WO2023115347A1 - 靶向gprc5d的全人源抗体 - Google Patents

靶向gprc5d的全人源抗体 Download PDF

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WO2023115347A1
WO2023115347A1 PCT/CN2021/140153 CN2021140153W WO2023115347A1 WO 2023115347 A1 WO2023115347 A1 WO 2023115347A1 CN 2021140153 W CN2021140153 W CN 2021140153W WO 2023115347 A1 WO2023115347 A1 WO 2023115347A1
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gprc5d
binding
seq
amino acid
fusion protein
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PCT/CN2021/140153
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English (en)
French (fr)
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谭涛超
魏巧娥
贾向印
黄星星
张千千
刘建伟
谢萌
金亮
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上海驯鹿生物技术有限公司
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Priority to PCT/CN2021/140153 priority Critical patent/WO2023115347A1/zh
Priority to IL313798A priority patent/IL313798A/en
Priority to KR1020247024554A priority patent/KR20240125026A/ko
Priority to CA3241997A priority patent/CA3241997A1/en
Priority to PCT/CN2022/140769 priority patent/WO2023116782A1/zh
Priority to AU2022418639A priority patent/AU2022418639A1/en
Priority to CN202280083287.1A priority patent/CN118451177A/zh
Priority to MX2024007390A priority patent/MX2024007390A/es
Publication of WO2023115347A1 publication Critical patent/WO2023115347A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A61P35/02—Antineoplastic agents specific for leukemia
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09—Recombinant DNA-technology
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N5/00—Undifferentiated human, animal or plant cells, e.g. cell lines; Tissues; Cultivation or maintenance thereof; Culture media therefor
    • C12N5/10—Cells modified by introduction of foreign genetic material

Definitions

  • the present invention relates to an antibody targeting GPRC5D, especially a fully human antibody targeting GPRC5D.
  • the present invention also relates to the application of the antibody.
  • Multiple myeloma is a plasma cell tumor that occurs in the bone marrow.
  • the tumor causes conditions such as hypercalcemia, anemia, renal dysfunction, osteonecrosis, and bone marrow failure.
  • Multiple myeloma is currently the second most common hematological malignancy.
  • WHO World Health Organization
  • the morbidity and mortality of the Asian population accounted for 36% and 42%, respectively, ranking first in the statistics of all continents.
  • the morbidity and mortality ratio of multiple myeloma in the world is 1.8:1.1, and it is 1.1:0.76 in Asia.
  • the survival rate of multiple myeloma in the affected population is low.
  • the main reason is that the median age of the population is about 66 years old, and the incidence rate of people under the age of 40 is about 2%.
  • the second is that multiple myeloma has almost no cure possibility under the commonly used chemotherapy, immunomodulators and monoclonal antibody therapy, and barely remission is accompanied by a very high recurrence rate, that is, relapsed/refractory multiple myeloma (Relapsed/refractory Multiple myeloma (Relapsed/refractory Multiple myeloma) RRMM), the five-year survival rate is only 51%.
  • T cell bispecific antibody therapy (bispecific T cell engagers, BiTEs) and secondary T cell therapy (adoptive T cell therapy, ACT) have made breakthroughs in the treatment of multiple myeloma.
  • Targeted therapy products for multiple myeloma mainly target BCMA, CD38, CD138, GPRC5D, etc.
  • CD38 and CD138 are also expressed on cells of normal tissues and hematopoietic stem cells. After targeted therapy is used to eliminate them, side effects are relatively large, and they often cause damage to normal organs or damage the autoimmune system.
  • BCMA and GPRC5D are mainly expressed in plasma cells or plasma cells in myeloma, which can be replenished by the continuous regeneration of the body's own B cells.
  • products targeting BCMA mainly include REGN5458 developed by Regeneron Pharmaceuticals, Inc. (REGN), Teclistama developed by Johnson & Johnson, and AMG420 developed by Amgen.
  • REGN5458 has completed Phase I clinical trials (NCT03761108).
  • NCT03761108 Phase I clinical trials
  • CR complete remission
  • sCR strict complete remission
  • Teclistamab has entered the clinical phase II trial (NCT04557098), and the clinical phase I results show that the overall response rate (ORR) is 65% , 40% of patients achieved complete remission (CR);
  • AMG420 clinical phase I NCT03836053
  • the CAR-T product developed by Bristol-Myers Squibb (BMS) targeting the BCMA target of multiple myeloma - bb2121 was approved by the FDA in May 2021 as the first CAR-T product for multiple myeloma to be marketed.
  • the product's overall response rate (ORR) was 72%, and 28% of patients achieved strict complete remission (sCR).
  • ORR overall response rate
  • sCR complete remission
  • this product has brought hope for the cure of multiple myeloid, according to the published data, the 22-month progression-free survival rate of patients with complete remission (CR) is less than 50%, which shows that the late stage of treatment There is also a high recurrence rate.
  • GPRC5D is more specific than that of BCMA, and it is only expressed in plasma cells of myeloma patients, while it is almost not expressed in normal tissues, and significant RNA and protein expression can only be detected in hair follicle tissues. No significant difference was found in the phenotype (including body weight, organ morphological differences, reproductive rate, etc.) between GPRC5D-knockout mice and normal wild-type mice. It can be seen that GPRC5D deletion is not necessary for survival and normal organ metabolism, and its clearance less side effects. It was further found that the expression of BCMA was not correlated with GPRC5D. Although both were expressed in plasma cells at the same time, their expression profiles were relatively independent. It can be seen that the expression of BCMA in patients with BCMA CAR-T therapy in the late stage is low, and GPRC5D can be targeted for treatment.
  • a GPRC5D binding peptide comprising a heavy chain variable region of an antibody molecule, wherein HCDR1, HCDR2 and HCDR3 in the heavy chain variable region are selected from one of the following combinations:
  • HCDR1 is GGSFSGYY (SEQ ID NO: 1);
  • HCDR2 is INHSGST (SEQ ID NO: 2);
  • HCDR3 is ARARRYGGRTRFDP (SEQ ID NO: 3);
  • HCDR1 is GFIFSSYG (SEQ ID NO: 4);
  • HCDR2 The sequence of HCDR2 is ISSSGDYT (SEQ ID NO: 5);
  • HCDR3 The sequence of HCDR3 is ARMSFRRYDH (SEQ ID NO: 6);
  • HCDR1 is GFSFSGYI (SEQ ID NO: 7);
  • HCDR2 The sequence of HCDR2 is TSSSGTET (SEQ ID NO: 8);
  • HCDR3 is ARYYSKYGRSYHVDS (SEQ ID NO: 9).
  • the GPRC5D-binding peptide is an antibody molecule or an antigen-binding fragment thereof.
  • the heavy chain variable region includes the amino acid sequence shown in SEQ ID NO: 10, 11 or 12; or the heavy chain variable region includes the amino acid sequence shown in SEQ ID NO: 10, 11 or 12
  • the amino acid sequence has at least 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99% sequence identity and is capable of specifically binding GPRC5D.
  • the GPRC5D binding peptide is a single domain antibody molecule.
  • the GPRC5D-binding peptide is a fully human antibody molecule.
  • the binding ability of the GPRC5D-binding peptide to cells expressing GPRC5D on the surface is that the EC50 value detected by FACS is no higher than 10 nM, 9 nM, 8 nM, 7 nM, 6 nM, or 5 nM.
  • fusion proteins are provided herein that include the GPRC5D-binding peptides described above.
  • the fusion protein includes at least two GPRC5D binding peptides.
  • said HCDR1, HCDR2 and HCDR3 of said two GPRC5D binding peptides are respectively selected from the different combinations listed above.
  • one of the two GPRC5D binding peptides includes the amino acid sequence shown in SEQ ID NO: 10, or includes at least 90%, 91% of the sequence shown in SEQ ID NO: 10 %, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99% sequence identity amino acid sequence and can specifically bind to GPRC5D, another comprising SEQ ID NO: 11 shown Amino acid sequence, or includes at least 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99% sequence identity to the sequence shown in SEQ ID NO: 11 amino acid sequence and can specifically bind GPRC5D; one of the two GPRC5D binding peptides includes the amino acid sequence shown in SEQ ID NO: 10, or includes at least 90%, 91%, 92% of the sequence shown in SEQ ID NO: 10 %, 93%, 94%, 95%, 96%, 97%, 98%, or 99% sequence identity amino acid sequence
  • the fusion protein includes at least three of the GPRC5D-binding peptides, wherein the HCDR1, HCDR2 and HCDR3 of the three GPRC5D-binding peptides are the three combinations listed above, respectively.
  • the first of the three GPRC5D-binding peptides of the fusion protein comprises the amino acid sequence set forth in SEQ ID NO: 10, or comprises at least 90% of the sequence set forth in SEQ ID NO: 10 , 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99% sequence identity amino acid sequence and can specifically bind GPRC5D;
  • the second comprises SEQ ID NO: 11
  • the amino acid sequence shown, or comprising at least 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99% of the sequence shown in SEQ ID NO: 11 Consistent amino acid sequence and can specifically bind GPRC5D;
  • the third comprises the amino acid sequence shown in SEQ ID NO: 12, or comprises at least 90%, 91%, 92%, An amino acid sequence having 93%, 94%, 95%, 96%, 97%, 98%, or 99% sequence identity and capable of specifically binding to GPRC5D.
  • the fusion protein also includes an Fc fragment.
  • the fusion protein further comprises another binding peptide capable of specifically binding an antigen other than GPRC5D.
  • the other binding peptide is a single domain antibody or a single chain antibody.
  • the fusion protein further includes a detectable tag or a purification tag.
  • the detectable label is enzymatically active.
  • nucleic acid molecules encoding the above-mentioned GPRC5D-binding peptide or the above-mentioned fusion protein.
  • the nucleic acid molecule comprises the nucleotide sequence shown in SEQ ID NO: 13, 14 or 15.
  • expression vectors comprising the nucleic acid molecules described above.
  • host cells comprising the nucleic acid molecules or expression vectors described above.
  • this paper provides a multispecific antibody molecule, which at least includes a first functional part and a second functional part, wherein the first functional part includes the above-mentioned GPRC5D binding peptide; the second functional part has a different binding specificity.
  • the second functional moiety has binding specificity for immune cells.
  • the second functional moiety has binding specificity for T cells.
  • the second functional moiety has binding specificity for CD3.
  • immunoconjugates comprising the above-described GPRC5D-binding peptides linked to a therapeutic agent.
  • the therapeutic agent is a drug.
  • the therapeutic agent is a cytotoxin.
  • the therapeutic agent is a radioisotope.
  • this paper provides a pharmaceutical composition, which includes: 1) the above-mentioned GPRC5D-binding peptide; the above-mentioned fusion protein; the above-mentioned multispecific antibody molecule; or the above-mentioned immunoconjugate; and 2) a pharmaceutically acceptable carrier.
  • GPRC5D-binding peptides fusion proteins, multispecific antibody molecules, immunoconjugates or pharmaceutical compositions can be used to treat GPRC5D-related diseases.
  • this paper provides the use of the above-mentioned GPRC5D-binding peptide, fusion protein, multispecific antibody molecule or immunoconjugate in the preparation of a medicament for treating GPRC5D-related diseases.
  • the GPRC5D-associated disorder is cancer, or an autoimmune disease
  • the cancer is preferably a plasma cell malignancy, such as multiple myeloma, or a B cell malignancy, such as Hodgkin's lymphoma or non-Hodgkin's lymphoma. Chiggin's lymphoma.
  • GPRC5D-related disorders which comprises administering an effective amount of the above-mentioned GPRC5D-binding peptide, fusion protein, multispecific antibody molecule, immunoconjugate or pharmaceutical composition to a subject in need medicine.
  • the GPRC5D-associated disorder is cancer, or an autoimmune disease
  • the cancer is preferably a plasma cell malignancy, such as multiple myeloma, or a B cell malignancy, such as Hodgkin's lymphoma or non-Hodgkin's lymphoma. Chiggin's lymphoma.
  • this paper provides a method for detecting the content of GPRC5D in a biological sample, comprising:
  • this paper provides a method for detecting the content of GPRC5D in a biological sample, comprising:
  • a detection kit which includes the above-mentioned GPRC5D-binding peptide, fusion protein or multispecific antibody molecule.
  • a pharmaceutical kit comprising the above-mentioned GPRC5D-binding peptide, fusion protein or multispecific antibody molecule.
  • GPRC5D-associated disorder in a subject, comprising:
  • the GPRC5D-associated disorder is cancer, or an autoimmune disease
  • the cancer is preferably a plasma cell malignancy, such as multiple myeloma, or a B cell malignancy, such as Hodgkin's lymphoma or non-Hodgkin's lymphoma. Chiggin's lymphoma.
  • this paper provides a method for determining the therapeutic effect of a drug for treating a GPRC5D-related disorder in a subject, comprising:
  • step 1) to determine the change of the GPRC5D-related disease state in the subject, and determine the therapeutic effect of the drug based on the change.
  • the GPRC5D-associated disorder is cancer, or an autoimmune disease
  • the cancer is preferably a plasma cell malignancy, such as multiple myeloma, or a B cell malignancy, such as Hodgkin's lymphoma or non-Hodgkin's lymphoma. Chiggin's lymphoma.
  • Figure 1 shows the enzyme-linked immunosorbent assay (ELISA) results of part of the panned phage monoclonals, target antigens and control antigens.
  • ELISA enzyme-linked immunosorbent assay
  • Figure 2A shows the results of flow cytometric analysis of CHO-K1-GPRC5D cell line stained with different antibodies; Human GPRC5D PE-conjugated Antibody stained is the result of commercialized flow cytometric antibody staining, Fluorescein (FITC) AffiniPure Goat Anti-Human IgG stained It is the negative control stained with fluorescently labeled antibody only; Positive benchmark stained/Fluorescein (FITC) AffiniPure Goat Anti-Human IgG stained is the result of staining with positive control antibody and fluorescently labeled antibody; Figure 2B shows some phage monoclonal and CHO - Flow cytometric analysis results of K1-GPRC5D and CHO-K1 cell binding.
  • FITC Fluorescein
  • FITC Fluorescein AffiniPure Goat Anti-Human IgG stained It is the negative control stained with fluorescently labeled antibody only
  • FIG. 3 shows the results of ELISA analysis of the screened phage monoclonals at the phage level and various non-related antigens.
  • Negative phage control is a negative control phage antibody clone
  • Anti-M13 phage mouse/anti-mouse HRP Ab is a negative antibody control with only primary and secondary antibodies added
  • anti-mouse HRP Ab is a negative antibody control with only secondary antibodies added
  • anti -human IgG HRP Ab is a negative antibody control with secondary antibody added only
  • anti-his tag HRP Ab is a positive antibody control for detecting antigen tags
  • Positive Benchamrk1 is a positive antibody control for target antigen.
  • Figure 4 shows the results of flow cytometric analysis of the binding of the screened phage monoclonals to various GPRC5D positive and negative cell lines at the phage level.
  • Negative phage Control is a negative control phage antibody clone
  • Positive Benchamrk1 Ab is a positive antibody to the target antigen
  • FITC anti-human IgG Ab is a negative control with only secondary antibodies added.
  • Figure 5 shows the results of ELISA analysis of the screened phage monoclonals at the protein level and various non-related antigens.
  • anti-human IgG HRP Ab is a negative antibody control with secondary antibody added only
  • anti-his tag HRP Ab is a positive antibody control for detecting antigen tags
  • Positive Benchamrk1 is a positive antibody control for target antigen.
  • Figure 6 shows the results of flow cytometric analysis of the binding of the screened phage monoclonals to various GPRC5D positive and negative cell lines at the protein level.
  • Positive Benchamrk1 Ab is a positive antibody to the target antigen
  • FITC anti-human IgG Ab is a negative control with only secondary antibodies added.
  • Figure 7 shows the results of FACS detection of the binding of the monoclonal to the cell CHO-K1-GPRC5D highly expressing the target antigen.
  • Antibodies refer to immunoglobulins secreted by plasma cells (effector B cells) and used by the body's immune system to neutralize foreign substances (polypeptides, viruses, bacteria, etc.). This foreign substance is accordingly called an antigen.
  • the basic structure of a classical antibody molecule is a 4-mer composed of 2 identical heavy chains and 2 identical light chains. According to the conservative difference in amino acid sequence, the heavy chain and light chain are divided into variable region (V) located at the amino terminal and constant region (C) located at the carboxy terminal. The variable regions of one heavy and one light chain interact to form the antigen binding site (Fv).
  • variable region the composition and arrangement of amino acid residues in certain regions are more variable than other regions (framework regions, FRs) in the variable region, which are called hypervariable regions (HVR), and the hypervariable regions are actually antibodies. Key site for antigen binding. Since these hypervariable regions are complementary to antigenic determinants, they are also called complementarity-determining regions (CDRs). Both the heavy and light chains have three complementarity determining regions, called HCDR1, HCDR2, HCDR3 and LCDR1, LCDR2, LCDR3, respectively.
  • CDRs complementarity-determining regions
  • the "antigen-binding fragment" of an antibody molecule refers to an amino acid fragment in an antibody molecule that participates in antigen-specific binding, for example, Fab, Fab' and (Fab') 2 and the like.
  • Single-chain antibodies and single-domain antibodies with antigen-binding ability are single-peptide chain antibody molecules, which can be regarded as "antigen-binding fragments" of classical antibody molecules.
  • Fc fragment refers to the handle region of the Y"-shaped antibody molecule, that is, the fragment crystallizable (Fc) includes the second and third constant domains (CH2 and CH3 domains) of the heavy chain. (eg, papain) hydrolysis of the antibody molecule yields the Fc region of the antibody.
  • the Fc region may comprise a hinge, CH2, and CH3. When the Fc region comprises a hinge, it may mediate dimerization between two Fc-containing polypeptides.
  • the Fc fragment can be from IgG, IgM, IgD, IgE, or IgA. In some examples, the Fc region is from IgGl, IgG2, IgG3, or IgG4.
  • Fc fragment also includes those derived from native Fc fragments that have been altered but retain their effector functions. Variant Fc fragments.
  • a “variant Fc fragment” comprises an amino acid sequence having at least one amino acid change over the amino acid sequence of a native Fc fragment.
  • a variant Fc fragment has At least one amino acid substitution, for example about 1 to about 10 amino acids is substituted in the parental Fc fragment, and preferably about 1 to about 5 amino acid substitutions.
  • the variant Fc fragment Fc region has at least about 80% sequence identity, at least about 90% sequence identity, at least about 95%, at least about 96%, at least about 97%, at least about 98%, or at least about 99% sequence identity.
  • the effector function of the "Fc fragment” can be Including binding to Fc receptors, Clq binding and complement-dependent cytotoxicity (CDC), antibody-dependent cell-mediated cytotoxicity (ADCC), mediating phagocytosis, etc.
  • Single-chain antibody (single chain fragment variable, scFv) is composed of antibody heavy chain variable region and light chain variable region connected by a short peptide to form a peptide chain. Through correct folding, the variable regions from the heavy chain and the light chain interact through non-covalent bonds to form Fv segments, so scFv can better retain its affinity activity for antigens.
  • Single domain antibody single domain antibody, sdAb
  • VHH antibody refers to an antibody molecule with antigen-binding ability, including a heavy chain variable region without a light chain. From a structural point of view, single-domain antibodies can also be considered as an antigen-binding fragment of an antibody molecule. It was first discovered in camelids. Subsequently, researchers screened antibody libraries (such as phage display libraries) and discovered more single-domain antibodies with antigen-binding ability.
  • Single-domain antibodies have some advantages over ordinary antibody molecules (for example, classical tetrameric antibody molecules) or their antigen-binding fragments, including but not limited to: smaller molecular weight, making it easy to reach tissues that are difficult for ordinary antibody molecules to reach when used in the human body or parts, or can access antigenic epitopes in proteins or polypeptides that are difficult for ordinary antibody molecules to access; more stable, able to withstand changes in temperature and pH, as well as the action of denaturants and proteases.
  • ordinary antibody molecules for example, classical tetrameric antibody molecules
  • their antigen-binding fragments including but not limited to: smaller molecular weight, making it easy to reach tissues that are difficult for ordinary antibody molecules to reach when used in the human body or parts, or can access antigenic epitopes in proteins or polypeptides that are difficult for ordinary antibody molecules to access; more stable, able to withstand changes in temperature and pH, as well as the action of denaturants and proteases.
  • a “fully human antibody” refers to an antibody in which both the variable and constant regions, if any, are derived from human germline immunoglobulin sequences.
  • Fully human antibodies can be obtained by a variety of techniques, including phage antibody library technology, single B cell cloning technology, transgenic mouse technology (for example, using human germline immunoglobulin genes and removing the mouse's own germline immunoglobulin protein gene transgenic mice), etc. Compared with animal-derived antibodies (such as mouse-derived antibodies), fully human-derived antibodies have the advantages of less immunogenicity and higher safety when used in human patients.
  • Bispecific antibody refers to an antibody molecule that has two different binding sites and can recognize and bind two different antigens, respectively.
  • one binding site of a bispecific antibody can be used to bind immune cells (such as T cells), and the other binding site can be used to bind tumor cells, thereby enhancing the killing effect of immune cells on tumor cells while reducing side effects such as off-target toxicity .
  • Such bifunctional antibodies usually have a higher efficacy than monoclonal antibody drugs as a drug for treating tumors.
  • antibody molecules can be engineered to include multiple distinct binding sites, resulting in “trispecific antibodies,” “tetraspecific antibodies,” and the like.
  • multispecific antibody encompasses such bispecific antibodies, trispecific antibodies, tetraspecific antibodies, and the like.
  • Immunoconjugate refers to a GPRC5D binding peptide disclosed herein conjugated to a therapeutic agent.
  • the treatment is, for example, cytotoxins, drugs (eg, immunosuppressants) or radiotoxins.
  • Fusion protein refers to a protein molecule that is artificially produced (for example, through genetic engineering techniques) and consists of at least two different peptide segments. These peptides do not exist in nature, or do not exist in the same protein molecule.
  • fusion proteins that include antibody fragments include antibody-cytokine fusion proteins, antibody-cytotoxin fusion proteins (also known as immunotoxins), enzyme-labeled antibodies for immunoassays, chimeric antigen receptors (CAR), etc. .
  • Targeting refers to the fact that one molecule (such as an antibody or antigen-binding fragment thereof) has a higher affinity for another molecule (such as a tumor cell surface antigen) relative to other molecules that are also present in the environment. binding affinity. "Targeting” or “specifically binding” does not exclude that the molecule may have binding affinity for more than one molecule, eg a bispecific antibody may have high affinity for two different antigens.
  • Binding complex refers to a complex formed between a molecule and its binding partner that includes both.
  • binding complexes may include antigen-antibody complexes, ligand-receptor complexes, protein dimers, and the like.
  • the forces that form the binding complex mainly include non-covalent bond forces such as hydrogen bonds, van der Waals forces, and ionic bonds.
  • GPRC5D is a G protein-coupled receptor C5 family subtype D, which belongs to an orphan receptor and is a 7-transmembrane protein. Orphan receptors refer to receptors that are structurally similar to other recognized receptors, but their endogenous ligands have not been found yet. GPRC5D is highly expressed on the surface of primary multiple myeloma cells, while its expression in normal tissues is limited to the hair follicle area. Studies have shown that 65% of multiple myeloma patients have an expression threshold of GPRC5D exceeding 50%. With this feature, GPRC5D has become A potential target for the treatment of multiple myeloma (MM).
  • MM multiple myeloma
  • Disease status refers to whether the disease exists, the severity of the disease, the stage, type, and progress of the disease, etc.
  • GPRC5D-binding peptide refers to a polypeptide that targets or specifically binds to GPRC5D.
  • the GPRC5D binding peptide is a single domain antibody targeting GPRC5D.
  • Protein segment refers to a polypeptide fragment, which is a short amino acid sequence, such as about 2-20 amino acids in length, and is usually a part of a polypeptide or protein.
  • EC50 concentration for 50% of maximal effect refers to the concentration that causes 50% of the maximal effect.
  • concentration of antibody molecules that produces half of the maximum fluorescence intensity When used in FACS to indicate the binding ability of antibody molecules to corresponding antigens on cells, it can refer to the concentration of antibody molecules that produces half of the maximum fluorescence intensity. The lower the EC50 value, the greater the binding affinity to the antigen on the cell.
  • Purification tag refers to the amino acid sequence used to purify the target protein or polypeptide expressed as a fusion protein with the target protein or polypeptide, including but not limited to His6 tag, Flag tag, MBP (maltose binding protein) tag and GST (gluten Glutathione thiol transferase) tag, SUMO (small ubiquitin related modifier (small ubiquitin related modifier)), etc. These tags can be removed by enzyme cleavage after purification, or can be used with tags (such as His6 tags) without affecting the normal function of the target protein or polypeptide.
  • Detectable label refers to an amino acid sequence or other chemical group attached to a protein or polypeptide to indicate the presence or amount of the protein or polypeptide in a sample, or to track the protein or polypeptide in the body or cells of a subject location information.
  • detectable labels include various enzymes that can be used in immunoassays, such as horseradish peroxidase (HRP), alkaline phosphatase (ALP); fluorophores (such as FAM, FITC) or fluorescent proteins (such as GFP ); radioactive isotopes (eg 3 H, 14 C, 35 S).
  • HRP horseradish peroxidase
  • ALP alkaline phosphatase
  • fluorophores such as FAM, FITC
  • fluorescent proteins such as GFP
  • radioactive isotopes eg 3 H, 14 C, 35 S.
  • polypeptide and “protein” are used interchangeably and refer to a polymer of amino acid residues.
  • Such polymers of amino acid residues may contain natural or unnatural amino acid residues and include, but are not limited to, peptides, oligopeptides, dimers, trimers, and multimers of amino acid residues. Both full-length proteins and fragments thereof are encompassed within this definition.
  • the term also includes post-expression modifications of the polypeptide, such as glycosylation, sialylation, acetylation, phosphorylation, and the like.
  • polypeptide refers to a protein that includes modifications to the native sequence, such as deletions, additions and substitutions (often conservative in practice), so long as the protein retains the desired activity. These modifications may be purposeful, such as induced through site-directed mutagenesis, or may be accidental, such as through mutation of the protein-producing host or errors due to PCR amplification.
  • nucleic acid molecule refers to a polymer of nucleotides.
  • nucleotide polymers may contain natural and/or unnatural nucleotides and include, but are not limited to, DNA, RNA and PNA.
  • Nucleic acid sequence refers to the linear sequence of nucleotides comprised in a nucleic acid molecule or polynucleotide.
  • vector refers to a nucleic acid molecule (eg, nucleic acid, plasmid, or virus, etc.) that can be engineered to contain a polynucleotide of interest (eg, a coding sequence for a polypeptide of interest) or that can replicate in a host cell.
  • a vector may include one or more of the following components: an origin of replication, one or more regulatory sequences (such as a promoter and/or enhancer) that regulate the expression of a polynucleotide of interest, and/or one or more Selectable marker genes (such as antibiotic resistance genes and genes useful in colorimetric assays, eg ⁇ -galactose).
  • expression vector refers to a vector used to express a polypeptide of interest in a host cell.
  • a "host cell” refers to a cell that can be or has been a recipient of a vector or isolated polynucleotide.
  • Host cells can be prokaryotic or eukaryotic.
  • Exemplary eukaryotic cells include mammalian cells, such as primate or non-primate cells; fungal cells, such as yeast; plant cells; and insect cells.
  • Non-limiting exemplary mammalian cells include, but are not limited to, NSO cells, 293, and CHO cells, and derivatives thereof, such as 293-6E, CHO-DG44, CHO-K1, CHO-S, and CHO-DS cells.
  • a host cell includes the progeny of a single host cell, and the progeny may not necessarily be completely identical (in morphology or genomic DNA complementation) to the original parent cell due to natural, accidental or deliberate mutation.
  • Host cells also include cells transfected in vivo with nucleic acid molecules or expression vectors provided herein.
  • Treatment means manipulating a subject to obtain a beneficial or desired clinical result.
  • Treatment encompasses a variety of manipulations including administration of any possible drug to a subject, surgery, radiation, and the like.
  • beneficial or desired clinical outcomes include, but are not limited to, any one or more of the following: alleviation of one or more symptoms, attenuation of disease extent, prevention or delay of disease spread (e.g. metastasis, e.g. metastases to the lungs or lymph nodes), preventing or delaying disease recurrence, delaying or slowing down disease progression, improving disease conditions, inhibiting disease or disease progression, arresting its development and remission (whether partial or complete).
  • the methods provided herein encompass any one or more of these therapeutic aspects.
  • “treating” does not require complete removal of all symptoms or complete remission of a disorder or disease.
  • terapéuticaally effective amount refers to the amount of an active compound sufficient to elicit a clinician's desired biological or medical response in a subject.
  • the "therapeutically effective amount” of the fusion protein of the present invention can be determined by those skilled in the art according to factors such as administration route, subject's body weight, age, and condition. For example, a typical daily dosage may range from 0.01 mg to 100 mg or more of active ingredient per kg body weight.
  • the term "pharmaceutically acceptable carrier” as used refers to substances such as solid or liquid diluents, fillers, antioxidants, stabilizers, etc. that can be safely administered, which are suitable for human and/or Animal administration without undue adverse side effects, while being suitable for maintaining the viability of the drug or active agent located therein.
  • various carriers well known in the art can be administered, including, but not limited to, sugars, starches, cellulose and its derivatives, maltose, gelatin, talc, calcium sulfate, vegetable oils, synthetic oils, polyols , alginic acid, phosphate buffer, emulsifier, isotonic saline, and/or pyrogen-free water, etc.
  • the pharmaceutical composition provided herein can be made into clinically acceptable dosage forms such as powder and injection.
  • the pharmaceutical composition of the present invention may be administered to a subject by any suitable route, for example, orally, intravenously, intramuscularly, subcutaneously, subperitoneally, rectally, sublingually, or by inhalation, transdermally, etc. route of administration.
  • Subject means an animal, such as a mammal, including, but not limited to, a human, rodent, simian, feline, canine, equine, bovine, porcine, sheep, goat, lactating laboratory animals, mammalian farm animals, mammalian sports animals and mammalian pets.
  • the subject can be male or female and can be of any appropriate age, including infant, infant, adolescent, adult and geriatric subjects.
  • a subject refers to an individual in need of treatment for a disease or condition.
  • a subject receiving treatment can be a patient who has, or is at risk of developing, a disorder associated with the treatment.
  • the subject is a human, such as a human patient. The term is often used interchangeably with "patient”, "subject", “subject” and the like.
  • population generally refers to a healthy population. In the context of a particular analysis of a disease, “population” can also refer to individuals who do not have that disease but have other diseases. In addition, some individuals can also be designated as “groups” according to characteristics such as age, whether they smoke, whether they drink alcohol, and personal health status. "Normal GPRC5D content" in a population can be determined by measuring a sufficient number of individuals.
  • Bio sample means a quantity of material from a living or formerly living organism. Such substances include, but are not limited to, blood (eg, whole blood), plasma, serum, urine, amniotic fluid, synovial fluid, endothelial cells, leukocytes, monocytes, other cells, organs, tissues, bone marrow, lymph nodes, and spleen.
  • sequence identity when referring to amino acid or nucleotide sequences, refers to the identity between two amino acid or nucleotide sequences (e.g., a query sequence and a reference sequence). The amount of degree, usually expressed as a percentage. Typically, prior to calculating the percent identity between two amino acid or nucleotide sequences, the sequences are aligned and gaps, if any, introduced. If at a certain alignment position, the amino acid residues or bases in the two sequences are the same, the two sequences are considered to be identical or match at this position; if the amino acid residues or bases in the two sequences are different, they are considered to be inconsistent at this position or mismatch.
  • sequence identity is obtained by dividing the number of matching positions by the total number of positions in the alignment window. In other algorithms, the number of gaps and/or gap lengths are also taken into account.
  • the publicly available alignment software BLAST available at ncbi.nlm.nih.gov
  • BLAST can be used to obtain an optimal sequence alignment and calculate two amino acid or nucleotide alignments by using default settings. Sequence identity between sequences.
  • GPRC5D binding peptides that specifically bind GPRC5D.
  • the GPRC5D binding peptide binds the GPRC5D molecule with relatively high binding affinity.
  • the GPRC5D can be a fusion protein linked to other polypeptides, such as GPRC5D-VLP, or a GPRC5D membrane protein expressed on the cell surface.
  • the binding ability of GPRC5D-binding peptides to GPRC5D can be measured by assay methods such as enzyme-linked immunosorbent assay (ELISA) and flow cytometry fluorescence sorting technique (FACS).
  • ELISA enzyme-linked immunosorbent assay
  • FACS flow cytometry fluorescence sorting technique
  • it can also be determined by other protein interaction assay methods known in the art, for example, surface plasmon resonance (SPR) biolayer interferometry (BLI) technique.
  • the GPRC5D binding peptide is an antibody molecule or an antigen-binding fragment thereof.
  • the GPRC5D-binding peptide is a single domain antibody.
  • the GPRC5D-binding peptide provided herein comes from the screening of a human phage antibody library and is a fully human single domain antibody.
  • Single domain antibodies are antibodies that include only the variable region of the heavy chain, examples of which may include, but are not limited to, heavy chain antibodies, antibodies naturally lacking light chains, single domain antibodies derived from classical 4 chain antibodies, and engineered antibodies .
  • Single domain antibodies may be derived from any species including, but not limited to, mouse, human, camel, llama, alpaca, vicuna, guanaco, shark, goat, rabbit, and/or bovine.
  • This paper provides the CDR sequences of three GPRC5D-binding peptides, which are respectively the sequences shown in SEQ ID NO: 1-3, 4-6, and 7-9.
  • GPRC5D binding peptide single domain antibody
  • those skilled in the art can construct various polypeptide constructs with GPRC5D binding ability, which include the use of framework regions (FR) and These CDR sequences are combined.
  • framework regions include native framework region sequences from human antibodies or animal (eg, mouse, rat, goat, camel, etc.) antibodies.
  • framework regions may also include framework region sequence variants produced by changes to the natural framework region sequences.
  • a polypeptide construct specifically binding to GPRC5D can be easily obtained by combining the CDR sequences provided herein with different framework region sequences to form a heavy chain variable region, and testing its ability to bind to GPRC5D.
  • the heavy chain variable region of the GPRC5D binding peptide (single domain antibody) provided herein comprises at least 90% sequence identity (e.g., at least 95%, at least 98%) to the sequence shown in SEQ ID NO: 10. %, at least 99% or even 100% sequence identity).
  • the heavy chain variable region of the GPRC5D binding peptide (single domain antibody) provided herein comprises at least 90% sequence identity (e.g., at least 95%, at least 98%) to the sequence shown in SEQ ID NO: 11. %, at least 99% or even 100% sequence identity).
  • the heavy chain variable region of the GPRC5D binding peptide (single domain antibody) provided herein comprises at least 90% sequence identity (e.g., at least 95%, at least 98%) to the sequence shown in SEQ ID NO: 12. %, at least 99% or even 100% sequence identity).
  • the antibody molecule or single domain antibody provided herein may have at least 1 and no more than 10, such as no more than 5, 4, 3, 2 or 1 amino acid in its full-length or variable region sequence or CDR sequence change.
  • the GPRC5D binding peptides described herein may contain conservative amino acid substitutions.
  • Conservative amino acid substitutions can generally be described as the substitution of one amino acid residue for another amino acid residue of similar chemical structure and have little or no substantial effect on the function, activity or other biological properties of the polypeptide. Conservative amino acid substitutions are well known in the art.
  • Conservative substitutions can be, for example, the substitution of one amino acid in the following groups (a)-(e) by another amino acid within the same group: (a) small aliphatic non-polar or weakly polar residues: Ala, Ser, Thr, Pro and Gly; (b) polar negatively charged residues and their (uncharged) amides: Asp, Asn, Glu and Gln; (c) polar positively charged residues: His, Arg and Lys; (d) large aliphatic nonpolar residues: Met, Leu, Ile, Val, and Cys; and (e) aromatic residues: Phe, Tyr, and Trp.
  • the polypeptide construct may also include more than one GPRC5D-binding peptides, which are directly connected in series or connected in series through a linker sequence (linker).
  • the polypeptide construct includes two GPRC5D-binding peptides, the two GPRC5D-binding peptides being the same.
  • the polypeptide construct comprises two GPRC5D-binding peptides that differ in amino acid sequence by at least one amino acid.
  • the polypeptide construct includes at least one GPRC5D-binding peptide provided herein and at least one other GPRC5D-binding peptide.
  • the polypeptide construct includes two different GPRC5D-binding peptides provided herein.
  • the polypeptide construct includes three different GPRC5D-binding peptides provided herein.
  • the linker sequence can be a naturally occurring linker, a synthetic linker, or a combination of both.
  • Particularly suitable linker sequences mainly comprise amino acid residues selected from the group consisting of glycine (Gly), serine (Ser), alanine (Ala) and threonine (Thr).
  • the linker may contain at least 75% (calculated based on the total number of residues present in the peptide linker), such as at least 80%, at least 85% or at least 90%, of amino acids selected from Gly, Ser, Ala and Thr Residues.
  • Linkers may also consist of only Gly, Ser, Ala and/or Thr residues.
  • the linker contains 1-25 glycine residues, 5-20 glycine residues, 5-15 glycine residues, or 8-12 glycine residues.
  • suitable peptide linkers typically contain at least 50% glycine residues, such as at least 75% glycine residues.
  • the peptide linker comprises only glycine residues.
  • the peptide linker comprises only glycine and serine residues, such as in the form (GS) n , where n is, for example, an integer from 1-20.
  • Fusion proteins comprising GPRC5D-binding peptides
  • polypeptide constructs comprising multiple GPRC5D-binding peptides belong to fusion proteins comprising GPRC5D-binding peptides.
  • the GPRC5D binding peptide can also form a fusion protein with other polypeptides.
  • a GPRC5D binding peptide can be linked to an Fc fragment to form a fusion protein.
  • the Fc fragment can be located at the C-terminus and N-terminus of the GPRC5D binding peptide.
  • the Fc fragment may be located at the C-terminus of the GPRC5D binding peptide.
  • the fusion protein formed by the GPRC5D-binding peptide and the Fc fragment has the ability to specifically bind GPRC5D, and at the same time has the effector function of the Fc fragment, such as mediating complement-dependent cytotoxicity (CDC), antibody-dependent cell-mediated cytotoxicity (ADCC) , Mediate phagocytosis, etc.
  • Non-limiting fusion protein constructs containing GPRC5D-binding peptides may include, but are not limited to, the following formats: VHH1-Fc, VHH1-VHH2-Fc, and VHH1-VHH2-VHH3-Fc, wherein VHH refers to GPRC5D-binding peptides (single domain antibodies), VHH1, VHH2 and VHH3 may be the same or different.
  • a GPRC5D binding peptide can be linked to a protein tag to form a fusion protein.
  • Protein tags can include purification tags and detectable tags.
  • Purification tags include, but are not limited to, His6 tags, Flag tags, MBP tags, GST tags, SUMO) tags, and the like.
  • the detectable label can be used to indicate the presence or content of the GPRC5D-binding peptide in the sample, or to track the location information of the GPRC5D-binding peptide in the body or cells of the subject.
  • detectable labels include various enzymes useful in immunoassays, such as horseradish peroxidase (HRP), alkaline phosphatase (ALP), etc.; fluorescent proteins, such as GFP.
  • the amount of the GPRC5D-binding peptide can be determined by the amount of the detectable label linked to the GPRC5D-binding peptide, and then the content of GPRC5D in the sample can be determined.
  • GPRC5D-binding peptides can be linked to cytokines or therapeutic proteins to form fusion proteins.
  • the specific binding ability of GPRC5D-binding peptides to GPRC5D can be used to deliver cytokines or therapeutic proteins to specific tissues or cells (such as tumor tissues expressing GPRC5D) to achieve cytokine or therapeutic effects. The therapeutic effect of proteins.
  • Multispecific antibodies comprising GPRC5D-binding peptides
  • multispecific binding peptides comprising at least one GPRC5D-binding domain (or functional unit) and one or more additional binding domains.
  • the one or more additional binding domains may bind to a second antigen or protein other than GPRC5D.
  • multispecific binding peptides comprising at least two GPRC5D-binding domains.
  • the two binding domains binding to GPRC5D have differences in amino acid sequence, and respectively bind to different epitopes on GPRC5D.
  • multispecific binding peptides comprising at least two GPRC5D-binding domains and one or more additional binding domains.
  • the two binding domains that bind GPRC5D differ in amino acid sequence and bind to different epitopes on GPRC5D respectively; the one or more additional binding domains may bind to a second antigen or protein other than GPRC5D .
  • the GPRC5D-binding domain is a single domain antibody provided herein; the one or more additional binding domains can be a single domain antibody, single chain antibody, or other antigen-binding fragment.
  • the second antigen is a tumor-associated antigen (TAA) or a tumor microenvironment-associated antigen (TMEAA).
  • TAA tumor-associated antigen
  • TAEAA tumor microenvironment-associated antigen
  • the second antigen is an immunomodulatory antigen, wherein the antigen is associated with enhancing or inhibiting signaling pathways in immune cells.
  • the second antigen is a T cell surface molecule, such as a component of the T cell receptor complex, eg, CD3 (including gamma, delta, epsilon, zeta and eta chains).
  • said multispecific binding peptide is a bispecific antibody molecule.
  • the multispecific binding peptide also includes an Fc fragment.
  • the presence of the Fc fragment facilitates multimerization of the binding domains and provides associated effector functions.
  • conjugates comprising at least one GPRC5D-binding peptide provided herein that specifically binds GPRC5D and one or more other functional moieties.
  • the other moiety may be a chemical group, eg a therapeutic agent, such as a cytotoxic agent, or may be a tracer.
  • the moiety can be a targeting moiety, a small molecule drug (e.g., a non-polypeptide drug less than 500 Da), a toxin, a cytostatic agent, a cytotoxic agent, an immunosuppressant, a radioactive agent suitable for diagnostic purposes, Radioactive metal ions for therapeutic purposes, etc.
  • the immunoconjugate is an antibody drug conjugate (ADC) comprising one or more GPRC5D binding peptides provided herein and a therapeutic agent that is cytotoxic, inhibits cell growth, or provides some therapeutic benefit .
  • the cytotoxic agent is a chemotherapeutic agent, a drug, a growth inhibitor, a toxin (such as an enzymatically active toxin or fragment thereof of bacterial, fungal, plant or animal origin), or a radioisotope (i.e., a radioconjugate ).
  • the antibody drug conjugates provided herein allow targeted delivery of drug moieties to tumors. In some instances, this can lead to targeted killing of tumor cells.
  • therapeutic agents include, for example, daunomycin, doxorubicin, methotrexate, vindesine, maytansinoids, and the like. In some instances, therapeutic agents are intracellularly active. In some examples, an immunoconjugate that binds GPRC5D is internalized and the therapeutic agent has cellular protein synthesis activity, blocks nucleic acid synthesis activity, and causes cell growth arrest or death.
  • an immunoconjugate comprises one or more GPRC5D-binding peptides provided herein and a tracer.
  • the immunoconjugates can be used for research or diagnostic purposes, eg for detection of cancer in vivo.
  • Tracers can directly or indirectly produce a detectable signal.
  • tracers may be radioactive isotopes such as 3 H, 14 C, 32 P, 35 S, 123 I; fluorescent (fluorophore) or chemiluminescent (chromophore) compounds such as fluorescent isothiocyanates, rhodamine or fluorescein; imaging agents; or metal ions.
  • the tracer is a radioactive atom for scintigraphic studies, such as99Tc or123I , or a spin label for nuclear magnetic resonance (NMR) imaging (also known as magnetic resonance imaging, MRI),
  • NMR nuclear magnetic resonance
  • 89 Zr can complex with various metal chelators and bind to antibodies, for example for PET imaging.
  • Linkage of GPRC5D binding peptides to other functional moieties may be covalent or non-covalent.
  • An example of non-covalent attachment may include via the Biotin-Avidin System.
  • Examples of covalent linkages can include various chemical linkers, including peptide linkers, cleavable linkers, or non-cleavable linkers.
  • linker components include 6-maleimidocaproyl ("MC”), maleimidopropionyl (“MP”), valine-citrulline (“val -cit”), alanine-phenylalanine (“ala-phe”), p-aminobenzyloxycarbonyl (“PAB”), N-succinimidyl 4-(2-pyridylthio base) pentanoate (“SPP”), N-succinimidyl 4-(N-maleimidomethyl)cyclohexane-1 carboxylate (“SMCC”) and N - Succinimidyl (4-iodo-acetyl)aminobenzoate (“SIAB”).
  • MC 6-maleimidocaproyl
  • MP maleimidopropionyl
  • val cit valine-citrulline
  • ala-phe alanine-phenylalanine
  • PAB p-aminobenzyloxycarbonyl
  • SPP N-s
  • linkers may comprise amino acid residues.
  • Exemplary amino acid linker components include dipeptides, tripeptides, tetrapeptides or pentapeptides.
  • Exemplary dipeptides include: valine-citrulline (vc or val-cit), alanine-phenylalanine (afa-phe).
  • Exemplary tripeptides include: glycine-valine-citrulline (gly-val-cit) and glycine-glycine-glycine-glycine (gly-gly-gly).
  • Amino acid residues comprising amino acid linker components include naturally occurring residues as well as non-naturally occurring amino acid analogs, such as citrulline.
  • Amino acid linker components can be designed and optimized with respect to their selectivity for enzymatic cleavage by specific enzymes such as tumor-associated proteases, cathepsins B, C and D, plasmin proteases.
  • Conjugates of GPRC5D-binding peptides with cytotoxic agents can be prepared using a variety of bifunctional protein coupling reagents, such as N-succinimidyl-3-(2-pyridyldithiol)propionate (SPDP) , iminothiolane (IT), bifunctional derivatives of imide esters (such as dimethyl adipimide HCl), active esters (such as disuccinimidyl substrates), Aldehydes (such as glutaraldehyde), bis-azido compounds (such as bis(p-azidobenzoyl)hexamethylenediamine), dinitrogen derivatives (such as bis-(p-diazobenzoyl)-ethylenediamine ), diisocyanates (such as toluene 2,6-diisocyanate), and bisactive fluorine compounds (such as 1,5-difluoro-2,4-dinitrobenzene).
  • SPDP
  • compositions and methods of treatment comprising GPRC5D binding peptides
  • the GPRC5D-binding peptides disclosed herein, as well as fusion proteins comprising the GPRC5D-binding peptides, multispecific antibody molecules, and immunoconjugates can be used for administration to subjects for cancer prevention or treatment. Amounts effective for this use will depend on the severity of the disease and the general state of the patient's own immune system.
  • the dosing regimen will also vary with the disease state and the state of the subject, and will generally range from a single bolus or continuous infusion to multiple daily doses (eg, every 4-6 hours).
  • a clinician skilled in the art can readily determine whether a subject is a candidate for such treatment, eg, by utilizing clinical tests, physical examination and the subject's family history.
  • the GPRC5D-binding peptides disclosed herein and fusion proteins, multispecific antibody molecules, and immunoconjugates comprising the GPRC5D-binding peptides can be administered in combination with one or more other drugs (such as anti-tumor agents) medicine.
  • the disease or condition treated is a tumor, preferably multiple myeloma.
  • the GPRC5D-binding peptides disclosed herein (as well as fusion proteins, multispecific antibody molecules, and immunoconjugates comprising the GPRC5D-binding peptides) disclosed herein may be used in any suitable method or approach, optionally in combination with other anti-tumor agents. Routes of administration include, for example, oral, intravenous, intraperitoneal, subcutaneous or intramuscular administration.
  • the nucleic acid molecule encoding the GPRC5D-binding peptide provided herein, the expression vector comprising the nucleic acid molecule, and the host cells transfected with the nucleic acid molecule or the expression vector can also be used for the above-mentioned therapeutic purposes in various ways.
  • the expression vector it can be introduced into the body of the subject by means of gene therapy known in the art to express the target protein or polypeptide (GPRC5D binding peptide), so as to achieve the purpose of treatment.
  • diagnostic kits or therapeutic kits comprising GPRC5D binding peptides
  • the GPRC5D-binding peptides provided herein, as well as other forms of molecules (such as fusion proteins or bispecific antibody molecules) comprising the GPRC5D-binding peptides, can specifically bind to GPRC5D in a sample.
  • the content (or presence) of GPRC5D in the sample can be conveniently determined.
  • the GPRC5D-binding peptides provided herein can be linked to various detection tags to facilitate detection by various means, including but not limited to bioluminescence, fluorescence, radiolabeling, enzymatic reaction. product production, etc.
  • detecting the GPRC5D content in the sample comparing it with the normal GPRC5D content in the normal population can be used to determine the disease status or severity of the subject who provided the sample.
  • comparing it with the normal GPRC5D content in the normal population can be used to determine the disease status or severity of the subject who provided the sample.
  • it can also be used to determine whether the treatment is effective, thereby providing a basis for the modification of the treatment plan.
  • the GPRC5D-binding peptides provided herein, as well as other forms of molecules comprising the GPRC5D-binding peptides, such as fusion proteins or bispecific antibody molecules, can be placed in containers to form detection, diagnostic or therapeutic kits. These containers may be in the form of cartridges, ampoules, vials, tubes, bags or other suitable containers known in the art. These containers can be made of plastic, glass, laminated paper, foil, or other materials suitable for holding medications. Instructions for use are provided with the container, if desired.
  • the instructions may generally include information on how to use the GPRC5D-binding peptide or a composition comprising the GPRC5D-binding peptide for the treatment or prevention of tumors (e.g., multiple myeloma), for example may include a description of a therapeutic agent (e.g., a GPRC5D-binding peptide); Dosage regimens for the treatment or prevention of neoplasia (eg, multiple myeloma); precautions; warnings; indications; contraindications; adverse reactions; animal pharmacology; clinical studies; and/or reference materials.
  • the instructions may be printed directly on the container (if present), or as a label affixed to the container, or as a separate paper, booklet, card or folded print provided in or with the container.
  • the GPRC5D-binding peptide (or GPRC5D-targeting antibody molecule) provided herein is a fully human single-domain antibody, and its binding affinity to GPRC5D is close to or better than that of the control antibody.
  • Example 1 Enrichment of specific antibody clones targeting GPRC5D protein from phage antibody library by affinity panning
  • the phage antibody libraries we constructed include natural libraries, semi-synthetic libraries and single-domain libraries.
  • Semi-synthetic phage antibody library used together with natural library, to solve the problem that natural library may lack GPRC5D high-affinity antibody clones.
  • the single-domain phage antibody library is an antibody library composed only of the variable region amino acids of heavy chain antibodies. Its molecular weight is only 12-15kDa, but it has similar or higher specificity and affinity than traditional antibodies.
  • single domain antibodies have attracted much attention because of their stable physical and chemical properties, high affinity, easy recombinant expression and preparation, and easy combination with other target or epitope antibodies.
  • Coating antigen Dilute the antigen GPRC5D-VLP to 10 ⁇ g/mL with clean coating buffer (PBS), add 100 ⁇ L working solution to each well, panning 6 wells per panning, and bind overnight at 4°C;
  • Blocking remove the antigen upside down, and pat off the residual liquid in the well with absorbent paper, add 250 ⁇ L of 3% BSA-PBS to block, and block at room temperature for 2 hours;
  • the enriched phage pool can be used for subsequent monoclonal selection and ELISA/FACS screening.
  • Fully human phage antibody library including natural library, semi-synthetic library and single domain library;
  • VLP protein VLP protein, Kactus, order
  • Table 2 shows the results of joint panning using recombinant GPRC5D protein and CHO-K1-GPRC5D/CHO-K1 cell line. Judging from the recovery rate, all 4 pannings were enriched and could be used to select single clones in the next step.
  • Example 2 Screening of specific clones from enriched phage pools using ELISA and FACS
  • the phage pool enriched by the affinity panning step contains phage antibodies of various properties: specific clones, non-specific clones, and negative clones.
  • specific clones we need to isolate single clones, package them into monoclonal phages, and conduct primary screening on a large number of single clones by ELISA) and FACS, and select the positive cell line CHO- Monoclonal K1-GPRC5D.
  • the specific monoclonal is further determined by DNA sequencing to determine the unique antibody sequence contained therein.
  • step 5 Add 100 ⁇ L of the phage supernatant cultured in step 1) to the wells coated with the target antigen, and combine at room temperature for 2 hours;
  • mice anti M13 primary antibody diluted 1:2000, 100 ⁇ L/well, incubate at room temperature for 45 minutes;
  • mice anti M13 primary antibody diluted 1:2000, 100 ⁇ L/well, mix well by pipetting, and incubate at room temperature for 45 minutes;
  • Fluorescein (FITC) AffiniPure Goat Anti-Human IgG, Fc ⁇ fragment specific, Jackson
  • Monoclonals were randomly selected from the enriched phage antibody pool, packaged into phages, and the binding of monoclonal phages to GPRC5D-VLP protein and control protein VLP was detected by phage ELISA to find GPRC5D-specific phage antibody clones.
  • the ELISA results of some clones are shown in Figure 1. It can be seen from the figure that clones A1, A2, A4, A7 and A8 bind strongly to the target antigen GPRC5D (GPRC5D-VLP), and do not bind to the control antigen VLP, showing good specificity. Clones A3, A5 and A6 combined with both the target antigen and the control antigen, and did not meet the requirements for specific binding.
  • Negative phage control is a negative control phage antibody clone, which does not bind to the target antigen or control antigen.
  • Anti-M13 phage mouse/anti-mouse HRP Ab is a negative antibody control with only primary and secondary antibodies added, and anti-mouse HRP Ab is Anti-human IgG HRP Ab is a negative antibody control with only secondary antibody added, which does not bind to the target antigen and control antigen; anti-his tag HRP Ab is a positive antibody control for detecting antigen tags, Combination with his-tagged antigen indicates that the coated antigen has been bound to the plate.
  • Positive Benchamrk1 is a positive antibody to the target antigen, which binds to the target antigen and does not bind to the control antigen.
  • FIG. 2A is the result after staining of CHO-K1-GPRC5D cell line by commercialized flow cytometry antibody Human GPRC5D PE-conjugated Antibody and Positive benchmark1 (variable region sequence comes from GC5B596 of Chinese patent application publication CN 109715667 A), the result shows that All cells can bind to GPRC5D antibody, indicating that CHO-K1-GPRC5D cells are positive for GPRC5D expression.
  • the A1, A2, A3, A4, A5, A6 and A7 clones in Figure 2B bind to CHO-K1-GPRC5D, but do not bind to CHO -K1 cell is a specific clone; A8 clone does not combine with the two kinds of cells, it is a negative clone; Negative phage control is a negative control phage antibody clone, which does not bind to the target antigen and the control antigen, Positive Benchamrk1 Ab (GC5B596) is The positive antibody of the target antigen binds to the highly expressed cell line CHO-K1-GPRC5D, but does not bind to the control negative cell CHO-K1.
  • the antibody used for treatment must have very good target specificity, and only bind the target antigen, not any unrelated antigen; on the other hand, the amino acid sequence of the same antigen on different cell lines will be different (Isomers or mutants) or binding ligands are different, and it is also necessary to investigate whether our antibodies can bind to cells positive for various target proteins.
  • ELISA enzyme-linked immunoassay
  • the rest of the reagents are the same as the ELISA primary screening.
  • Antibodies used for therapy must have very good target specificity.
  • Negative phage control is a negative control phage antibody clone that does not bind to the target antigen or control antigen.
  • Anti-M13 phage mouse/anti-mouse HRP Ab is a negative antibody control that only adds primary and secondary antibodies
  • anti-mouse HRP Ab is the negative antibody control with secondary antibody only, they do not bind to the target antigen and the control antigen
  • Positive Benchmark1 Ab (GC5B596) is the positive antibody control of the target antigen (GPRC5D-VLP), it binds to the target antigen , does not bind to the control antigen.
  • Anti-human IgG HRP Ab is a negative antibody control with only secondary antibody added
  • anti-his HRP Ab is a positive antibody control for detecting antigen tags, which binds to the his-tagged antigen, indicating that the coated antigen has been bound to the plate. Clones 18, 39, and 41 all bound to the GPRC5D antigen, but none of the four non-related antigens, indicating that clones 18, 39, and 41 could bind to the GPRC5D antigen with good specificity.
  • MM1S cell line MM1S cell line, GPRC5D positive cell line;
  • CHO-K1 cell line GPRC5D negative cell line
  • Antibodies used for therapy must have very good target specificity. In order to further analyze the specificity of these monoclonal antibodies, we identified the only clone obtained in Example 2 on more antigens and cell lines using ELISA and flow cytometry. The results are shown in Figure 4, Negative phage Control is a negative control phage antibody clone.
  • Clones 18, 39, and 41 combined with the two GPRC5D-positive cell lines CHO-K1-GPRC5D and MM1S, but did not bind with the two GPRC5D-negative cell lines CHO-K1 and Jurkat, with good specificity; Positive Benchamrk1 Ab (GC5B596) was The positive antibody of the target antigen binds to the highly expressed cell line CHO-K1-GPRC5D, but does not bind to the control negative cell CHO-K1; combined.
  • Specific antibody clones targeting the GPRC5D antigen were enriched from the phage antibody library by affinity panning and screened and identified to obtain clones that bind to the GPRC5D antigen, but the antibody molecules expressed in the prokaryotic system were converted to those expressed in the eukaryotic system After the IgG antibody molecule, its binding ability and specificity need to be further confirmed.
  • Anti-human IgG HRP Ab is a negative antibody control with only secondary antibody added, and anti-his HRP Ab is a positive antibody control for detecting antigen tags, which binds to the his-tagged antigen, indicating that the coated antigen has been bound to the plate.
  • Clones 18, 39, and 41 all bound to the GPRC5D antigen, but none of the four non-related antigens, indicating that clones 18, 39, and 41 could bind to the GPRC5D antigen with good specificity.
  • Fluorescein (FITC) AffiniPure Goat Anti-Human IgG, Fc ⁇ fragment specific, Jackson
  • Positive Benchamrk1 Ab (GC5B596) is a positive antibody to the target antigen, which binds to the highly expressed cell line CHO-K1-GPRC5D, but does not bind to the control negative cell CHO-K1;
  • FITC anti-human IgG Ab is a negative control that only adds secondary antibodies, Does not bind to either cell line.
  • the affinity between GPRC5D antibody molecules and antigens may have an important impact on the killing effect and duration of CAR-T or antibody drugs in patients. Because it is difficult to obtain purified antigens for the target GPRC5D, we used the FACS binding method to analyze the half effective concentration (Ec50) of antibody molecules, which provided important information for the research and development process.
  • Affinity refers to the binding strength of a single molecule to its ligand.
  • FACS can be used to detect the binding ability to positive cell lines to evaluate the strength of the interaction between two molecules and rank them.
  • Benchmark1 clone 18, clone 39 and clone 41 can all bind to the GPRC5D overexpression cell line CHO-K1-GPRC5D cells, and the affinity of clone 18 is slightly higher than that of Benchamrk1, higher than that of clone 39 and clone 41.
  • Pillarisetti K Edavettal S, M, Li Y, Tornetta M, Babich A, Majewski N, Husovsky M, Reeves D, Walsh E, Chin D, Luistro L, Joseph J, Chu G, Packman K, Shetty S, Elsayed Y, Attar R, Gaudet FA T -cell-redirecting bispecific G-protein-coupled receptor class 5member D x CD3 antibody to treat multiple myeloma.Blood.2020 Apr 9;135(15):1232-1243.doi:10.1182/blood.2019003342.PMID:320405 49;PMCID :PMC7146017.

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Abstract

提供了靶向GPRC5D的抗体或其抗原结合片段，包括全人源抗体，其以高亲和力特异性结合GPRC5D。还提供了包括该靶向GPRC5D的全人源抗体或其抗原结合片段的融合蛋白、双特异性抗体、免疫偶联物以及它们的检测和治疗用途。

Description

靶向GPRC5D的全人源抗体 技术领域
本发明涉及靶向GPRC5D的抗体，尤其是靶向GPRC5D的全人源抗体。本发明还涉及该抗体的应用。
背景技术
多发性骨髓瘤(multiple myleloma)是一种发生于骨髓的浆细胞肿瘤。该肿瘤会引发高钙血症、贫血、肾功能障碍、骨坏死和骨髓衰竭等病症。目前多发性骨髓瘤是第二大常见血液肿瘤。以2020年世界卫生组织WHO公布的多发性骨髓瘤发病率统计显示，亚洲人群发病率和死亡率占比分别为36％和42％，居所有洲统计的首位。全球多发性骨髓瘤的发病率和死亡率比为1.8:1.1，亚洲为1.1:0.76，可见多发性骨髓在发病人群的生存率较低。主要原因一是发生人群的年龄中位值偏高在66岁左右，40岁以下人群的发生率在2％左右。二是多发性骨髓瘤在常用的化疗，免疫调节剂以及单抗疗法下几乎无治愈可能性，勉强缓解也伴随着极高的复发率，即复发难治性骨髓瘤(Relapsed/refractory Multiple myeloma(RRMM)，五年生存率仅有51％。
近年来在多发性骨髓瘤治疗上，T细胞双特异性抗体疗法(bispecific T cell engagers，BiTEs)和继发性T细胞疗法(adoptive T cell therapy，ACT)取得了突破性进展。针对多发性骨髓瘤的靶向疗法产品靶点主要有BCMA、CD38、CD138、GPRC5D等。CD38和CD138还会在正常组织的细胞上及造血干细胞上表达，利用靶向疗法清除后副作用较大，往往会对正常器官造成损伤或是自身免疫系统受损，而BCMA和GPRC5D主要表达在浆细胞或骨髓瘤中的浆细胞上，而浆细胞可以依靠人体自身B细胞的不断再生得到弥补。以T细胞双特异性抗体产品为例，BCMA靶点的产品主要有再生元制药公司(Regeneron Pharmaceuticals,Inc.(REGN))研发的REGN5458，强生研发的Teclistama，以及安进的AMG420。REGN5458目前已结束临床一期实验(NCT03761108)。19名接受治疗的患者种，42％达到完全缓解(CR)或者严格完全缓解(sCR)；Teclistamab已进入临床二期实验(NCT04557098)，临床一期结果显示，总体响应率(ORR)为65％，40％的患者完全缓解(CR)；AMG420的临床一期(NCT03836053)显示，总体响应率(ORR)为71％。
百时美施贵宝(BMS)研发的针对多发性骨髓瘤BCMA靶点的CAR-T产品－bb2121在2021年5月被FDA批准为第一款多发性骨髓瘤上市的CAR-T产品。该产品总体响应率(ORR)为72％，28％患者可达到严格完全缓解(sCR)。尽管该产品为多发性骨髓的治愈带来了希望，但是从公布的数据来看，其完全缓解(CR)的患者中22个月疾病无进展生存期占比也不到50％，可见治疗后期也存在较高的复发率。此外，由于该疗法清除所有的浆细胞， 仍然有血细胞减少免疫球蛋白降低等引发的副作用。GPRC5D表达相对BCMA更为特异，仅在骨髓瘤患者的浆细胞中表达，而正常组织几乎不表达，仅在毛囊组织中能检测到明显的RNA和蛋白表达。在敲除GPRC5D的老鼠与正常野生型的表型比较上(包括体重，器官形态学差异，生殖率等)，也未发现明显差异，可见GPRC5D缺失对生存和正常器官的代谢并非必需，其清除的副作用较小。进一步发现，BCMA的表达和GPRC5D并没有相关性，两者虽然都同时在浆细胞中表达，但表达谱相对独立。可见对于BCMA CAR-T疗法后期患者中BCMA表达偏低，可用靶向GPRC5D来治疗。
因此，开发能够对GPRC5D表达的细胞发挥临床有效的细胞毒性、细胞抑制或免疫抑制效应，对GPRC5D不表达的细胞无不良影响的全人源抗体，对研发GPRC5D表达相关的免疫治疗产品，有非常重要的意义。
发明内容
在一方面，本文提供了GPRC5D结合肽，其包括抗体分子的重链可变区，所述重链可变区中的HCDR1、HCDR2和HCDR3选自如下组合之一：
1)HCDR1为GGSFSGYY(SEQ ID NO：1)；
HCDR2为INHSGST(SEQ ID NO：2)；
HCDR3的序列为ARARRYGGRTRFDP(SEQ ID NO：3)；
2)HCDR1为GFIFSSYG(SEQ ID NO：4)；
HCDR2的序列为ISSSGDYT(SEQ ID NO：5)；
HCDR3的序列为ARMSFRRYDH(SEQ ID NO：6)；以及
3)HCDR1为GFSFSGYI(SEQ ID NO：7)；
HCDR2的序列为TSSSGTET(SEQ ID NO：8)；
HCDR3的序列为ARYYSKYGRSYHVDS(SEQ ID NO：9)。
在一些实施方案中，所述GPRC5D结合肽为抗体分子或其抗原结合片段。
在一些实施方案中，所述重链可变区包括SEQ ID NO：10、11或12所示的氨基酸序列；或者所述重链可变区包括与SEQ ID NO：10、11或12所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D。
在一些实施方案中，所述GPRC5D结合肽为单域抗体分子。
在一些实施方案中，所述GPRC5D结合肽为全人源抗体分子。
在一些实施方案中，所述GPRC5D结合肽与表面表达GPRC5D的细胞结合能力为通过FACS检测的EC50值不高于10nM、9nM、8nM、7nM、6nM、或5nM。
另一方面，本文提供了融合蛋白，其包括上述GPRC5D结合肽。
在一些实施方案中，所述融合蛋白包括至少两个GPRC5D结合肽。
在一些实施方案中，所述两个GPRC5D结合肽的所述HCDR1、HCDR2和HCDR3分别选自上文列出的不同组合。
在一些实施方案中，所述融合蛋白中：所述两个GPRC5D结合肽中一个包括SEQ ID NO：10所示的氨基酸序列，或者包括与SEQ ID NO：10所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D，另一个包括SEQ ID NO：11所示的氨基酸序列，或者包括与SEQ ID NO：11所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D；所述两个GPRC5D结合肽中一个包括SEQ ID NO：10所示的氨基酸序列，或者包括与SEQ ID NO：10所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D，另一个包括SEQ ID NO：12所示的氨基酸序列，或者包括与SEQ ID NO：12所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D；或者所述两个GPRC5D结合肽中一个包括SEQ ID NO：11所示的氨基酸序列，或者包括与SEQ ID NO：11所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D，另一个包括SEQ ID NO：12所示的氨基酸序列，或者包括与SEQ ID NO：12所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D。
在一些实施方案中，所述融合蛋白包括至少三个所述GPRC5D结合肽，其中三个所述GPRC5D结合肽的所述HCDR1、HCDR2和HCDR3分别为上文列出的三个组合。
在一些实施方案中，所述融合蛋白的三个所述GPRC5D结合肽中的第一个包括SEQ ID NO：10所示的氨基酸序列，或者包括与SEQ ID NO：10所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D；第二个包括SEQ ID NO：11所示的氨基酸序列，或者包括与SEQ ID NO：11所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D；并且第三个包括SEQ ID NO：12所示的氨基酸序列，或者包括与SEQ ID NO：12所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D。
在一些实施方案中，所述融合蛋白还包括Fc片段。
在一些实施方案中，所述融合蛋白还包括另一结合肽，其能够特异性结合不同于GPRC5D的抗原。
在一些实施方案中，所述另一结合肽为单域抗体或单链抗体。
在一些实施方案中，所述融合蛋白还包括可检测标签或纯化标签。
在一些实施方案中，所述可检测标签具有酶学活性。
另一方面，本文提供了编码上述GPRC5D结合肽或上述融合蛋白的核酸分子。
在一些实施方案中，所述核酸分子包括SEQ ID NO：13、14或15所示的核苷酸序列。
另一方面，本文提供了包括上述核酸分子的表达载体。
另一方面，本文提供了包括上述核酸分子或表达载体的宿主细胞。
另一方面，本文提供了多特异性抗体分子，其至少包括第一功能部分和第二功能部分，其中第一功能部分包括上述GPRC5D结合肽；第二功能部分具有与所述第一功能部分不同的结合特异性。
在一些实施方案中，所述第二功能部分对免疫细胞具有结合特异性。
在一些实施方案中，所述第二功能部分对T细胞具有结合特异性。
在一些实施方案中，所述第二功能部分对CD3具有结合特异性。
另一方面，本文提供了免疫偶联物，包括与治疗剂连接的上述GPRC5D结合肽。
在一些实施方案中，所述治疗剂是药物。
在一些实施方案中，所述治疗剂是细胞毒素。
在一些实施方案中，所述治疗剂是放射性同位素。
另一方面，本文提供了药物组合物，其包括：1)上述GPRC5D结合肽；上述融合蛋白；上述多特异性抗体分子；或上述免疫偶联物；以及2)药学上可接收的载体。
上述的GPRC5D结合肽、融合蛋白、多特异性抗体分子、免疫偶联物或药物组合物，可用于治疗GPRC5D相关病症。
另一方面，本文提供了上述GPRC5D结合肽、融合蛋白、多特异性抗体分子或免疫偶联物在制备用于治疗GPRC5D相关病症的药物中的用途。
在一些实施方案中，所述GPRC5D相关病症为癌症，或自身免疫疾病，所述癌症优选浆细胞恶性肿瘤疾病，例如多发性骨髓瘤，或者B细胞恶性疾病，例如霍奇金淋巴瘤或非霍奇金淋巴瘤。
另一方面，本文提供了治疗GPRC5D相关病症的方法，其包括以有效量的上述GPRC5D结合肽、融合蛋白、多特异性抗体分子、免疫偶联物或药物组合物向有需要的受试者给药。
在一些实施方案中，所述GPRC5D相关病症为癌症，或自身免疫疾病，所述癌症优选浆细胞恶性肿瘤疾病，例如多发性骨髓瘤，或者B细胞恶性疾病，例如霍奇金淋巴瘤或非霍奇金淋巴瘤。
另一方面，本文提供了检测生物样品中GPRC5D的含量的方法，其包括：
1)使所述生物样品与上述GPRC5D结合肽、融合蛋白或多特异性抗体分子接触，以便与所述GPRC5D形成结合复合物；
2)基于步骤1)生成的结合复合物的量确定所述生物样品中的GPRC5D含量。
另一方面，本文提供了检测生物样品中GPRC5D的含量的方法，其包括：
1)使上述GPRC5D结合肽偶联可检测标签；
2)使带有所述可检测标签的所述GPRC5D结合肽与所述生物样品接触；
3)通过检测所述可检测标签的量来确定所述生物样品中的GPRC5D的含量。
另一方面，本文提供了检测试剂盒，其包括上述GPRC5D结合肽、融合蛋白或多特异性抗体分子。
另一方面，本文提供了药物试剂盒，其包括上述GPRC5D结合肽、融合蛋白或多特异性抗体分子。
另一方面，本文提供了在受试者中鉴定GPRC5D相关病症的方法，包括：
1)使用上述检测试剂盒确定来自所述受试者的生物样品中的GPRC5D含量；以及
3)与群体中正常GPRC5D含量进行比较，以确定所述GPRC5D相关病症是否存在或其状态。
在一些实施方案中，所述GPRC5D相关病症为癌症，或自身免疫疾病，所述癌症优选浆细胞恶性肿瘤疾病，例如多发性骨髓瘤，或者B细胞恶性疾病，例如霍奇金淋巴瘤或非霍奇金淋巴瘤。
另一方面，本文提供了确定GPRC5D相关病症治疗药物在受试者中的治疗效果的方法，其包括：
1)使用上述方法鉴定所述受试者的GPRC5D相关病症状态；
2)以所述药物治疗所述受试者；
3)重复步骤1)以确定所述受试者中所述GPRC5D相关病症状态的变化，基于所述变化确定所述药物的治疗效果。
在一些实施方案中，所述GPRC5D相关病症为癌症，或自身免疫疾病，所述癌症优选浆细胞恶性肿瘤疾病，例如多发性骨髓瘤，或者B细胞恶性疾病，例如霍奇金淋巴瘤或非霍奇金淋巴瘤。
附图说明
图1显示了所淘选的部分噬菌体单克隆与靶抗原和对照抗原的酶联免疫吸附测定(ELISA)结果。
图2A显示了CHO-K1-GPRC5D细胞系与不同抗体染色的流式细胞分析结果；Human GPRC5D PE-conjugated Antibody stained为使用商品化流式抗体染色结果，Fluorescein(FITC)AffiniPure Goat Anti-Human IgG stained为只使用荧光标记的抗体染色的阴性对照；Positive benchmark stained/Fluorescein(FITC)AffiniPure Goat Anti-Human IgG stained为使用阳性对照抗体和荧光标记抗体染色的结果；图2B显示了部分噬菌体单克隆与CHO-K1-GPRC5D和CHO-K1细胞结合的流式细胞分析结果。
图3显示了所筛选的噬菌体单克隆在噬菌体水平与多种非相关抗原的酶联免疫吸附测定分析结果。Negative phage control为阴性对照噬菌体抗体克隆，Anti-M13 phage  mouse/anti-mouse HRP Ab为只加一抗和二抗的阴性抗体对照，anti-mouse HRP Ab为只加二抗的阴性抗体对照，anti-human IgG HRP Ab为只加二抗的阴性抗体对照，anti-his tag HRP Ab为检测抗原标签的阳性抗体对照，Positive Benchamrk1为靶抗原的阳性抗体对照。
图4显示了所筛选的噬菌体单克隆在噬菌体水平与多种不同的GPRC5D阳性和阴性细胞系的结合的流式细胞分析结果。Negative phage Control为阴性对照噬菌体抗体克隆，Positive Benchamrk1 Ab为靶抗原的阳性抗体，FITC anti-human IgG Ab为只加二抗的阴性对照。
图5显示了所筛选的噬菌体单克隆在蛋白水平与多种非相关抗原的酶联免疫吸附测定分析结果。anti-human IgG HRP Ab为只加二抗的阴性抗体对照，anti-his tag HRP Ab为检测抗原标签的阳性抗体对照，Positive Benchamrk1为靶抗原的阳性抗体对照。
图6显示了所筛选的噬菌体单克隆在蛋白水平与多种不同的GPRC5D阳性和阴性细胞系的结合的流式细胞分析结果。Positive Benchamrk1 Ab为靶抗原的阳性抗体，FITC anti-human IgG Ab为只加二抗的阴性对照。
图7显示了FACS检测单克隆与高表达靶抗原的细胞CHO-K1-GPRC5D的结合实验结果。
具体实施方式
除非另有说明，本文使用的所有技术和科学术语具有本领域普通技术人员所通常理解的含义。
抗体指由浆细胞(效应B细胞)分泌、被机体免疫系统用来中和外来物质(多肽、病毒、细菌等)的免疫球蛋白。该外来物质相应地称作抗原。经典抗体分子的基本结构是由2个相同重链和2个相同轻链组成的4聚体。根据氨基酸序列的保守性差异，将重链和轻链分为位于氨基端的可变区(V)和位于羧基端的恒定区(C)。一条重链和一条轻链的可变区相互作用形成了抗原结合部位(Fv)。在可变区中，某些区域氨基酸残基的组成和排列次序比可变区内的其它区域(骨架区，FR)更易变化，称为高变区(HVR)，高变区实际上是抗体与抗原结合的关键部位。由于这些高变区序列与抗原决定簇互补，故又称为互补决定区(complementarity-determining region,CDR)。重链和轻链均具有三个互补决定区，分别称为HCDR1、HCDR2、HCDR3和LCDR1、LCDR2、LCDR3。
抗体分子的“抗原结合片段”指抗体分子中参与抗原特异性结合的氨基酸片段，例如，Fab、Fab’和(Fab’) 2等。具有抗原结合能力的单链抗体和单域抗体为单肽链抗体分子，可视为经典抗体分子的“抗原结合片段”。
“Fc片段”指Y”形抗体分子的柄部区域，即可结晶片段(fragment crystallizable，Fc)包括重链的第二和第三恒定结构域(CH2和CH3结构域)。可通过蛋白水解酶(如木瓜蛋白酶)水解抗体分子得到抗体Fc区。在一些实例中，Fc区可包含铰链、CH2和CH3。当Fc区包含铰链时可介导两个含Fc的多肽之间的二聚化。Fc片段可来自IgG、IgM、IgD、IgE 或IgA。在一些实例中，Fc区来自IgG1、IgG2、IgG3或IgG4。“Fc片段”还包括来自天然Fc片段，经改动但仍保持其效应功能的变体Fc片段。“变体Fc片段”包含在天然Fc片段的氨基酸序列上具有至少一个氨基酸变动的氨基酸序列。在一些实例中，变体Fc片段相比于亲本Fc片段(天然Fc片段)具有至少一个氨基酸取代，例如在亲本Fc片段中约1至约10个氨基酸被取代，且优选约1至约5个氨基酸取代。在一些实例中，变体Fc片段Fc区与亲本Fc片段具有至少约80％序列一致性、至少约90％序列一致性、至少约95％、至少约96％、至少约97％、至少约98％或至少约99％序列一致性。“Fc片段”的效应功能可包括与Fc受体的结合、Clq结合和补体依赖性细胞毒性(CDC)、抗体依赖性细胞介导的细胞毒性(ADCC)、介导吞噬作用等。
单链抗体(single chain fragment variable,scFv)，是由抗体重链可变区和轻链可变区通过短肽连接成一条肽链而构成。通过正确折叠，来自重链和轻链的可变区通过非共价键相互作用形成Fv段，因而scFv能较好地保留其对抗原的亲和活性。
“单域抗体(single domain antibody，sdAb)”，或者也称为“VHH抗体”，指具有抗原结合能力，包括重链可变区而无轻链的抗体分子。从结构上看，单域抗体也可以认为是抗体分子的一种抗原结合片段。其首先在骆驼科动物中被发现，随后，研究人员通过抗体库(例如噬菌体展示文库)筛选发现了更多的具有抗原结合能力的单域抗体。单域抗体相对于普通抗体分子(例如，经典四聚体抗体分子)或其抗原结合片段具有一些优势，例如包括但不限于：分子量更小，使用于人体时易于到达普通抗体分子难以到达的组织或部位，或者，能够接触到蛋白或多肽中普通抗体分子难以接触到的抗原表位；更加稳定，能够耐受例如温度和pH的变化以及变性剂和蛋白酶的作用。
“全人源抗体”指可变区和恒定区(如果有的话)均衍生自人生殖系免疫球蛋白序列的抗体。全人源抗体可通过多种技术获得，包括噬菌体抗体库技术、单个B细胞克隆技术、转基因小鼠技术(例如，使用引入了人生殖系免疫球蛋白基因并去除了小鼠自身生殖系免疫球蛋白基因的转基因小鼠)等。相对于动物源抗体(例如鼠源抗体)，全人源抗体在用于人患者时具有免疫原性小、安全性高的优势。
“双特异性抗体”指具有两个不同的结合位点、能分别识别和结合两种不同的抗原的抗体分子。例如，双特异性抗体的一个结合位点可用于结合免疫细胞(例如T细胞)，另一个结合位点用于结合肿瘤细胞，进而增强免疫细胞对肿瘤细胞的杀伤作用，同时减少脱靶毒性等副作用。这种具有双功能的抗体作为治疗肿瘤的药物通常比单抗药物有更高的疗效。类似地，可对抗体分子进行改造以使其包括多个不同的结合位点，生成“三特异性抗体”、“四特异性抗体”等。本文使用的“多特异性抗体”涵盖这些双特异性抗体、三特异性抗体、四特异性抗体等。
“免疫偶联物”指与治疗剂偶联的本文公开的GPRC5D结合肽。该治疗例如为细胞毒素、药物(例如，免疫抑制剂)或放射性毒素。
“融合蛋白”指人为生成(例如通过基因工程技术)的由至少两个不同肽段构成的蛋白分子。这些肽段在自然界中不存在，或者不存在于同一个蛋白分子中。常见的包括抗体片段的融合蛋白的实例包括抗体-细胞因子融合蛋白、抗体-细胞毒素融合蛋白(也称为免疫毒素)、用于免疫检测的酶标抗体、嵌合抗原受体(CAR)等。
“靶向”或“特异性结合”指，相对于环境中同时存在的其他分子，一种分子(例如抗体或其抗原结合片段)对另一种分子(如肿瘤细胞表面抗原)具有更高的结合亲和力。“靶向”或“特异性结合”并不排除该分子可以对一种以上的分子具有结合亲和力，例如双特异性抗体可以对两种不同抗原具有高亲和力。
“结合复合物”指某分子与其结合对象之间形成的包括这二者的复合体。结合复合物的实例可包括抗原抗体复合物、配体受体复合物、蛋白二聚体等。形成结合复合物的作用力主要包括氢键、范德华力、离子键等非共价键作用力。
GPRC5D是G蛋白偶联受体C5家族亚型D，属于一种孤儿受体，为7次跨膜蛋白。孤儿受体(Orphan Receptor)是指与其它已确认的受体结构明显相似，但其内源配体还未发现的受体。GPRC5D在原代多发性骨髓瘤细胞表面高表达，而在正常组织的表达仅限于毛囊区域，有研究表明65％的多发性骨髓瘤患者GPRC5D有超过50％的表达阈值，凭借这一特点，GPRC5D成为了治疗多发性骨髓瘤(MM)的潜在靶标。
“病症状态”指病症是否存在、病症的严重性、病症的分期、分型、进展等情况。
GPRC5D结合肽指靶向或特异性结合GPRC5D的多肽。例如，该GPRC5D结合肽为靶向GPRC5D的单域抗体。
“肽段”，指多肽片段，为短氨基酸序列，例如长度约2-20个氨基酸，通常为多肽或蛋白的一部分。
EC50(concentration for 50％of maximal effect)指引起50％最大效应的浓度。在FACS中用于表示抗体分子与细胞上对应抗原的结合能力时，可指产生最大荧光强度一半时的抗体分子浓度。EC50值越低，则与细胞上抗原的结合亲和力越大。
“纯化标签”指与目的蛋白或多肽以融合蛋白形式一起表达的用于纯化该目的蛋白或多肽的氨基酸序列，包括但不限于His6标签、Flag标签、MBP(麦芽糖结合蛋白)标签和GST(谷胱甘肽巯基转移酶)标签、SUMO(小泛素相关修饰物(small ubiquitin related modifier))等。这些标签可在纯化后通过酶切去除，或者在不影响目的蛋白或多肽正常功能情况下可带标签使用(例如His6标签)。
“可检测标签”指与蛋白或多肽连接的氨基酸序列或其他化学基团，用于指示样品中该蛋白或多肽的存在或含量，或者用于跟踪该蛋白或多肽在受试者体内或细胞内的位置信息。可检测标签的实例包括免疫检测中可使用的各种酶，例如辣根过氧化物酶(HRP)、碱性磷酸酶(ALP)；荧光基团(如FAM、FITC)或荧光蛋白(如GFP)；放射性同位素(例如 3H、 14C、 35S)。当可检测标签为酶时，可通过酶的酶学活性来确定与酶连接的蛋白或多肽的存在或含量。
术语“多肽”和“蛋白质”可互换使用且指氨基酸残基的聚合物。氨基酸残基的此类聚合物可含有天然或非天然氨基酸残基且包括但不限于氨基酸残基构成的肽、寡肽、二聚体、三聚体和多聚体。全长蛋白与其片段皆涵盖于该定义中。该术语亦包括多肽的表达后修饰，例如糖基化、唾液酸化、乙酰化、磷酸化和类似修饰。此外，出于本发明的目的，“多肽”指一种蛋白质，其包括对天然序列的修饰，诸如缺失、添加和取代(实际上通常为保守的)，只要该蛋白质保持所需活性即可。这些修饰可为有目的的，如经由定点突变诱发；或可为偶然的，诸如经由产生蛋白质的宿主的突变或因PCR扩增所致的误差。
本文中，术语“核酸分子”、“核酸”和“多核苷酸”可互换使用，指核苷酸聚合物。此类核苷酸聚合物可含有天然和/或非天然核苷酸且包括(但不限于)DNA、RNA和PNA。“核酸序列”指包含于核酸分子或多核苷酸中的核苷酸线性序列。
术语“载体”指可经工程改造以含有目的多核苷酸(例如目的多肽的编码序列)的核酸分子或可在宿主细胞中复制的核酸分子(例如，核酸、质粒、或病毒等)。载体可包括以下组件中的一个或更多个：复制起点、一或更多个调控目的多核苷酸的表达的调控序列(诸如启动子和/或增强子子)和/或一个或更多个可选择标记物基因(诸如抗生素抗性基因和可用于比色分析中的基因，例如β-半乳糖)。术语“表达载体”指用于在宿主细胞中表达目的多肽的载体。
“宿主细胞”指可为或已为载体或经分离多核苷酸的接受体的细胞。宿主细胞可为原核细胞或真核细胞。示例性真核细胞包括哺乳动物细胞，诸如灵长类动物或非灵长类动物细胞；真菌细胞，诸如酵母；植物细胞；以及昆虫细胞。非限制性示例性哺乳动物细胞包括(但不限于)NSO细胞、293以及CHO细胞，以及其衍生细胞，诸如293-6E、CHO-DG44、CHO-K1、CHO-S和CHO-DS细胞。宿主细胞包括单个宿主细胞的后代，且后代可能由于自然、偶然或故意突变而不一定与原始母细胞完全一致(在形态或基因组DNA互补方面)。宿主细胞也包括在活体内经本文提供的核酸分子或表达载体转染的细胞。
“治疗”指对受试者进行处理以获得有益的或所期望的临床结果。本文所用的“治疗”涵盖各种处理手段，包括以任何可能的药物向受试者给药、手术、辐射等。出于本发明的目的，有益或所期望的临床结果包括但不限于以下的任一种或多种：减轻一种或更多种症状、减弱疾病程度、预防或延迟疾病扩散(例如转移，例如转移至肺或淋巴结)、预防或延迟疾病复发、延迟或减缓疾病进展、改善疾病病况、抑制疾病或疾病进展、阻滞其发展和缓解(无论部分抑或完全缓解)。本文所提供的方法涵盖这些治疗方面中的任一种或多种。按照以上内容，“治疗”不需要完全去除病症或疾病的所有症状或完全缓解。
术语“治疗有效量”指足以在受试者体内引起临床医师所期望的生物学或医学反应的活性化合物的量。本发明融合蛋白的“治疗有效量”可由本领域技术人员根据给药途径、受试者的体重、年龄、病情等因素而确定。例如，典型的日剂量范围可以为每kg体重0.01mg至100mg或更多活性成分。
提及药物组合物，所使用的术语“药学上可接受的载体”指可以安全地进行施用的固体或液体稀释剂、填充剂、抗氧化剂、稳定剂等物质，这些物质适合于人和/或动物给药而无过度的不良副反应，同时适合于维持位于其中的药物或活性剂的活力。依照给药途径，可以施用本领域众所周知的各种不同的载体，包括，但不限于糖类、淀粉、纤维素及其衍生物、麦芽糖、明胶、滑石、硫酸钙、植物油、合成油、多元醇、藻酸、磷酸缓冲液、乳化剂、等渗盐水、和/或无热原水等。本文所提供的药物组合物可以制成粉末、注射剂等临床可接受的剂型。可以使用任何适当的途径向受试者施用本发明的药物组合物，例如可通过口服、静脉内输注、肌肉内注射、皮下注射、腹膜下、直肠、舌下，或经吸入、透皮等途径给药。
“受试者”指动物，例如哺乳动物，包括(但不限于)人类、啮齿动物、猿猴、猫科动物、犬科动物、马科动物、牛科动物、猪科动物、绵羊、山羊、哺乳类实验动物、哺乳类农畜、哺乳类运动动物和哺乳类宠物。受试者可为雄性或雌性且可为任何适龄受试者，包括婴儿、幼年、青年、成年和老年受试者。在一些实例中，受试者指需要治疗疾病或病症的个体。在一些实例中，接受治疗的受试者可为患者，其患有与该治疗有关联的病症，或有风险患上该病症。在特定实例中，受试者为人类，诸如人类患者。该术语通常可与“患者”、“检测对象”、“治疗对象”等互换使用。
本文所用的“群体”通常指健康人群。在就某种疾病进行特定分析时，“群体”亦可指未患该疾病但患有其他疾病的个体。另外，还可根据年龄、是否抽烟、是否酗酒、个人健康状态等特征指定部分个体为“群体”。群体中“正常GPRC5D含量”可通过对足够数量的个体进行测定得出。
“生物样品”意谓一定量的来自活物或先前活物的物质。所述物质包括(但不限于)血液(例如全血)、血浆、血清、尿液、羊水、滑液、内皮细胞、白血球、单核细胞、其他细胞、器官、组织、骨髓、淋巴结和脾脏。
提及氨基酸或核苷酸序列时，术语“序列一致性(sequence identity)”(也称为“序列同一性”)指两氨基酸或核苷酸序列(例如查询序列和参照序列)之间一致性程度的量，一般以百分比表示。通常，在计算两氨基酸或核苷酸序列之间的一致性百分比之前，先进行序列比对(alignment)并引入缺口(gap)(如果有的话)。如果在某个比对位置，两序列中的氨基酸残基或碱基相同，则认为两序列在该位置一致或匹配；两序列中的氨基酸残基或碱基不同，则认为在该位置不一致或错配。在一些算法中，用匹配位置数除以比对窗口中的位置总数以获得序列一致性。在另一些算法中，还将缺口数量和/或缺口长度考虑在内。出于本发明的目的，可以采用公开的比对软件BLAST(可在网页ncbi.nlm.nih.gov找到)，通过使用缺省设置来获得最佳序列比对并计算出两氨基酸或核苷酸序列之间的序列一致性。
GPRC5D结合肽
本文提供了特异性结合GPRC5D的GPRC5D结合肽。该GPRC5D结合肽以相对较高的结合亲和力结合GPRC5D分子。该GPRC5D可以为与其他多肽连接的融合蛋白，例如GPRC5D-VLP，或者为表达在细胞表面上的GPRC5D膜蛋白。例如下文实施例中所阐述的，GPRC5D结合肽与GPRC5D结合能力可通过诸如酶联免疫吸附测定(ELISA)和流式细胞荧光分选技术(FACS)的测定方法来进行测量。另外，也可通过本领域已知的其他蛋白相互作用测定方法来测定，例如，表面等离子体共振技术(SPR)生物层干涉(BLI)技术。
在一些实施方案中，该GPRC5D结合肽为抗体分子或其抗原结合片段。优选地，该GPRC5D结合肽为单域抗体。
本文实施例中所记载的，本文提供的GPRC5D结合肽来自于对人源噬菌体抗体库的筛选，为全人源单域抗体。
单域抗体为仅包括重链可变区的抗体，其实例可包括(但不限于)重链抗体、天然缺乏轻链的抗体、来源于经典4链抗体的单域抗体和经工程改造的抗体。单域抗体可来源于任何物种，包括但不限于小鼠、人类、骆驼、美洲驼、羊驼、小羊驼、原驼、鲨鱼、山羊、兔和/或牛。
本文提供了三种GPRC5D结合肽的CDR序列，它们分别为SEQ ID NO：1-3、4-6、和7-9所示序列。
在本文已提供该GPRC5D结合肽(单域抗体)的CDR序列基础上，本领域技术人员可构建各种具有GPRC5D结合能力的多肽构建体，这包括使用来自不同抗体分子的骨架区(FR)与这些CDR序列进行组合。这些骨架区包括来自人抗体或动物(如小鼠、大鼠、羊、骆驼等)抗体的天然骨架区序列。这些骨架区还可以包括对天然骨架区序列改动所产生的骨架区序列变体。让本文提供的CDR序列与不同的骨架区序列组合形成重链可变区，并检测其与GPRC5D的结合能力可容易地获得特异性结合GPRC5D的多肽构建体。
在一些实施方案中，本发明提供的GPRC5D结合肽(单域抗体)的重链可变区包括与SEQ ID NO：10所示序列有至少90％序列一致性(例如，至少95％、至少98％、至少99％或甚至100％序列一致性)的氨基酸序列。
在一些实施方案中，本发明提供的GPRC5D结合肽(单域抗体)的重链可变区包括与SEQ ID NO：11所示序列有至少90％序列一致性(例如，至少95％、至少98％、至少99％或甚至100％序列一致性)的氨基酸序列。
在一些实施方案中，本发明提供的GPRC5D结合肽(单域抗体)的重链可变区包括与SEQ ID NO：12所示序列有至少90％序列一致性(例如，至少95％、至少98％、至少99％或甚至100％序列一致性)的氨基酸序列。
本领域技术人员可以理解的是，在本文提供的具体序列基础上，可以通过对少数氨基酸进行替换、删除、添加并验证或筛选所得产物与相应抗原GPRC5D的结合能力或生物学活性，从而获得本文提供的靶向GPRC5D的抗体分子的相应变体，这些变体也应包括在 本发明的范围内。例如，本文提供的抗体分子或单域抗体在其全长或可变区序列或CDR序列上，可以有至少1个且不超过10个，例如不超过5、4、3、2或1个氨基酸的改变。
预期本文描述的GPRC5D结合肽可包含保守氨基酸取代。保守氨基酸取代通常可被描述为一种氨基酸残基被类似化学结构的另一种氨基酸残基取代，并且对多肽的功能、活性或其他生物学性质几乎没有或基本上没有影响。保守氨基酸取代是本领域众所周知的。保守性取代可例如是下列(a)-(e)组中的一个氨基酸被同组内的另一个氨基酸取代：(a)小的脂肪族非极性或弱极性残基：Ala、Ser、Thr、Pro和Gly；(b)极性带负电荷的残基及其(不带电荷的)酰胺：Asp、Asn、Glu和Gln；(c)极性带正电荷的残基：His、Arg和Lys；(d)大的脂肪族非极性残基：Met、Leu、Ile、Val和Cys；和(e)芳族残基：Phe、Tyr和Trp。
该多肽构建体还可包括一个以上的GPRC5D结合肽，它们之间直接串联连接或通过接头序列(linker)串联连接。在一些实施方案中，该多肽构建体包括两个GPRC5D结合肽，这两个GPRC5D结合肽相同。在一些实施方案中，该多肽构建体包括两个GPRC5D结合肽，这两个GPRC5D结合肽在氨基酸序列上至少有一个氨基酸差异。在一些实施方案中，该多肽构建体包括至少一个本文提供的GPRC5D结合肽和至少一个其他GPRC5D结合肽。在一些实施方案中，该多肽构建体包括本文提供的两个不同的GPRC5D结合肽。在一些实施方案中，该多肽构建体包括本文提供的三个不同的GPRC5D结合肽。
所述接头序列可为天然存在的接头、合成的接头或两者的组合。特别适合的接头序列主要包括选自甘氨酸(Gly)、丝氨酸(Ser)、丙氨酸(Ala)和苏氨酸(Thr)的氨基酸残基。举例而言，接头可含有至少75％(基于存在于肽接头中的残基的总数计算)(诸如至少80％、至少85％或至少90％)的选自Gly、Ser、Ala和Thr的氨基酸残基。接头亦可由仅Gly、Ser、Ala和/或Thr残基组成。在一些实施例中，接头含有1-25个甘氨酸残基、5-20个甘氨酸残基、5-15个甘氨酸残基或8-12个甘氨酸残基。在一些方面中，适合的肽接头典型地含有至少50％甘氨酸残基，诸如至少75％甘氨酸残基。在一些实施例中，肽接头仅包含甘氨酸残基。在一些实例中，肽接头仅包含甘氨酸和丝氨酸残基，例如为(GS) n形式，其中n例如为1-20的整数。
包括GPRC5D结合肽的融合蛋白
上文提到的包括多个GPRC5D结合肽的多肽构建体属于包括GPRC5D结合肽的融合蛋白。另外，GPRC5D结合肽还可与其他多肽形成融合蛋白。
在一些实施方案中，GPRC5D结合肽可以与Fc片段连接形成融合蛋白。Fc片段可位于GPRC5D结合肽的C末端和N末端。优选地，Fc片段可位于GPRC5D结合肽的C末端。GPRC5D结合肽与Fc片段形成的融合蛋白具有特异性结合GPRC5D的能力，同时具有Fc片段的效应功能，例如介导补体依赖性细胞毒性(CDC)、抗体依赖性细胞介导的细胞毒性(ADCC)、介导吞噬作用等。另外，与Fc片段的融合可增加GPRC5D结合肽在体内的半衰期，以便在将GPRC5D结合肽用作治疗药物时增加其给药间隔时间。含GPRC5D结合肽的非限制性融合蛋白构建体可包括但不限于如下形式：VHH1-Fc、VHH1-VHH2- Fc和VHH1-VHH2-VHH3-Fc，其中VHH指GPRC5D结合肽(单域抗体)，VHH1、VHH2和VHH3可相同或不同。
在一些实施方案中，GPRC5D结合肽可以与蛋白标签连接形成融合蛋白。蛋白标签可包括纯化标签和可检测标签。纯化标签包括但不限于His6标签、Flag标签、MBP标签、GST标签、SUMO)标签等。可检测标签可用于指示样品中GPRC5D结合肽的存在或含量，或者用于跟踪GPRC5D结合肽在受试者体内或细胞内的位置信息。可检测标签的实例包括免疫检测中可使用的各种酶，例如辣根过氧化物酶(HRP)、碱性磷酸酶(ALP)等；荧光蛋白，例如GFP。由于GPRC5D结合肽与GPRC5D的特异性结合能力，可通过与GPRC5D结合肽连接的可检测标签的量来确定GPRC5D结合肽的量，并进而确定样品中GPRC5D的含量。
在另一些实施方案中，GPRC5D结合肽可以与细胞因子或治疗性蛋白连接形成融合蛋白。这种情况下，可以借助GPRC5D结合肽与GPRC5D的特异性结合能力，将细胞因子或治疗性蛋白有目的地输送至特定的组织或细胞(例如表达GPRC5D的肿瘤组织)，实现细胞因子或治疗性蛋白的治疗作用。
包括GPRC5D结合肽的多特异性抗体
在一些实施方案中，本文提供了多特异性的结合肽，其至少包括一个结合GPRC5D的结构域(或功能单元)和一个或更多个额外的结合结构域。该一个或更多个额外的结合结构域可结合至除GPRC5D外的第二抗原或蛋白质。
在一些实施方案中，本文提供了多特异性的结合肽，其至少包括两个结合GPRC5D的结构域。该两个结合GPRC5D的结合结构域在氨基酸序列上有差异，并且分别结合GPRC5D上的不同抗原表位。
在一些实施方案中，本文提供了多特异性的结合肽，其至少包括两个结合GPRC5D的结构域和一个或更多个额外的结合结构域。该两个结合GPRC5D的结合结构域在氨基酸序列上有差异，并且分别结合GPRC5D上的不同抗原表位；该一个或更多个额外的结合结构域可结合至除GPRC5D外的第二抗原或蛋白质。
在一些实施方案中，所述结合GPRC5D的结构域为本文提供的单域抗体；所述一个或更多个额外的结合结构域可为单域抗体、单链抗体或其他抗原结合片段。
在一些实施方案中，所述第二抗原为肿瘤相关抗原(TAA)或肿瘤微环境相关抗原(TMEAA)。在一些实施方案中，所述第二抗原为免疫调节抗原，其中所述抗原与增强或抑制免疫细胞中的信号传导路径相关。在一些实施方案中，所述第二抗原为T细胞表面分子，诸如T细胞受体复合物的组分，例如CD3(包括γ、δ、ε、ζ和η链)。
优选地，所述多特异性的结合肽为双特异性抗体分子。
在一些实施方案中，多特异性的结合肽还包括Fc片段。Fc片段的存在可方便地形成结合结构域的多聚化，并且可提供相关的效应功能。
包括GPRC5D结合肽的免疫偶联物(或抗体偶联物)
本文提供了含有至少一个本文提供的特异性结合GPRC5D的GPRC5D结合肽和一个或多个其他功能部分的偶联物。所述其他部分可为化学基团，例如治疗剂，诸如细胞毒性剂，或可为示踪剂。在一些实例中，所述部分可为靶向部分、小分子药物(例如小于500Da的非多肽药物)、毒素、细胞生长抑制剂、细胞毒性剂、免疫抑制剂、适合于诊断目的的放射性试剂、用于治疗目的的放射性金属离子等。
在一些实施方案中，免疫偶联物为含有一个或更多个本文提供的GPRC5D结合肽和治疗剂的抗体药物偶联物(ADC)，其具有细胞毒性，抑制细胞生长，或者提供一些治疗益处。在一些实施例中，细胞毒性剂为化学治疗剂、药物、生长抑制剂、毒素(例如细菌、真菌、植物或动物来源的酶活性毒素或其片段)或放射性同位素(亦即，放射性偶联物)。在一些实例中，本发明提供的抗体药物偶联物允许药物部分靶向递送至肿瘤。在一些情况下，此可引起肿瘤细胞的靶向杀死。
在一些实例中，治疗剂包括例如道诺霉素(daunomycin)、阿霉素(doxorubicin)、甲氨喋呤(methotrexate)、长春地辛(vindesine)、类美登素(maytansinoid)等。在一些实例中，治疗剂具有细胞内活性。在一些实例中，结合GPRC5D的免疫偶联物经内化且治疗剂具有阻断细胞蛋白质合成活性，阻断核酸合成活性，并导致细胞生长停滞或死亡。
在一些实施方案中，免疫偶联物含有一个或更多个本文提供的GPRC5D结合肽和示踪剂。该免疫偶联物可用于研究或诊断目的，例如用于活体内检测癌症。示踪剂可直接或间接产生可侦测信号。例如，示踪剂可为射性同位素，如 3H、 14C、 32P、 35S、 123I；荧光(荧光团)或化学发光(发色团)化合物，诸如荧光异硫氰酸盐、若丹明或荧光素；显影剂；或金属离子。在一些实施例中，示踪剂为用于闪烁摄影研究的放射性原子，例如 99Tc或 123I，或用于核磁共振(NMR)成像(亦称为磁共振成像，MRI)的自旋标记，例如 89Zr、 123I、 19F、 13C、 15N、 17O。 89Zr可与多种金属螯合剂错合且结合至抗体，例如用于PET成像。
GPRC5D结合肽与其他功能部分的连接可为共价或非共价连接。非共价连接的实例可包括通过生物素-亲和素系统(Biotin-Avidin System)。共价连接的实例可包括各种化学接头，包括肽接头、可裂解接头、或不可裂解接头。示例性接头组分包括6-顺丁烯二酰亚胺基己酰基(“MC”)、顺丁烯二酰亚胺基丙酰基(“MP”)、缬氨酸-瓜氨酸(“val-cit”)、丙氨酸-苯丙氨酸(“ala-phe”)、对氨基苯甲氧基羰基(“PAB”)、N-丁二酰亚胺基4-(2-吡啶基硫基)戊酸酯(“SPP”)、N-丁二酰亚胺基4-(N-顺丁烯二酰亚胺基甲基)环己烷-1甲酸酯(“SMCC”)和N-丁二酰亚胺基(4-碘-乙酰基)胺基苯甲酸酯(“SIAB”)。
在一些实施方案中，接头可包含氨基酸残基。例示性氨基酸接头组分包括二肽、三肽、四肽或五肽。示例性二肽包括：缬氨酸-瓜氨酸(vc或val-cit)、丙氨酸-苯丙氨酸(afa-phe)。示例性三肽包括：甘氨酸-缬氨酸-瓜氨酸(gly-val-cit)和甘氨酸-甘氨酸-甘氨酸(gly-gly-gly)。包含氨基酸接头组分的氨基酸残基包括天然存在的残基以及非天然存在 的氨基酸类似物，诸如瓜氨酸。氨基酸接头组分可在其选择性方面经设计和优化，以通过特定酶，例如肿瘤相关蛋白酶、组织蛋白酶B、C和D、胞浆素蛋白酶进行酶促裂解。
GPRC5D结合肽与细胞毒性剂的偶联物可使用多种双官能蛋白质偶合剂制得，诸如N-丁二酰亚胺基-3-(2-吡啶基二硫醇)丙酸酯(SPDP)、亚胺基硫杂环戊烷(IT)、酰亚胺酯的双官能衍生物(诸如己二酰亚胺酸二甲酯HCl)、活性酯(诸如二丁二酰亚胺基基质)、醛(诸如戊二醛)、双叠氮基化合物(诸如双(对叠氮基苯甲酰基)己二胺)、双重氮衍生物(诸如双-(对重氮苯甲酰基)-乙二胺)、二异氰酸酯(诸如甲苯2,6-二异氰酸酯)和双活性氟化合物(诸如1,5-二氟-2,4-二硝基苯)。
包括GPRC5D结合肽的药物组合物和治疗方法
本文公开的GPRC5D结合肽以及包括该GPRC5D结合肽的融合蛋白、多特异性抗体分子、免疫偶联物(可以与药学上可接收的载体一起配制为药物组合物)可用于对受试者给药以进行肿瘤预防或治疗。该用途的有效用量可取决于疾病的严重性和患者自身免疫系统的总体状态。给药方案将也随疾病状态和受试者状态而变动，并且一般范围将从单次大量(bolus)给药或连续输注至每天多次给药(例如每隔4-6小时)。本领域熟练的临床医生可以例如通过利用临床试验、身体检查和受试者家族史，容易地确定某受试者是否为这种治疗的候选者。
在一些实施方式中，本文公开的GPRC5D结合肽以及包括该GPRC5D结合肽的融合蛋白、多特异性抗体分子、免疫偶联物可以与一种或更多种其他药物(例如抗肿瘤剂)联合给药。
在一些实施方案中，所治疗的疾病或病症为肿瘤，优选多发性骨髓瘤。可以使用任何合适的方法或途径本文公开的GPRC5D结合肽(以及包括该GPRC5D结合肽的融合蛋白、多特异性抗体分子、免疫偶联物)，并任选地联用其他抗肿瘤剂。给药途径包括，例如，口服、静脉内、腹膜内、皮下或者肌内给药。
本文提供的编码GPRC5D结合肽的核酸分子、包括该核酸分子的表达载体以及仅所述核酸分子或表达载体转染的宿主细胞也可通过各种方式用于上述治疗目的。例如，对于表达载体，可通过本领域已知的基因治疗手段引入受试者体内，表达目的蛋白或多肽(GPRC5D结合肽)，从而达到治疗目的。
包括GPRC5D结合肽的检测、诊断试剂盒或治疗试剂盒
本文提供的GPRC5D结合肽以及包括该GPRC5D结合肽的其他形式分子(例如融合蛋白或双特异性抗体分子)可与样品中的GPRC5D特异性结合。让通过检测所形成的GPRC5D结合肽-GPRC5D复合物的量，或者所形成的GPRC5D结合肽-GPRC5D复合物中GPRC5D结合肽的量，可方便的确定样品中的GPRC5D含量(或是否存在)。
如上文所描述的，用于该目的，本文提供的GPRC5D结合肽可与各种检测标签连接，方便通过各种手段进行检测，这包括但不限于生物发光、荧光、放射性标记、酶促反应的产物生产量等。检测样品中GPRC5D含量后，与正常人群中正常GPRC5D含量进 行比较，可用于确定提供该样品的受试者的疾病状况或严重程度。通过在受试者治疗过程随时间反复检测GPRC5D含量变化，还可用于确定治疗手段是否有效，从而为治疗方案的改动提供依据。
本文提供的GPRC5D结合肽以及包括该GPRC5D结合肽的其他形式分子(例如融合蛋白或双特异性抗体分子)可被置于容器中，以形成检测、诊断或治疗试剂盒。这些容器可以是盒、安瓿瓶、小瓶、管子、袋子或本领域已知的合适容器形式。这些容器可以由塑料、玻璃、层压纸、金属箔或适用于保存药物的其他材料制成。如果需要，与该容器一起提供的还包括使用说明书。说明书通常可包括关于如何使用GPRC5D结合肽或包括GPRC5D结合肽的组合物用于治疗或预防肿瘤(例如多发性骨髓瘤)的信息，例如可包括对治疗剂(如GPRC5D结合肽)的描述；用于治疗或预防瘤形成(例如多发性骨髓瘤)的剂量方案；注意事项；警告；适应症；禁忌症；不良反应；动物药理学；临床研究；和/或参考资料。说明书可直接打印在容器(如果存在的话)上，或作为贴于容器的标签，或者作为提供于容器中或与容器在一起的单独的纸、册、卡或折叠印刷品。
本文提供的GPRC5D结合肽(或称为靶向GPRC5D的抗体分子)为全人源单域抗体，与GPRC5D的结合亲和力与对照抗体接近，或优于对照抗体。
研究概述：
我们应用大容量噬菌体(phage)抗体库筛选全人源的GPRC5D特异抗体，并通过酶联免疫吸附测定(enzyme linked immunosorbent assay，ELISA)和流式细胞荧光分选技术(fluorescence activated cell sorting，FACS)实验来评估这些抗体在phage水平和蛋白水平的特异性，再通过FACS测定筛选抗体与细胞结合的亲和力，并将这些抗体分子构建至二代CAR慢病毒表达载体上，转染T细胞，通过体外细胞杀伤实验初步评价这些抗体分子的杀伤功能。最终，我们获得了3个特异性良好且具有很强杀伤功能的全人源抗体克隆。
我们使用不同的抗体库，经过重组GPRC5D蛋白淘选和GPRC5D蛋白/细胞(CHO-K1-GPRC5D)淘选，总共挑选了768个单克隆进行酶联免疫吸附测定(ELISA)和流式细胞术(FACS)检测初筛，其中216个克隆特异结合GPRC5D-VLP蛋白和GPRC5D表达阳性细胞CHO-K1-GPRC5D，而不结合对照蛋白VLP和GPRC5D表达阴性细胞CHO-K1。测序后得到了35种不同的单克隆序列。随后，我们将这35种抗体与多种GPRC5D阳性(CHO-K1-GPRC5D，MM1S)和阴性细胞系(CHO-K1，Jurkat)进行流式细胞分析(FACS)鉴定，与多种非相关抗原(VLP，BAFFR-his-Bio，IL10-Bio，SA)和GPRC5D蛋白(GPRC5D-VLP)进行酶联免疫吸附(ELISA)鉴定，其中3个克隆在多种细胞系和多种蛋白抗原上都表现出良好的结合力和特异性。这些克隆的获得为后续开发全人源的GPRC5D CAR-T产品或者抗体药奠定了基础。
以下结合具体实施例详细说明本发明。
实施例1.通过亲和淘选从噬菌体抗体库富集靶向GPRC5D蛋白的特异抗体克隆
采用合适的负淘选和正淘选策略从噬菌体抗体库中富集我们所需的特异性抗体克隆。
噬菌体抗体库的构建
我们构建的噬菌体抗体库包括天然库、半合成库和单域库。半合成噬菌体抗体库，与天然库一起使用，解决天然库可能缺乏GPRC5D高亲和力抗体克隆的问题。单域噬菌体抗体库是只由重链抗体的可变区氨基酸组成的抗体库，其分子量仅有12-15kDa，但却具备与传统抗体相似或更高的特异性和亲和力。此外，单域抗体理化性质稳定、亲和力高、易于重组表达制备、易于与其它靶点或表位抗体组合等特点使其备受关注。
GPRC5D蛋白淘选
以GPRC5D-VLP作为正淘选蛋白，以VLP蛋白作为负淘选蛋白进行多轮淘选，获得富集目的抗体克隆的噬菌体池(pool)。实验步骤简述如下：
1)包被抗原:将抗原GPRC5D-VLP用干净的包被缓冲液(PBS)稀释到10μg/mL，每孔加入100μL工作液，每个淘选6个孔，4℃过夜结合；
将抗原VLP蛋白用干净的包被缓冲液(PBS)稀释到10μg/mL，每孔加入100μL工作液，每个淘选6个孔，4℃过夜结合；负淘抗原标记为负板，正淘抗原为正板；
2)封闭:将抗原倒扣掉，并在吸水纸拍去孔内残液，加入250μL 3％BSA-PBS封闭，室温封闭2h；
3)加入噬菌体文库(含5x10 12个噬菌体颗粒)和对照抗原VLP一起孵育，以便扣除非特异结合VLP的噬菌体抗体克隆；
4)孵育后将上清转移到结合了靶抗原GPRC5D-VLP的正板中，继续孵育，使噬菌体和靶抗原结合；
5)用洗涤液洗涤磁珠，将未结合的噬菌体洗去；
6)用洗脱液将阳性噬菌体从靶抗原上洗脱下来，加入中和液中和；
7)以洗脱后的噬菌体重新感染宿主菌XL1-blue，扩增回收的噬菌体。留少量样品梯度稀释，感染宿主菌，涂Amp抗性平板，计算回收噬菌体数量；
8)重复步骤1)至6)，通常需要进行3轮淘选，直到观察到噬菌体的回收率(洗脱噬菌体数/投入噬菌体数)有明显上升。
富集好的噬菌体池可用于进行随后的单克隆挑选以及ELISA/FACS筛选。
主要材料和试剂：
全人源噬菌体抗体库，包含天然库，半合成库和单域库；
辅助噬菌体KO7，Thermo/Invitrogen,18311019；
Human GPRC5D Protein-VLP,Kactus,GPR-HM05P；
VLP protein,Kactus,order
High binding ELSIA plate,Costar，#3590
封闭液：PBS+3％BSA
漂洗液：PBS+0.1％Tween20
洗脱液：0.2M Glycine，pH2.2
中和液：1M Tris，pH9.1
实验结果：
使用不同的抗体库，通过3轮蛋白淘选，每个淘选都观察到了回收率的显著上升(表1)，证明抗体克隆得到了有效富集。
表1 蛋白淘选实验结果
Figure PCTCN2021140153-appb-000001
可以看到经过3轮淘选，不同的抗体库都得到了富集(第3轮回收率比上一轮显著提高)。但是该淘选策略筛选到的特异性结合克隆较少，且在后续的FACS实验中，与高表达GPRC5D抗原的CHO-K1-GPRC5D细胞结合较差，即它们不能识别细胞表面天然状态的GPRC5D抗原。因此，我们在随后的实验中采用了蛋白和细胞交替淘选的方法从噬菌体抗体库中富集可以同时结合GPRC5D蛋白和细胞表面天然状态的GPRC5D的特异性抗体克隆。表2显示了利用重组GPRC5D蛋白和CHO-K1-GPRC5D/CHO-K1细胞系联合淘选的结果。从回收率来看，所有4个淘选都得到了富集，可以用于下一步挑选单克隆。
表2 蛋白+细胞淘选实验结果
Figure PCTCN2021140153-appb-000002
Figure PCTCN2021140153-appb-000003
实施例2.采用ELISA和FACS从经富集的噬菌体池筛选特异性克隆
目的和原理：通过亲和淘选步骤富集的噬菌体池中包含各种性质的噬菌体抗体：特异克隆、非特异克隆、以及阴性克隆。为了获得特异克隆，我们需要从中分离单克隆，包装成单克隆的噬菌体，并通过ELISA)和FACS对大量单克隆进行初筛，从中挑选到同时特异结合GPRC5-VLP蛋白和GPRC5D阳性细胞系CHO-K1-GPRC5D的单克隆。特异的单克隆再进一步通过DNA测序确定其中包含的唯一的抗体序列。
在ELISA初筛中，只结合GPRC5D-VLP而不结合对照抗原VLP的被认定为特异克隆。FACS初筛使用GPRC5D高表达的阳性细胞系CHO-K1-GPRC5D和GPRC5D阴性的细胞系CHO-K1来进行，只结合细胞CHO-K1-GPRC5D且不结合CHO-K1细胞的被认定为特异克隆。通过ELISA和FACS两种初筛，我们可以获得既能结合重组表达的GPRC5D蛋白，又能识别细胞表面天然状态GPRC5D分子的候选抗体，供随后进一步筛选。
ELISA初筛实验简要步骤：
1)用深孔96孔板培养和包装单克隆噬菌体；
2)将GPRC5D-VLP用PBS稀释到10μg/mL，以100μL/孔加入到高结合酶标板中，4℃过夜包被；
3)弃掉包被液，每孔加入250μL封闭液，室温封闭2h；
4)250μL漂洗液洗板2次；
5)加入100μL步骤1)培养好的噬菌体上清到包被好靶抗原的孔，室温结合2h；
6)250μL漂洗液洗板4次；
7)加入1:2000稀释的mouse anti M13一抗，100μL/孔，室温孵育45min；
8)250μL漂洗液洗板4次；
9)加入1:2000稀释的HRP Donkey anti-mouse IgG，100μL/孔，室温孵育45min；
10)250μL漂洗液洗板6次；
11)加入100μL TMB显色底物，显色10min；
12)加入100μL 2M H 2SO 4终止反应，在酶标仪上读取结果。
FACS初筛实验简要步骤：
1)用深孔96孔板培养和包装单克隆噬菌体；
2)CHO-K1-GPRC5D和CHO-K1细胞用PBS洗2次，用PBS重悬成1x10 7/mL浓度，以50μL分装到96孔深孔板中；
3)每孔加入50μL包装好的单克隆噬菌体，混匀后，4℃结合2h；
4)200μL PBS洗涤2次；
5)加入1:2000稀释的mouse anti M13一抗，100μL/孔，吹打混匀后，室温孵育45min；
6)200μL PBS洗涤2次；
7)加入1:300稀释的FITC horse anti mouse-IgG(H+L)，100μL/孔，吹打混匀后，室温孵育45min；
8)200μL PBS洗涤2次；最后用200μL PBS重悬细胞；
9)在流式细胞仪上检测样品FITC通道的荧光强度，分析结果。
主要材料和试剂：
辅助噬菌体KO7，Thermo/Invitrogen,18311019
Streptavidin,Pierce,21125
Human GPRC5D Protein-VLP,Kactus,GPR-HM05P；
Biotinylated Human IL-10Protein,Kactus,IL1-HM410B；
Biotinylated Recombinant human BAFFR Protein,Kactus,BAF-HM40RB；
High binding ELSIA plate,Costar,#3590
Corning 96Well Clear Round Bottom TC-Treated Microplate,Costar,#3799
封闭液：PBS+3％BSA
漂洗液：PBS+0.1％Tween20
可溶型单组分TMB底物溶液,Tiangen,PA-107-02
Anti-M13Bacteriophage Coat Protein g8p antibody,abcam,ab9225
HRP Goat anti-mouse IgG(minimal x-reactivity)Antibody,Biolegend,405306
HRP Donkey anti-human IgG(minimal x-reactivity)Antibody,Biolegend,410902
HRP Conjugated Anti His-Tag Mouse Monoclonal Antibody，CWBIO,CW0285
FITC horse anti mouse-IgG(H+L),Vector,FI2000
H_GPRC5D CHO-K1Cell Line Clone，上海吉满，GM-C03857
Human GPRC5D PE-conjugated Antibody，RD，FAB6300RP
Fluorescein(FITC)AffiniPure Goat Anti-Human IgG,Fcγfragment specific，Jackson
ImmunoReseach,109-095-190
实验结果：
从富集后的噬菌体抗体池随机挑选单克隆，包装成噬菌体后，通过噬菌体ELISA检测单克隆噬菌体与GPRC5D-VLP蛋白、对照蛋白VLP的结合，找到GPRC5D特异的噬菌体抗体克隆。部分克隆的ELISA结果如图1所示。从图中可知，A1、A2、A4、A7和A8号克隆与靶抗原GPRC5D(GPRC5D-VLP)结合较强，且不与对照抗原VLP结合，特异性良好。A3、A5和A6号克隆与靶抗原和对照抗原都结合，不符合特异性结合要求。Negative phage control为阴性对照噬菌体抗体克隆，与靶抗原和对照抗原都不结合，Anti-M13 phage mouse/anti-mouse HRP Ab为只加一抗和二抗的阴性抗体对照，anti-mouse HRP Ab为只加二抗的阴性抗体对照，anti-human IgG HRP Ab为只加二抗的阴性抗体对照，它们与靶抗原和对照抗原都不结合；anti-his tag HRP Ab检测抗原标签的阳性抗体对照，与his标签的抗原结合，说明包被的抗原已经结合到板子上。Positive Benchamrk1为靶抗原的阳性抗体，与靶抗原结合，与对照抗原不结合。
与ELISA相对应的抗体克隆的FACS初筛结果如图2所示。图2A为CHO-K1-GPRC5D细胞系通过商品化流式抗体Human GPRC5D PE-conjugated Antibody和Positive benchmark1(可变区序列来自于中国专利申请公开CN 109715667 A的GC5B596)染色后的结果，结果显示该细胞均可与GPRC5D抗体结合，说明CHO-K1-GPRC5D细胞为GPRC5D表达阳性的细胞，图2B中的A1、A2、A3、A4、A5、A6和A7克隆结合CHO-K1-GPRC5D，不结合CHO-K1细胞，是特异克隆；A8号克隆与2种细胞都不结合，是阴性克隆；Negative phage control为阴性对照噬菌体抗体克隆，与靶抗原和对照抗原都不结合，Positive Benchamrk1 Ab(GC5B596)为靶抗原的阳性抗体，与高表达细胞系CHO-K1-GPRC5D结合，与对照阴性细胞CHO-K1不结合。
通过ELISA检测和FACS初筛，我们总共获得216个ELISA和FACS双阳性且特异性良好的克隆，随后我们将获得的216个双阳性且特异性良好的克隆测序，测序后得到了35种不同的单克隆序列，然后将这35个不同序列的单克隆进一步通过多细胞系的FACS鉴定和多种抗原的ELISA鉴定检测候选克隆的结合特异性。以下实施例选择了其中的三个单域抗体克隆(克隆编号18、39和41)进行实验，它们的HCDR序列、重链可变区(VH)序列和VH编码核酸序列如下。
Figure PCTCN2021140153-appb-000004
Figure PCTCN2021140153-appb-000005
Figure PCTCN2021140153-appb-000006
实施例3.在噬菌体水平通过ELISA和FACS进一步鉴定单克隆特异性
实验目的和原理：用于治疗的抗体必须具有非常好的靶点特异性，只结合靶抗原，而不结合任何无关的抗原；另一方面，不同的细胞系上同一抗原的氨基酸序列会有差异(异构体或突变体)或结合的配体不一样，也需要考察我们的抗体能否与各种靶蛋白阳性的细胞都结合。为了进一步分析这些单克隆的特异性和普适性，寻找最佳的候选克隆，我们通过酶联免疫检测(ELISA)和流式细胞术进一步评估初筛克隆的特异性。
采用多种非相关抗原通过ELISA进一步鉴定单克隆特异性
在这个实验中，我们采用靶抗原GPRC5D-VLP抗原和多种GPRC5D不相关抗原与这些单克隆噬菌体抗体进行反应，分析这些克隆是否与其它GPRC5D不相关抗原有任何非特异的结合。通过这个实验，我们获得了若干具有优良特异性的克隆。
实验方法：与ELISA初筛相同；
主要样品和试剂：
Figure PCTCN2021140153-appb-000007
其余试剂与ELISA初筛相同。
实验结果：
用于治疗的抗体必须具有非常好的靶点特异性。为了进一步分析这些单克隆抗体的特异性，我们将实施例2获得的多个克隆在多种抗原应用酶联免疫吸附(ELISA)进行了鉴定。结果显示在图3中，Negative phage control为阴性对照噬菌体抗体克隆，与靶抗原和对照抗原都不结合，Anti-M13 phage mouse/anti-mouse HRP Ab为只加一抗和二抗的阴性抗体对照，anti-mouse HRP Ab为只加二抗的阴性抗体对照，它们与靶抗原和对照抗原都不结合，Positive Benchmark1 Ab(GC5B596)为靶抗原(GPRC5D-VLP)的阳性抗体对照，与靶抗原结合，与对照抗原不结合。Anti-human IgG HRP Ab为只加二抗的阴性抗体对照，anti-his HRP Ab为检测抗原标签的阳性抗体对照，与his标签的抗原结合，说明包被的抗原已经结合到板子上。克隆18、39、41克隆与GPRC5D抗原都结合，与4种非相关抗原都不结合，说明克隆18、39、41能够结合GPRC5D抗原且特异性良好。
在噬菌体水平采用多种细胞系通过FACS进一步鉴定单克隆特异性
在这个实验中，我们采用多种GPRC5D阳性的细胞系和多种GPRC5D阴性的细胞系与这些单克隆噬菌体抗体进行反应，分析这些克隆是否可以结合不同的细胞系上的GPRC5D抗原，以及是否与其它不表达GPRC5D的细胞系有任何非特异的结合。通过这个实验，我们获得了若干具有优良特异性的克隆。
实验方法：与FACS初筛相同；
主要样品和试剂：
CHO-K1-GPRC5D细胞系，GPRC5D阳性细胞系；
MM1S细胞系，GPRC5D阳性细胞系；
CHO-K1细胞系，GPRC5D阴性细胞系；
Jurkat细胞系,GPRC5D阴性细胞系；
其余试剂与FACS初筛相同。
实验结果：
用于治疗的抗体必须具有非常好的靶点特异性。为了进一步分析这些单克隆抗体的特异性，我们将实施例2获得的唯一克隆在更多的抗原和细胞系上应用酶联免疫吸附和流式细胞术进行了鉴定。结果显示在图4中，Negative phage Control为阴性对照噬菌体抗体克隆。克隆18、39、41与2种GPRC5D阳性细胞系CHO-K1-GPRC5D和MM1S都结合，与2种GPRC5D阴性细胞系CHO-K1和Jurkat都不结合，特异性良好；Positive Benchamrk1 Ab(GC5B596)为靶抗原的阳性抗体，与高表达细胞系CHO-K1-GPRC5D结合，与对照阴性细胞CHO-K1不结合；FITC anti-human IgG Ab为只加二抗的阴性对照，与两种细胞系都不结合。
实施例4.在蛋白水平通过ELISA和FACS进一步确定单克隆的结合特异性
实验目的和原理
通过亲和淘选从噬菌体抗体库富集靶向GPRC5D抗原的特异抗体克隆并进行筛选和鉴定后获得了具有和GPRC5D抗原结合的克隆，但从原核系统表达的抗体分子转换成真核系统表达的IgG抗体分子后，其结合能力和特异性还需要进一步确认。为此，我们制备了这些克隆的IgG表达质粒，并通过瞬时转染CHOS细胞表达，Protein A纯化到抗体。然后，通过ELISA和FACS进一步确定单克隆的结合特异性。
在蛋白水平通过ELISA进一步确定单克隆在抗体水平的结合特异性
主要样品和试剂：
与噬菌体水平的ELISA试剂相同；
实验结果：
为了进一步分析这些单克隆抗体在真核系统中表达为IgG形式的抗体后是否仍然保持原有抗体的结合能力和特异性，我们将实施例3获得的3个克隆通过CHOS表达，Protein A纯化到IgG形式的抗体在多种抗原应用酶联免疫吸附(ELISA)进行了鉴定。结果显示在图5中，Positive Benchmark1 Ab为靶抗原(GPRC5D-VLP)的阳性抗体对照，与靶抗原结合，与对照抗原不结合。Anti-human IgG HRP Ab为只加二抗的阴性抗体对照，anti-his HRP Ab为检测抗原标签的阳性抗体对照，与his标签的抗原结合，说明包被的抗原已经结合到板子上。克隆18、39、41克隆与GPRC5D抗原都结合，与4种非相关抗原都不结合，说明克隆18、39、41能够结合GPRC5D抗原且特异性良好。
在蛋白水平通过FACS进一步确定单克隆在抗体水平的结合特异性
主要样品和试剂：
Fluorescein(FITC)AffiniPure Goat Anti-Human IgG,Fcγfragment specific，Jackson
ImmunoReseach,109-095-190
实验结果：
为了进一步分析这些单克隆抗体在真核系统中表达为IgG形式的抗体后是否仍然保持原有抗体的结合能力和特异性，我们将实施例3获得的3个克隆通过CHOS表达，Protein A纯化到IgG形式的抗体在更多的抗原和细胞系上应用酶联免疫吸附和流式细胞术进行了鉴定。结果显示在图6中，克隆18、39和41与2种GPRC5D阳性细胞系CHO-K1-GPRC5D和MM1S都结合，与2种GPRC5D阴性细胞系CHO-K1和Jurkat都不结合，特异性良好；Positive Benchamrk1 Ab(GC5B596)为靶抗原的阳性抗体，与高表达细胞系CHO-K1-GPRC5D结合，与对照阴性细胞CHO-K1不结合；FITC anti-human IgG Ab为只加二抗的阴性对照，与两种细胞系都不结合。
实施例5.通过FACS检测单克隆抗体与高表达细胞系的结合能力
GPRC5D抗体分子与抗原间的亲和力大小可能对CAR-T或者抗体药在患者体内发挥杀伤作用及存续时间有着重要影响。因靶点GPRC5D难以获得纯化的抗原，我们采用了FACS binding方法分析抗体分子的半数有效浓度(Ec50)，为研发过程提供重要的信息。
FACS binding实验简要步骤：
1)不同浓度抗体的准备:使用PBS将抗GPRC5D IgG从300nM，依次5倍稀释，稀释至0.00384nM共8个浓度准备进行抗体与CHO-K1-GPRC5D细胞的结合能力；
2)CHO-K1-GPRC5D细胞用PBS洗2次，用PBS重悬成1x10 7/mL浓度，以50μL分装到96孔深孔板中；
3)每孔加入50μL稀释好的抗体，混匀后，4℃结合2h；
4)200μL PBS洗涤2次；
5)加入1:300稀释的Alexa
Figure PCTCN2021140153-appb-000008
647 AffiniPure Goat Anti-Human IgG，100μL/孔，吹打混匀后，室温孵育45min；
6)200μL PBS洗涤2次；最后用200μL PBS重悬细胞；
7)在流式细胞仪上检测样品Alexa
Figure PCTCN2021140153-appb-000009
647通道的荧光强度；
8)通过使用Graphpad Prism软件分析结合常数。
主要样品和试剂：
CHO-K1-GPRC5D细胞系，GPRC5D阳性细胞系；
Alexa
Figure PCTCN2021140153-appb-000010
647 AffiniPure Goat Anti-Human IgG,Fcγfragment specific，Jackson ImmunoReseach,109-605-008
实验结果
亲和力系指单个分子与其配体结合的强度，通常可以通过FACS检测与阳性细胞系的结合能力来评估两分子间相互作用的强度并对此进行排序。Ec50值越小，抗体对其靶标的亲和力越大。如表3及图7所示，Benchmark1、克隆18、克隆39和克隆41均可与GPRC5D过表达细胞系CHO-K1-GPRC5D细胞结合，且克隆18亲和力稍高于Benchamrk1，高于克隆39和克隆41。
表3 亲和力测定结果
抗体 Ec50(nM) TOP(MFI)
克隆18 1.58 3462
克隆39 6.93 2795
克隆41 41.02 3690
Benchmark 1 6.72 2525
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Figure PCTCN2021140153-appb-000012
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Claims (49)

  1. GPRC5D结合肽，包括抗体分子的重链可变区，所述重链可变区中的HCDR1、HCDR2和HCDR3选自如下组合之一：
    1)HCDR1为GGSFSGYY(SEQ ID NO：1)；
    HCDR2为INHSGST(SEQ ID NO：2)；
    HCDR3的序列为ARARRYGGRTRFDP(SEQ ID NO：3)；
    2)HCDR1为GFIFSSYG(SEQ ID NO：4)；
    HCDR2的序列为ISSSGDYT(SEQ ID NO：5)；
    HCDR3的序列为ARMSFRRYDH(SEQ ID NO：6)；以及
    3)HCDR1为GFSFSGYI(SEQ ID NO：7)；
    HCDR2的序列为TSSSGTET(SEQ ID NO：8)；
    HCDR3的序列为ARYYSKYGRSYHVDS(SEQ ID NO：9)。
  2. 如权利要求1所述的GPRC5D结合肽，其中所述GPRC5D结合肽为抗体分子或其抗原结合片段。
  3. 如权利要求1或2所述的GPRC5D结合肽，其中所述重链可变区包括SEQ ID NO：10、11或12所示的氨基酸序列；或者所述重链可变区包括与SEQ ID NO：10、11或12所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D。
  4. 如权利要求1-3任一项所述的GPRC5D结合肽，其中所述GPRC5D结合肽为单域抗体分子。
  5. 如权利要求1-4任一项所述的GPRC5D结合肽，其中所述GPRC5D结合肽为全人源抗体分子。
  6. 如权利要求1-5任一项所述的GPRC5D结合肽，其与表面表达GPRC5D的细胞结合能力为通过FACS检测的EC50值不高于10nM、9nM、8nM、7nM、6nM、或5nM。
  7. 融合蛋白，包括至少一个权利要求1-6任一项所述的GPRC5D结合肽。
  8. 如权利要求7所述的融合蛋白，包括至少两个权利要求1-6任一项所述的GPRC5D结合肽。
  9. 如权利要求7或8任一项所述的融合蛋白，其中两个所述GPRC5D结合肽的所述HCDR1、HCDR2和HCDR3分别选自权利要求1中列出的不同组合。
  10. 如权利要求7-9任一项所述的融合蛋白，其中：
    所述两个GPRC5D结合肽中一个包括SEQ ID NO：10所示的氨基酸序列，或者包括与SEQ ID NO：10所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D，另一个包括SEQ ID NO：11所示的氨基酸序列，或者包括与SEQ ID NO：11所示序列有至少90％、 91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D；
    所述两个GPRC5D结合肽中一个包括SEQ ID NO：10所示的氨基酸序列，或者包括与SEQ ID NO：10所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D，另一个包括SEQ ID NO：12所示的氨基酸序列，或者包括与SEQ ID NO：12所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D；或者
    所述两个GPRC5D结合肽中一个包括SEQ ID NO：11所示的氨基酸序列，或者包括与SEQ ID NO：11所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D，另一个包括SEQ ID NO：12所示的氨基酸序列，或者包括与SEQ ID NO：12所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D。
  11. 如权利要求7-10任一项所述的融合蛋白，其中所述融合蛋白包括至少三个所述GPRC5D结合肽，其中三个所述GPRC5D结合肽的所述HCDR1、HCDR2和HCDR3分别为权利要求1中列出的三个组合。
  12. 如权利要求7-11任一项所述的融合蛋白，其中所述融合蛋白的三个所述GPRC5D结合肽中的第一个包括SEQ ID NO：10所示的氨基酸序列，或者包括与SEQ ID NO：10所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D；第二个包括SEQ ID NO：11所示的氨基酸序列，或者包括与SEQ ID NO：11所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D；并且第三个包括SEQ ID NO：12所示的氨基酸序列，或者包括与SEQ ID NO：12所示序列有至少90％、91％、92％、93％、94％、95％、96％、97％、98％、或99％序列一致性的氨基酸序列并且能够特异性结合GPRC5D。
  13. 如权利要求7-12任一项所述的融合蛋白，其中所述融合蛋白还包括Fc片段。
  14. 如权利要求7-13任一项所述的融合蛋白，其中所述融合蛋白还包括另一结合肽，其能够特异性结合不同于GPRC5D的抗原。
  15. 如权利要求7-14任一项所述的融合蛋白，其中所述另一结合肽为单域抗体或单链抗体。
  16. 如权利要求7-15任一项所述的融合蛋白，其中所述融合蛋白还包括可检测标签或纯化标签。
  17. 如权利要求7-16任一项所述的融合蛋白，其中所述可检测标签具有酶学活性。
  18. 编码权利要求1-6任一项所述GPRC5D结合肽或权利要求7-17任一项所述的融合蛋白的核酸分子。
  19. 如权利要求18所述的核酸分子，其中所述核酸分子包括SEQ ID NO：13、14或15所示的核苷酸序列。
  20. 包括权利要求18或19所述的核酸分子的表达载体。
  21. 宿主细胞，包括权利要求18或19所述的核酸分子或权利要求20所述的表达载体。
  22. 多特异性抗体分子，至少包括第一功能部分和第二功能部分，其中第一功能部分包括权利要求1-6任一项所述的GPRC5D结合肽；第二功能部分具有与所述第一功能部分不同的结合特异性。
  23. 如权利要求22所述的多特异性抗体分子，其中第二功能部分对免疫细胞具有结合特异性。
  24. 如权利要求22或23所述的多特异性抗体分子，其中所述第二功能部分对T细胞具有结合特异性。
  25. 如权利要求22-24任一项所述的多特异性抗体分子，其中所述第二功能部分对CD3具有结合特异性。
  26. 免疫偶联物，包括与治疗剂连接的权利要求1-6中任一项所述的GPRC5D结合肽。
  27. 如权利要求26所述的免疫偶联物，其中所述治疗剂是药物。
  28. 如权利要求26或27所述的免疫偶联物，其中所述治疗剂是细胞毒素。
  29. 如权利要求26-28任一项所述的免疫偶联物，其中所述治疗剂是放射性同位素。
  30. 药物组合物，包括：
    1)权利要求1-6任一项所述的GPRC5D结合肽；
    权利要求7-17任一项所述的融合蛋白；
    权利要求22-25任一项所述的多特异性抗体分子；或
    权利要求26-29任一项所述的免疫偶联物；以及
    2)药学上可接收的载体。
  31. 权利要求1-6任一项所述的GPRC5D结合肽、权利要求7-17任一项所述的融合蛋白、权利要求22-25任一项所述的多特异性抗体分子或权利要求26-29任一项所述的免疫偶联物在制备用于治疗GPRC5D相关病症的药物中的用途。
  32. 如权利要求31所述的用途，其中所述GPRC5D相关病症为癌症或自身免疫疾病，所述癌症优选浆细胞恶性肿瘤疾病，例如多发性骨髓瘤，或者B细胞恶性疾病，例如霍奇金淋巴瘤或非霍奇金淋巴瘤。
  33. 治疗GPRC5D相关病症的方法，包括以有效量的权利要求1-7任一项所述的GPRC5D结合肽、权利要求7-17任一项所述的融合蛋白、权利要求22-25任一项所述的 多特异性抗体分子、权利要求26-29任一项所述的免疫偶联物或权利要求30所述的药物组合物向有需要的受试者给药。
  34. 如权利要求33所述的方法，其中所述GPRC5D相关病症为癌症或自身免疫疾病。
  35. 如权利要求34所述的方法，其中所述癌症为浆细胞恶性肿瘤疾病或B细胞恶性疾病。
  36. 如权利要求35所述的方法，其中所述浆细胞恶性肿瘤疾病为多发性骨髓瘤，所述B细胞恶性疾病为霍奇金淋巴瘤或非霍奇金淋巴瘤。
  37. 检测生物样品中GPRC5D的含量的方法，包括：
    1)使所述生物样品与权利要求1-6任一项所述的GPRC5D结合肽、权利要求7-17任一项所述的融合蛋白或权利要求22-25任一项所述的多特异性抗体分子接触，以便与所述GPRC5D形成结合复合物；
    2)基于步骤1)生成的结合复合物的量确定所述生物样品中的GPRC5D含量。
  38. 检测生物样品中GPRC5D的含量的方法，包括：
    1)使权利要求1-6任一项所述的GPRC5D结合肽偶联可检测标签；
    2)使带有所述可检测标签的所述GPRC5D结合肽与所述生物样品接触；以及
    3)通过检测所述可检测标签的量来确定所述生物样品中的GPRC5D的含量。
  39. 检测试剂盒，包括权利要求1-6任一项所述的GPRC5D结合肽、权利要求7-17任一项所述的融合蛋白或权利要求22-25任一项所述的多特异性抗体分子。
  40. 药物试剂盒，包括权利要求1-6任一项所述的GPRC5D结合肽、权利要求7-17任一项所述的融合蛋白或权利要求22-25任一项所述的多特异性抗体分子。
  41. 在受试者中鉴定GPRC5D相关病症的方法，包括：
    1)使用权利要求39所述的检测试剂盒确定来自所述受试者的生物样品中的GPRC5D含量；以及
    2)与群体中正常GPRC5D含量进行比较，以确定所述GPRC5D相关病症是否存在或其状态。
  42. 如权利要求41所述的方法，其中所述GPRC5D相关病症为癌症或自身免疫疾病。
  43. 如权利要求42所述的方法，其中所述癌症为浆细胞恶性肿瘤疾病或B细胞恶性疾病。
  44. 如权利要求43所述的方法，其中所述浆细胞恶性肿瘤疾病为多发性骨髓瘤，所述B细胞恶性疾病为霍奇金淋巴瘤或非霍奇金淋巴瘤。
  45. 确定GPRC5D相关病症治疗药物在受试者中的治疗效果的方法，包括：
    1)使用权利要求42-44任一项所述的方法鉴定所述受试者的GPRC5D相关病症状态；
    2)以所述药物治疗所述受试者；以及
    3)重复步骤1)以确定所述受试者中所述GPRC5D相关病症状态的变化，基于所述变化确定所述药物的治疗效果。
  46. 如权利要求45所述的方法，其中所述GPRC5D相关病症为癌症或自身免疫疾病，所述癌症优选浆细胞恶性肿瘤疾病，例如多发性骨髓瘤，或者B细胞恶性疾病，例如霍奇金淋巴瘤或非霍奇金淋巴瘤。
  47. 如权利要求46所述的方法，其中所述癌症为浆细胞恶性肿瘤疾病或B细胞恶性疾病。
  48. 如权利要求47所述的方法，其中所述浆细胞恶性肿瘤疾病为多发性骨髓瘤，所述B细胞恶性疾病为霍奇金淋巴瘤或非霍奇金淋巴瘤。
  49. 权利要求30所述的药物组合物，用于治疗GPRC5D相关病症。
PCT/CN2021/140153 2021-12-21 2021-12-21 靶向gprc5d的全人源抗体 WO2023115347A1 (zh)

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KR1020247024554A KR20240125026A (ko) 2021-12-21 2022-12-21 Gprc5d를 표적으로 하는 완전 인간 항체와 키메라 항원 수용체(car) 및 이의 용도
CA3241997A CA3241997A1 (en) 2021-12-21 2022-12-21 Fully human antibody targeting gprc5d and chimeric antigen receptor (car) and use thereof
PCT/CN2022/140769 WO2023116782A1 (zh) 2021-12-21 2022-12-21 靶向gprc5d的全人源抗体和嵌合抗原受体(car)及其应用
AU2022418639A AU2022418639A1 (en) 2021-12-21 2022-12-21 Fully human antibody targeting gprc5d and chimeric antigen receptor (car) and use thereof
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