Classifications

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  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K39/02—Bacterial antigens
  • A61K39/095—Neisseria
• • 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
  • A61K47/62—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 a protein, peptide or polyamino acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/702—Oligosaccharides, i.e. having three to five saccharide radicals attached to each other by glycosidic linkages
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
  • A61K31/739—Lipopolysaccharides
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61K39/385—Haptens or antigens, bound to carriers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • 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
  • A61K47/62—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 a protein, peptide or polyamino acid
  • A61K47/64—Drug-peptide, drug-protein or drug-polyamino acid conjugates, i.e. the modifying agent being a peptide, protein or polyamino acid which is covalently bonded or complexed to a therapeutically active agent
  • A61K47/6415—Toxins or lectins, e.g. clostridial toxins or Pseudomonas exotoxins
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
  • A61P31/04—Antibacterial agents
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07H—SUGARS; DERIVATIVES THEREOF; NUCLEOSIDES; NUCLEOTIDES; NUCLEIC ACIDS
  • C07H15/00—Compounds containing hydrocarbon or substituted hydrocarbon radicals directly attached to hetero atoms of saccharide radicals
  • C07H15/02—Acyclic radicals, not substituted by cyclic structures
  • C07H15/04—Acyclic radicals, not substituted by cyclic structures attached to an oxygen atom of the saccharide radical
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
  • C07K16/12—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from bacteria
  • C07K16/1203—Gram-negative bacteria
  • C07K16/1217—Neisseriaceae (F)
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K19/00—Hybrid peptides, i.e. peptides covalently bound to nucleic acids, or non-covalently bound protein-protein complexes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
  • A61K2039/55505—Inorganic adjuvants
• • 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
  • A61K2039/57—Medicinal preparations containing antigens or antibodies characterised by the type of response, e.g. Th1, Th2
  • A61K2039/575—Medicinal preparations containing antigens or antibodies characterised by the type of response, e.g. Th1, Th2 humoral response
• • 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
  • A61K2039/60—Medicinal preparations containing antigens or antibodies characteristics by the carrier linked to the antigen
  • A61K2039/6031—Proteins
  • A61K2039/6037—Bacterial toxins, e.g. diphteria toxoid [DT], tetanus toxoid [TT]
• • 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
  • A61K2039/60—Medicinal preparations containing antigens or antibodies characteristics by the carrier linked to the antigen
  • A61K2039/6031—Proteins
  • A61K2039/6081—Albumin; Keyhole limpet haemocyanin [KLH]
• • 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
  • A61K2039/62—Medicinal preparations containing antigens or antibodies characterised by the link between antigen and carrier
  • A61K2039/627—Medicinal preparations containing antigens or antibodies characterised by the link between antigen and carrier characterised by the linker
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K2300/00—Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
• • 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
  • C07K2317/34—Identification of a linear epitope shorter than 20 amino acid residues or of a conformational epitope defined by amino acid residues
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/70—Immunoglobulins specific features characterized by effect upon binding to a cell or to an antigen
  • C07K2317/73—Inducing cell death, e.g. apoptosis, necrosis or inhibition of cell proliferation
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/70—Immunoglobulins specific features characterized by effect upon binding to a cell or to an antigen
  • C07K2317/73—Inducing cell death, e.g. apoptosis, necrosis or inhibition of cell proliferation
  • C07K2317/734—Complement-dependent cytotoxicity [CDC]
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2319/00—Fusion polypeptide
  • C07K2319/55—Fusion polypeptide containing a fusion with a toxin, e.g. diphteria toxin

Definitions

• This disclosure relates generally to Neisseria surface moieties. More particularly, the present disclosure relates to oligosaccharides corresponding to Neisseria lipooligosaccharides and to chimeric molecules comprising these moieties for eliciting an immune response to Neisseria organisms and/or for treating or inhibiting the development of Neisseria infections.
• Neisseria gonorrhoeae is a host adapted bacterial pathogen that causes the sexually transmitted disease gonorrhea.
• Gonococcal infections can be symptomatic or asymptomatic, with up to 80% of infections in females being asymptomatic.
• Untreated gonorrhea in females can lead to pelvic inflammatory disease, adverse pregnancy outcomes, neonatal complications, or infertility. Moreover, it can increase the risk of acquiring and transmitting HIV. It is estimated that there are more than 106 million cases of gonorrhea worldwide each year and the emergence of multidrug resistant (MDR) strains of N. gonorrhoeae is a major public health problem.
• MDR multidrug resistant
• Lipooligosaccharide is one of the major structural components of the outer membrane and is a key virulence factor of N. gonorrhoeae. It plays a number of key roles in the pathogenesis of N. gonorrhoeae, including mediating direct interaction between N. gonorrhoeae and human urethral epithelial cells (Harvey et a/. 2000, Mol Microbiol. 36:1059-70 and Song et a/. 2000, J Exp Med 191:949-60).
• N. gonorrhoeae binds to complement component C3 which is required for activation of complement receptor 3 in primary cervical epithelial cells (Edwards et al. 2002, Cell Microbiol 4:585-98).
• Bacteria such as N. gonorrhoeae, can mimic host structures to avoid detection. An aspect of this mimicry is the expression of sialic acid, a sugar structure found in humans, on the bacterial surface.
• the LOS structure of N. gonorrhoeae can be terminated with a N-acetylneuraminic acid (Neu5Ac), which has multiple roles in gonococcal virulence (Apicella et al. 1989, Pediatr Infect Dis J.
• Lst sialyltransferase that transfers Neu5Ac from CMP-Neu5Ac to the terminal galactose of LOS as shown in Figure 1 (Gilbert et a/. 1996 , J Biol Chem 271:28271-6).
• the Lst sialyltransferase expressed by the pathogenic Neisseria species is homologous to the LsgB sialyltransferase of non- typeable Haemophilus influenzae (NTHi).
• KDO keto-deoxyoctulosonate
• CMP-KDP cytidine-monophosphate KDO
• a KDO-based vaccine will elicit an immune response that is distinct to that elicited during natural infections and that the antibodies targeting this bacterial KDO epitope will mediate bactericidal and opsonophagocytic killing, thus providing immune protection against Neisseria infections.
• a chimeric molecule comprising, consisting or consisting essentially of a carrier and an oligosaccharide comprising an oligosaccharide sequence corresponding to a Neisseria lipooligosaccharide (LOS) (e.g., a N. gonorrhoeae or N. meningitidis LOS), wherein the oligosaccharide sequence comprises keto- deoxyoctulosonate (KDO) as a terminal saccharide unit.
• LOS Neisseria lipooligosaccharide
• KDO keto- deoxyoctulosonate
• the oligosaccharide sequence suitably comprises the KDO attached to galactose (Gal), typically wherein the Gal is further attached to N- acetylg!ucosamine (GicNAc).
• the KDO is attached to Gal via an a(2®3) linkage and/or the Gal is attached to GicNAc via a b(1®4) linkage.
• the oligosaccharide sequence comprises KDOa(2®3)Gal, or KDOa(2®3)Galp(l®4)GlcNAc.
• the oligosaccharide comprises n occurrences of the oligosaccharide sequence, wherein n is 1 to 4. In representative examples of this type, n is 2.
• respective oligosaccharide sequences are connected to one another by a linker.
• the carrier is typically connected to the oligosaccharide by a linker.
• the carrier is a protein, a peptide, a lipid, a polymer, a dendrimer, a virosome, a virus-like particle (VLP), an outer membrane vesicle or a combination thereof.
• VLP virus-like particle
• the carrier is a protein carrier, which can be for example a bacterial toxoid, a toxin, an exotoxin, and a nontoxic derivative thereof, such as keyhole limpet hemocyanine (KLH), hepatitis B virus core protein, thyroglobulin, albumins (such as bovine serum albumin (BSA), human serum albumin (HSA), and ovalbumin), pneumococcal surface protein A (PspA), pneumococcal adhesin protein (PsaA), purified protein derivative of tuberculin (PPD); transferrin binding proteins, polyamino acids, such as poly(lysine:glutamic acid), tetanus toxoid, tetanus toxin Fragment C, diphtheria toxoid, CRM (a nontoxic diphtheria toxin mutant), cholera toxoid, Staphylococcus aureus exotoxins or toxoids
• compositions comprising, consisting or consisting essentially of a chimeric molecule as broadly described above and elsewhere herein, and a pharmaceutically acceptable vehicle or adjuvant.
• the composition may optionally comprise one or more ancillary agents for treating or inhibiting the development of a Neisseria infection.
• the ancillary agents may be selected from antimicrobial agents and immunogens (e.g., proteinaceous immunogens derived from Neisseria antigens such as AniA, MsrAB, MetQ, NhbA, etc.) for eliciting an immune response to a Neisseria organism.
• a method of eliciting an immune response to a Neisseria organism in a subject comprising, consisting or consisting essentially of immunizing the subject with a chimeric molecule or composition as broadly described above and elsewhere herein, to thereby elicit an immune response to the Neisseria organism in the subject.
• the Neisseria organism is N. gonorrhoeae or N. meningitidis.
• the Neisseria organism is resistant to at least one antibacterial drug.
• Still another aspect of the present disclosure relates to a method of producing an antigen-binding molecule that binds specifically with a Neisseria organism, the method comprising: (1) immunizing an animal with a chimeric molecule or composition as broadly described above and elsewhere herein; (2) detecting a B cell from the animal, which binds specifically with the chimeric molecule (particularly its oligosaccharide component) or the LOS of the Neisseria organism; and (3) isolating the antigen-binding molecule expressed by that B cell.
• Also disclosed herein in another aspect is a method of producing an antigen binding molecule that binds specifically with a Neisseria organism, the method comprising: (1) screening a library of antigen-binding molecules with a chimeric molecule or composition as broadly described above and elsewhere herein; (2) detecting an antigen-binding molecule that binds specifically with the chimeric molecule (particularly its oligosaccharide component) or the LOS of the Neisseria organism; and (3) isolating the detected antigen-binding molecule.
• the present disclosure relates to an antigen-binding molecule produced by the methods broadly described above and elsewhere herein, or a derivative antigen-binding molecule with the same epitope-binding specificity as the antigen-binding molecule.
• the derivative antigen-binding molecule is selected from antibody fragments (such as Fab, Fab', F(ab' , Fv), single chain (scFv) and domain antibodies (including, for example, shark and camelid antibodies), and fusion proteins comprising an antibody, and any other modified configuration of the immunoglobulin molecule that comprises an antigen binding/recognition site.
• the present disclosure relates to a cell (e.g ., a hybridoma or cell line) that produces the antigen-binding molecule as broadly described above and elsewhere herein.
• Also disclosed herein is a method for treating or inhibiting the development of a Neisseria infection in a subject, the method comprising administering to the subject an effective amount of a chimeric molecule, composition or antigen-binding molecule as broadly described above and elsewhere herein.
• the chimeric molecule or antigen-binding molecule is administered concurrently with an ancillary agent (e.g., an antimicrobial agent and/or immunogen).
• Disclosed herein in yet another aspect is a method for detecting the presence of a Neisseria organism in a subject, the method comprising contacting a biological sample taken from the subject with an antigen-binding molecule that binds specifically with a Neisseria organism as broadly described above and elsewhere herein and detecting the presence of a complex comprising the Neisseria organism or part thereof (e.g., LOS) to thereby detect the presence of the Neisseria organism in the subject.
• an antigen-binding molecule that binds specifically with a Neisseria organism as broadly described above and elsewhere herein and detecting the presence of a complex comprising the Neisseria organism or part thereof (e.g., LOS) to thereby detect the presence of the Neisseria organism in the subject.
• kits for treating or inhibiting the development of a Neisseria infection in a subject comprising: a chimeric molecule, composition, or antigen-binding molecule as broadly described above and elsewhere herein, and optionally instructional material for performing the treatment or inhibition.
• kits for detecting the presence of a Neisseria organism in a subject, the kit comprising: an antigen-binding molecule as broadly described above and elsewhere herein, and optionally instructional material for performing the detection.
• FIG. 1 is an illustration depicting the structure of the KDO-containing LOS of N. gonorrhoeae strain 1291.
• MAb 6E4 only recognizes the terminal KDO glycan.
• Lst is the sialyltransferase which can also incorporate KDO onto the terminal Gal, in the absence of Neu5Ac.
• LgtB is the galactosyltransferase that transfers the KDO acceptor galactose (Gal) to N- acetylglucosamine (GlcNAc). Without Lst, Gal is the terminal sugar of LOS in N. gonorrhoeae.
• Figure 2 is a graphical and photographical representation showing whole-cell ELISA of 6E4.
• A ELISA of whole-cell N. gonorrhoeae WT and 1st mutant strains using 6E4 MAb.
• FIG. 3 is a photographic representation depicting a confocal microscopy study of cervical swab from a patient with a documented N. gonorrhoeae infection stained with both anti- KDO MAb 6E4 (Texas red) and anti-LOS MAb 6B4 (FITC).
• PMNs polymorphonuclear leukocytes
• gonococci stained with both antibodies separately (red or green) and with antibodies colocalized to the same organisms (yellow). This study indicates that KDO termination occurs in vivo as well as in vitro.
• FIG. 4 is a graphical representation showing the functional activity of Mab 6E4 against N. gonorrhoeae.
• the survival of the N. gonorrhoeae in the presence of 0-10 pg/mL Mab 6E4, primary human PMNs and 10% normal human serum as a complement source is shown.
• Data represent the average survival ( ⁇ 1 standard deviation) for triplicate samples, shown as a percentage of bacteria in the absence of antibody (the 0 pg/mL Mab 6E4 set at 100%, represents 5.07xl0 3 CFU).
• Statistically significant differences relative to the untreated wild type, using a two-tailed Student's t test are indicated: * P ⁇ 0.05; ** P ⁇ 0.01;
• FIG. 5 is a schematic representation showing chemical synthesis of KDO- spacer.
• a protected form of KDO synthesized using published chemistry, is converted into the glycosyl fluoride derivative which is then reacted with the spacer unit using standard Lewis Acid catalyzed glycosidation chemistry. All protecting groups that have been installed to facilitate the chemical synthesis are then removed to give the final compound ready for conjugation.
• FIG. 6 is an illustration and photographic representation depicting (A) Coupling of NH2-linked KDO to CRM197. (B) After conjugation, CRM197 (Coomassie, lane 2) shifts to a higher apparent molecular weight (Coomassie, lane 1) and becomes KDO positive (Western blot with 6E4, lane 1) relative to unconjugated CRM197.
• FIG. 7 is a schematic representation showing chemical synthesis of KDOa(2,3)Gal-spacer.
• a protected form of KDO synthesized using published chemistry, is converted into the glycosyl fluoride derivative.
• Commercially available galactose is converted into the Gal-spacer derivative using standard carbohydrate chemistry manipulations.
• the KDO fluoride and the Gal-spacer unit are combined together using standard Lewis Acid catalyzed glycosidation chemistry. All protecting groups that have been installed to facilitate the chemical synthesis are then removed using standard methods to give the final compound ready for conjugation.
• FIG. 8 is a schematic representation showing chemical synthesis of KDOa(2,3)Gal8(l,4)GlcNAc-spacer.
• a protected form of KDO synthesized using published chemistry, is converted into the glycosyl fluoride derivative.
• Commercially available lactulose is converted into the Gal-GIcNAc-spacer derivative using standard carbohydrate chemistry manipulations.
• the KDO fluoride and the Gal-GIcNAc-spacer unit are combined together using standard Lewis Acid catalyzed glycosidation chemistry. All protecting groups that have been installed to facilitate the chemical synthesis are then removed using standard methods to give the final compound ready for conjugation.
• Figure 9 is a schematic representation showing a chemoenzymic approach to synthesize KDO (A) di- and (B) tri-saccharide antigens.
• KdsB and Lst in green are enzymes involved in synthesis.
• FIG 10 is a schematic and graphical representation showing (A) in vivo biosynthetic pathway of LOS containing the KDO antigen in outer membrane vesicles (OMVs; the inset electron microscopy image, which shows OMV production typical of E. coli strains with a dual mutations lacking expression of OmpA and Braun's lipoprotein, is modified from Stanford et a/. (1978, J. Bacteriol. 136:280-285). Lacto-N-neotetraose (LNnT) is synthesized by LgtE, LgtA and LgtB. Up-regulation of Lst and KdsB (in orange) will increase the modification of terminal KDO to the LNnT.
• OMVs outer membrane vesicles
• LgtE, LgtA, LgtB and Lst can be co-expressed and produce the same terminal KDO glycan as Ng in E.coli.
• the terminal KDO is confirmed by ELISA using mAb 6E4. * P ⁇ 0.05.
• adjuvant refers to a compound that, when used in combination with a specific immunogen (e.g., a chimeric molecule of the present disclosure) in a composition, will augment the resultant immune response, including intensification or broadening the specificity of either or both antibody and cellular immune responses.
• a specific immunogen e.g., a chimeric molecule of the present disclosure
• an adjuvant will preferably enhance the specific immunogenic effect of the active agents of the present disclosure.
• adjuvant is typically understood not to comprise agents which confer immunity by themselves.
• An adjuvant assists the immune system unspecifically to enhance the antigen-specific immune response by e.g., promoting presentation of an antigen to the immune system or induction of an unspecific innate immune response.
• an adjuvant may preferably e.g., modulate the antigen-specific immune response by e.g., shifting the dominating Th2-based antigen specific response to a more Thl-based antigen specific response or vice versa. Accordingly, an adjuvant may favorably modulate cytokine expression/secretion, antigen presentation, type of immune response etc.
• administering concurrently or “co administering” and the like refer to the administration of a single composition containing two or more agents, or the administration of each agent as separate compositions and/or delivered by separate routes either contemporaneously or simultaneously or sequentially within a short enough period of time that the effective result is equivalent to that obtained when all such agents are administered as a single composition.
• simultaneous is meant that the agents are administered at substantially the same time, and desirably together in the same composition.
• temporary it is meant that the agents are administered closely in time, e.g., one agent is administered within from about one minute to within about one day before or after another. Any contemporaneous time is useful.
• the agents when not administered simultaneously, the agents will be administered within about one minute to within about eight hours and suitably within less than about one to about four hours.
• the agents are suitably administered at the same site on the subject.
• the term "same site” includes the exact location, but can be within about 0.5 to about 15 centimeters, preferably from within about 0.5 to about 5 centimeters.
• the term "separately” as used herein means that the agents are administered at an interval, for example at an interval of about a day to several weeks or months. The agents may be administered in either order.
• the term “sequentially” as used herein means that the agents are administered in sequence, for example at an interval or intervals of minutes, hours, days or weeks. If appropriate the agents may be administered in a regular repeating cycle.
• antigens refer to a compound, composition, or substance that may be specifically bound by the products of specific humoral or cellular immunity, such as an antibody molecule or T-cell receptor.
• Antigens can be any type of molecule including, for example, haptens, simple intermediary metabolites, sugars (e.g., oligosaccharides), lipids, and hormones as well as macromolecules such as complex carbohydrates (e.g., polysaccharides), phospholipids, and proteins.
• antigen-binding molecule a molecule that has binding affinity for a target antigen. It will be understood that this term extends to immunoglobulins, immunoglobulin fragments and non-immunoglobulin derived protein frameworks that exhibit antigen-binding activity.
• Representative antigen-binding molecules that are useful in the practice of the present disclosure include polyclonal and monoclonal antibodies as well as their fragments (such as Fab, Fab', F(ab' , Fv), single chain (scFv) and domain antibodies (including, for example, shark and camelid antibodies), and fusion proteins comprising an antibody, and any other modified configuration of the immunoglobulin molecule that comprises an antigen binding/recognition site.
• An antibody includes an antibody of any class, such as IgG, IgA, or IgM (or sub-class thereof), and the antibody need not be of any particular class.
• immunoglobulins can be assigned to different classes. There are five major classes of immunoglobulins: IgA, IgD, IgE, IgG, and IgM, and several of these may be further divided into subclasses (isotypes), e.g., IgGl, IgG2, IgG3, IgG4, IgAl and IgA2.
• the heavy-chain constant regions that correspond to the different classes of immunoglobulins are called a, d, e, y, and m, respectively.
• the subunit structures and three-dimensional configurations of different classes of immunoglobulins are well known.
• Antigen-binding molecules also encompass dimeric antibodies, as well as multivalent forms of antibodies.
• the antigen binding molecules are chimeric antibodies in which a portion of the heavy and/or light chain is identical with or homologous to corresponding sequences in antibodies derived from a particular species or belonging to a particular antibody class or subclass, while the remainder of the chain(s) is identical with or homologous to corresponding sequences in antibodies derived from another species or belonging to another antibody class or subclass, as well as fragments of such antibodies, so long as they exhibit the desired biological activity (see, for example, US Pat. No. 4,816,567; and Morrison et al., 1984, Proc. Natl. Acad. Sci. USA 81:6851-6855).
• humanized antibodies which are generally produced by transferring complementarity determining regions (CDRs) from heavy and light variable chains of a non-human (e.g., rodent, preferably mouse) immunoglobulin into a human variable domain. Typical residues of human antibodies are then substituted in the framework regions of the non-human counterparts.
• CDRs complementarity determining regions
• the use of antibody components derived from humanized antibodies obviates potential problems associated with the immunogenicity of non-human constant regions.
• General techniques for cloning non-human, particularly murine, immunoglobulin variable domains are described, for example, by Orlandi et al. (1989, Proc. Natl. Acad. Sci. USA 86: 3833).
• Humanized antibodies include "primatized” antibodies in which the antigen binding region of the antibody is derived from an antibody produced by immunizing macaque monkeys with the antigen of interest. Also contemplated as antigen-binding molecules are humanized antibodies.
• antimicrobial agent refers to any agent with antimicrobial activity, i.e., the ability to inhibit or reduce the growth and/or kill a microbe, e.g., by at least about 30%, at least about 40%, at least about 50%, at least about 75%, at least about 90% or more, as compared to in the absence of an antimicrobial agent.
• antimicrobial agent encompasses agents that that inhibit or reduce the growth and/or kill a microbe by directly interacting with the microbe and/or cells of the host in which the microbe resides or is located.
• Non-limiting examples of antimicrobial agents include a silver nanoparticle, a small molecule, a peptide, a peptidomimetics, an antibody or a fragment thereof, a nucleic acid, an enzyme ⁇ e.g., an antimicrobial metalloendopeptidase such as lysostaphin), an aptamer, a drug, an antibiotic, a chemical or any entity that can inhibit the growth and/or kill a microbe.
• an antimicrobial peptide that can be included in the compositions described herein, include, but are not limited to, mefloquine, venturicidin A, antimycin, myxothiazol, stigmatellin, diuron, iodoacetamide, potassium tellurite hydrate, aDL-vinylglycine, N-ethylmaleimide, L-allyglycine, diaryquinoline, betaine aldehyde chloride, acivcin, psicofuraine, buthionine sulfoximine, diaminopemelic acid, 4-phospho-D-erythronhydroxamic acid, motexafin gadolinium and/or xycitrin or modified versions or analogues thereof.
• Representative antimicrobial agents include, antibiotics, antifungals, antiprotozoals, antimalarials, antituberculotics and antivirals, and any mixtures thereof.
• the term “binds specifically” refers to a binding reaction which is determinative of the presence of a chimeric polypeptide or complex of the present disclosure in the presence of a heterogeneous population of molecules including macromolecules such as proteins and other biologies.
• the term “binds specifically” when referring to an antigen-binding molecule is used interchangeably with the term “specifically immuno-interactive” and the like to refer to a binding reaction which is determinative of the presence of a chimeric polypeptide or complex of the present disclosure in the presence of a heterogeneous population of proteins and other biologies.
• a molecule binds specifically to a chimeric polypeptide or complex of the disclosure and does not bind in a significant amount to other molecules (e.g., proteins or antigens) present in the sample.
• a variety of immunoassay formats may be used to select antigen-binding molecules that are specifically immuno-interactive with a chimeric polypeptide or complex of the disclosure.
• solid-phase ELISA immunoassays are routinely used to select monoclonal antibodies that are specifically immuno-interactive with a protein. See Harlow and Lane (1988) Antibodies, A Laboratory Manual, Cold Spring Harbor Publications, New York, for a description of immunoassay formats and conditions that can be used to determine specific immunoreactivity.
• carrier refers to a protein, a peptide, a lipid, a polymer, a dendrimer, a virosome, a virus-like particle (VLP), an outer membrane vesicle or a combination thereof, which is coupled to an oligosaccharide of the present disclosure to enhance the immunogenicity of the resulting oligosaccharide-carrier chimeric molecule to a greater degree than the oligosaccharide alone.
• VLP virus-like particle
• protein carrier refers to a protein or peptide, which is operably linked to an oligosaccharide to enhance the immunogenicity of the resulting oligosaccharide-protein carrier chimeric molecule to a greater degree than the oligosaccharide alone.
• the protein carrier when used as a carrier, may serve as a T- dependent antigen which can activate and recruit T-cells and thereby augment T-cell dependent antibody production.
• a chimeric molecule of the present disclosure is an immunogenic chimeric molecule for stimulating or eliciting a specific immune response in an animal.
• the immune response is protective in that it enables the animal to better resist infection from the organism against which the immunogenic chimeric molecule is directed.
• conjugation refers to an oligosaccharide chemically coupled to a carrier through a linker and/or a cross-linking agent.
• an effective amount in the context of treating, inhibiting the development of, or preventing a condition is meant the administration of an amount of an agent or composition to an individual in need of such treatment, inhibition or prophylaxis, either in a single dose or as part of a series, that is effective for the prevention of incurring a symptom, holding in check such symptoms, and/or treating existing symptoms, of that condition.
• the effective amount will vary depending upon the health and physical condition of the individual to be treated, the taxonomic group of individual to be treated, the formulation of the composition, the assessment of the medical situation, and other relevant factors. It is expected that the amount will fall in a relatively broad range that can be determined through routine trials. For example, non-limiting symptoms of N.
• gonorrhoeae infections include pain in the lower abdomen, pelvis, testicle, or vagina, painful urination, abnormal vaginal discharge, discharge from penis, or increased vaginal discharge, fever, frequent urge to urinate, irregular menstruation, pus, or sore throat.
• Representative examples of N. meningitidis infections include fever and chills, fatigue, vomiting, cold hands and feet, severe aches or pains in the muscles, joints, chest, or abdomen, rapid breathing diarrhea, and in later stages, dark purple rash.
• epitope means an antigenic determinant that is specifically bound by an antigen-binding molecule or an antigen receptor such as a B-cell receptor (BCR) or T-cell receptor (TCR).
• BCR B-cell receptor
• TCR T-cell receptor
• Epitopes usually consist of surface groupings of molecules, such as amino acids and/or sugar side chains, and may be linear or have specific three-dimensional structural characteristics, as well as specific charge characteristics.
• B cell epitope sites on proteins, oligosaccharides, or other biopolymers may be composed of moieties from different parts of the macromolecule that have been brought together by folding.
• Epitopes of this kind are referred to as conformational or discontinuous epitopes, since the site is composed of segments of the polymer that are discontinuous in the linear sequence but are continuous in the folded conformation(s).
• Epitopes that are composed of single segments of biopolymers or other molecules are termed continuous or linear epitopes.
• T cell epitopes are generally restricted to linear peptides.
• Antigen binding molecules that recognize the same epitope can be identified in a simple immunoassay showing the ability of one antigen-binding molecule to block the binding of another antigen-binding molecule to a target antigen.
• the terms “inhibit”, “inhibits”, or “inhibition” are not meant to imply complete abolition of disease and encompasses any type of prophylactic treatment that reduces the incidence of the condition, delays the onset of the condition, and/or reduces the symptoms associated with the condition after onset.
• an immune response refers to a response by the immune system of a subject.
• an immune response may be to an antigen/immunogen that the subject's immune system recognizes as foreign ⁇ e.g., non-self-antigens) or self ⁇ e.g., self-antigens recognized as foreign).
• Immune responses may be humoral, involving production of immunoglobulins or antibodies, or cellular, involving various types of B and T lymphocytes, dendritic cells, macrophages, antigen presenting cells and the like, or both. Immune responses may also involve the production or elaboration of various effector molecules such as cytokines.
• immune response encompasses immunogenic responses that cause, activate, elicit, stimulate, or induce an immune response against a particular antigen (e.g., an antigen of a pathogenic organism) or organism (e.g., a pathogenic microorganism) in a subject, as well as immunosuppressive or tolerogenic immune responses that inhibit, suppress, diminish or eliminate an immune response, or render the immune system unresponsive, or delay the occurrence or onset of an immune response, to an allergen, or to a self-antigen or a cell, tissue or organ that expresses such an antigen.
• a particular antigen e.g., an antigen of a pathogenic organism
• organism e.g., a pathogenic microorganism
• immuno-interactive includes reference to any interaction, reaction, or other form of association between molecules and in particular where one of the molecules is, or mimics, a component of the immune system.
• the term "immunity” refers to protection from disease (e.g., preventing or attenuating (e.g., suppression) of a sign, symptom or condition of the disease) upon exposure to a microorganism (e.g., pathogen) capable of causing the disease.
• Immunity can be innate (e.g., non-adaptive (e.g., non-acquired) immune responses that exist in the absence of a previous exposure to an antigen) and/or acquired/adaptive (e.g., immune responses that are mediated by B and T cells following a previous exposure to antigen (e.g., that exhibit increased specificity and reactivity to the antigen)).
• immunogen refers to a molecule that stimulates a response from the adaptive immune system, which may include responses drawn from the group comprising an antibody response, a cytotoxic T cell response, a T helper response, and a T cell memory response.
• An immunogen may stimulate an upregulation of the immune response with a resultant inflammatory response, or may result in down regulation or immunosuppression.
• an immunogen is capable of initiating lymphocyte activation resulting in an antigen-specific immune response.
• immunogenic composition or “immunogenic formulation” refers to a preparation which, when administered to a vertebrate, especially an animal such as a mammal, will induce an immunogenic immune response, which may include responses that result in at least some level of immunity in the subject to which the immunogenic composition is administered.
• linker and “spacer” are used interchangeably herein to refer to a molecule or group of molecules (such as a monomer or polymer) that connects two molecules and often serves to place the two molecules in a desirable configuration.
• the linker may be a covalent bond that connects two groups, or a chemical moiety having a chain of between 1 and 50 atoms in length, between 2 and 20 atoms in length, between 3 and 30 atoms in length, between 4 and 40 atoms in length, between 10 and 50 atoms in length, between 10 and 30 atoms in length, between 12 and 26 atoms in length, between 14 and 30 atoms in length, or any range therein in amounts of 1 atom in length.
• a linker or a portion of a linker can have a length that is 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32, 34, 36, 38, 40, 45, or 50 carbon atoms in length, where the linker may be linear, branched, cyclic, or a single atom.
• the linker may be 10 angstroms, 11 angstroms, 12 angstroms, 13 angstroms, 14 angstroms, 15 angstroms, 16 angstroms, 17 angstroms, 18 angstroms, 19 angstroms, 20 angstroms, 22 angstroms, 23 angstroms, 24 angstroms, 25 angstroms, 26 angstroms, 27 angstroms, 28 angstroms, 29 angstroms, 30 angstroms, 32 angstroms, 34 angstroms, 36 angstroms, 38 angstroms, 40 angstroms, 45 angstroms, 50 angstroms, or any amount therein in increments of 1 angstrom, in length.
• one, two, three, four or five or more carbon atoms of a linker backbone may be optionally substituted with a sulfur, nitrogen or oxygen heteroatom.
• the bonds between backbone atoms may be saturated or unsaturated, usually not more than one, two, or three unsaturated bonds will be present in a linker backbone.
• the linker may include one or more substituent groups, for example with an alkyl, aryl or alkenyl group.
• a linker may include, without limitations, oligo(ethylene glycol); ethers, thioethers, tertiary amines, alkyls, which may be straight or branched, e.g., methyl, ethyl, n- propyl, 1-methylethyl (iso-propyl), n-butyl, n-pentyl, 1,1-dimethylethyl (t-butyl), and the like.
• the linker backbone may include a cyclic group, for example, an aryl, a heterocycle or a cycloalkyl group, where 2 or more atoms, e.g., 2, 3 or 4 atoms, of the cyclic group are included in the backbone.
• the linker may be at least one saccharide unit.
• a linker may be cleavable or non-cleavable.
• moiety refers to a portion of a molecule, which may be a functional group, a set of functional groups, and/or a specific group of atoms within a molecule, that is responsible for a characteristic chemical, biological, and/or medicinal property of the molecule.
• the terms "monosaccharide unit” and “monosaccharide residue” are used interchangeably herein to refer to the most basic units of carbohydrates, and includes aldoses (e.g., D-glucose, D-galactose, D-mannose, D-ribose, D-arabinose, L-arabinose, D-xylose, etc.), ketoses (e.g., D-fructose, D-sorbose, D-tagatose, etc.), deoxysugars (e.g., L-rhamnose, L-fucose, etc.), deoxy-aminosugars (e.g., /V-acetylglucosamine, /V-acetylmannosamine, N- acetylgalactosamine, etc.), aldaric acids, uronic acids, ketoaldonic acids (e.g., sialic acid), ulsonic acids (e.g.,
• N. meningitidis one of the pathogens responsible for bacterial meningitis
• N. gonorrhoeae the pathogen responsible for gonorrhea
• infections that are targeted by the agents and compositions of the present disclosure include secondary infections which can arise from lack of treatment of a primary N. gonorrhoeae infection.
• Exemplary secondary infections include urethritis, dysuria, epididymitis, pelvic inflammatory disease, cervicitis and endometritis and also systemic gonococcal infections (e.g., those manifesting as arthritis, endocarditis or meningitis).
• the gonorrhea infection may be one caused by a strain of N. gonorrhoeae which is resistant to at least one known antibacterial drug, e.g. at least one b-lactam drug.
• neutralize and its grammatical equivalents refer to the ability of an antigen-binding molecule to inhibit activity of an antigen to which the antigen binding molecule binds, including activity of an organism that expresses the antigen.
• the term “neutralizes” also includes within its scope causing a pathogenic organism that expresses the antigen to become non-pathogenic.
• an organism may be neutralized through binding of an antigen-binding molecule that elicits an immune response (e.g., by phagocytic cells) against the organism.
• the organism may also be neutralized through binding of an antigen-binding molecule that disables the organism from reproducing, infecting a host, or producing a toxin.
• oligosaccharide refers to a molecule comprising two or more, generally 2-10, typically 2-6, which are suitably glycosidically linked (e.g., by a- and/or b- glycosidic bonds), monosaccharide residues (also referred to herein as "monosaccharide units"). Oligosaccharides are considered to have a reducing end and a non-reducing end.
• oligosaccharide sequence indicates that the monosaccharide residue/ residues in the sequence are part of a larger glycoconjugate, which contains other monosaccharide residues in a chain, which may be branched, and/or may have substituted (e.g., natural substituted) modifications of oligosaccharide chains.
• the oligosaccharide chain is normally conjugated or otherwise linked to a lipid anchor or to a protein.
• an oligosaccharide sequence is a non-reducing terminal oligosaccharide sequence, which means that the oligosaccharide sequence is not linked to another monosaccharide or oligosaccharide structure except optionally from the reducing end of the oligosaccharide sequence.
• the oligosaccharide sequence when present as a conjugate or chimeric molecule is suitably conjugated or otherwise linked from the reducing end of the oligosaccharide sequence, though other linkage positions which are tolerated by an antigen-binding molecule or other binding substance can also be used.
• adjacent monosaccharide units defined in an oligosaccharide sequence of the present disclosure include within their scope alternative glycosidic linkages therebetween, and that specific monosaccharide units defined in a disclosed oligosaccharide sequence include within their scope derivatives of those monosaccharide units.
• operably linked refers to a juxtaposition wherein the components so described are in a relationship permitting them to function in their intended manner.
• "operably linking" a carrier to an oligosaccharide as described herein encompasses positioning and/or orientation of the carrier such that the oligosaccharide is presented to the immune system for the elicitation of an immune response to the oligosaccharide.
• patient refers to any subject, particularly a vertebrate subject, and even more particularly a mammalian subject, for whom therapy or prophylaxis is desired.
• Suitable vertebrate animals that fall within the scope of the disclosure include, but are not restricted to, any member of the subphylum Chordata including primates (e.g., humans, monkeys and apes, and includes species of monkeys such from the genus Macaca (e.g., cynomolgus monkeys such as Macaca fascicularis, and/or rhesus monkeys ( Macaca mulatta )) and baboon ( Papio ursinus), as well as marmosets (species from the genus Callithrix), squirrel monkeys (species from the genus Saimiri ) and tamarins (species from the genus Saguinus), as well as species of apes such as chimpanzees ( Pan troglodytes)), rodents (e.g., mice rats, guinea pigs), lagomorphs (e.g., rabbits, hares), bovines (e.g.
• pharmaceutically acceptable vehicle a solid or liquid filler, diluent or encapsulating substance that can be safely used in topical or systemic administration to an animal, preferably a mammal, including humans.
• Representative pharmaceutically acceptable vehicles include any and all solvents, dispersion media, coatings, surfactants, antioxidants, preservatives (e.g., antibacterial agents, antifungal agents), isotonic agents, absorption delaying agents, salts, preservatives, drugs, drug stabilizers, gels, binders, excipients, disintegration agents, lubricants, sweetening agents, flavoring agents, dyes, such like materials and combinations thereof, as would be known to one of ordinary skill in the art (see, for example, Remington's Pharmaceutical Sciences, 18th Ed.
• vehicle typically denotes an organic or inorganic ingredient, natural or synthetic, with which the active agent combined to facilitate the application.
• pharmaceutically acceptable salt is a broad term, and is to be given its ordinary and customary meaning to a person of ordinary skill in the art (and is not to be limited to a special or customized meaning), and refers without limitation to derivatives of the disclosed compounds wherein the parent compound is modified by converting an existing acid or base moiety to its salt form (e.g., by reacting the free base group with a suitable organic acid).
• pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as carboxylic acids; and the like.
• Representative acid addition salts include acetate, adipate, alginate, ascorbate, aspartate, benzenesulfonate, benzoate, bisulfate, borate, butyrate, camphorate, camphorsulfonate, citrate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, fumarate, glucoheptonate, glycerophosphate, hemisulfate, heptonate, hexanoate, hydrobromide, hydrochloride, hydroiodide, 2-hydroxy-ethanesulfonate, lactobionate, lactate, laurate, lauryl sulfate, malate, maleate, malonate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, nitrate, oleate, oxalate, palmitate, pamoate, pe
• alkali or alkaline earth metal salts include sodium, lithium, potassium, calcium, magnesium, and the like, as well as nontoxic ammonium, quaternary ammonium, and amine cations, including, but not limited to ammonium, tetramethylammonium, tetraethylammonium, methylamine, dimethylamine, trimethylamine, triethylamine, ethylamine, and the like.
• the pharmaceutically acceptable salts of the present disclosure include the conventional non-toxic salts of the parent compound formed, for example, from non-toxic inorganic or organic acids.
• the pharmaceutically acceptable salts of the present disclosure can be synthesized from the parent compound which contains a basic or acidic moiety by conventional chemical methods.
• such salts can be prepared by reacting the free acid or base forms of these compounds with a stoichiometric amount of the appropriate base or acid in water or in an organic solvent, or in a mixture of the two; generally, nonaqueous media like ether, ethyl acetate, ethanol, isopropanol, or acetonitrile are preferred.
• nonaqueous media like ether, ethyl acetate, ethanol, isopropanol, or acetonitrile are preferred.
• Lists of suitable salts are found in Remington's Pharmaceutical Sciences, 17.sup.th ed., Mack Publishing Company, Easton, Pa., 1985, p. 1418, Pharmaceutical Salts: Properties, Selection, and Use, P. H. Stahl and C. G. Wermuth (eds.), Wiley-VCH, 2008, and Berge et al., Journal of Pharmaceutical Science, 66, 1-19 (1977), each of which is incorporated herein by reference in its entirety.
• Polypeptide “peptide”, “protein” and “proteinaceous molecule” are used interchangeably herein to refer to molecules comprising or consisting of a polymer of amino acid residues and to variants and synthetic analogues of the same. Thus, these terms apply to amino acid polymers in which one or more amino acid residues are synthetic non-naturally occurring amino acids, such as a chemical analogue of a corresponding naturally occurring amino acid, as well as to naturally-occurring amino acid polymers.
• resistant is intended to refer to strains of bacteria that have shown non-susceptibility to one or more known antibacterial drugs.
• a non-susceptible strain is one in which the MIC of a given compound or class of compounds for that strain has shifted to a higher number than for corresponding susceptible strains.
• it may refer to strains that are non-susceptible to b-lactam antibiotics, strains that are non-susceptible to one or more fluoroquinolones and/or strains that are non-susceptible to one or more other antibiotics (/.e., antibiotics other than b-lactams and fluoroquinolones).
• the term "resistant” may refer to one in which the MIC of a given compound or class of compounds for that strain has shifted to a significantly higher number than for corresponding susceptible strains.
• a bacterial strain might be said to be resistant to a given antibiotic when it is inhibited in vitro by a concentration of this drug that is associated with a high likelihood of therapeutic failure.
• the bacterial strain may be resistant to one or more fluoroquinolone antibiotics, e.g., one or more antibiotics selected from levofloxacin, enoxacin, fleroxacin, lomefloxacin, nadifloxacin, norfloxacin, rufloxacin, balofloxacin, grepafloxacin, pazufloxacin, sparfloxacin, temafloxacin, tosufloxacin, besifloxacin, clinafloxacin, garenoxacin, gemifloxacin, gatifloxacin, sitafloxacin, trovafloxacin, prulifloxacin, ciprofloxacin, pefloxacin, moxifloxacin, ofloxacin, delafloxacin, zabofloxacin, avarofloxacin, finafloxacin.
• the term "saccharide unit" refers to levofloxacin,
• terminal saccharide unit refers to the saccharide unit that is linked to either none (in case of a monosaccharide) or only one neighboring saccharide unit (in case of an oligosaccharide).
• treat By the terms “treat”, “treating” or “treatment of” (or grammatically equivalent terms) it is meant that the severity of a subject's condition is reduced or at least partially improved or ameliorated and/or that some alleviation, mitigation or decrease in at least one clinical symptom is achieved and/or there is a delay in the progression of the condition. [0068] Each embodiment described herein is to be applied mutatis mutandis to each and every embodiment unless specifically stated otherwise.
• CFU colony forming units
• CMP cytidine monophosphate
• CRM197 non-toxic mutant of diphtheria toxin
• KDO 3-deoxy-D-manno-oct-2-ulosonic acid, keto-deoxyoctonic acid, or keto-deoxyoctulosonate
• Neu5Ac /V-acetylneuraminic acid
• NCS /V-cb!orosuccinimide
• NTHi non-typeable Haemophilus influenzae
• the present disclosure is based in part on the determination that Neisseria LOS alpha-2, 3-sialyltransferase (Lst) is present in the cytoplasm of the bacterium and that in addition to transferring Neu5Ac from CMP-Neu5Ac to the terminus of LOS, Lst is able to transfer KDO to LOS in place of Neu5Ac in both N. gonorrhoeae and N. meningitidis.
• the present inventors have found that KDO is expressed as a terminal LOS structure in in vivo samples from infected women and that the anti-KDO monoclonal antibody 6E4 can mediate opsonophagocytic killing of N. gonorrhoeae. Accordingly, it is proposed that KDO expressed on gonococcal LOS represents a new oligosaccharide antigen for the development of immunogenic compositions against Neisseria organisms.
• the present disclosure relates to chimeric molecules for use in eliciting an immune response to Neisseria organisms such as N. gonorrhoeae or N. meningitidis and methods of using such chimeric molecules for treating and/or inhibiting Neisseria infection, for example by eliciting an immune response targeting Neisseria oligosaccharide antigens.
• the chimeric molecules comprise a carrier and an oligosaccharide that comprises an oligosaccharide sequence corresponding to a Neisseria LOS, wherein the oligosaccharide sequence comprises KDO as a terminal saccharide unit.
• the chimeric molecule is represented by formula (I):
• KDO-OS represents an oligosaccharide sequence comprising 2-10 (e.g., 2, 3, 4, 5, 6, 7, 8, 9 or 10), typically 2-6, monosaccharide units and KDO as a terminal saccharide unit;
• L is an optional linker
• Cr is a carrier; n is 1 to 4; and m is at least 1, or a pharmaceutically acceptable salt thereof.
• the oligosaccharide sequence preferably comprises KDO attached to the Gal, suitably wherein the Gal is further attached to G!cNAc.
• the KDO is attached to Gal via an a(2®3) linkage and/or the Gal is attached to GlcNAc via a b(1®4) linkage.
• the oligosaccharide sequence comprises KDOa(2®3)Gal, or KDOa(2®3)Galp(l®4)GlcNAc.
• Suitable carriers are known in the art (See e.g., Remington's Pharmaceutical Sciences (18th ed., Mack Easton, Pa. (1990)) and may include, for example, proteins, peptides, lipids, polymers, dendrimers, virosomes, virus-like particles (VLPs), outer membrane proteins (OMPs) or combinations thereof, which by themselves may not display particular antigenic properties, but can support immunogenic reaction of a host to the oligosaccharides of the present disclosure (antigens) displayed on the surface of the carrier(s).
• VLPs virus-like particles
• OMPs outer membrane proteins
• the carrier is a protein carrier, including but not limited to, bacterial toxoids, toxins, exotoxins, and nontoxic derivatives thereof, such as tetanus toxoid, tetanus toxin Fragment C, diphtheria toxoid, CRM (a nontoxic diphtheria toxin mutant) such as CRM 197, cholera toxoid, S. aureus exotoxins or toxoids, E coli heat labile enterotoxin, P. aeruginosa exotoxin A, including recombinantly produced, genetically detoxified variants thereof; bacterial outer membrane proteins, such as N.
• bacterial toxoids such as tetanus toxoid, tetanus toxin Fragment C, diphtheria toxoid, CRM (a nontoxic diphtheria toxin mutant) such as CRM 197, cholera toxoid, S. aureus exotoxins or tox
• meningitidis serotype B outer membrane protein complex OMPC
• outer membrane class 3 porin rPorB
• KLH keyhole limpet hemocyanine
• hepatitis B virus core protein thyroglobulin
• albumins such as bovine serum albumin (BSA), human serum albumin (HSA), and ovalbumin
• PspA pneumococcal surface protein A
• PsaA pneumococcal adhesin protein
• PPD purified protein derivative of tuberculin
• transferrin binding proteins polyamino acids, such as poly(lysine:giutamic acid); peptidylagonists of TLR-5 (e.g., flagellin of motile bacteria like Listeria ); and derivatives and/or combinations of the above carriers.
• Preferred carriers for use in humans include tetanus toxoid, CRM 197, and OMPC.
• a carrier may display on average, for example,
• Methods for attaching an oligosaccharide to a carrier are conventional, and a skilled practitioner can create conjugates in accordance with the present disclosure using conventional methods.
• Guidance is also available in various disclosures, including, for example, U.S. Pat. Nos. 4,356,170; 4,619,828; 5,153,312; 5,422,427; and 5,445,817; and in various print and online Pierce protein cross-linking guides and catalogs (Thermo Fisher, Rockford, III.).
• the chimeric molecule can be purified by a variety of techniques well known to one of skill in the art.
• One goal of the purification step is to remove the unbound oligosaccharide from the conjugation reaction product composition.
• An illustrative method for purification involves ultrafiltration in the presence of ammonium sulfate, which is described in U.S. Pat. No. 6,146,902.
• the chimeric molecules can be purified away from unreacted oligosaccharide and carrier by any number of standard techniques including, for example, size exclusion chromatography, density gradient centrifugation, hydrophobic interaction chromatography, or ammonium sulfate fractionation (see, for example, Anderson et al., 1986. J. Immunol. 137:1181-1186; and Jennings 8i Lugowski, 1981.
• compositions and purity of the chimeric molecules can be determined by GLC-MS and MALDI-TOF spectrometry.
• the oligosaccharide antigens of the present disclosure are conjugated to CRM197, a commercially available protein carrier used in a number of FDA approved vaccines.
• CRM-conjugates have the advantage of being easier to synthesize, purify and characterize than other FDA approved carriers such as OMPC.
• Oligosaccharide antigens may be conjugated to CRM via thiol-bromoacetyl conjugation chemistry.
• CRM activation may be achieved by reacting the lysine side chains with the NHS ester of bromoacetic acid using standard conditions as previously described in U.S. Pat. Appl. Publ. 2007-0134762.
• CRM conjugates may be purified via size exclusion chromatography to remove and recover any unreacted carbohydrate.
• MBTH specific for GlcNAc residues
• Bradford assays may be used to determine carbohydrate: protein ratio and protein content, respectively, as previously described (see, for example, Manzi et a/., 1995. Curr. Prot. Mol. Biol., section 17.9.1 (Suppl. 32)).
• a minimum oligosaccharide content of about 10% by weight for each conjugate may be generated.
• a conjugate may include about 3-20 antigens per protein carrier.
• oligosaccharide antigens may be conjugated to one or more carriers suitable for development of diagnostic assays, including ELISAs and microarrays.
• exemplary carriers for use in such assays include bovine serum albumin (BSA), keyhole limpet hemocyanine (KLH), biotin, a label, a glass slide or a gold surface.
• BSA bovine serum albumin
• KLH keyhole limpet hemocyanine
• biotin a label
• a glass slide or a gold surface a gold surface.
• synthetic carbohydrate antigens may be conjugated to BSA by a thiol-maleimide coupling procedure (FIG. 5B).
• BSA conjugates may be purified via size exclusion chromatography to remove and recover any unreacted carbohydrate. Characterization via the phenol-sulfuric acid and Bradford assays may be performed along with MALDI-MS to provide information on the carbohydrate content and valency of the conjugates. In preferred embodiments, conjugates will contain a minimum oligosaccharide content of about 10% by weight per BSA conjugate and >8 antigen copies per conjugate.
• the disclosure relates to an oligosaccharide that comprises an oligosaccharide sequence corresponding to a Neisseria LOS, wherein the oligosaccharide sequence comprises KDO as a terminal saccharide unit, as broadly described above and elsewhere herein.
• the oligosaccharides disclosed herein are structural mimetics of Neisseria LOS and in accordance with the present disclosure are useful for producing antigen-binding molecules that bind specifically with Neisseria organisms, including pathogenic Neisseria organisms such as gonorrhoeae and N. meningitidis.
• antigen binding proteins that bind specifically with a Neisseria LOS are antibodies.
• Antibodies include intact antibodies and antigen binding fragments thereof, as described in the definition section.
• An antibody may comprise a complete antibody molecule (including polyclonal, monoclonal, chimeric, humanized, or human versions having full length heavy and/or light chains), or comprise an antigen binding fragment thereof.
• Antibody fragments include F(ab')2, Fab, Fab', Fv, Fc, and Fd fragments, and can be incorporated into single domain antibodies, single-chain antibodies, maxibodies, minibodies, intrabodies, diabodies, triabodies, tetrabodies, v-NAR and bis-scFv (see e.g., Hollinger and Hudson, 2005, Nature Biotechnology, 23, 9, 1126-1136).
• antibody polypeptides such as those disclosed in U.S. Pat. No. 6,703,199, including fibronectin polypeptide monobodies.
• Other antibody polypeptides are disclosed in U.S. Patent Publication 2005/0238646, which are single chain polypeptides.
• monoclonal antibodies that bind specifically with a Neisseria LOS can be made using conventional hybridoma methods that are often based on the seminal method of Kohler, G. et ai. (1975, "Continuous Cultures Of Fused Cells Secreting Antibody Of Predefined Specificity," Nature 256:495-497) or a modification thereof.
• monoclonal antibodies are developed in non-human species, such as mice. In general, a mouse or rat is used for immunization but other animals may also be used.
• the antibodies may be produced by immunizing mice with an immunogenic amount of an immunogen, in this case a chimeric molecule of the present disclosure.
• the immunogen may be administered multiple times at periodic intervals such as, bi weekly, or weekly, or may be administered in such a way as to maintain viability in the animal.
• a small biological sample e.g., blood
• the spleen and/or several large lymph nodes can be removed and dissociated into single cells.
• the spleen cells may be screened (after removal of non-specifically adherent cells) by applying a cell suspension to a plate or to a well coated with the antigen. B-cells, expressing membrane-bound immunoglobulin specific for the antigen, will bind to the plate, and are not rinsed away with the rest of the suspension.
• Resulting B-cells, or all dissociated spleen cells can then be fused with myeloma cells (e.g., X63-Ag8.653 and those from the Salk Institute, Cell Distribution Center, San Diego, Calif.).
• myeloma cells e.g., X63-Ag8.653 and those from the Salk Institute, Cell Distribution Center, San Diego, Calif.
• PEG Polyethylene glycol
• the hybridoma is then cultured in a selective medium (e.g., hypoxanthine, aminopterin, thymidine medium, otherwise known as "HAT medium").
• the resulting hybridomas are then plated by limiting dilution, and are assayed for the production of antibodies that bind specifically to the immunogen, using, for example, FACS (fluorescence activated cell sorting) or immunohistochemistry (IHC) screening.
• FACS fluorescence activated cell sorting
• IHC immunohistochemistry
• Epstein-Barr Virus (EBV)- immortalized B cells may be used to produce monoclonal antibodies that bind specifically with a Neisseria LOS.
• the hybridomas are expanded and subcloned, if desired, and supernatants are assayed for anti-immunogen activity by conventional assay procedures ⁇ e.g., FACS, IHC, radioimmunoassay, enzyme immunoassay, fluorescence immunoassay, etc.).
• the present disclosure further contemplates methods of producing an antigen-binding molecule that binds specifically with a Neisseria organism, wherein the method comprises: (1) immunizing an animal with a chimeric molecule as disclosed herein; (2) detecting a B cell from the animal, which binds specifically with the chimeric molecule, or Neisseria organism or LOS thereof; and (3) isolating the antigen-binding molecule expressed by that B cell.
• the present disclosure also encompasses antigen-binding molecule that are produced by such methods as well as derivatives thereof. Also encompassed are cells including hybridomas that are capable of producing the antigen-binding molecules of the disclosure, and methods of producing antigen-binding molecules from those cells. In specific embodiments, the antigen-binding molecules produced by the methods and cells of the disclosure are preferably neutralizing antigen-binding molecules.
• a humanized monoclonal antibody comprises the variable domain of a murine antibody (or all or part of the antigen binding site thereof) and a constant domain derived from a human antibody.
• a humanized antibody fragment may comprise the antigen binding site of a murine monoclonal antibody and a variable domain fragment (lacking the antigen-binding site) derived from a human antibody.
• Procedures for the production of engineered monoclonal antibodies include those described in Riechmann et ai, 1988, Nature 332:323, Liu et ai., 1987,
• the chimeric antibody is a CDR grafted antibody.
• Techniques for humanizing antibodies are discussed in, e.g., U.S. Pat. Nos. 5,869,619; 5,225,539; 5,821,337; 5,859,205; 6,881,557, Padlan et ai., 1995, FASEB J. 9:133-39, Tamura et ai., 2000, J. Immunol. 164:1432-41, Zhang, W., et a/., Molecular Immunology 42(12):1445-1451, 2005;
• An antibody of the present disclosure may also be a fully human monoclonal antibody.
• Fully human monoclonal antibodies may be generated by any number of techniques with which those having ordinary skill in the art will be familiar. Such methods include, but are not limited to, Epstein Barr Virus (EBV) transformation of human peripheral blood cells (e.g., containing B lymphocytes), in vitro immunization of human B-cells, fusion of spleen cells from immunized transgenic mice carrying inserted human immunoglobulin genes, isolation from human immunoglobulin V region phage libraries, or other procedures as known in the art and based on the disclosure herein.
• EBV Epstein Barr Virus
• mice in which one or more endogenous immunoglobulin genes have been inactivated by various means have been prepared.
• Human immunoglobulin genes have been introduced into the mice to replace the inactivated mouse genes.
• elements of the human heavy and light chain locus are introduced into strains of mice derived from embryonic stem cell lines that contain targeted disruptions of the endogenous heavy chain and light chain loci (see also Bruggemann et ai, 1997. Curr. Opin. Biotechnoi. 8:455-58).
• human immunoglobulin transgenes may be mini-gene constructs, or transloci on yeast artificial chromosomes, which undergo B-cel l-specific DNA rearrangement and hypermutation in the mouse lymphoid tissue.
• Antibodies produced in the animal incorporate human immunoglobulin polypeptide chains encoded by the human genetic material introduced into the animal.
• a non-human animal such as a transgenic mouse, is immunized with a subject chimeric polypeptide or complex immunogen.
• the chimeric molecules disclosed herein may be used to screen for antigen-binding molecules from antigen-binding molecule libraries.
• a chimeric molecule of the present disclosure may be immobilized to a solid support ⁇ e.g., a silica gel, a resin, a derivatized plastic film, a glass bead, cotton, a plastic bead, a polystyrene bead, an alumina gel, or a polysaccharide, a magnetic bead), and screened for binding to antigen-binding molecules.
• the antigen-binding molecules may be immobilized to a solid support and screened for binding to the chimeric molecule.
• any screening assay such as a panning assay, ELISA, surface plasmon resonance, or other antigen-binding molecule screening assay known in the art may be used to screen for antigen-binding molecules that bind to a chimeric molecule disclosed herein, particularly its oligosaccharide component.
• the antigen-binding molecule library screened may be a commercially available library, an in vitro generated library, or a library obtained by identifying and cloning or isolating antibodies from an individual infected with a Neisseria organism.
• the antigen-binding molecule library is generated from a subject that has been infected with a Neisseria organism.
• Antigen-binding molecule libraries may be generated in accordance with methods known in the art.
• the library is generated by cloning the antibodies and using them in phage display libraries or a phagemid display library.
• the present disclosure further encompasses fragments of an a nti -Neisseria LOS antibody.
• Such fragments can consist entirely of antibody-derived sequences or can comprise additional sequences.
• antigen-binding fragments include Fab, F(ab')2, single chain antibodies, diabodies, triabodies, tetrabodies, and domain antibodies. Other examples are provided in Lunde et a/., Biochem. Soc. Trans. 2002, 30:500-06.
• Single chain antibodies may be formed by linking heavy and light chain variable domain (Fv region) fragments via an amino acid bridge (short peptide linker), resulting in a single polypeptide chain.
• Fv region heavy and light chain variable domain
• amino acid bridge short peptide linker
• Such single-chain Fvs have been prepared by fusing DNA encoding a peptide linker between DNAs encoding the two variable domain polypeptides (VL and VH).
• the resulting polypeptides can fold back on themselves to form antigen-binding monomers, or they can form multimers (e.g., dimers, trimers, or tetramers), depending on the length of a flexible linker between the two variable domains (Kortt et a/., Prot. Eng.
• Antigen binding fragments derived from an antibody can also be obtained, for example, by proteolytic hydrolysis of the antibody, for example, pepsin or papain digestion of whole antibodies according to conventional methods.
• antibody fragments can be produced by enzymatic cleavage of antibodies with pepsin to provide a 5S fragment termed F(ab')2. This fragment can be further cleaved using a thiol reducing agent to produce 3.5S Fab' monovalent fragments.
• the cleavage reaction can be performed using a blocking group for the sulfhydryl groups that result from cleavage of disulfide linkages.
• CDRs complementarity determining regions
• CDRs can be obtained by constructing polynucleotides that encode the CDR of interest. Such polynucleotides are prepared, for example, by using the polymerase chain reaction to synthesize the variable region using mRNA of antibody- producing cells as a template (see, for example, Larrick et al., Methods: A Companion to Methods in Enzymoiogy 2:106, 1991; Courtenay-Luck, "Genetic Manipulation of Monoclonal Antibodies," in Monoclonal Antibodies: Production, Engineering and Clinical Application, Ritter et al.
• the antibody fragment further may comprise at least one variable region domain of an antibody described herein.
• the V region domain may be monomeric and be a VL and VH domain, which is capable of independently binding a subject ectodomain polypeptide or complex with an affinity at least equal to 10 -7 M or less.
• variable region domain may be any naturally occurring variable domain or an engineered version thereof.
• engineered version is meant a variable region domain that has been created using recombinant DNA engineering techniques.
• engineered versions include those created, for example, from a specific antibody variable region by insertions, deletions, or changes in or to the amino acid sequences of the specific antibody.
• Particular examples include engineered variable region domains containing at least one CDR and optionally one or more framework amino acids from a first antibody and the remainder of the variable region domain from a second antibody.
• variable region domain may be covalently attached at a C-terminal amino acid to at least one other antibody domain or a fragment thereof.
• a VH domain that is present in the variable region domain may be linked to an immunoglobulin CHI domain, or a fragment thereof.
• a VL domain may be linked to a CK domain or a fragment thereof.
• the antibody may be a Fab fragment wherein the antigen binding domain contains associated VH and VL domains covalently linked at their C-termini to a CHI and CK domain, respectively.
• the CHI domain may be extended with further amino acids, for example to provide a hinge region or a portion of a hinge region domain as found in a Fab' fragment, or to provide further domains, such as antibody CH2 and CH3 domains.
• Antigen-binding molecules identified in the methods described herein may be tested for neutralizing activity and lack of autoreactivity using biological assays known in the art or described herein.
• an antigen-binding molecule elicited or identified using a chimeric molecule disclosed herein neutralizes a Neisseria organism.
• antigen-binding molecules elicited or identified using a chimeric molecule disclosed herein may be used to monitor the efficacy of a therapy and/or disease progression.
• Antigen-binding molecules elicited or identified using a chimeric molecule may be used in diagnostic immunoassays to detect the presence of a Neisseria organism in biological samples, passive immunotherapy, and generation of antiidiotypic antigen-binding molecules.
• the ability of the antigen-binding molecules to neutralize a Neisseria organism and the specificity of the antigen-binding molecules for the Neisseria LOS may be tested prior to using the antigen-binding molecules in passive immunotherapy.
• Immunoassays which can be used to analyze specific binding and cross-reactivity include, but are not limited to, competitive and non-competitive assay systems using techniques such as western blots, radioimmunoassays, ELISA (enzyme linked immunosorbent assay), "sandwich” immunoassays, immunoprecipitation assays, precipitin reactions, gel diffusion precipitin reactions, immunodiffusion assays, agglutination assays, complement-fixation assays, immunoradiometric assays, fluorescent immunoassays, protein A immunoassays, to name but a few.
• Such assays are routine and well known in the art (see, e.g., Ausubel et al., eds., 1994, Current Protocol
• the antigen-binding molecules disclosed herein are used in immunodetection methods for binding, purifying, removing, quantifying and otherwise generally detecting Neisseria organisms such as N. gonorrhoeae or N. meningitidis.
• Some immunodetection methods include enzyme linked immunosorbent assay (ELISA), radioimmunoassay (RIA), immunoradiometric assay, fluoroimmunoassay, chemiluminescent assay, bioluminescent assay, and Western blot to mention a few.
• the immunodetection methods also include methods for detecting and quantifying the amount of Neisseria organism or related components (e.g., LOS thereof) in a sample and the detection and quantification of any immune complexes formed during the binding process.
• a sample suspected of containing a Neisseria organism is obtained from a patient, and the sample is contacted with an antigen-binding molecule that binds specifically to the oligosaccharide component of a chimeric molecule disclosed herein, followed by detecting and quantifying the amount of immune complexes formed under the specific conditions.
• the biological sample analyzed may be any sample that is suspected of containing a Neisseria organism, such as a tissue section or specimen, a homogenized tissue extract, a biological fluid, including a biological fluid and/or tissue associated with infection by a Neisseria organism.
• sample- antigen-binding molecule composition such as a tissue section, ELISA plate, dot blot or Western blot
• the sample- antigen-binding molecule composition will generally be washed to remove any non-specifically bound antigen-binding molecule species, allowing only those antigen-binding molecule specifically bound within the primary immune complexes to be detected.
• active agents may be included in pharmaceutical compositions (including therapeutic and prophylactic formulations), typically combined together with one or more pharmaceutically acceptable vehicles and, optionally, other therapeutic ingredients (e.g., antimicrobials, immunogens, etc.).
• compositions may be employed to enhance the delivery and/or control the duration of action of the active agent.
• Control release preparations may be achieved through the use of polymers to complex or absorb the active agent, and/or adjuvants.
• Controlled delivery may be effected by selecting appropriate macromolecules (for example polyesters, polyamino acids, polyvinyl, pyrrolidone, ethylenevinylacetate, methylcellulose, carboxymethylcellulose, or protamine sulfate) and the concentration of macromolecules as well as the method of incorporation in order to control release.
• suitable macromolecules for example polyesters, polyamino acids, polyvinyl, pyrrolidone, ethylenevinylacetate, methylcellulose, carboxymethylcellulose, or protamine sulfate
• concentration of macromolecules as well as the method of incorporation in order to control release.
• Another possible method to control the duration of action by controlled release preparations is to incorporate an active agent disclosed herein into particles of a polymeric material such as polyesters, polyamino acids, hydrogels, poly(lactic acid) or ethylene vinylacetate copolymers.
• microcapsules prepared, for example, interfacial polymerization, for example, hydroxymethylcellulose or gelatin- microcapsules and poly(methylmethacylate)-microcapsules, respectively, or in colloidal drug delivery systems, for example, liposomes, albumin microspheres, microemulsions, nanoparticles, and nanocapsules or in macroemulsions.
• colloidal drug delivery systems for example, liposomes, albumin microspheres, microemulsions, nanoparticles, and nanocapsules or in macroemulsions.
• Adjuvants can be included in the compositions.
• Exemplary adjuvants and/or adjuvant combinations may be selected from mineral salts, including aluminum salts, such as aluminum phosphate and aluminum hydroxide (alum) (e.g., AlhydrogelTM, Superfos, Denmark) and calcium phosphate; RIBI, which contains three components extracted from bacteria, monophosphoryl lipid A, trehalosedimycolate, and cell wall skeleton (MPL+TDM+CWS) in a 2% squalene/Tween 80 emulsion, whereby any of the 3 components MPL, TDM or CWS may also be used alone or combined 2 by 2; toll-like receptor (TLR) agonists, including, for example, agonists of TLR-1 (e.g.
• tri-acyl lipopeptides agonists of TLR-2 [e.g. peptidoglycan of gram-positive bacteria like streptococci and staphylococci; lipoteichoic acid]; agonists of TLR-3 (e.g. double- stranded RNA and their analogs such as poly 1:C); agonists of TLR-4 (e.g. lipopolysaccharide (endotoxin) of gram-negative bacteria like Salmonella and E. coli ); agonists of TLR-5 (e.g. flagellin of motile bacteria like Listeria); agonists of TLR-6 (e.g.
• TLR-2 peptidoglycan and certain lipids d iacyl lipopeptides
• TLR-7 e.g. single-stranded RNA (ssRNA) genomes of such viruses as influenza, measles, and mumps; and small synthetic guanosine-base antiviral molecules like loxoribine and ssRNA and their analogs
• agonists of TLR-8 e.g. binds ssRNA
• agonists of TLR-9 e.g. unmethylatedCpG of the DNA of the pathogen and their analogs
• agonists of TLR-10 function not defined
• TLR-11- e.g.
• MPL.RTM monophosphoryl lipid A
• D-MPL 3 De-O-acylatedmonophosphoryl lipid A
• OM-174 E. coli lipid A derivative
• OM triacyl lipid A derivative and other MPL- or lipid A-based formulations and combinations thereof, including MPL.RTM.
• ISCOMs immunostimulating complexes
• other ISCOM-based adjuvants such as ISCOMATRIX.TM. and AbISCO.RTM.-lOO and -300 series adjuvants (Isconova AB, Uppsala, Sweden); QS21 and 3 D-MPL together with an oil in water emulsion as disclosed in U.S. Pat. Appl. No.
• VLPs virus-like particles
• IRIVs reconstituted influenza virosomes
• CFA complete Freund's adjuvant
• IFA incomplete Freund's adjuvant
• coli heat-labile enterotoxin LT
• immune-adjuvants including cytokines, such as IL-2, IL-12, GM-CSF, Flt3, accessory molecules, such as B7.1
• mast cell (MC) activators such as mast cell activator compound 48/80 (C48/80); water-insoluble inorganic salts; liposomes, including those made from DNPC/Chol and DC Choi; micelles; squalene; squalane; muramyl dipeptides, such as N-acetyl-muramyl-L-threonyl-D-isoglutamine (thr-MDP) as found in U.S. Pat. No.
• adjuvant potency may be enhanced by combining multiple adjuvants as described above, including combining various delivery systems with immunopotentiating substances to form multi-component adjuvants with the potential to act synergistically to enhance antigen-specific immune responses in vivo.
• immunopotentiating substances include the above-described adjuvants, including, for example,
• CpGetc oligonucleotides
• PAMPs alternative pathogen-associated molecular patterns
• SIPs small molecule immune potentiators
• compositions of the present disclosure can be formulated according to known methods to prepare pharmaceutically useful compositions, whereby these materials, or their functional derivatives, are combined in admixture with a pharmaceutically acceptable vehicle (or diluents).
• a pharmaceutically acceptable vehicle or diluents.
• Suitable vehicles and their formulation, inclusive of other human proteins, e.g., human serum albumin, are described, for example, in Remington's Pharmaceutical Sciences, supra.
• a pharmaceutically acceptable composition suitable for effective administration such compositions will contain an effective amount of the above-described compounds together with a suitable amount of protein carrier and/or vehicle.
• compositions may be prepared as injectables, either as liquid solutions or suspensions; solid forms suitable for solution in, or suspension in, liquid vehicles prior to injection.
• An aqueous composition for parenteral administration may include a solution of the active agent(s) dissolved or suspended in a pharmaceutically acceptable vehicle or diluent, preferably a primarily aqueous vehicle.
• Pharmaceutically acceptable vehicles or diluents may include water, saline, including neutral saline solutions buffered with phosphate, Tris, glycerol, ethanol, and the like.
• An aqueous composition may be formulated as a sterile, pyrogen-free buffered saline or phosphate-containing solution, which may include a preservative or may be preservative free. Suitable preservatives include benzyl alcohol, parabens, thimerosal, chlorobutanol, and benzalkonium chloride, for example.
• Aqueous solutions are preferably approximately isotonic, and its tonicity may be adjusted with agents such as sodium tartrate, sodium chloride, propylene glycol, and sodium phosphate.
• auxiliary substances required to approximate physiological conditions including pH adjusting and buffering agents, tonicity adjusting agents, wetting or emulsifying agents, pH buffering substances, and the like, including sodium acetate, sodium lactate, sodium chloride, potassium chloride, calcium chloride, sorbitan monolaurate, triethanolamine oleate, etc. may be included with the vehicles described herein.
• compositions may be sterilized by conventional sterilization techniques, or may be sterile filtered.
• the resulting aqueous solutions may be packaged for use as is, or lyophilized, the lyophilized preparation being combined with a sterile solution prior to administration.
• the preparation of such pharmaceutical compositions is within the ordinary skill in the art, and may be guided by standard reference books such as Remington's Pharmaceutical Science, supra.
• compositions may be formulated in a solid or liquid form for oral delivery.
• nontoxic and/or pharmaceutically acceptable solid protein carriers may include, for example, pharmaceutical grades of mannitol, lactose, starch, magnesium stearate, sodium saccharin, talcum, cellulose, glucose, sucrose, magnesium carbonate, and the like.
• a pharmaceutically acceptable nontoxic composition may be formed by incorporating any of the normally employed excipients, including those protein carriers previously listed, and a unit dosage of an active ingredient, that is, one or more active agents disclosed herein.
• the concentration of the active agents in the pharmaceutical compositions can vary widely, i.e., from less than about 0.1%, usually at or at least about 0.1% to as much as 20% to 50% or more by weight, and will be selected primarily by fluid volumes, viscosities, etc., and in accordance with the particular mode of administration selected.
• a human unit dose form of the active agents is typically included in a pharmaceutical composition that comprises a human unit dose of an acceptable protein carrier, preferably an aqueous protein carrier, and is administered in a volume of fluid that is known by those of skill in the art to be used for administration of such compositions to humans, and is adjusted according to commonly understood principles for a particular subject to be treated.
• a unit dosage of active agent is provided in a suitable amount of an aqueous solution, such as 0.1-3 mL, preferably 0.2-2 mL.
• Such pharmaceutical compositions can be administered to subjects by a variety of mucosal administration modes, including by oral, rectal, intranasal, intrapulmonary, or transdermal delivery, or by topical delivery to other surfaces.
• the active agents can be administered by non-mucosal routes, including by intramuscular, subcutaneous, intravenous, intra- atrial, intra-articular, intraperitoneal, or parenteral routes.
• the active agents can be administered ex vivo by direct exposure to cells, tissues or organs originating from a subject.
• the route of administration includes parenteral administration (e.g,, intradermal, intramuscular or subcutaneous delivery), ocu!ar administration, oral administration, intranasa!
• Formulations of the pharmaceutical compositions may include liquid formulations for parenteral, subcutaneous, Intradermal, intramuscular, intravenous, or ocular administration ⁇ e.g., injectable administration) such as sterile solutions, suspensions, or emulsions.
• Formulations of the pharmaceutical compositions also may include liquid formulations (e.g., topical formulations or ingestib!e formulations) for ocular, oral, nasal, anal, and vaginal administration, including solutions, suspensions, syrups or elixirs.
• the pharmaceutical compositions may be !yophilized prior to delivery and reconstituted prior to administration
• compositions of the disclosure typically are sterile and stable under conditions of manufacture, storage and use.
• Sterile solutions can be prepared by incorporating the conjugate in the required amount in an appropriate solvent with one or a combination of ingredients enumerated herein, as required, followed by filtered sterilization.
• dispersions are prepared by incorporating the active agent and/or other biologically active agent into a sterile vehicle that contains a basic dispersion medium and the required other ingredients from those enumerated herein.
• methods of preparation include vacuum drying and freeze-drying which yields a powder of the conjugate plus any additional desired ingredient from a previously sterile-filtered solution thereof.
• the prevention of the action of microorganisms can be accomplished by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal, and the like.
• compositions of the present disclosure may be administered to a subject that is infected with a Neisseria organism, or at risk for developing an infection by Neisseria organism.
• the active agents can be delivered to a subject in a manner consistent with conventional methodologies associated with management of Neisseria infection for which treatment or prevention is sought.
• a prophylactically or therapeutically effective amount of the active agent is administered to a subject in need of such treatment for a time and under conditions sufficient to prevent, inhibit, and/or ameliorate a Neisseria infection or one or more symptom(s) thereof.
• non-limiting symptoms of N for example, non-limiting symptoms of N.
• gonorrhoeae infections include pain in the lower abdomen, pelvis, testicle, or vagina, painful urination, abnormal vaginal discharge, discharge from penis, or increased vaginal discharge, fever, frequent urge to urinate, irregular menstruation, pus, or sore throat.
• Representative examples of N. meningitidis infections include fever and chills, fatigue, vomiting, cold hands and feet, severe aches or pains in the muscles, joints, chest, or abdomen, rapid breathing diarrhea, and in later stages, dark purple rash.
• composition comprises a chimeric molecule of the present disclosure as an active agent
• the treatment may be given in a single dose schedule, or preferably a multiple dose schedule in which a primary course of treatment may be with 1-10 separate doses, followed by other doses given at subsequent time intervals required to maintain and or reinforce the response, for example, at 1-4 months for a second dose, and if needed, a subsequent dose(s) after several months.
• suitable treatment schedules include: (i) 0, 1 month and 6 months, (ii) 0, 7 days and 1 month, (iii) 0 and 1 month, (iv) 0 and 6 months, or other schedules sufficient to elicit the desired responses expected to reduce disease symptoms, or reduce severity of disease.
• the amounts effective for inducing an immune response or providing protective immunity will depend on a variety of factors, including the oligosaccharide antigen component of the chimeric molecule, the associated carrier, inclusion and nature of any adjuvant(s), the manner of administration, the weight and general state of health of the patient, and the judgment of the prescribing physician.
• the amounts may generally range for the initial immunization (that is for a prophylactic administration) from about 1.0 pg to about 5,000 pg of oligosaccharide antigen for a 70 kg patient, ⁇ e.g., 1.0 pg, 2.0 pg, 2.5 pg, 3.0 pg, 3.5 pg, 4.0 pg, 4.5 pg, 5.0 pg, 7.5 pg, 10 pg, 12.5 pg, 15 pg, 17.5 pg, 20 pg, 25 pg, 30 pg, 35 pg, 40 pg, 45 pg, 50 pg, 75 pg, 100 pg, 250 pg, 500 pg, 750 pg, 1,000 pg, 1,500 pg, 2,000 pg, 2,500 pg, 3,000 pg, 3,500 pg, 4,000 pg, 4,500 pg or 5,000 pg).
• a primary dose may optionally be followed by boosting dosages of from about 1.0 to about 1,000 of oligosaccharide antigen (e.g., 1.0 pg, 2.0 pg, 2.5 pg, 3.0 pg, 3.5 pg, 4.0 pg, 4.5 pg, 5.0 pg, 7.5 pg, 10 pg, 12.5 pg, 15 pg, 17.5 pg, 20 pg, 25 pg, 30 pg, 35 pg, 40 pg, 45 pg, 50 pg, 75 pg, 100 pg, 250 pg, 500 pg, 750 pg, 1,000 pg, 1,500 pg, 2,000 pg, 2,500 pg, 3,000 pg, 3,500 pg, 4,000 pg, 4,500 pg or 5,000 pg) pursuant to a boosting regimen over weeks to months depending upon the patient's response and condition by measuring specific antibody
• the active agents may be optionally administered in combination with ancillary or adjunctive pharmaceutically active substances.
• the active agents may be administered in combination with antimicrobials useful for treating Neisseria infections, representative examples of which include antibiotic(s) such as: Aminoglycosides (e.g., amikacin, gentamicin, kanamycin, neomycin, netilmicin, streptomycin, tobramycin and paromomycin); Ansamycins (e.g., geldanamycin and herbimycin); Carbacephems (e.g., loracarbef); Carbapenems (e.g., ertapenem, doripenem, imipenem/cilastatin and meropenem); Cephalosporins (first generation), including e.g., cefadroxil, cefazolin, cefa loti n/cefa loth in and cephalexin); Cephalosporins (second generation), including
• antibiotics useful as adjunctive agents include one or more antibiotic(s) selected from: arsphenamine, chloramphenicol, clindamycin, lincoamycin, ethambutol, fosfomycin, fusidic acid, furazolidone, isoniazid, linezolid, metronidazole, mupirocin, nitrofurantoin, platensimycin, pyrazinamide, quinupristin/dalfopristin, rifampin/rifampicin and tinidazole.
• antibiotic(s) selected from: arsphenamine, chloramphenicol, clindamycin, lincoamycin, ethambutol, fosfomycin, fusidic acid, furazolidone, isoniazid, linezolid, metronidazole, mupirocin, nitrofurantoin, platensimycin, pyrazinamide, quinupristin/dalfop
• the active agents disclosed herein may be used in combination with one or more antibiotics selected from: penicillin, cloxacillin, d icloxaci 11 i n, methicillin, nafcillin, oxacillin, ampicillin, amoxicillin, bacampicillin, capreomycin, cycloserine, azlocillin, carbenicillin, mezlocillin, piperacillin, ticarcillin, azithromycin, clarithromycin, clindamycin, erythromycin, lincomycin, demeclocycline, doxycycline, ethambutol, ethionamide, minocycline, oxytetracycline, tetracycline, quinolone, cinoxacin, nalidixic acid, fluoroquinolones (e.g., levofloxacin, moxafloxacin and gatifloxacin, ciprofloxacin, e
• antibiotics
• Suitable antibacterial adjunctive agents may be selected from those listed in the table below: DU-6859, Erythromycin stinoprate, Oritavancin, Telavancin, Dalbavancin, Ceftobiprole medocaril, Tebipenem pivoxil, Iclaprim, OPT-80, Ceftaroline fosamil, RX- 3341, Cethromycin, TD-1792, EDP-420, RX-1741, MK-2764, Nemonoxacin, Flopristin + Linopristin, Tomopenem, Ramoplanin, Linezolid, Cefditoren pivoxil, Ertapenem, Gemifloxacin, Daptomycin, Telithromycin, and Tigecyline.
• a chimeric molecule of the present disclosure is used in combination with one or more immunogens derived from Neisseria antigens representative examples of which include AniA, BamA, CssA, CssB, CssC, CtrA, CtrB, CtrC, CtrD, CtrE, CtrF , ExbB, GNA1030, GNA1162, GNA1220, GNA1870 (fHbp), GNA1946, GNA2001, GNA2091, GNA2132 (NHBA), GNA33, GNA992, LctP, LpdA, LptD, MsrAB, NadA, NGO2054, NG02139 (MetQ) , NspA, OpaD, OpcA, PilCl, PilQ, PorA PI, TamA, TBP2, and TbpA.
• the immunogens are selected from AniA, MsrAB, Met
• Typical subjects intended for treatment with the compositions and methods of the present disclosure include humans, as well as non-human primates and other animals.
• accepted screening methods are employed to determine risk factors associated with a targeted or suspected disease of condition (e.g.,, coughing disease) as discussed herein, or to determine the status of an existing disease or condition in a subject.
• These screening methods include, for example, conventional work-ups to determine environmental, familial, occupational, and other such risk factors that may be associated with the targeted or suspected disease or condition, as well as diagnostic methods, such as various ELISA and other immunoassay methods, which are available and well known in the art to detect and/or characterize disease-associated markers.
• a conjugate and/or other biologically active agent can be administered according to the teachings herein as an independent prophylaxis or treatment program, or as a follow-up, adjunct or coordinate treatment regimen to other treatments, including surgery, vaccination, immunotherapy, hormone treatment, cell, tissue, or organ transplants, and the like.
• the administration of the active agents of the disclosure can be for either prophylactic or therapeutic purpose.
• the active agent is provided in advance of any symptom.
• the prophylactic administration of the active agent serves to prevent or ameliorate any subsequent infection.
• the conjugate is provided at (or shortly after) the onset of a symptom of disease or infection.
• An active agent of the disclosure can thus be provided prior to an anticipated exposure to a Neisseria organism so as to attenuate the anticipated severity, duration or extent of an infection and/or associated disease symptoms, after exposure or suspected exposure to the bacteria, or after the actual initiation of an infection.
• compositions comprising chimeric molecules of the present disclosure can be used for active immunization for prevention of infection, and for preparation of immune antibodies.
• kits for practicing the methods of the disclosure may vary and will typically contain any one or more of the active agents or compositions disclosed herein, optionally including instructions or means for administering the same for use in the prevention and treatment of Neisseria infections in vertebrate subjects.
• Kits for diagnostic use are also provided.
• these kits include a container or formulation that contains one or more of the chimeric molecules described herein.
• this component is formulated in a pharmaceutical preparation for delivery to a subject.
• a chimeric molecule of the present disclosure is optionally contained in a bulk dispensing container or unit or multi-unit dosage form.
• Optional dispensing means can be provided.
• Packaging materials optionally include a label or instruction indicating for what treatment purposes and/or in what manner the active agent packaged therewith can be used.
• the pharmaceutical compositions or components may be provided In any suitable form (e.g., liquid form or iyophi!ized form). Kits further may include solvents for resuspending or dissolving a lyophiiized active agent.
• KDO as the terminal monosaccharide of LOS
• whole cell ELISA was performed with the LOS terminal KDO specific monoclonal antibody (MAb) 6E4 on three well characterized N. gonorrhoeae strains, 1291, MS11 and F62 and their 1st knockout mutants.
• Variable presentation of KDO on gonococcal LOS may be due to the absence of a terminal galactose acceptor, if LgtA is switched off, or via competition if another glycosyltransferase, LgtD, is phase varied "on" and transfers GalNAc in competition with Lst/CMP-KDO for the terminal galactose acceptor.
• the transfer of KDO to LOS was also investigated in N. meningitidis, which unlike N. gonorrhoeae, can synthesize CMP-Neu5Ac via SiaB.
• the ELISA results in Figure 2C show the absence of KDO in meningococcal strain MC58 wild- type and 1st mutant.
• LgtB is a 81,4-galactosyltransferase that transfers CMP- Neu5Ac and CMP-KDO receptor galactose (Gal) to the N-acetylglucosamine (GlcNAc).
• Gal CMP- Neu5Ac
• CMP-KDO receptor galactose Gal
• GlcNAc N-acetylglucosamine
• N. gonorrhoeae can incorporate KDO as the terminal glycan of LOS during in vivo infection
• a confocal microscopy study was conducted using MAb 6E4 on the cervical swab from a patient with a documented N. gonorrhoeae infection.
• Figure 3 demonstrates that in vivo, the terminal KDO epitope is present in N. gonorrhoeae on cervical epithelial cells. This suggests that the free CMP-Neu5Ac in the cervical environment was not sufficient to inhibit Lst incorporating KDO to LOS.
• KDQg(2.3)GalB(1.4)GlcNAc - spacer synthesis [0142] Commercially available mannose is converted into the protected KDO derivative in 2 steps, following the method described by the Feng group (Feng et a/. 2015, supra). The protected KDO is then activated to the glycosyl fluoride following the procedure of L'Heureux, et al. (2010, supra). Commercially available lactulose is converted into LacNAc (Gal (l,4)GlcNAc) using the method described by Agoston et a/. (2016, Tet Lett. 57: 2595-2597).
• LacNAc is converted into the Gal (l,4)GlcNAc - spacer compound.
• Glycosidation between the activated KDO and the Gal (l,4)GlcNAc - spacer is accomplished using a method adapted from the literature (Kong et a/. 2016, supra). Deprotection then provides the KDOa(2,3)Galp(l,4)GlcNAc - spacer compound for conjugation.
• Figure 8 shows steps of KDOa(2,3)Gal (l,4)GlcNAc - spacer chemical synthesis.
• CRM197 (alternatively, BSA or other carriers) in 0.3 M NaHC0 3 (1 mg/mL) was added to NCS KDO-linked (200 molar equiv.) in 0.3 M Na 2 C0 3 pH 9 to a final volume of 1 mL. The resultant mixture was gently shaken for 18 hrs. at 20°C. SDS-PAGE and western blot were used to analyze reaction product.
• EDC-NHS reaction CRM197 and NH 2 linked KDO were incubated in EDO (25 mM) and NHS (25 mM) (GE, EDC-NHS coupling kit) for 30 min at room temperature.
• the resultant conjugation reactions were stopped by passing through the desalting columns (Bio- SpinTM, Bio-Rad) to remove excess un-conjugated glycans and buffer exchanged to PBS. SDS-PAGE western blot of 6E4, and MS were used to analyze and confirm the glyco-conjugated CRM197.
• mice will be each immunized with 25, 50 or 100 pg of KDO glycoconjugate or the native carrier protein (CRM197) in a 1:1 formation with AlhydrogelTM adjuvant. Two booster injections will be administered at days 21 and 28 after initial injection, with a terminal bleed scheduled at day 42. All animals remained healthy for the duration of the study, and no adverse reactions were observed. Terminal bleed sera will be analyzed for an anti-KDO immune response via ELISA assay.
• CCM197 native carrier protein
• ELISA will be used to determine antibody titers and isotypes for sera raised, using plates coated with either the BSA-KDO antigens or with N. gonorrhoeae whole cells. Wells of plates will be coated with 100 ng of BSA-KDO glycoconjugate and BSA protein in 100 pL of coating buffer (0.5M carbonate/bicarbonate buffer, pH 9.6) for 1 hr. at room temperature or overnight at 4°C to test KDO specific immune response.
• coating buffer 0.5M carbonate/bicarbonate buffer, pH 9.6
• the Gal derivative or the LacNAc derivative from EXAMPLE 5 are deprotected with the free NCS or NH 2 at the end of the linker that enables EDC-NHS coupling with CRM197.
• the next phase of the chemoenzymatic approach involves using enzyme KdsB (CMP-KDO synthetase from E. coli ) based on (Sugai et ai. 1995, Bioorg Med Chem.
• the CMP-KDO synthetase (KdsB) and CMP-KDO transferase (Lst) will be transferred to the N. gonorrhoeae chromosome on an IPTG inducible expression construct.
• the level of terminal KDO expression on LOS will be determined by ELISA using MAb 6E4 and MS.
• Naturally-secreted outer membrane vesicles (OMVs) will be isolated/purified by two previously described methods: natively purified by ultracentrifugation (Semchenko et ai. 2017, Infect Immun. 85(2)) and deoxycholate (DOC) detergent extracted (Fredriksen et a/. 1991, NIPH Ann.
• a 6-hour inoculated culture is incubated in 0.1 M Tris-HCI, pH 8.6, containing 10 mM EDTA and 0.5% DOC for 30 min at room temperature, then centrifuged (20,000 x g; 30 min; 4°C). The supernatant is ultracentrifuged (125,000 x g; 2 hrs.; 4°C) and the OMV pellet is resuspended in 50 mM Tris-HCI, pH 8.6, 2mM EDTA, 1.2% DOC, 20% sucrose for second ultracentrifugation step. OMVs will then be homogenized in 30% sucrose. All purified OMVs will be analyzed by SDS-PAGE and protein concentration measured using the BCA protein assay.
• mice Groups of 10 BALB/c mice will be immunized with 5 pg of OMVs with Alhydrogel TM (aluminum hydroxide, InvivoGen) on days 0, 21, and 28. Terminal bleeds will be collected on day 42, as per standard procedures.
• Control mice will be immunized with 5 pg native OMV, or a PBS sham, with Alhydrogel TM .
• a pre-bleed of each mouse will be collected 4 days before immunization.
• We will then use ELISA to determine antibody titers and isotypes for sera raised, using plates coated with either the immunizing antigens or N. gonorrhoeae whole cells.
• E. coli endotoxin reduced and OMV upregulated strain ⁇ CeOOAwaaOBAIppAmsbBattA ⁇ . :ParaB-/ppAompA:pGb3) has been generated as a strain to express heterologous oligosaccharides and may be used to deliver carbohydrate vaccine antigens (Paton et al. 2015 Infect Immun. 83(9):3526-33).
• the plasmids pLNnT (a LgtE, LgtA and LgtB expression construct) and pBAD Lst will be transformed into this E. coli strain.
• LgtE, LgtA, LgtB and Lst encode a b- 1,4-galactosyltransferase, a 8-l,3-N-acetylglucosaminyltransferase, a 8-l,4-galactosyltransferase and sialyltransferase with distinct acceptor specificity, respectively.
• Whole cell 6E4 ELISA as shown in Figure 10B and MS were used to confirm KDO expression on LOS in the E. coli blebbing strain.
• Blebbing of this strain will be induced by supplementing 0.2% glucose in growing culture, and the OMVs will be isolated by centrifugation (3,900 x g at 4°C for 10 min, then again for 15 min to remove whole cells). The resulting supernatant will be centrifuged at 150,000 x g for 3 hours at 4°C. The pellet containing OMVs will be washed with PBS before a second centrifugation at 120,000 g for 30 min. at 4°C. The OMVs in the pellet will be resuspended in PBS for analysis by SDS-PAGE and BCA protein assay.
• Murine antigenicity studies of purified OMVs will be performed as previously published (Jen et al, 2015, supra). Groups of 10 BALB/c mice will be immunized with 5 pg of OMVs with Alhydrogel TM (aluminum hydroxide, InvivoGen) on days 0, 21, and 28. Terminal bleeds are collected on day 42, as per standard procedures. Control mice will be immunized with native E. coli OMVs and a PBS sham with Alhydrogel TM . A pre-bleed of each mouse will be collected 4 days before immunization. We will then use ELISA to determine antibody titers and isotypes for sera raised, using plates coated with either the immunizing antigens or with N. gonorrhoeae whole cells.
• Alhydrogel TM aluminum hydroxide, InvivoGen
• KDO tetrasaccharide antigen shown in Figure 10 can be generated in E. coli and then instead of OMVs, minicells or bacterial ghosts may be prepared to present the KDO carbohydrate vaccine antigen (Paton et a/. 2015 Infect Immun. 83(9):3526-33).
• a further in vivo strategy for heterologous expression of the KDO antigen shown in Figure 10 is to express appropriate glycosyltransferases to generate the desired KDO antigen that can be conjugated in vivo to a carrier protein using established approaches (Ravenscroft et a/. 2019 Glycobiology. 29(9): 669-680).
• KDO specific titer for each NHS sample was measured by subtracting the reading of LOS without KDO (Lst mutant LOS) from the reading of LOS with KDO (wild-type LOS). The endpoint was determined by the positive reading above the secondary antibody only control. ELISA results showed that human sera has a measurable anti-KDO titer as shown in Table 2. 6E4 is used as the positive control.
• *6E4 is unpurified MAb culture supernatant.
• N. gonorrhoeae strain 1291, 1291/st, MS11, MSll/st, F62, and F62/st were grown on GC agar (Oxoid) or GC broth with 1% IsoVitaleX and N. meningitidis strain MC58, MC58/st (Mubaiwa et al. 2017, Sci Rep 7:5693) and MC58s/aS (Chopra et al, submitted) were grown on brain-heart infusion (BHI) 1% agar and 10% Levinthal's Medium Base at 37°C with 5% CO2.
• BHI brain-heart infusion
• Bacteria were grown on BHI or GC plates for 16 hr. Cells were harvested and resuspended in PBS at an OD 600 nm of 0.20. Microtiter plate wells were filled with 50 pL of the bacterial suspension and dried at room temperature overnight in the laminar flow cabinet. After the bacteria in the dried wells were heat-killed for 1 hr. in 56°C, the wells were washed, and ELISA was performed with MAb 6E4 at a dilution of 1:64. Secondary antibody (Dako P044701 polyclonal anti mouse Ig HRP) was used at a dilution of 1:2,000.
• the substrate TMB (3,3', 5,5;- tetramethylbenzidine) solution (Thermofisher Scientific) was used as per manufacturer's instruction. Equal amount of 1 N hydrochloric acid was added to stop the reaction. Absorbance was read in a TECAN Model Infinite 200 Pro plate reader at 450 nm.
• PMNs Polymorphonuclear leukocytes
• N. gonorrhoeae survival was determined after plating of serial dilutions on GC agar, and survival calculated as a percentage relative to no antibody control. Statistical significance was calculated using one-way analysis of variance (ANOVA) and Student's t- test.

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