The samples were vortexed and centrifuged briefly and then incubated at 95°C for 10 minutes. The samples were then cooled, and briefly centrifuged prior to the addition of 2.75 pL 10X iodoacetamide (Sigma) for a concentration of 10 mM. The samples were vortexed and centrifuged prior to incubation at room temp for 30 minutes in the dark. The samples were then diluted to 125.0 pL with 25 mM ABC. A 2.0 pL (1.0 pg) aliquot of trypsin (Promega) was then added to each sample, which were then mixed gently and briefly centrifuged prior to incubation in a Multitherm Incubator/Chiller unit (model H5000) at 37°C for 12 hours and at 4°C thereafter. The samples were then stored at -80°C until MRM analysis was conducted. Prior to MRM analysis, the DOC was precipitated by adding 15 pL AAF buffer (54% acetic acid, 150 mM ammonium acetate, 10% formic acid) to a 1 15 pL aliquot of the digested sample. The samples were then centrifuged at 50,400 x g for 10 min at 4°C, and 60 pL of the supernatant was transferred to a fresh vial. MRM analysis was performed using 20 pL of the supernatant.
In selected animals, brain homogenates of the left hemisphere were subjected to a vessel depletion protocol to obtain brain parenchyma and brain vessel fractions. The tissues were homogenized as above and sequential filtration through 100 pm and 20 pm nylon Nitex mesh filters (pluriSelect, Leipzig, Germany) was performed to obtain the brain fractions. Concentrations of test substances were determined in the vessel-depleted parenchymal fractions and the vessel fractions using SRM as above.
Serum and CSF pharmacokinetics. At several post-injection timepoints, blood was collected, and serum was prepared to determine serum half-life. Blood samples were taken from the lateral tail vein at 5, 10, 15 and 30 min and 1 , 2, 4, 6, 8, and 24 h post administration. Samples were centrifuged (15 min at 15,000 rpm; room temperature) and serum was stored at -80°C until analysis. Serum half-life was determined by plotting serum concentration (in mM) versus time and performing non-linear curve fitting using the one-phase and two-phase decay models. In both models, the plateau value was set to zero and the best fit (one-phase vs. two-phase) was determined by performing an F test on the sum of squares. Area under the curve (AUC) data was also calculated for serum using GraphPad Prism.
nanoLC/MS/MS. The protein levels of the test samples in ex vivo samples (serum, cerebrospinal fluid (CSF), and brain) were quantified using targeted nanoflow liquid chromatography tandem mass spectrometry (nanoLC MS/MS). Pure VHH or fusion proteins and body fluid samples containing these proteins are reduced, alkylated, and trypsin digested (Haqqani et al., 2008b, 2013). Typically, for isotopically labeled internal standard (ILIS)-based quantification, isotopically heavy versions of a peptide that contains heavy C-terminal K (+8 Da) is synthesized from a commercial source (New England Peptide LLC, Gardner, MA, USA). However, since no ILIS for the protein-of-interest are available, ILIS for an alternative protein (e.g., FC5 or hFc) is included as an indicator of sample-cleanup variability. Each protein is first analyzed by nanoLC-MS/MS [nanoAcquity UPLC (Waters, Milford, MA, USA) coupled to LTQ XL ETD MS (ThermoFisher, Waltham, MA, USA)] using data-dependent acquisition to identify all ionizable peptides, and the 3-5 of the most intense fragment ions are chosen. An initial selected reaction monitoring (SRM) assay is developed to monitor these fragments at attomole amounts of the digest. Fragments showing reproducible intensity ratios at low amounts (~100- 300 amol; Pearson r2>0.95) are considered stable and are chosen for the final SRM assay. Blood contamination of CSF samples is evaluated by in-reaction monitoring of rat albumin levels using a nanoLC-SRM method. Measurement of CSF protein concentration is used as a rapid quantitative and nonspecific method for identifying serum contaminated samples. Typical protein concentration of CSF is 0.2-0.4 mg/mL in rat. Protein concentrations >0.4 mg/mL are considered to be likely contaminated with blood. The albumin blood-CSF ratio is determined by multiple SRM analysis of CSF and the corresponding serum sample. Ratios less than 1500- fold are considered contaminated with blood and are excluded from further analyses.
Figure 16A shows protein concentrations of IDS-C1 , IGF1 R3H5-IDS, IGF1 R3H5-IDS-
HSA(K573P), IGF 1 R3H5-IDS-R28 and IGF1 R3H5-IDS-M79 in rat serum following single bolus iv injections of equimolar doses of the test articles. The data indicate that both IDS-C1 and IGF1 R3H5-IDS are rapidly cleared from the serum with kinetics (Alpha_hl and Beta_hl) that are appreciably different (Figure 17). In comparison to IDS-C1 , the serum PK of IGF1 R3H5- IDS was unexpectedly extended, resulting in an 80% increase in the serum area under the curve (AUC). Analysis of serum IDS concentration based on IDS enzymatic activity confirmed that IDS-C1 and IGF1 R3H5-IDS are quickly cleared from the serum (Figure 16B). In comparison, the serum PK data shown in Figure 17 indicate that the IGF1 R3H5-IDS- HSA(K573P) construct had a greatly reduced serum clearance (CL) rate (0.0705 mL/min/kg) compared to IGF1 R3H5-IDS (0.516 mL/min/kg) and IDS-C1 (0.924 mL/min/kg). The PK analysis indicated that the test sample (IGF1 R3H5-IDS-HSA) exhibited a much longer serum half-life (ati/2 = 27.6 min, bίi/2 = 36.8 hr; Figures 16 and 17) than what was previously observed for IGF1 R3H5-IDS and IDS-C1. Correspondingly, the elimination of IGF1 R3H5-IDS- HSA(K573P) was ~ 8- to 14-fold (according to serum AUC values) slower than the constructs lacking HSA (Figure 17). Similarly, the constructs containing albumin binding VHH domains (IGF1 R3H5-IDS-M79 and IGF1 R3H5-IDS-R28) exhibited reduced serum clearance and increased serum ti/2 values. Unexpectedly, the serum clearance of IGF1 R3H5-IDS-M79 and IGF1 R3H5-IDS-R28 were less than that observed for IGF1 R3H5-IDS-HSA(K573P). As a result, the serum aL/2 values of IGF1 R3H5-IDS-M79 and IGF1 R3H5-IDS-R28 were 1.51- and 1.61 -fold longer than for IGF1 R3H5-IDS-HSA(K573P). Importantly, the anti-albumin containing constructs exhibited serum PK values that were consistent with the HSA containing construct. Thus, serum half-life extension was realized using two distinct strategies.
Figure 18 shows protein concentrations of IDS-C1 and IGF1 R3H5-IDS-HSA(K573P) in cynomolgus monkey ( Macaca fascicularis) serum following single bolus iv injections of equimolar doses of the test articles. Levels were determined by MRM. The data confirms that IDS-C1 is rapidly cleared from serum (ti/2 = 32 min) in non-human primates. Additionally, a significant, 4-fold increase in serum ti/2 is observed for the IGF1 R3H5-IDS-HSA(K573P) construct (ti/2 = 131 min).
Figure 19 compares protein concentrations of IDS-C1 , IGF1 R3H5-IDS, IGF1 R3H5-IDS- HSA(K573P) and IGF1 R3H5-IDS-R28 in rat CSF following single bolus iv injections of equimolar doses of the test articles. It can be seen that the peak CSF concentrations of IGF1 R3H5-IDS, IGF1 R3H5-IDS-HSA(K573P) and IGF1 R3H5-IDS-R28 are very similar, which is likely the result of the similar dosing levels employed. This is in stark contrast to the minimal amounts of IDS-C1 that were detected in the CSF, thus confirming the capability of the IGF1 R3H5 VHH to enable in vivo BBB transcytosis of IDS. Analysis of CSF levels of IGF1 R3H5-IDS-HSA(K573P) and IGF1 R3H5-IDS-R28 indicates that maximum peak levels were observed 4 hr post-administration, with detectable levels present 24 post-administration (Figure 19). In comparison, peak CSF levels of IGF1 R3H5-IDS were observed at 30-60 min post-administration and were virtually absent by 8 hr post-administration. In comparison to IGF1 R3H5-IDS, IGF1 R3H5-IDS-HSA(K573P) levels in CSF at 8 hr post-administration were comparable to the peak observed levels (Figure 19). Importantly, the IGF1 R3H5-IDS- HSA(K573P) and IGF1 R3H5-IDS-R28 constructs exhibited distinctly prolonged CSF PK profiles, resulting in 42.4- and 52.4-fold increases, respectively, in the observed AUC compared to IDS-C1 (Figure 20). Calculation of the AUC ratio (CSF / serum) indicated that the IGR1 R3H5 containing constructs exhibited a similar degree of BBB transcytosis, with all constructs being improved by a factor of ~ 3 - 5 compared to IDS-C1. Furthermore, these data emphasize the dramatic effect of serum half-life prolongation on increasing brain delivery. Analysis of the IDS-R28 construct indicated that it exhibited an increased serum PK relative to IGF1 R3H5-IDS and IDS-C1 , with 2.6- and 5.3-fold increases in serum AUC, respectively. Surprisingly, the serum AUC of IGF1 R3H5-IDS-R28 was 3.1 -fold greater than IDS-R28. Considering the unexpected serum PK extension observed with the inclusion of IGF1 R3H5 (Figure 17, Figure 20), it appears that IGF1 R3H5 and R28 act through an unpredicted mechanism to synergistically extend the serum PK of IDS-C1 .
Whole brain levels of IDS-C1 (1 , 4 & 8 hours), IGF1 R3H5-IDS (1 , 4, 8 & 24 hours), IGF1 R3H5- IDS-HSA(K573P) (4 & 24 hours) and IGF1 R3H5-IDS-R28 (4 & 24 hours only) were quantified and Figure 21 shows the test sample levels in rat brain over a 24-hour period. Brain levels of IGF1 R3H5-IDS were substantially greater than IDS-C1 at 1 and 4 hours, with IDS-C1 not detected at 8 hours. In comparison, detectable levels of IGF1 R3H5-IDS-HSA(K573P) and IGF1 R3H5-IDS-R28 were observed in the brain at 4 and 24 hours, indicating an increase in brain delivery that is commensurate with the observed CSF levels. This indicates that overall brain exposure was enhanced by the inclusion of HSA or R28. Figure 22 shows an analysis of IDS-C1 , IGF1 R3H5-IDS and IGF1 R3H5-IDS-R28 in brain parenchyma and brain vessels. Figure 21 shows that IDS-C1 was detected in whole brain at 1 and 4 hours post-administration. However, IDS-C1 was below the detection limits in brain parenchyma and vessel samples from the same animals (Figure 22). In contrast, IGF1 R3H5-IDS was detected in whole brain (Figure 21) and brain parenchyma at 1 and 4 hours. Furthermore, IGF1 R3H5-IDS was not detected in the vessel fractions. In comparison, IGF1 R3H5-IDS-R28 was detected in whole brain (Figure 21) as well as in brain parenchyma and vessels (Figure 22). Importantly, the IGF1 R3H5-IDS and IGF1 R3H5-IDS-R28 levels in brain parenchyma were much greater than in brain vessels. This indicates that retention of IGF1 R3H5-IDS and IGF1 R3H5-IDS-R28 in the vessel component is likely to be limited and that delivery to the parenchyma is achieved. An additional experiment was conducted using higher doses of the test articles. Figure 23 shows protein concentrations of IDS-C1 and IGF1 R3H5-IDS-HSA(K573P) in rat brain parenchyma and vessels following single bolus iv injections of equimolar doses of the test articles. Figure 23A confirms that IDS-C1 is detectable in whole brain at 1 and 4 hours, but not at 24 hours. The figure also demonstrates IGF1 R3H5-IDS-HSA(K573P) levels were much greater than IDS-C1 and the non-BBB crossing controls (A20.1 VHH and A20.1 hFc1X7). Figure 23B demonstrates that IDS-C1 and A20.1 hFc1X7 are not detectable in brain parenchyma at 4 hours, while IDS- C1 is present at low levels in brain vessels at 4 hours. In stark contrast, the majority of IGF1 R3H5-IDS-HSA was found in the brain parenchyma and was not observed to be trapped in brain vessels. Furthermore, the low level of brain vessel“trapping” in the in vivo studies is consistent with observations in the in vitro BBB models (Figure 9).
The embodiments and examples described herein are illustrative and are not meant to limit the scope of the invention as claimed. Variations of the foregoing embodiments, including alternatives, modifications and equivalents, are intended by the inventors to be encompassed by the claims. Furthermore, the discussed combination of features might not be necessary for the inventive solution.
SEQUENCES
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Claims

CLAIMS:
1. A compound comprising
an antibody or a fragment thereof operable to transmigrate the blood-brain barrier (BBB), and
a polypeptide related to the treatment of lysosomal storage disease (LSD).
2. A compound comprising
an antibody or a fragment thereof operable to transmigrate the blood-brain barrier (BBB), and
a polypeptide related to the treatment of a-synucleinopathies.
3. The compound of claim 1 or 2, wherein the antibody or fragment thereof binds TMEM30A or IGF1 R.
4. The compound of any one of claims 1 to 3, wherein the antibody or fragment thereof comprises
a complementarity determining region (CDR) 1 sequence GFKITHYTMG (SEQ ID NO:1); CDR2 sequence RITWGGX1X2TX3YSNSVKG, where XT is D or K, X2 is N or D, sequence GSTSTAX4PLRVDY, where X4
Figure imgf000056_0001
a complementarity determining region (CDR) 1 sequence EYPSNFYA (SEQ ID NO:6); CDR2 sequence VSRDGLTT (SEQ ID NO:7); and CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8); or
a complementarity determining region (CDR) 1 sequence GRTIDNYA (SEQ ID NO:1 1); CDR2 sequence IDWGDGGX, where X is A or T (SEQ ID NO: 12), where X is A or T; and CDR3 sequence AMARQSRVNLDVARYDY (SEQ ID NO: 13).
5. The compound of any one of claims 1 to 4, wherein the antibody or fragment thereof comprises an amino acid sequence selected from the group consisting of:
• X1VQLVESGGGLVQPGGSLRLSCAASGFKITHYTMGWX2RQAPGKX3X4EX5VS
RITWGGDNTFYSNSVKGRFTISRDNSKNTX6YLQMNSLRAEDTAVYYCAAGST
STATPLRVDYWGQGTLVTVSS (SEQ ID NO:5), wherein X^D or E, X2=F or V, XB=E or G, X4=R or L, X5=F or W, and X6=L or V;
• X1VX2LX3ESGGGLVQX4GGSLRLSCX5ASEYPSNFYAMSWX6RQAPGKX7X8EX 9VXioGVSRDGLTTLYADSVKGRFTXiiSRDNXi2KNTXi3Xi4LQMNSXi5Xi6AEDT AVYYCAIVITGVWNKVDVNSRSYHYWGQGTX17VTVSS (SEQ ID NO:9), wherein Xi is E or Q; X2 is K or Q; X3 is V or E; X4 is A or P; X5 is V or A; X6 is F or V; X7 is E or G; Xg is R or L; Xg is F or W; X10 is A or S; Xu is M or I; X12 is A or S; X13 is V or L; X14 is D or Y; X15 is V or L; Xi6 is K or R; and X17 is Q or L; and
• X^LXgESGGGLVQXiGGSLRLSCAASGRTIDNYAMAWXsRQAPGKXgXzEXe VX9TIDWGDGGX10RYANSVKGRFTISRDNX11KX12TX13YLQMNXMLX15X16EDT AVYX17CAMARQSRVNLDVARYDYWGQGTX18VTVSS (SEQ ID NO:14), wherein X-i is E or Q; X2 is K or Q; X3 is V or E; X is A or P; X5 is V or S; X6 is D or G; X7 is L or R; Xs is F or W; Xg is A or S; X10 is A or T; Xu is A or S; X12 is G or N; X13 is M or L; Xi is N or R; X15 is E or R; Xi6 is P or A; Xi7 is S or Y; and X18 is Q or L;
or a sequence substantially identical thereto operable to transmigrate across the BBB.
6. The compound of any one of claims 1 to 5, wherein the antibody or fragment thereof is a single chain Fab (scFab), a single chain Fv (scFv), or a single domain antibody (sdAb).
7. The compound of any one of claims 1 to 6, wherein the polypeptide related to the treatment of LSD of claim 1 , or for the treatment of a-synucleinopathy of claim 2 is selected from the group consisting of Type I sulfatases, a glucosidase or a glucocerebrosidase.
8. The compound of any one of claims 1 to 7, wherein the polypeptide related to the treatment of LSD of claim 1 , or for the treatment of a-synucleinopathy of claim 2 is iduronate-2- sulfatase (IDS) (SEQ ID NO:24), acid-beta-glucosidase (GCase) (SEQ ID NO:68), acid-beta- glucosidase mut1 (GCase-mut1) (SEQ ID NO:26).
9. The compound of any one of claims 1 to 8, wherein the antibody or fragment thereof is linked to the polypeptide.
10. The compound of claim 9, wherein said antibody or fragment thereof is linked to the polypeptide with a linker sequence.
1 1. The compound of claim 10, wherein said linker sequence in any one of SEQ ID NO: 30, 31 , 32, 33, 34, 35, 36, 37, 39, 41 , 42, 43, 44, 47, 48, 49, 50, 52, 53, 54, 55, 56, 57, 58. 59, 60, 61 , 62, 64, 65, or 70 8.
12. The compound of any one of claims 1 to 11 , wherein said compound is glycosylated.
13. The compound of any one of claims 1 to 12, wherein the polypeptide related to the treatment of LSD of claim 1 , or for the treatment of a-synucleinopathy of claim 2 is a glycosylated polypeptide.
14. The compound of claim 13, wherein said glycosylated polypeptide is glycosylated with one or more N-glycans.
15. The compound of any one of claims 13 to 14, wherein said N-glycans of said glycosylated polypeptide contain one or more mannose 6-phosphate residues.
16. The compound of claim 14 to 15, wherein said glycosylated polypeptide contains monophosphorylated N-glycans, bi-phosphorylated N-glycans or a combination thereof.
17. The compound of any one of claims 1 to 16, further comprising human serum albumin (HSA) (SEQ ID NO:67), human serum albumin K573P (HSA(K573P)) (SEQ ID NO:28), or an albumin targeting moiety.
18. The compound of claim 17, wherein said albumin targeting moiety is an antibody or a fragment thereof capable of targeting albumin.
19. The compound of claim 17, wherein said albumin targeting moiety is a single domain antibody (sdAb) comprising:
• a CDR1 sequence G RTF I AY A (SEQ ID NO: 16), CDR2 sequence ITNFAGGTT (SEQ ID NO: 17), and CDR3 sequence AADRSAQTMRQVRPVLPY (SEQ ID NO:18);
• a CDR1 sequence GSTFSSSS (SEQ ID NO:20), CDR2 sequence ITSGGST (SEQ ID NO:21), and CDR3 sequence NVAGRNWVPISRYSPGPY (SEQ ID NO:22);
• an amino acid sequence
QVQLVESGGGLVQAGGSLRLSCVASGRTFIAYAMGWFRQAPGKEREFVAAITNF AGGTTYYADSVKGRFTISRDNAKTTVYLQMNSLKPEDTALYYCAADRSAQTMRQV RPVLPYWGQGTQVTVSS (SEQ ID NO:19); or
• an amino acid sequence
QVKLEESGGGLVQAGGSLKLSCAASGSTFSSSSVGWYRQAPGQQRELVAAITSG GSTNTADSVKGRFTMSRDNAKNTVYLQMRDLKPEDTAVYYCNVAGRNWVPISRY SPGPYWGQGTQVTVSS (SEQ ID NO: 23).
20. The compound of any one of claim 18 to 19, wherein said compound is any one of the following compounds:
7) a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7), CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO: 24); and human serum albumin (HSA) (SEQ ID NO:67) or human serum albumin K573P (HSA(K573P)) (SEQ ID NO:28);
8) a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7), a CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO:24), and a CDR1 sequence G RTF I AY A (SEQ ID NO:16), CDR2 sequence ITNFAGGTT (SEQ ID NO: 17), and CDR3 sequence AAD RSAQTM RQ VRPVLPY (SEQ ID NO: 18);
9) a compound comprising an antibody or fragment thereof having CDR 1 sequence EYPSNFYA (SEQ ID NO:6), CDR2 sequence VSRDGLTT (SEQ ID NO:7); CDR3 sequence AIVITGVWNKVDVNSRSYHY (SEQ ID NO:8), IDS (SEQ ID NO:24), and a CDR1 sequence GSTFSSSS (SEQ ID NO:20), CDR2 sequence ITSGGST (SEQ ID NO:21), and CDR3 sequence NVAGRNWVPISRYSPGPY (SEQ ID NO:22);
10) IGF1 R3H5 - IDS - HSA(K573P) (SEQ ID NO:35);
1 1) IGF1 R3H5 - IDS - R28 (SEQ ID NO:36); and
12) IGF1 R3H5 - IDS - M79 (SEQ ID NO:37).
21. A composition comprising the compound of any one of claims 1 to 20 and a pharmaceutically acceptable diluent, carrier, or excipient.
22. A compound of any one of claims 1 to 19 or a composition of claim 20, for the treatment of LSD in the brain in a subject in need thereof.
23. A compound of any one of claims 1 to 19, or a composition of claim 20, for the treatment of a-synucleinopathy in the brain in a subject in need thereof.
24. A method of delivering a polypeptide related to LSD across the BBB, comprising administering the compound according to any one of claims 1 to 20 or a composition according to claim 21 to a subject in need thereof.
25. A method of delivering a polypeptide related to a-synucleinopathy across the BBB, comprising administering the compound according to any one of claims 1 to 20 or a composition according to claim 21 to a subject in need thereof.
26. The method of any one of claims 23 to 24, wherein said administering is intravenous (iv), subcutaneous (sc), or intramuscular (im).
27. Use of the compound of any one of claims 1 to 20 or a composition of claim 21 related to the treatment of LSD in the brain in a subject in need thereof.
28. Use of the compound of any one of claims 1 to 20 or a composition of claim 21 related to the treatment of a-synucleinopathy in the brain in a subject in need thereof.
29. The use of any one of claims 27 to 28, wherein said compound is for use intravenously (iv), subcutaneously (sc), or intramuscularly (im).
30. The compound of claim 22, the method of claim 24 or 26, and the use of claim 27 or 29, wherein said LSD is a sphingolipidose, a mucopolysaccharidoses, a glycoproteinose, an oligosaccharidose, a glycogenose, a lipidose or a neuronal ceroid lipofuscinoses.
31. The compound of claim 23, the method of claim 25 or 26, and the use of claim 28 or 29, wherein said a-synucleinopathy is Parkinson Disease (PD), dementia with Lewy Bodies or Multiple System Atrophy (MSA).
32. A nucleic acid vector comprising a nucleotide sequence encoding a compound of any one of claims 1 to 19.
33. A cell comprising the nucleic acid vector of claim 29 for expressing the compound of any one of claims 1 to 20.
34. A cell for expressing the compound of any one of claims 1 to 20.
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